August provides some wins and losses in PH fight vs COVID-19, but outlook for NCR not good

Warren de Guzman and Edson Guido, ABS-CBN News

Posted at Aug 15 2020 02:36 PM

Members of the local barangay health unit patrol the streets to make sure the lockdown at Barangay San Martin De Porres in Parañaque City is implemented on August 13, 2020. Jonathan Cellona, ABS-CBN News

Data show Region 7 is beating COVID-19, while Region IV-A is making strides in the right direction. The National Capital Region isn’t as fortunate. In fact, it is now worse than ever.

MANILA -- Another quarantine decision looms large for President Rodrigo Duterte, as the end of the modified enhanced community quarantine over NCR and surrounding provinces approaches on August 18.

The first two weeks of August have produced some record numbers, pushing the Philippines’ total COVID-19 cases above that of Indonesia to officially make the outbreak in the Philippine Archipelago the worst in Southeast Asia. But it hasn’t all been bad news, as other parts of the Philippines have made great strides in their local fights against the nasty virus.

 These charts prepared by ABS-CBN Data Analytics Team can help put the latest numbers from the National Capital Region, CALABARZON, and Central Visayas in perspective.

Let’s start with the bad news.

After overtaking Indonesia last week in terms of total COVID-19 cases, the Philippines has solidified its lead, with nearly double the active cases of the next worst outbreak in ASEAN. No other country in the region has even breached the 40,000 total active COVID-19 cases. The Philippines is at 74,713 active cases as of August 13.

Total active cases however should drop as more COVID-19 patients recover. Unfortunately the Philippine Department of Health is unable to provide us with real time data, and has instead elected to announce recoveries in lumpsum, similar to what happened on July 30, when over 37,000 recoveries were announced in a single day. You can see this clearly in the big drop of red active cases in this graph. The DOH’s next big OPLAN Recovery update is set for Sunday, August 16, and will be regularly released every Sunday thereafter.

These recovery data dumps however do little to mask the daily number of reported COVID-19 cases, which has sharply spiked this month. The Philippines’ 7 day moving average of daily reported COVID-19 cases for August is at 4,000, shown by the black line here. That is double the average of Indonesia shown in purple. The Philippines’s COVID-19 cases are trending higher, almost exponentially, as ASEAN’s other COVID-19 hotspots, Singapore and Malaysia, are flattening their respective curves.

The spike in reported COVID-19 cases has unfortunately come with a spike in deaths. As of August 13 the 7-day average of reported deaths, shown here in black, has hit 40. It is trending back toward the highs hit in mid July.

The case fatality rate and the positivity rate remain among the best measures of the COVID-19 pandemic. The case fatality rate looks at how many confirmed COVID-19 cases result in death. The positivity rate compares total positive cases versus total individuals tested. The Philippines’ positivity rate has remained on an uptrend, even as the number of tests being conducted continues to increase. That is a clear indication the COVID-19 virus is transmitting locally, and it dispels the argument that the only reason positive cases are on the rise is because more testing is being conducted. More tests should bring the positivity rate down. The Philippines’ case fatality rate however is low, which means even though COVID-19 is still spreading, it is not as deadly relative to the rising number of cases as compared to earlier in the pandemic. This is one of the primary data points used by the government to argue the COVID-19 battle in the Philippines is doing well. '

There is however the matter of late registration of deaths, which has shown an uptick during quarantine months, based on the latest data from the Philippine Statistics Authority. The numbers show total deaths, regardless of cause, were actually down year on year in the first half of 2020, with the caveat that deaths may be underreported due to quarantine restrictions. It is possible the underreporting of deaths may have affected the COVID-19 death rate, but we can’t say for sure without more data.

This chart looks at the positivity rate of the NCR and Central Visayas. NCR is currently under MECQ and is shown in blue. Region 7 is home to Cebu City, which was lifted out of modified enhanced community quarantine two weeks ago, and is shown in orange. The positivity rates of the two areas are on opposite trajectories. Cebu City’s ECQ for a month was clearly effective. However, the effect of the return to general community quarantine will only be seen by next week, after the 14-day gestation period of the COVID-19 virus. The same also goes for the return to MECQ for NCR, which was instituted at the start of August. Without any data on how the latest lockdown adjustments affected the pandemic, it will be tough to make an informed decision.

The increase in cases in NCR however cannot be denied. The majority of the 4,000 new positive COVID-19 cases reported daily come from the National Capital Region. The heart of the Philippine economy is experiencing the worst acceleration in COVID-19 transmission to date.

This is the latest data on intensive care unit bed occupancy rate, comparing NCR in blue, CALABARZON in green, and Cebu City in red. Cebu City is now well below the danger zone, which is 70% of COVID-19 dedicated beds occupied. CALABARZON has also shown a drop in recent days. NCR is above the danger zone line, and it has been there since July.

The NCR has the worst ICU occupancy statistics in the Philippines, with 412 ICU beds occupied versus just 140 vacant. The Duterte administration promised to use the last two weeks under MECQ to improve healthcare facilities and containment efforts. These numbers show there is much more work to be done.

The Philippines is clearly doing worse in terms of total COVID-19 cases, active cases, and positivity rate. It has the worst COVID-19 outbreak in ASEAN, and healthcare metrics are showing little sign of improvement in the National Capital Region. If it wasn’t for the low death rate, this would be an unmitigated disaster.

But the data also show an improvement in Central Visayas. Unfortunately, NCR is still a huge viral mess, and it is the home to a significant chunk of the Philippine population and the economic center of the nation.

At this point, an extension of MECQ in NCR might be a no brainer, but it would be an absolute waste if no simultaneous effort is made for immediate improvements to healthcare and containment. Earlier lockdowns have already produced the worst quarterly economic contraction on record in Philippine history, so any extension decision would have consequences.