It's our second highest number of deaths since April. REUTERS/Eloisa Lopez
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Of the 42 COVID-related deaths reported yesterday, 36 were from Cebu

The previous report based on DoH data was also inaccurate; there were four deaths on July 9, bringing our fatality rate up. With these bothersome numbers and inconsistent data, what’s the IATF’s exit plan, asks our resident expert. BY BENJAMIN CO MD
ANCX | Jul 11 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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Let me start off with a disclaimer, as the Health Agency would do. Whatever is written here is based on the information released by the Department of Health (DoH) at the time of publication. Whatever changes DoH makes in their data later on, well, that’s a different story in itself. As they say in their disclaimer that “the total cases reported may be subject to change as these numbers undergo constant cleaning and validation.”

In short, there was nothing to be happy about yesterday. We did not have zero deaths. Actually, after “cleaning and validation” (and the reaction of the people who were shocked with such good news), there were actually four deaths.

I have personally suggested to some people in the Health Agency that it is best they release announcements and data after they have all the data drop ready. They don’t need to do the 4 o’clock habit of announcing a summary of the cases of COVID-19 and end up giving different numbers the following day. No one will mind that they clean up their junk instead of committing and trumpeting a faux pas.

The tracker is really becoming a pain and burden as a source of accurate information. It is best that if they’re not really ready to upload data they shouldn’t press the return key. It just shows how appalling the situation is in the Health Agency when you see Iloilo City, Mindoro Oriental, Iriga, Minalabac, Pili and Uson in the National Capital Region (NCR).

The data came yesterday came too early. There was no reason for celebrating zero deaths. We had four. One from NCR, two from Region III, and one from Region IVA. The lone death from NCR was recorded from Taguig. The two deaths in Region III were from Bataan (1) and Pampanga (1). The lone death from Region IVA came from Rizal.

While there are less total new confirmed cases today with 1,233 (848 fresh and 385 otherwise), the report of the Health Agency today needs further clarification. Of the new reported cases today, there were 73 duplicates and you will need to deduct that from the total case count (as to why they cannot do that before putting out the final infographic is beyond my comprehension). In short, we had a total of 1,160 new confirmed cases reported.

Today, we report the second highest deaths today with 42 deaths since reporting 50 deaths last April 12, 2020. Of the 42 deaths reported, 27 occurred in July and 12 in June. I suppose arithmetically, the remaining three deaths occurred sometime way back in May or April or March. Of the 42 deaths reported today, 36 (86 percent) were from Cebu.

I cannot understand why they report the way they do. With 73 duplicates subtracted from the total case reports, shouldn’t they be deducting those from the respective regions as well? Apparently it doesn’t show that. The total number of new cases based on the breakdown per region still totals 1,233. Which makes their infographics and their announcement of cases at the 4 o’clock habit confusing and bewildering.

Our case fatality rate is at 2.57 percent up from yesterday’s 2.54 percent. Recovery rate is at 25 percent. According to the virtual presser this afternoon, we will have better news on Monday as they coordinate with LGUs in submitting the recoveries. This is something they should have done months ago.

Recovery rates are not good indicators of how well we are doing in a pandemic. The gold standard will always be the deaths.

While the number of cases is high and the number of deaths look “seemingly” low, this is a poor indicator of success in our battle against the virus. Remember that the course of illness of the disease depends on severity and may last for four weeks or more in some patients. This means that every case reported today, we will be seeing the fatalities from these in the next four to six weeks (or even later on) among patients who become critically ill. The sequelae of the more than 12,000 cases since July 1? We will know their outcome next month. That is why deaths are the most important parameter in this pandemic.

Because we will need to count tomorrow what we count today. It is called reconciliation of the data.

Of the 1,395 new confirmed cases on July 9, 2020, 423 are unknown, or have no tagged locations. All regions had reported cases with the following top three regions: NCR with 444 cases and one death; Region VII with 290 cases; and Region IVA with 76 cases. Other regions with double digit cases included CARAGA (15), Region III (20 with two deaths—one apiece from Bataan and Pampanga), Region IX (10), Region V (22), Region X (26), Region XI (26), and 26 among repatriates. The remaining regions have single digit cases

In NCR, 169 (38 percent) of the 444 cases did not have any tagged location. All cities had reported cases with the highest number of cases coming from Quezon City (83), Manila (45), Malabon (26), Caloocan (21), Valenzuela (18), Makati(14), Marikina (13), Pasig and Mandaluyong (11 each), Navotas (10), Taguig (7); five each for Pasay and Parañaque, San Juan (3), and one apiece for Las Piñas, Muntinlupa, and Pateros.

Region VII had 290 cases with Cebu City reporting 140, Cebu Province with 67, Lapu-Lapu with 45, Mandaue with 34, Bohol with 3 and 1 for Negros Oriental.

According to the Department of Health, there are now 62 licensed RT-PCR and 21 licensed Gene Expert labs in the country: a grand total of 83 testing facilities to date.

Based on testing capacity, DoH provides a corrected report that 22,521 samples were tested on July 8, 2020 with 22,187 individuals tests among 70 out of 72 laboratories reporting. There were 2,405 and not 2,260 positive cases giving a 11.35 percent daily positivity rate (and not 11.14 percent) pushing the cumulative positivity rate up to 7.6 percent (from a previous 7.5 percent).

There is no laboratory report for July 9, 2020 as of this writing.

The way that the health agency corrects piecemeal and reports when it is not yet ready to publish them is disturbing. Providing data in aliquots is not appropriate. They need to decide a cut-off period and publish the data based on the cut-off. Whatever is published cannot be altered until the next cut-off period because it becomes disconcerting on why there is no single method for reporting.

 

The world

There are now more than 12.4 million confirmed cases of coronavirus (SARS-CoV-2) in the world. We’re back at over 200,000 new cases globally for three consecutive days and the world breaks its record for total highest cases of the day with more than 233,000 cases reported on July 9, 2020. Total number of deaths reported yesterday was 5252 cases. The seven-day average for new cases is up at >199,000/day and deaths at approximately 4,773/day.

The global case fatality rate is lower at 4.5 percent and recovery rate slightly up at 58.3 percent. Recovery rates are not very reliable indicators because they are subjective to the country’s definition of how and when they consider patients “recovered.”

Data from WorldOMeters.

The United States continues its upward trajectory past the 3.2 million mark as it continues to report > 60,000 cases overnight. It now has a seven-day average of over 54,800 cases/day or over 100,000 cases every other day. The last two days saw a surge in deaths with close to 800-900 deaths/day or a seven-day average of 625 deaths/day. Top three states contributing to yesterday’s haul are Texas (+11,394), Florida (+8,935), and California (+7,248).

The case fatality rate in the US is now at 4.22 percent with 3,220,559 cases as of this report. The US had the second highest number of deaths globally with 960 fatalities.

Brazil stays in second spot with almost 1.76 million cases and continues to report the highest death cases in the world with 1,199 deaths overnight.

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

  • USA – 61,067
  • Brazil – 42,907
  • India – 25,790
  • South Africa – 13,674
  • Mexico – 6,995
  • Russia – 6,509
  • Colombia – 5,335
  • Argentina – 3,633
  • Peru – 3,537
  • Bangladesh – 3,360

The Philippines moves down to 35th place in the world with the 1,160 new cases today, and are a few cases away from overtaking the United Arab Emirates.

With the 42 reported deaths today, and the fact that we really never had zero deaths yesterday (we had 4), and the significant rise in severe and critically ill patients, this is one uphill battle as the virus continues to propagate in the various communities.

What’s the exit plan of the IATF?