Is PH about to flatten the curve on COVID-19 outbreak? Numbers tell the story

Kristine Sabillo, ABS-CBN News

Posted at Apr 03 2020 02:41 PM | Updated as of Apr 03 2020 02:43 PM

MANILA — Confirmed COVID-19 cases in the Philippines are now doubling every 4 days, according to Department of Health (DOH) data analyzed by the ABS-CBN Data Analytics team.

As of Thursday, the number of cases have gone up to 2,633. Of that number, only 51 patients have recovered and 107 have died.

A graph prepared by the ABS-CBN Data Analytics team shows the Philippines in between nations that have managed to control the spread of the virus (Singapore and Japan) and those that have done extensive testing but continue to see an exponential increase in cases (US and Italy).

COVID-19 pandemic trajectory. Data based on daily announcements of new cases by the Philippine Department of Health and other countries. Graph by ABS-CBN Data Analytics

“For countries that have controlled the spread of COVID-19 like Singapore, Japan and South Korea (after its initial surge), we see that their trajectories have flatter trendlines and slower doubling time,” said ABS-CBN Data Analytics Head Edson Guido, who explained how other countries are doubling their number of COVID-19 cases at a faster or slower rate than the Philippines.
 
“While the initial surge for other countries is faster than the Philippines, it is still trending toward a steep curve as confirmed cases double every 4 days,” he said.

Similar graphs have circulated online as experts and the general public attempt to understand if their country is able to “flatten the curve” soon.

Flattening the curve refers to efforts to slow down an outbreak and make it more manageable. This includes community isolation measures such as the Luzon lockdown imposed on March 16.

Experts believe that by slowing the spread of a contagious disease such as COVID-19, the health sector will have enough time to manage cases, resulting in more lives saved.

BACKLOGS

But Guido said he expects the numbers in the Philippines to continue to rise as testing capacity improves and backlogs are addressed.

Just a week ago, it took 5 to 7 days for some patients to get their COVID-19 test results as samples from the increasing number of patients under investigation pile up.

By then, almost half of the fatalities were confirmed days after they died.

With more test kits being donated and more laboratories being accredited for COVID-19 testing, the Research Institute for Tropical Medicine said it is able to bring the processing time down to 48 to 72 hours.

Because of the backlogs, it is hard to say if the Philippines is nearing flattening the curve.

Former health secretary Dr. Manuel Dayrit said the DOH data is 7 to 10 days late.

“The data we are seeing today is data of say, one week ago,” he told ABS-CBN News, referring to the earlier reported delays in testing results.

“And then you tack on all the days before the patient actually gave a sample. Their report of positives are from samples collected over a week ago,” he said.

This means the latest numbers that the country is seeing is just a portion of the extent of the spread of COVID-19 around a week after the lockdown was imposed on Luzon.

LOGISTICAL PROBLEM

Dayrit said to get more relevant graphs, the country needs to get test results within 24 hours.

“The testing has already gone up five fold. But it’s not enough. Not only should you increase the number of tests…You want to have your test results within a day or earlier,” he said.

Dayrit also said the incomplete data being released by hospitals and the DOH are a problem.

“The reporting is not precise,” he said, referring to how some patients do not have location information. “You have to have a correlation between the intensity or the compliance of the lockdown.”

He said experts will need to see which areas are seeing a spike in cases and if these places are strictly following the lockdown.

“That’s an organizational challenge,” he said, saying that the problem of having incomplete information on the patients will need to be addressed soon by hospitals and DOH.

MASS TESTING NOT ENOUGH

Dayrit also pointed out that having mass testing is not enough to flatten the curve.

“As you improve the testing and identify the positives, you have to be able to quarantine them and isolate them,” he said. “You really should be isolating them in spaces where they do not infect their family.”

He said Italy and the US have increased their testing capacity but cases continue to rise because they are not able to isolate everyone.

“There’s a lot to be improved on. You can’t, we can’t just really say na after the two weeks it’s going to be okay,” he admitted.

He said the best example would be South Korea, which has mass testing for COVID-19 but also extensive efforts on contact tracing and isolating people who might be infected.

PROJECTIONS

At the start of the lockdown, various projections came out on when the outbreak in the Philippines would peak.

The Department of Health said on March 18 that it might see 75,000 cases within 3 months.

Meanwhile Dr. Darwin Bandoy, a genomic data scientist and assistant professor at the University of the Philippines-Los Baños, estimated 250,000 cases including those without symptoms by June.

However, both projections were made before the effects of the lockdown was observed.

Dayrit said groups helping the government create projection models will probably come out with new data in a week or so.

The Department of Health also said it would come out with new projections soon.

Bandoy agreed that the government will have to test more people for them to get an accurate prediction.

“I cannot confidently estimate trajectory unless we test more. So I am waiting for more results in the next two weeks,” he told ABS-CBN News.

For Dr. Rontgene Solante, head of the adult infectious diseases department of San Lazaro Hospital, the slow down in the spread of COVID-19 might start in May or June.

"If we didn't have a lockdown, we could have become like the US. We might not only have more than 2,000 cases. It could have doubled or tripled right now," he said during a DZMM interview on Wednesday.

However, he also questioned the new cases being observed.

“It's already [past] 14 days. The incubation period of the virus is 14 days. When the lockdown was imposed, there should be no transmission anymore," Solante said in Filipino.

"Is it a failure of the lockdown or we had inadequate lockdown procedures that we didn't foresee?"

For now, experts will have to wait for more test results and details coming from the DOH.

However, even information being released by the DOH is incomplete, with hundreds of cases without details on location or hospital.

As Dayrit said, at least in terms of getting and giving out COVID-19 case information, hospitals and the DOH will need to “get their act together.”