With 8,748 new cases announced by the Health Agency, and less than half that number as recoveries today (4,143) the active cases are up again at 7.1% (73,908). The total number of cases from April 1-30, 2021 officially stood at 281,287 compared to the month of March, which totaled 168,907 cases or almost a 70% increase in number of cases from the previous month. This is disturbing as the NCR plus bubble stays in MECQ, but Metro Manila mayors and the government has allowed some “flexibility” in rules in order to “spur” a fledging economy within the nation’s capital region. Note also that the number of total deaths for the month of March 2021 was only 975, and paled in comparison to the 3,931 deaths for April 2021. An increase of more than 400%.

The tremendous burden on healthcare capacity can still be felt in most hospitals in spite of the Department of Health claiming that only 71 percent of the ICUs in Mega Manila are filled up and a low utilization for isolation bed and ward beds.

Our positivity rate stays above 15% (three times higher than the recommended upper limit of positivity rate as recommended by the World Health Organization), in spite of the more than 54,000 tests last April 28 (reported today).

With the 89 new deaths and fewer recoveries today, the case fatality ratio based on outcomes of COVID19 cases remains unchanged at 1.79%.

Today’s granular data continued to show the NCR outperforming other regions but with slightly lower number of cases at 3,054 or 35% of the total cases today. CALABARZON had slightly more of the daily share than previous days with close to 2000 cases (22%). Central Luzon came in third with 1,124 (13%) cases. These three regions continue to consistently account for 70% of the total cases in the country.

In the National Capital Region, Quezon City continued to lead, albeit at a lower number of 505 new cases (16.5%). Thirteen other LGUs reported triple digits. Fourteen of the 17 LGUs in NCR were among the top twenty cities with most cases.

Among the top ten provinces with most cases, three provinces in the CALABARZON area continued to lead the number of cases – Cavite, Laguna, and Rizal. In Central Luzon, Pampanga took the lead with 348 cases.

After the lower number of cases Tuesday and Wednesday, we’re back at the 8,000 mark with the Health Agency announcing 8,276 new cases today. The number of recoveries today is lower than the number of new cases, with 6,636 new recoveries announced. This brings the total active cases up close to 70,000 (6.7%). The positivity rate is at 16.9 percent with close to 50,000 tests according to reports last April 27.

ICU beds are up at 72 percent today (from 71% yesterday) and new deaths is at 114, giving a case fatality ratio of 1.79 percent (unchanged from the previous day).

Note that the Philippines recorded 168,907 new cases from March 1-31, 2021. From April 1-29, 2020, the country has passed the 1,000,000 total with 272,539 new cases and will most likely breach the 280,000 mark tomorrow. The death count is also depressing news. From March 1-31, 2021, the country recorded 975 new deaths while 3,842 new deaths have been counted from April 1-29, 2021 alone. Death reports will always be late by a few weeks considering the long drawn battle of some patients with COVID-19 who eventually become severe or critical. One has to remember that patients who may be asymptomatic at the start may end up critical because the full spectrum of the disease evolves over a two weeks period.

With 6,895 new cases and 10,739 recoveries today, the number of active cases is lower at 6.6 percent with 67,769 actives. This brings the total cases to more than 1.02 million.

There were 115 new deaths reported, which brings the case fatality ratio based on outcomes to 1.79% today.

Hospital ICUs are back to the critical level as it surges past 70% again today.

On a regional level, the NCR accounted for a larger chunk of the total. From a previous 38% to a 42% today. Seven regions reported triple digits. Thirty four individuals were tagged with no known regional location.

In the NCR, Quezon City continued its daily lead with more than 30% of the share for Mega Manila. Surprisingly was Las Piñas that came in second with 316 new cases and Taguig in third. Twelve of the 17 LGUs in NCR were among the 20 top cities in the Philippines.

On a provincial level, Rizal led the pack with 574 new cases followed by Batangas in second with 304.

As expected for Tuesdays (and Wednesdays) the Health Agency reported 7,204 new cases with more than 10,000 recoveries, brings the total active cases to 7.1% of the total. This brings up the critical and severe cases to 2.4% (or 1,720 requiring intensive care or hospitalization). The DoH reports today, lower than critical level for intensive care beds in the National Capital Region at 69% (1% below the critical level). Positivity rate is stable at an average of 15-17 percent the past days.

There were 63 new deaths, bringing the case fatality ratio based on outcomes (recoveries and deaths) to 1.8%.

The NCR had less than 3,000 new cases for today, with CALABARZON in second with 1,312 cases and Central Luzon login in less than 1,000. Seven other regions reported triple digits. There were 34 cases with no known location based on region.

In the National Capital Region where 40% of the total cases in the Philippines are found, Quezon City continued to lead, accounting for more than 30% of the cases in Mega Manila. Nine LGUs reported more than 100 cases, while the rest had only double digits. With the very erratic number of cases from most LGUs, it would be premature to claim that the numbers are “down” and that easing quarantine would be a prudent decision after April 30.

Twelve of 17 LGUs in NCR were in the top 20 cities with most cases.

On a provincial level, Cavite continued the lead with 454 new cases, followed by Bulacan and Rizal. Surprisingly, Negros Occidental is up in fourth spot, outpacing Laguna and Batangas.

Today marks a grim and yet painful milestone in the pandemic as the Philippines passes the 1,000,000 total number of cases for COVID-19. This puts us in 26th rank globally together with 25 other countries that have crossed the million cases marker. We are also the second country in Asia (Indonesia being the first) to have more than a million cases.

The Health Agency reports 8,929 new cases today pushing the total cases to 1,006,428. With 11,333 new recoveries, the active cases are a tad lower at 7.4% (less than 75,000) with 70 new deaths reported. This brings down the case fatality ratio to 1.8%. However, with 16.7 % positivity rate with testing ramped up, will we expect fewer cases tomorrow?

We need to work harder at bringing the numbers lower and extending the MECQ will, at this time, be the most prudent recommendation so that we do not overtake other nations who are faring better than us during this outbreak. The government should also work doubly harder at rolling out vaccines quickly and safely during these tumultuous times.

The NCR contributed to 38% of the cases for today, followed by CALABARZON with 19% and Central Luzon at 13%. Seven regions continued to report triple digits.

In Mega Manila, Quezon City continued to lead with 18% of the cases followed by Taguig owning 17%, Pasig accounting for 9.9%, Caloocan for 9.8% and Manila with 9.5% of the total cases. Thirteen of 17 LGUs in NCR were among the top twenty cities with most cases.

On a provincial level, it was Cavite that continued to lead, followed by Bulacan, Rizal and Isabela with more than 400 new cases apiece (but less than 500).

In spite of the awful data we’ve had in the last month, there is a silver lining to the lockdowns. Which makes this weekend end on a more hopeful note.

As the Health Agency reported 8,162 new cases, 109 new deaths and an astounding 20,509 new recoveries, this brings the total cases in the Philippines within a day close to the one million mark. There is no stopping the country in being the 26th nation with more than 1,000,000 cases (~1% of the population) tomorrow.

The case fatality ratio based on patients with outcomes (recovery or death) is now lower at 1.82 percent with the active cases lower at 7.7 percent (77,075 cases).

The weekend summary from April 19-25, 2021 showed 71,505 new cases, 977 new deaths and 124,965 new recoveries. This weekend (including today) had the most number of recoveries in a single week as reported by the Department of Health.

The number of cases weighed heavily on the testing capacity of the nation. While there were days where we tested more than 50,000 cases, most of the days were below that (in spite of the more than 230 testing centers in the country). The positivity rate averaged a high 20 percent for the week that was. In short, 1 in every 5 individuals tested would end up continuing to test positive.

There is a slight decline in the total number of new daily cases with a 7-day average of 9,049/day and new deaths at 124/day. With the OCTA Monitoring Update report below (as of April 25, 2021), note that the reproduction number for the country stands at 1.0 while in the NCR, the epicenter of the outbreak in the country is at 0.93. I will reiterate – the Rt SHOULD STAY BELOW 0.8 FOR THE NEXT 4 WEEKS, WITH NO DAY THAT SHOULD EXCEED 1.0.

It is important to note that other nations are also dealing with the global surge in cases. India, Thailand, Japan and Cambodia are resorting to some form of lockdown or quarantine in order to bring their sudden surge of cases to a standstill. Together with the Philippines, these neighboring countries are seeing surges in cases as well.

The NCR alone contributes to more than 40 percent of the total cases in the country in a single day. The objective will always be to make sure that this region, home to almost 15 million Filipinos that is the epicenter of both the outbreak in the pandemic and commerce, must continue to suppress its daily new cases CONSISTENTLY.

The average number of new COVID-19 cases reported per day in the NCR was 3,841 over the past week, with a one week growth rate of -20%. The current average is also 30% lower than the average of 5,552 during the peak of the surge three weeks ago. The moving average (blue) and trend lines (red) show a clear downward trajectory for new COVID-19 cases in the NCR. The positivity rate in the NCR over the past week was 19% from a average of 26.120 tests per day. Three weeks go, the positivity rate was as high as 25%. Hospital bed occupancy in the NCR decreased to 61% while ICU bed occupancy also decreased to 71%.

Philippine COVID-19 Update, OCTA Monitoring Report, April 25, 2021

Among the top twenty LGUs with the most cases for the week April 18-24, 2021, all of the LGUs in Mega Manila are seeing a negative growth rate (or decline in cases). Hospital bed occupancy and ICU occupancy are significantly correlated with that decline. Only 5 of the LGUs in NCR have 100 percent capacity. As a matter of fact, Caloocan, Las Piñas, Valenzuela are below critical level for intensive care.

Outside of the “NCR plus bubble” is Pampanga. And Angeles City had a significant jump (+31%) in new COVID-19 cases daily. Pampanga province as a whole also had higher cases over the past week, up by 6% compared to the previous week. Batangas also had an increase of 24% from the previous week.

While there is a slight increase in number of new cases at 9,661 announced by the Health Agency at 4PM today, this is due to the higher number of tests performed last April 23. As there are close to 23,0000 new recoveries being reported overnight, the number of active cases drops to less than 90,000 (9 percent).

New deaths reported was at 145, bringing the case fatality ratio of those with outcomes (recoveries or deaths) to 1.85 percent.

There is a significant decline in the utilization of intensive care unit beds from a previous high of over 80 percent to just 71 percent today and isolation, wards, and ventilators to less than 70 percent (or below the critical threshold) of the health agency.

With a 16.3 percent positivity rate reported April 23, the Philippines continues to inch closer to the 1,000,000 mark as we are still on track to inevitably surpass this by next week.

On a regional level, the NCR, CALABARZON, and Central Luzon continue to dominate the new cases. NCR, however, owned only 37.7% of the total share for today, with CALABARZON owning 19.2% and Central Luzon 15%. Eight other regions reported triple digits.

Among the LGUs in NCR, it was still Quezon City that continued to lead with 724 (20%) of the cases in Mega Manila. Pasig and Manila came in second and third, respectively. Nine of there LGUs had more than 100 but less than 300 cases. They were: Caloocan, Taguig, Makati, Malabon, Valenzuela, Parañaque, Mandaluyong, Marikina and Las Piñas. Thirteen of 17 LGUs in NCR were in the top twenty cities with most cases.

On a provincial level, Cavite continued to lead the pack with 574 new cases. The sudden rise of Pampanga to second spot among the top ten provinces is quite alarming as this province is seeing an uptick in cases, overtaking erstwhile leader Bulacan for the region of Central Luzon.

Lockdowns definitely work at bringing down the cases of COVID-19. The impact of the two week ECQ from March 22-April 4, 2021 is being seen one month later.

Yesterday saw a 20 percent drop from the expected number of daily new cases for COVID-19. The 8,742 new cases yesterday was based on tests done on April 20, 2021 where of 43,664 samples tested in 40,227 individuals. Hence the lower number of new cases reported on April 22, 2021. This actually would have been lower if the Health Agency reported real time data. However, because of correction and continuous clean up of data does not allow us to see from where additional cases are coming from. Of the 40,227 individuals tested on April 20, 7,055 tested positive. The almost 1,700 cases discrepancy in the test results and announcement of new cases may most likely due to previous positive patients who have not yet been announced because of delays in submission of reports.

The Health Agency today reports 8,719 new cases based on report that 17.1 percent tested positive last April 21, from close to 51,000 individuals tested. If we are to follow the trend of reporting of the Health Agency, this would mean that we will most likely have more cases tomorrow.

But we revel in the better news today as there are 13,812 new recoveries, bringing the total active cases down to 10.5 percent. New deaths were at 159 today with the case fatality ratio lower now to 1.88 percent (based on those with outcomes – recovered or died).

The current health care capacity in the NCR remains to be inundated as the ICU beds are still above the critical level at 82 %.

Whether the shift to MECQ will see a sustained momentum in bringing down the cases the coming weeks is the challenge as the last week of April approaches and the country inches closer to the 1,000,000 mark, let us not keep our guards down as COVID-19 is hitting too close to our own homes and places of work.

It was a striking deviation from the usual pattern of reporting where the Thursday reports are usually higher than the patterns see on Tuesday and Wednesday. So todays report from the Health Agency of 8,767 new cases was both a welcome news (at a same time quite an unsettling one). Nevertheless, we take the report on a positive note together with the additional 17,138 new recoveries, bringing down the total active cases to 11.1 percent (107,988). The positivity rate is still high at 17.5 percent for April 20. Note that the data on testing as explained in the infographic is data released on April 22 according to reports for April 20, 2021.

There were 105 new deaths reported bringing the case fatality rate for resolved cases (recoveries and deaths) is lower at 1.9% compared to the global CFR which stands at 2.44%.

Globally, Iraq is the 25th country to pass the 1,000,000 mark for number of COVID-19 cases. We are in 26th rank with 971,049 total cases.

The granular data based on region, the cities in the NCR, top ten provinces and top twenty cities are provided below:

After the weekend recovery haul, the Health Agency has continuously reported time-based recovery with 19,699 new recoveries today and 9,227 new cases reported. With a positivity rate of 19.5 percent, we will most likely see more than 10,000 cases again tomorrow.

On April 5, 2021, the Department of Health released circular number 2021-0122 on “Reiteration of Prevention, Detection, Isolation, Treatment and Reintegration (PIDTR) Strategies for COVID-19 in Light of the Implementation of Enhance Community Quarantine in NCR Plus Bubble” https://doh.gov.ph/sites/default/files/health-update/dc2021-0122.pdf

Two highlights in this circular included the use of rapid antigen tests by LGUs in accordance with Department Memorandum 2021-0169 (Interim Guidelines on Rapid Antigen Test Reporting for the NCR Plus Bubble https://doh.gov.ph/sites/default/files/health-update/dm2021-0169.pdf) and the reiteration of disposition of patients with suspect, probably and confirmed COVID-19 cases.

Based on this circular, repeat testing shall NOT be required for the discharge criteria of suspect, probable and confirmed COVID-19 cases, provided that a medical doctor certifies or clears the patient. The criteria for clearance are:

• Patients with mild symptoms who have completed at least 10 days of isolation from the onset of illness AND have been asymptomatic or clinically recovered for 3 consecutive days may already be discharged.
• Patients with moderate, severe or critical symptoms who have completed at least 21 days of isolation in a hospital from the onset of illness and have been asymptomatic or clinically recovered for 3 consecutive days may already be discharged
• Asymptomatic confirmed cases who remained asymptomatic for at least 10 days from date of specimen collection may already be discharged.
• Close contacts who remain asymptomatic for at least 14 days from date of exposure may already discontinue their quarantine.

There are 124 new deaths reported today and the case fatality rate based on patient outcomes (recoveries and deaths) now stands at 1.92%. Close to 120,000 cases are still active (12.1%).

It was unusual that the number of ICU beds suddenly freed up (of course unless many died, or many survived and were stepped down to less critical care). However, highlighted is the total number of critical, severe, and moderate active cases, which is around 2% of the total active cases. One should also remember that when looking at this data, the classification of patient status is NOT cast in stone. Patients who are asymptomatic may become severe within the disease period. Those who may have been severe initially may have eventually responded to treatment. As this information is not provided by the DoH, it would be interesting to find out what the initial clinical status of patients were at the time of reporting and how they progressed or recovered during the whole duration of illness. For example, did the asymptomatic patients stay asymptomatic all throughout the isolation period? If they did not, what the progression of the disease during the disease interval? This would provide us a better picture of how the healthcare system is coping so that we can understand better on how to improve allocation of resources.

The granular data per region, NCR, top ten provinces and top ten cities are provided below