The very slow decline and the data of 09.20.2021

We will take the slow decline any day of the week.

The Health Agency reports 18,937 new cases today and with more than 20,000 recoveries, the total active cases have gone down a tad.

Of the 72,770 tests done September 18, the positivity rate is still an astounding 26.3%. Which means that the decreasing cases may still go south. We are not testing enough. And we all know that contact tracing will never happen if we do not test.

A total of 146 new deaths were reported. The case fatality ratio for outcomes is at 1.68%.

Hospital utilization is still more than 70%, while ICU utilization rate is up at 77% (79% in the NCR).

It was decent numbers in the NCR as it recorded 4,952 or 26.1% of the total cases in the country today. Three other regions reported four digits. They were: CALABARZON, Central Luzon, and Cagayan Valley. As in the previous days, all other regions reported triple digits.

The provinces of Cavite, Rizal, Laguna, and Batangas – all from Region IVA – are among the top five provinces with most cases in the nation today.

In spite of the lower cases for NCR, 14 of 17 LGUs make it to the top 20 cities/municipalities with most cases for the day. Three LGUs in CALABARZON were in the list as well.

-5% growth rate and a lower R and the data for 09.19.2021

It wasn’t really good news, but we will take the less than 20,000 new cases as we see the cases decline slowly and the reproduction number hold steady a little above 1.0.

The Health Agency announces 19,271 new cases today and with more than 25,000 recoveries, the active cases are a little less than 180,000.

More than 70,000 tests on September 17 show the positivity rate at 25.1% a slight improvement from the previous days.

There are 205 new deaths announced. Case fatality ratio for outcomes is steady at 1.7%.

In the NCR alone, the data from Prof. Guido David shows the negative growth rates in the NCR in the past days. As in yesterday’s blog, there is a pattern that shows that Mega Manila may have attained peaks in daily cases, but the effort at holding on to this momentum should be sustainable. Rushing to open too much of the economy can result in a dramatic overturning of the painful gains made so far.

NCR continued its second day streak for lower than usual expected range of cases (25-30%). The 4,748 reported cases accounted for 24.6% of the total of NCR. Three other regions had quadruple digits: CALABARZON, Central Luzon, and Davao Region. All other regions reported triple numbers.

On a provincial level, Cavite was back in the lead with quadruple digits.

Thirteen of the 17 LGUs in NCR were among the top twenty cities/municipalities with most cases today. Three LGUs from CALABARZON were in the top twenty list as well.

THE WEEK IN REVIEW

The 7-day average of cases is at a high of almost 21,000 daily cases and 7-day average of deaths is greater than 200 daily. While the R has slowed down (see graph below) on a national scale, the R is still >1.0. Which means that we are most likely plateauing (and this should be interpreted with caution) and are likely peaking as well.

Tests are lower this week compared to the last week, which throws the positivity rate to an all time high. The high positive rate adds to the large uncertainty on the direction of the surge because there are too many red flags that with increased mobility, the high positive rate is an indicator that the poor testing may be a driver for higher numbers in a few weeks.

With continued increasing cases, the Philippines has now managed to shove its way to the front of the pack as the epicenter in the ASEAN region. Notice that it now leads the pack as all countries, except for the Philippines and Singapore are seeing higher 7-day averages.

The outbreak in Singapore has placed it in a precarious position in the region with R that is up at close to 2.0. While they may have much fewer cases numerically, based on the size of the population, the increase in cases tips the balance of the reproduction number. Singapore leads in highest reproduction rate and will not see a decline until a few weeks later as for the first time since their first surge, the breach the 1,000 new cases in a single day.

Many countries have now managed to vaccinate more than 60% of the population. The countries that have been able to achieve this are mostly higher income nations. Note the difference between those countries and those in the lower middle income and lower income classes. The delta variant is a force to reckon with as many nations now have to deal with vaccination and the dominant variant concern spreading globally.

The Saturday habit of record new cases and the data of 09.18.2021

The Health Agency reports the second highest cases the Philippines records since the more than 26,000 cases reported last September 11 (exactly one week ago).

With 23,134 new cases today, the Philippines surpasses the Ukraine and sits now in 18th rank for most number of COVID19 cases in the world. There are still more than 180,000 active cases.

On September 16, 73,635 tests were done with a slightly lower positivity rate at 26%.

There are 255 new deaths reported. The case fatality ratio for outcomes is at 1.70%

The NCR, that remains the epicenter of the surge, is still seeing increasing cases. Note that while the R has dropped from 1.39 to 1.22, and the growth rate is down to +8% from 11%, the 7 day average of cases is almost 6,000 per day. And while there is a slight decrease in hospital bed occupancy, the ICU bed occupancy is up by almost 20%.

With the NCR moving into a quarantine status that allows more mobility due to economic repercussions of lockdowns, we will see how the data plays out in the next two weeks.

In spite of the spike in cases today, the NCR had considerably lower cases than its usually range of 25-30%. The NCR owned 22% of the total cases. The news of the day was Cagayan Valley, which came in third with 2,912 cases – their all time high!

NCR PLUS also trended lower from its usual range of 60-65%, down to 50.6% today, as 6 other regions outside of NCR saw quadruple digits. They were: CALABARZON, Cagayan Valley, Central Luzon, Davao Region, Ilocos Region and Western Visayas. All other regions in the country report triple digits for the day.

Even on a provincial scale, Isabela reported 1,512 cases today to displace Cavite from the over-all lead. Nevertheless, the four provinces of Cavite, Laguna, Rizal and Batangas in the CALABARZON ranked 2nd to 5th for the day.

Eleven of 17 LGUs in NCR were among the top twelve cities/municipalities with most cases. Davao City remained in the top five, while Santiago (in Isabela Province) ranked 9th today.

Plateauing or peaking and the data of 09.17.2021

With reproduction number ranging from 1.1-1.2 (+/- 0.5), we continue to average more than 20,000 new daily cases. The common question asked is are we plateauing or have we peaked?

Based on the surge data and the reproduction rate, we seem to plateau at 20,000. If we maintain the reproduction number and keep it lower, then we most likely would have occasional bursts of higher numbers, but should be peaking this weekend.

The problem in this scenario is the high positive rate that continues to exceed 25% in spite of more than 75,000 tests done last September 15, 2021.

During the last surge in April, the highest positivity we recorded was 22.8% on April 7. The positivity rate dropped significantly to 9.8% on May 26. But the next smaller surge in June showed a peak positivity rate of 13%. The July surge was accompanied with positivity rates exceeding 25%. And plateauing at more than 25% positivity rate at a time when the government decides to loosen mobility restrictions can go either ways. We will sit this one out. In the meantime, please, if you don’t need to go out unnecessarily, don’t.

The Health Agency reports 20,336 new cases today, and with less than half that number as recoveries, the active cases are now close to 190,000.

With 310 new deaths, the total deaths now exceed 36,000.

Even NCR had a decent share of the total cases for the day with 25% of daily total. Other regions with quadruple digits were: CALABARZON, Central Luzon, Cagayan Valley and Western Visayas.

On a provincial level the top 4 provinces were all from CALABARZON – Cavite, Laguna, Batangas and Rizal.

Twelve of 17 LGUs from NCR were in the top twenty cities/municipalities with most cases. Four LGUs were from CALABARZON, while Davao City remains in the top five.

Passing 2.3M total COVID-19 cases and the data of 09.16.2021

The data today was expected. Remember, the reproduction number? It is still above 1.0.

The Health Agency reports 21,261 new cases today, pushing the active cases back to more than 177,000. The total cases today was enough to breach the 2.3M mark as the Philippines now has 2,304,192 COVID-19 cases.

Of the 74,149 tests done on September 14, the positivity rate jumps to 27%.

New deaths announced today are 277. The case fatality ratio for outcomes is at 1.69%.

While the R is a bit lower both in the NCR and nationally, the number of cases continue to rise.

The readers need to understand that a R of 1.0 indicates flat reproduction. If you had 1 case yesterday, with R at 1.0, you would have mostly likely 1 additional case tomorrow. With effective reproduction still above 1.0, the number of new daily cases continue to increase BUT have slowed down. In the NCR, the growth rate is down from 14% to 9%.

The bad news is that the positivity rate remains very high at 25% (albeit, lower than the national positivity rate of 27%).

The NCR accounted for a high median of 27.5% with 5,846 cases. NCR plus maintained more that 57% of the total cases in the country. Seven regions report 4 digit cases per region including Western Visayas, Ilocos Region, and Davao Region. All other regions report triple digits.

Cavite led among provinces with most cases, with Rizal, Laguna and Batangas in the top 10 provinces.

Twelve of 17 LGUs in NCR are in the top twenty cities/municipalities with most cases. Five LGUs in Region IVA were in the top twenty.

The low Wednesday and the data of 09.15.2021

In an unusual turn of events, the past Wednesdays have had lower cases than the low Tuesdays.

The Health Agency reports, close to 17,000 cases today. And with more than 24,000 new recoveries, brings down the active cases to a little above 170,000.

More than 57,000 tests done on September 13, showed a positivity of 25.9%.

There were 214 new deaths announced today, bringing the case fatality ratio for outcomes to 1.7%.

Rising ICU bed utilization in the NCR at close to 80% places the region in a critical state. As the region experimentally transitions to a new level of quarantine classification tomorrow, the balance between economy and health at a time of high cases will be tested.

The percentage range of cases for NCR is usually between 25-30% of the total cases for the day. The NCR is at the low range today with 25.8% of the total cases. Regions IVA and III continue to trail NCR. These three regions contributed to 57% of the total cases in the nation.

Cavite remains the province to beat. The provinces of Laguna, Rizal and Batangas, all within the CALABARZON region, are in the top 10.

Among LGUs, 10 of 17 LGUs in NCR are in the top twenty cities/municipalities with most cases. In NCR, Quezon City alone had more cases than the combined total of the cities of Taguig, City of Manila and Makati today. Three LGUs in Cavite join the top 20 list.

Unusual Tuesday and the data of 09.14.2021

The usual Tuesday is 25-30% lesser than the 7-day average of cases. Since the 7-day average is now at 20,500, the usually ‘low’ Tuesdays would be around 15,000 new cases.

Not this Tuesday.

The Health Agency reports 18,056 new cases, as tests done last Sunday, September 12 pass the 50,000 mark (the highest number of tests on a Sunday). The positivity rate is also up at 29.7%. ICU rate in NCR is up at 79% (which I think is even higher considering that some hospitals may have beds but direly lack manpower at this point).

The total deaths reported today is 222, bringing the case fatality rate for outcomes to 1.70%.

Based on the 7 day average the past week, we add 100,000 new cases every 5 days. If the cases continue in this trajectory, we will be seeing a new record high this week.

The NCR had a more than higher median average cases today (27.5%). Four other regions reported four digits – CALABARZON, Central Luzon, Ilocos Region, and Cagayan Valley. NCR plus accounted for 55% of the total shares of cases today.

Cavite, Rizal and Laguna topped provinces with most cases today.

Thirteen of 17 LGUs in NCR were among the top 20 cities/municipalities with most cases for the day. Five LGUs in CALABARZON were in the top 20 list as well. There we six unknowns in the NCR reported today.

Not bad for a Monday and the data of 09.13.2021

With 20,745 new cases announced today, the 7-day average cases for the country is around 20,500 new daily cases. The active cases remain high at over 180,000.

Tests done on September 11 was close to 72,000 with a slightly lower positivity rate of 26.7% (nevertheless still critically high).

New deaths today are 163, with the case fatality ratio for outcomes steady at 1.71%.

With the upcoming new classification for lockdowns to be implemented in the NCR, Mega Manila continued to account for more than one-fourth (28%) of the cases in the country. NCR plus owned 62% of the total share. Again, all regions outside of NCR plus had triple digit cases.

The provinces of Cavite, Laguna, Rizal, Bulacan and Batangas continued to lead on a provincial level.

On a LGU level, 13 of 17 LGUs in NCR now are in the top twenty cities/municipalities with most cases. Five LGUs in CALABARZON also make it to the list.

7-day average of >20K new daily cases and the data of 09.12.2021

Hopefully, the glitches have been fixed, as the backlogs have somehow are being addressed.

The Health Agency reports 21,411 new cases today and with more than 25,000 recoveries, the active cases are down to around 182,000.

More than 78,000 tests (the highest number of daily tests) were done last September 10 still showed 27% positive rate. Way above the acceptable positive rate.

ICU utilization rate is now close to 80% in the NCR and at 77% nationally.

There are 168 new deaths reported today. The case fatality ratio for outcomes is at 1.72%.

With the technical glitches addressed (that is my presumption), the NCR average trend is back to 26-27% with the 5,619 cases today. Other regions with quadruple digits are CALABARZON, Central Luzon and Ilocos Region. All other regions reported triple digits.

The provinces of Cavite and Laguna led with four digits on a provincial level.

Among LGUs, 12 of 17 LGUs in NCR were in the top twenty with Quezon City leading with quadruple numbers. 3 LGUs in Cavite were also in the top 20 list.

THE WEEK IN REVIEW

The Philippines finished the week with a day in the top 4 countries in the world with most COVID-19 cases. In a nation where the face shield is the symbol of managing this pandemic, the daily numbers do not reflect the actual cases we are seeing daily. And here is why.

TESTING

The World Health Organization pegs 5% as the acceptable positivity rate. Between 5-10%, is still manageable. But notice that we have never looked back to even <10% positivity rate since March 2021. Today, we have eclipsed all records and the 7-day average for positive stands at more than 25% or 1 in every 4 people tested, testing positive. Although we have had more tests done in this surge compared to the last one in March/April, it isn’t enough. Which means that most likely only those with symptoms or hospitalized end up being tested. With cases this high, the only way we can bring down the positive rate is to do good contact tracing. The total number to test to bring the positive rate to ~10%? At least 250,000 – 300,000 per day. An impossible feat considering that more than half of all testing facilities are in NCR plus.

CASES AND DEATHS

We have not peaked yet. As of September 11, 2021, the 7-day average is 20,722 new cases daily. With a national R still >1.0, there will be a continued rise in daily cases, but managing to slow down, based on the data being churned by the Health Agency. Remember, all these data do not come from thin air. They come from the Data Drop of the the COVID19 tracker of the Department of Health. We are still in an upward trajectory. And the densest regions and provinces are taking the brunt of the outbreak.

The new cases include breakthrough infections. While the Food and Drug Authority reports that only a small percentage are attributable to breakthrough infections, the data on the ground do not seem to point to that. That is because many of have been vaccinated, develop symptoms and get tested, are either asymptomatic or mild. Breakthrough infections, like other countries are under reported.

The deaths are lower, which may be a good sign because of having many of those living in the more dense areas of the country vaccinated. It may, however, also mean that because deaths are late reports, we are not seeing the actual picture for now. The course of illness of those that are severe and critical may take a longer course. When the cases begin to decline, the true picture of deaths will be revealed.

HOW ARE WE FARING WITH OTHER SELECT ASIAN COUNTRIES

Compared to other countries, the Philippines now ranks number 1 among other ASEAN nations and is second to India in the whole of Asia in terms of daily new cases. All other countries that are in the midst of the delta crisis are seeing a decline in cases. Singapore, a country with less than 6M people is seeing an increase in cases but is at the lower end because of their population size.

THE REPRODUCTION NUMBER

While the Philippines may have the highest daily cases, it is Singapore that leads among countries with the highest reproduction number. The R of the PH is lower this week at 1.10 compared to last week at 1.2. This does not mean that there is a decline in cases. It only means that we have plateaued at a certain average and have not peaked yet. The daily numbers are slowing down and not significantly increasing. The data, however, should be taken with the perspective of the high positive rate. This means that whatever numbers we are seeing, are most likely higher if more testing and tracing were done.

VACCINATION AND DELTA

The IATF reports that almost 50% of the eligible adults in the National Capital Region have been vaccinated (either with one or two doses). With the variability of vaccine efficacy on which vaccine was rolled out and when they were vaccinated (many frontliners receiving Sinovac over 6 months ago), the question on boosters is now up in the air. Many of the neighboring countries where the Delta variant is the predominant serotype, have started providing “boosters” to frontliners who are at highest risk of breakthrough infections due to the natural hazard of their work. While the total number of vaccinated (whether fully or partially) is at over 17% in the country (as of this report), the government should work quicker in order to allow access of more vaccines sans red tape so that they can rationalize reopening the economy. After all, the virus is not specific to Mega Manila alone. The whole country especially the workforce should be the priority. For those that can afford to purchase the vaccines, this should be allowed particularly with vaccines like Pfizer-BioNTech which already has full authorization in the country of origin (USA). This will solve the inequity issue in the country, where those who can afford to buy the vaccine can purchase it on their own.

A record high in the PH and in other ASEAN nations on 09.11.2021

I guess the numbers 9/11 is symbolic. Twenty years ago, it stood for the worst terror attack in the United States.

As the world stood to remember that day, the Philippines breaks an all time high in COVID19 cases with the Health Agency announcing 26,303 new cases. It took a day to surpass the 2.2 Million mark. This pushes the active cases past 185,000 and climbing.

Note that of todays cases, 1,608 were supposed to have been included yesterday but were not. The total number of cases for September 11 is actually 24,695.

Tests done September 9 were past 75,000 but the positivity rate was still unmanageable at 27.6%.

The health care capacity is definitely at past critical levels, with the NCR’s ICU rate past 77% (which is an under report). Note that this does not count the beds for “closed” ICUs because of lack of personnel to man these units.

Total deaths reported was 79 as the total deaths near 35,000. The case fatality ratio for outcomes is at 1.73%.

The NCR had a record high of more than 9,000 cases or close to one-third of the total cases in the country today. Three other regions were reporting quadruply digits – CALABARZON, Central Luzon, and Western Visayas. But it was NCR that stood out among the rest with numbers too numerous to validate that more than 11% of the NCR cases were from unknown LGUs.

On a provincial level, six provinces reported quadruple digits, making this the highest number of provinces recording 4-digits in a single day. They were: Cavite, Laguna, Rizal, Bulacan, Iloilo and Batangas.

Twelve of 17 LGUs in NCR were in the top 20 cities/municipalities with most cases. This, notwithstanding the fact that 1,026 were unknowns from NCR. Six LGUs in CALABARZON were also in the 20 twenty list.

As the day closed, the Philippines, for the first time, ranked 4th (it’s highest ever) among the global cases of COVID-19 on 09.11.2021.

Truly, spiraling out of control.