Most of the new COVID cases announced on Sunday were from the National Capital Region. Photo by George Calvelo, ABS-CBN News
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Sunday’s 2,434 new COVID cases outstrips Friday record, and is 5th highest in the world

This pushes our overall total to 44,254. While the easing of restrictions can be easily blamed for these huge numbers, our resident expert believes there was also a case of bad planning. BY BENJAMIN CO MDn
ANCX | Jul 06 2020

Infectious diseases and clinical pharmacology expert Dr. Benjamin Co has been thankfully breaking down coronavirus numbers in his personal blog since the outbreak started. The perspective he provides is informative, and comforting in those who are craving for a clear picture of how we are faring against the virus. Dr. Co will share daily updates and analysis of the Department of Health reported numbers with ANCX. 

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We didn’t even bother to test the 2,000 mark.

Almost 2,500 cases all in one day, with more than half late (1,287) and the remaining 1,147 fresh. This pushes our numbers to 44,254.

And there is now a warning on the infographic of the announcement. It reads that the rise by almost 100 percent is probably attributed to the increased contact among the population due to easing in community quarantine measures. 

Seriously, how did it get so bad? The cases went from 200 plus in May to 2,000 plus in July. Easing restrictions will always be the prime mover. There was just bad planning. And here we are today.

Of the 2,434 reported cases today, 1,069 are from National Capital Region, 602 from Region VII, 756 from “others,” and seven from repatriates. 

Seven deaths and 489 recoveries were also reported. This brings our case fatality rate to 2.93 percent and recovery rates to another low of 27 percent due to the huge haul in cases today. 

Of the seven reported deaths, six of them occurred in June.

Based on Department of Health data as of July 4, 2020, there are 29,087 active cases with 99.4 percent of them being mild (27,429 or 94.3 percent) or asymptomatic (1,486 or 5.1 percent). The serious cases (severe and critical) remain at 0.6 percent. While there is no change in critical cases, there are eight additional severe cases today to yesterday’s tally of 136. 

I have my reservations on the accuracy of the breakdown in active cases. I am quite sure that there are more severe and critical cases than what the Health Agency claims in this bulletin. Perhaps it is time that they present more accurate data, because the way the data is being “sanitized” is not really helping set directions on how to combat this pandemic in the country.

There is still no breakdown in the 2,454 cases from DoH as of the publication of this report. I will update the report when the breakdown is provided because I don’t know what time they intend to upload everything. I have suggested that they should do all the reporting and updating in the morning at 10 o’clock so that the breakdown of the data can be best understood the same day. But I guess the 4 o’clock habit is the easiest way to placate people who are tired and will not bother to look at the specifics of the bad news. 

According to DoH, there are now 55 that do RT-PCR and 20 licensed Gene Expert labs in the country. 

The sudden surge in cases in NCR and in Region VII over the last week is very alarming. And that is evident in today’s 4 o’clock report from the Health Agency.

This mismatch in the number of severe and critical cases and occupancy of ICU beds and ventilator usage in the infographics is glaring.

The occupancy rate in the hospitals, in both NCR and Region VII, have dramatically increased over the past two weeks. The infographic below shows that of the bed occupancy in the whole Philippines is at 40.6 percent. This isn’t too bad considering that only 13.5 percent are in the danger zone. 

The bar graph below on occupancy rate level excludes facilities with no dedicated COVID beds or no ICU beds. 

In summary, of 924 ICU beds, 382 (41.34 percent) are occupied. Of 1,361 total mechanical ventilators, 25.72 percent (or 350 ventilators are in use). And this comprises only 79.1 percent of the facilities submitted to the DoH DataCollect App. In short, with more than 20 percent unaccounted for, this could even be higher. Definitely a total departure from the 172 severe and critical cases the Health Agency reported today.

NCR shows almost 70 percent bed occupancy with 45 percent or 42 out of the 94 facilities in this region in the danger zone. 

On July 2, 2020 alone, more than half of the 331 available ICU beds in NCR were occupied. More than half of the 118 available ICU beds in Region VII were also occupied. And you see the same story with ventilator utilization. Why would anyone who is not critical be using a ventilator?

In order to understand this further, one needs to know how Metro Manila is divided into four distinct districts. The first district is Manila alone. The second district is made up of the cities of Mandaluyong, Marikina, Pasig, Quezon City, and San Juan. The third district comprises Caloocan, Malabon, Navotas, and Valenzuela. The fourth district includes Las Piñas, Makati, Muntinlupa, Parañaque, Pasay, Pateros, and Taguig. 

Hospital capacity broken down based on district is shown in the table below. The first district has half (50 percent) its hospital facilities at the danger level.

The other critical area is Region VII. The bed occupancy is almost similar to NCR. However, only 23 percent of the 75 facilities with dedicated COVID beds and ICU facilities are in the danger zone.

When Region VII is broken down based on province, Cebu Province has 37.2 percent of its facilities in the danger zone.

And like NCR, among the cities in Cebu the hardest hit is Cebu City where 67 percent of their 12 hospitals are in the danger zone. As a matter of fact, none of the 12 facilities in the city are in the safe zone. 

The week that was

The crossover from the end of the second quarter to the beginning of the third quarter was marred with grim data. 

The Rt of DoH was approximately 1.05 +/- 0.03 on June 14, 2020. The current Rt of the Philippines as of June 28, 2020 places us at 1.14 (+/- 0.03) 

In a spectacularly dizzying change of process in the reporting system (hopefully to a better one the following week), the total number of cases from June 28 to July 4, 2020 was 7,034 (approximately 1,004 cases per day). Total deaths for the week was 54 (approximately eight deaths daily). We had one day where the Health Agency reported only 294 cases (July 2, 2020). They were migrating to a new reporting system, and that means that the data drop is back on the same day as the reports (but coming in two to three hours later than the official 4 o’clock habit). 

While the death rates remain low, the cases are on an upswing. This is not good. Case fatality rate is not a good reflection of mortality rate of the pandemic. Remember, as the number of cases of go up, the health system becomes overwhelmed. Overwhelming the health care system results in patients getting hospitalized or patients not getting hospitalized even if they need hospital care. The domino effect eventually affects health outcomes, of both patients and healthcare workers. No matter how you look at any disease, as the number of cases climb, the number of deaths due to a disease rise as well.

Daily confirmed COVID-19 deaths 

Case fatality rate in the Philippines as of July 4, 2020

Confirmed cases from Jan 21 to July 4, 2020.

Daily COVID-19 tests in the Philippines

  • A total of 118,559 tests were done between June 26 to July 3, 2020 in 112,135 individuals. That’s around 16,937 tests a day. Nine thousand nine hundred fifty six patients tested positive, for a positivity rate of 8.9 percent on the average for the week. This translates also to at least 1,422 positive cases daily.
  • Based on 41,830 points, 7.4 percent of cases (3,086) were less than 19 years old while 15.3 percent (6,398) were greater than 60 years old. More than 77 percent of patients belong to the 20-59 years old bracket.
  • The fatality rate was 2.4 percent for those younger than 19 years old and 47.7 percent for those > 60 years old.

 

The world

With a little more than 160,000 cases overnight, the total number of coronavirus cases globally approaches 11.4 million. Total number of deaths also declined overnight with a little more than 3,200 compared to the previous days tipping over the 5,000 mark. 

The global case fatality rate is lower at 4.68 percent and recovery rate lower at 56.6 percent because of the increase in cases.

Data from WorldOMeters.

While many of the countries report fewer cases, some were enough to move the top 10 countries in the ranking. The highest number of cases came from the US, Brazil, and India. India is 500 cases shy of displacing Russia from the third position. 

The US is set to break the three million mark in a day or two. The three top states in the US with the most number of cases are Florida (+11,458), Texas (+5,382), and California (+3,718). 

The case fatality rate in the US is now at 4.51 percent with 2.935,770 cases as of this report. 

Brazil stays in second spot with close to 1.6 million cases and continues to report the highest death cases in the world. Overnight they had 1,111 deaths. Their case fatality rate is at 4.08 percent.

The top 10 countries that had the highest new cases overnight were:

  • USA – 45,182
  • Brazil – 35,035
  • India – 24,015
  • South Africa – 10,853
  • Mexico – 6,740
  • Russia – 6,632
  • Saudi Arabia – 4,128
  • Colombia – 3,884
  • Chile – 3,758
  • Peru – 3,481

The Philippines moves up to 38th spot in the world in terms of number of total confirmed cases with 404 people infected per million population. With the large decline in number of cases in Singapore, they are now in 37th place and we overtake Portugal today. The Philippines is the fifth biggest contributor in the world to the cases today with 2,424 cases. We overtake Indonesia that reported only 1,607 cases. 

Our doubling time is now shortened to 23 days based on a seven-day average daily growth rate of three percent. 

At this rate, the UP prediction of 60,000 to 85,000 may be short. Perhaps 90,000 to 100,000? We will know in the next few days how this evolves.