16.4% positivity rate and the data on 08.04.2021

With 1 laboratory failing to submit data and 41,257 tests done on August 2, the positivity rate of 16.4% is staggeringly high.

The Health Agency reports 7,342 new cases today and with almost equal number of recoveries, the total active cases still exceed 63,000. Note however the healthcare capacities both nationally and in the National Capital Region, where the latter has numbers higher than the previous week alone. ICU is up at 59%, Isolation beds at 52%, ward beds at 48% and ventilators at 42%.

With 90 new deaths, the case fatality ratio for outcomes is at 1.81%.

17.5% positivity for a low Tuesday on 08.03.2021

It’s a Tuesday, and with 17.5% positivity rate (the highest we’ve had since last year) for more than 37,000 tests done on August 1, the Health Agency reports 6,879 new cases today. Not only is this worrisome but is a sign of worst numbers in the days ahead, which could reach a record of 10,000 again towards the weekend.

Forty eight new deaths puts the case fatality ratio for outcomes at 1.82%.

The ICU bed utilization in both the NCR and the national level begin to significantly climb at 57% and 62%, respectively.

While the NCR continued to lead the daily numbers, the surprise of the day was Muntinlupa City, which came in THIRD among 17 LGUs in NCR and 7th in the country in one of the wildest jump of cases for the day. CALABARZON, Central Visayas, Central Luzon, Western Visayas were 2nd-5th, respectively.

Cebu led among provinces on a provincial level, and yes, among LGUs, Cebu City took the lead today from Quezon City with more than 300 cases. Ten LGUs had triple digits in the country, while nine of 17 LGUs from NCR were among the top 20 cities/municipalities for the day.

A 4 days streak of 8K and the data for 08.02.2021

With 8,167 new cases reported today based on more than 50,000 tests done last July 31, (there is a typo error in the infographic of the Health Agency and that should read July not August 31), the positivity rate of 15.7% is worrisome. Not enough tests are being done, and not enough people are being contact traced. Todays new cases was enough to push the total COVID-19 cases to more than 1.6M.

There are 77 new deaths, bringing the case fatality ratio for outcomes to 1.82%.

In spite of more recoveries today, the active cases remain at more than 62,000.

NCRs cases continued an upward trend and pulled away from all regions as almost 25% of the country’s total cases are from Mega Manila alone. Five regions had more than 500 new cases reported.

While Cebu province continued to dominate the provincial level, it was Cavite, Laguna and Rizal that raked in more than 1,200 new cases for the day, accounting for the most cases in Region IVA.

Among LGUs, Quezon City reported almost 400 new cases, followed by Cebu City, Manila, Cagayan de Oro and Makati City. We are back to that point where many LGUs in NCR are in the top 20. Today, 12 of 17 LGUs from NCR made it to the top twenty.

Eleven of 17 LGUs in NCR had triple digits.

OCTA MONITORING REPORT

In today’s report, OCTA presents the hotspots outside of NCR.

Cagayan de Oro remains to be at critical risk over-all. With the five indicators used, Mandaue has the highest infection rate, while Laoag has the highest incidence rate (ADAR). Both Cagayan de Oro and Lapu Lapu City are at critical levels on hospital bed use. ICU utilization is also critical in Iloilo City and Cagayan de Oro. Positive testing surpasses 20% in Laoag, Cagayan de Oro, General Santos and Iloilo City.

Close to 1.6M total cases and more than 28,000 total deaths and the data on 08.01.2021

Three straight days of more than 8,000 new daily cases.

The Health Agency reports 8,735 new cases today for more than 50,000 tests done last July 30 with an almost 15% positivity rate. With fewer recoveries, the active cases now are up at 4% (more than 63,000 cases).

The 127 new deaths reported today are enough to push the total deaths now to more than 28,000. The case fatality ratio for outcomes (recoveries and deaths) are at 1.83%.

NCR continues to lead, with CALABARZON not very far behind and both regions reporting quadruple digits. Seven regions reported more than 500 new cases today.

Cebu province remains the top province with most cases on a provincial level. However, Cavite saw a surge in numbers, followed by Ilocos Norte.

Among LGUs, it was a mixed bag. Quezon City led the LGUs in the country with 320 cases. Cebu City, Misamis Oriental, Makati and Paranaque were second to fifth in rank. Fifteen of the top 20 LGUs had triple digits.

Eight of 17 LGUs from NCR were among the top twenty cities/municipalities with most cases for the day.

OCTA MONITORING REPORT

Without a doubt, the cases in the National Capital Region rose significantly in the past week. LGUs that never saw case with numbers that doubled, tripled and even quadrupled from the previous lows are now literally seeing surges.

Based on the five indicators: reproduction number, ADAR, beds, ICU capacity and positivity rate, only 4 of the 17 LGUs in NCR would be classified and moderate risk. The rest are at high risk.

Pateros, Malabon, Navotas have reproduction numbers more than 2, while the other cities with critical R are: Makati, San Juan, Muntinlupa, Valenzuela, Quezon City, Marikina and Caloocan.

The ADAR (average daily attack rate) is highest in Pateros at 26 per 100,000 population. This municipality that is known to have days where zero cases are being reported are seeing increasing cases.

Bed capacity is still good in most LGUs but already at moderate risk in Pateros, Pasay, Valenzuela and Quezon City.

ICU utilization is critical in Las Piñas, while it is moderate in Makati and Muntinlupa.

Finally, positivity is critical in Valenzuela at 23%, but is at high risk in Makati, Las Piñas, Pasig, Muntinlupa, Taguig, Parañaque and Caloocan.

Overall, the NCRs Rt is now at 1.52, with positivity rate at 10%.

THE WEEK IN REVIEW

It was a week that started with low cases. The surprise came when there was a reversal of numbers. The low Tuesdays took us aback. July 27 had an unusually high number of cases, considering that the data was coming from around 30,000 tests alone. Undoubtedly, the cases are now climbing, especially in the National Capital Region, CALABARZON, and Central Visayas.

But the reported glitches of the week could not overshadow the fact that the number of cases are up.

Sadly, this does not reflect the real situation on the ground as we see testing still averaging 45,000 a day (note on the word AVERAGING). The high positivity rate (which has actually shot up to more than 15% on certain days) is worrisome because that would point to only one fact – not enough people are tests are done because not enough people are traced.

But the problem of rising cases is not only internal to the country. Many countries in the world are experiencing the fury of a fitter variant in the form of delta. In Asia and some ASEAN countries, the cases continue an upward trajectory with a steep slope for some nations.

Reproduction rates are up as well and Singapore has managed to bring down its reproduction number as it escalates more lockdown measures in this tiny country that has the most number of people in the world receiving a jab and where testing and contact tracing is most efficient. Except for Cambodia, all the countries below have Rt more than 1.0 as of July 28, 2021.

The delta variant continues to predominate in most countries, even among those that have more than 50% of its population fully vaccinated. As more people are now vaccinated, it is expected that the number of patients that will require hospitalization will be lower, but there will also be more people who have already been vaccinated that will require hospitalization as the proportion of number of patients who get vaccinated yet get COVID-19 infections shift.

Note that while there will be a shift in numbers to patients who receive a vaccine getting hospitalized, the over-all hospitalization rate will far be fewer. And all models suggest that those hospitalized but are vaccinated have a less severe course than the unvaccinated.

Rt=1.44 in NCR and cases are more than 8K on 07.31.2021

The last day of the July has the Health Agency reporting 8,147 new cases from a high of almost 55,000 tests done last July 29. Sadly, the positivity rate is still high at 14.7%. With a few more recoveries than new cases, the active cases are still more than 60,000 today.

In addition, 167 new deaths were announced, bringing the deaths from COVID-19 close to 28,000 or a case fatality ratio for outcomes at 1.82%.

So far, the Philippines has almost 1.6M total COVID-19 cases (reported and documented) since the start of the pandemic. This brings us to more than 14,000 cases/M population as of today.

And NCR adds more cases today as the new cases now mount to close to 1,750. CALABARZON and Central Visayas in second and third, respectively. Central Luzon, Western Visayas, and Ilocos Region had more than 500 new cases each region.

While Cebu province continued to dominate on a provincial level, Cavite, Laguna and Rizal, which make up the chunk of CALABARZON account for more than 1,100 of the 1,392 cases in that region alone.

On an LGU level, Quezon City, Cebu City, City of Manila, Davao City and Makati City are the top 5 cities with most cases for the day. Eleven of 17 LGUs in NCR are in the top 20. Three LGUs in Cebu province are also in the top 20.

All LGUs in the NCR are seeing rising cases. Even Pateros, Navotas and San Juan which has seen single or zero numbers are not spared from the increasing cases.

OCTA MONITORING REPORT

There were 1,533 new cases reported yesterday in Mega Manila. The table below summarizes the increase (or decrease) in the respective provinces. The country has a 7% increase in cases versus the past week. The positivity rate in the NCR also increased from 6% the past week to 9% this week alone.

Note that those highlighted in yellow in the report below show significant increasing cases over the week on week.

A storm is brewing and the data on 07.30.2021

The Health Agency reports 8,562 new cases today from more than 52,000 tests done last July 28 with a positivity rate of almost 15%. The total active cases now exceed 60,000.

New deaths today are 145. The case fatality ratio for outcomes stays at 1.82%.

Notice, however, the ICU bed capacity in the NCR, including isolation and ward beds, which are on the rise. ICU utilization is now at 52%. A red flag that there is a storm approaching.

NCR has more than 1,500 new cases today, with CALABARZON and Central Luzon not a distant second and third, respectively. This is Mega Manila’s highest tally for the week.

Cebu continued to dominate on a provincial level, with Cavite and Laguna in second and third.

Among LGUs in the country, Quezon City is back on top with more than 300 cases, with Cebu City, Cagayan de Oro, Davao City and the City of Manila among the top. Ten of 17 LGUs in the NCR are among the top twenty cities with most cases for the day in the Philippines.

OCTA MONITORING RESEARCH

The numbers are up. So are the reports on the Delta Variant. The latter though is much later data compared to the already delayed case reports provided by the Health Agency. Through no fault of the the Philippine Genome Center, as they do their best in providing what data they can based on their resources.

There are five indicators used in determining the risk level. This makes decisions on how to institute critical measures at addressing rising cases during a pandemic. As the Delta Variant causes havoc globally, there is a need to stave and starve the variant of concern.

These indicators are: Rt (infection rate or reproduction rate), ADAR (average daily attack rate or incidence), HCUR (healthcare utilization rate), ICU (intensive care unit), and testing (positive rate).

In the list provided below are the top 50 LGUs in the countries ranked from highest to lowest in terms of MOST NEW CASES for the period July 23 -29, 2021.

Quezon City had a 39% jump in cases with Rt at 1.44.

This LGUs that had the highest incremental change from the the last week are: Malabon (200%), San Juan (186% ) and Navotas (100%) – all within Mega Manila.

Rt nationally is up at 1.09. On a regional level, Rt is also up in NCR at 1.39. The LGUs with critical Rt are: Malabon, Mandaue, Cebu City, Lapu Lapu City, Makati, Cagayan de Oro, Quezon City, Valenzuela, Laoag, and Caloocan.

ADAR is highest in Laoag, Mariveles, Tuguegarao and Batac.

HCUR is pst 80% in Cagayan de Oro, Lapu Lapu CIty, Iloilo CIty, and Mariveles. ICU utilization is critical in Davao City, Iloilio City, and Las Piñas.

Positive rate is critical in many LGUs with Laoag at 33%, Valenzuela and General Santos at 26%, Cagayan de Oro at 25% and Santa Rosa (Laguna) at 21%.

Cagayan de Oro remains at critical risk. The following cities are considered high risk based on the indicators: Quezon City, Cebu City, Davao City, Makati, Lapu Lapu, Iloilo City, General Santos, Laoag, Caloocan, Mandaue, Mariveles, Las Piñas, Valenzuela, Bacoor, Malabon, and Santa Rosa.

With Rt at 1.35 for NCR, the increase in cases is worrisome. The data for 07.29.30

Let’s start off with answering the question – are the cases rising?

The answer, without a doubt is yes. The graph below alone will tell you the story of the pandemic in the Philippines.

While I usually show this graph on a weekend, let’s put things into the proper perspective. A week ago, our 7-day average was at 5,500 cases per day. Today, our 7-day average is at 6,032 new cases daily. That’s a 10% increase in cases over the week.

While NCR averaged around 600-700 new cases daily in the past weeks, it now averages almost 1,000 per day. An increase of almost 40%. Mega Manila has always been the major driver in the increase in cases in the country. A jump in this populous region brings the whole country to a halt. That’s because the healthcare system capacity is a finite one. We do not grow the healthcare industry overnight. And, while there may be more beds available, it is the health worker that needs to be augmented. When the health worker gets sick with COVID-19, those who have come in contact with that worker inevitably will not come to work as well. In a normal situation where COVID-19 is not a problem, when one health worker is sick, life in the hospitals do not come to a halt.

Arguably therefore, exhausting the health system before calling for a time out increases the burden and the demand in the health system.

This is why there is a need to prepare for the worst case scenario as our neighboring countries and the global data shows that increasing cases are being seen again in nations that have not only successfully vaccinated a greater percentage of its population but have reopened economies already only to have it tumble down once more because of the delta variant.

The Health Agency reports 5,742 new cases today for tests done last July 27 with a whopping 16.2% positivity rate in close to 50,000 tests done. Based on the infographics provided, there is a discrepancy in the number of new cases if we were to base it on the test results for the date indicated in the poster of the Department of Health.

There are higher number of cases compared to recoveries putting the active cases at more than 56,000.

The total new deaths is at 176. The case fatality ratio for outcomes is at 1.82%.

Notice however the ICU bed utilization which is up at 50% in the National Capital Region. This is up from a previous low ranging from 40-45%.

NCR continued to see increasing cases, accounting for close to 1/4 of the cases in the country today. And we’re back to the triumvirate of NCR + CALABARZON + Central Luzon as the top three regions with most cases. Both Central and Western Visayas reported more than 500 cases as well.

It was the province of Cebu that continued to lead on a provincial level with 559 new cases, followed by two provinces in Region IVA – Laguna and Cavite.

Among LGUs in the country, four of the top five LGUs with highest cases were from the NCR. Quezon City is back in first place, followed by Cebu City in second. In third to fifth are: Makati, Manila and Malabon. Eleven of 17 LGUs in the NCR are in the top twenty cities/municipalities with most cases today.

OCTA MONITORING REPORT

The July 29 National Update from OCTA shows that the national Rt is at 1.09. There is variability of the Rt (reproduction number) depending on the region or the LGU. The Rt in NCR is up from 1.33 a few days ago to 1.35.

Notice that based on the five indicators – infection (Rt), ADAR (incidence rate), HCUR (health care utilization rate), ICU (intensive care use) and testing (positivity rate) – Cagayan de Oro remains at critical risk. This is because it posted a 139% increase in new cases with 1.69 Rt, 88% usage of ICU and 25% positivity rate.

Key cities in Cebu are seeing higher Rt – Mandaue, Cebu City, and Lapu Lapu City.

Laoag has the highest incidence (Average Daily Attack Rate) at 60.56 per 100,000 population and the highest positivity rate in the country at 35%.

Healthcare utilization has exceeded 80% in Lapu Lapu City (Cebu province) and Mariveles (Bataan).

The rest of the report is seen below.

Circuit breaker lockdowns and the data on 07.28.2021

There is talk of a circuit breaker lockdown.

What is a circuit breaker ‘lockdown’?

A circuit breaker is short, temporary and time-bound. It is enacted with the intention of reducing the R0, briefly, hence, slowing down transmission and delaying peak in infections.

For those interested, there is a published article that is a good read on how ‘circuit breaker’ lockdowns can avert subsequent surges. The link is provided here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750327/.

As the Delta Variant outbreak looms, and with rising cases seen in major cities in the country, instituting an early and short lockdown can avert surges similar to what is being seen in our neighboring countries and globally. As the SARS-CoV-2 evolves in variants, we need to be one step ahead of curtailing its transmission. And because man is the first and final host, averting transmission in the community is vital at addressing surges.

Doing it early and more impactful clearly allows economies to return to normal states earlier as well rather than implementing a lockdown much later when cases are high, hospitals and healthcare are overwhelmed, and majority of the people are scrambling for life. Whatever economy is salvaged will be futile when lockdowns are declared very late.

Clearly, a circuit breaker has an objective, and an endpoint. It also provides a guide to people on what to do.

It is divided into phases and has a timeline. The phases are meant for a country to move forward while knowing when to step back. It is a map of how the government intends to address the pandemic. It puts into the map when the ‘circuit breaker’ is reinstitute based on parameters or indicators of imminent outbreaks or surges. In short, it is a rational way of addressing how we contain surges in order to save lives and help the economy prosper at the same time.

It may not be a perfect model, but it is a rational one.

In the meantime, the Health Agency reports 4,478 new cases today. The shocker is that this is data for a little less than 35,000 tests done on July 26 (with 4 laboratories not reporting), the positivity rate is an astounding 15%! That means that for every 100 people tested, 15 end up as positive.

New deaths announced are 84 and the case fatality ratio for outcomes is at 1.81%.

Based on the Tuesday report and today’s report, the cases that were reported yesterday most likely included cases that were unreported over the weekend accounting for the over 7000 cases on a day where a little over 30K tests were done and a positivity rate of 13.2% only.

The NCR is back in the lead with 25% of the total cases for today. Most likely the other data from regions outside of NCR are late or have had less testing done as seen in the lower testing output for July 26.

Among provinces, Cebu continued to lead with lower cases, followed by Ilocos Norte and Laguna.

On an LGU level, ten of 17 LGUs in the NCR are among the top 20 cities with most cases, with Quezon City, Makati City and the City of Manila in first, second, and third, respectively.

We are f*cked Tuesday with more than 7K on 07.27.2021

Tuesdays will always deliver some good news – lower new cases.

Today was different, and one cannot help but think – did they hold back the data yesterday or the previous days because of the SONA of the President?

Let’s look at the data for July 25 where a little more than 30,000 tests were done. And where the positivity rate was 13.2%. With the few tests, how could you arrive at 7,186 new cases?

So yes, there are more than 7,000 new cases, the active cases are more than 56,000 and it will be interesting to find out if the Department of Health will upload the Data Drop tomorrow, because they did not do it today (as of this writing).

With 72 new deaths reported, the case fatality ratio for outcomes is at 1.81%.

While NCR continued the lead, regions outside of NCR, in particular Central Visayas, CALBARZON, Central Luzon, Ilocos Region, Northern Mindanao and Davao Region saw more than 500 cases today. As to whether the data are based on a single day test result, most likely not. It is highly likely that some of the cases were attributed to delayed reporting due to whatever reason.

The province of Cebu marched on with 904 new cases, with Ilocos Norte and Davao del Sur in second and third, respectively.

Among LGUs, it was a different story as Cebu City took the lead. Three key cities reported more than or close to 350 cases each – CEBU CITY, DAVAO CITY, AND QUEZON CITY. Nine LGUs in the top twenty had triple digits. Six of 17 LGUs in NCR were among the tope 20 cities with most cases for the day.

OCTA MONITORING REPORT

While the rise in cases due to the Delta Variant is not proprietary to the Philippines or Asian nations, we need to learn from the experience of countries that had this variant eventually dominate the serotype circulating in the community. It is understandable that the concern is on how badly hit the economic sector is with never ending lockdowns. We need to balance the health risks on healthcare with economy.

The Health Agency and IATF need to consider using self-test antigen kits as screening tools for exposures and contact tracing and government should financially support those who test positive with free PCR testing.

The Rt is up at 1.11 nationally and 1.33 in the NCR.

During the first and second surges, NCR was the main driver of the cases. As we see a rise in cases, short of calling it a possible surge, there are multiple LGUs driving the increasing numbers. Western Visayas has not seen a significant decline in cases for the past months and still remains as one of the biggest contributors to the daily cases. This, as Cebu province tops the list of provinces pouring in more cases.

And as cases are now on an upswing, from Aparri to Jolo, it’s anyone’s guess how this will play out with a country where its sprawling archipelago is the perfect picture for leaky borders and where mobility will be difficult to control.

NCR Rt at 1.31, while major cities in Central Visayas are seeing increasing cases on 07.26.2021

New cases are higher today at more than 6,600 with one laboratory not submitting report for July 24 and only 45,000 tests done. The positivity rate is up at 13.4%! As the delta variant unfolds in our midst, the numbers seem to point to one thing – that there should be more urgent sequencing of the samples sent to the Philippine Genome Center, more testing should be done and contact tracing should be instituted early.

People need to understand that the behavior of the delta variant is a bit different from the previous variant of concerns, the alpha and beta variants. The delta variant has a shorter infection period, which makes it spread quicker. Because of the higher viral load compared to the original Wuhan virus, it also has the propensity to spread in greater populations because of the shorter time from exposure to symptom development. And the virus has the propensity to have escape mechanisms that may affect response to vaccination and a previous infection.

There are 23 reported deaths today, moving the case fatality ratio for outcomes to 1.81%.

OCTA MONITORING REPORT

The update for the week July 19-25 still shows Cagayan de Oro and Mariveles as the LGUs in the critical zone based on the four indicators used for monitoring how the top LGUs are doing.

In the high risk are: Davao City, Cebu City, Makati City, Iloilo City, Lapu Lapu City, Laoag, General Santos, Mandaue, Baguio, Las Piñas, and Valenzuela.

Notice the uptick in the reproduction number in the NCR. It now stands at 1.31. The national Rt is at 1.08.

The vaccination status in the country is updated and provided below (as issued by the Department of Health). Based on the report that over 30M COVID vaccines have arrived, a little more than half had been administered. Obviously, with a little more than 6% fully vaccinated for now and the threat of the delta variant looming over us like the Damocles sword, it will take awhile before a larger segment of the population will get jabbed. In the meantime, people are still advised to spread the word that we need to be mindful of when and how we move about. Mobility should be restricted for essentials for now.