Plateauing at 7K because of rising cases outside of NCR, the PH Rt = 1.03 on 06.20.2021

With 2 laboratories not submitting reports for June 18, the Health Agency announces 5,803 new cases today. The positivity rate is still high at 13.2% because testing is insufficient at less than 50,000 test two days ago. The active cases dip a little less than the 60,000 average.

With 84 new deaths, the case fatality ratio for outcomes is at 1.81%.

CALABARZON, NCR, and Western Visayas continued to lead the regions with most cases for the day. The Visayas and Mindanao Regions continue to account for majority of the cases in the country.

In NCR, Quezon City has difficulty in controlling its cases, as the city contributes to almost 1/3 of the total cases for Mega Manila alone. Five of 17 LGUs in NCR were among the top twenty cities with most cases.

On a provincial level, Negros Occidental, Davao del Sur and Leyte reported more than 300 cases apiece.

Davao City continued to lead as the city with most cases. Other cities rounding up the top five LGUs for the day are – Quezon City, Bacolod City, Dumaguete City and General Santos City.

The OCTA Research Monitoring Report updated for June 20, shows how the various LGUs in the country are performing week-on-week and contributing to the cases of COVID-19 in the country. NCR, the erstwhile epicenter of the country is currently seeing an average of 750 new cases/day. A drop of 11%. It’s ADAR (average daily attack rate) is lower at 5.43/100,000 population as a region.

LGUs seeing significant rises include Davao City (up at 42%), Cebu City (up at 45%), Polomok (up at 32%), and Valencia (Bukidnon, up at 80%). Notice that while Cebu City is seeing higher cases, their health care utilization (beds and ICU) remain significantly low. This is because the cases are from extensive contact tracing done and patients who are positive being isolated early. This, however, is not true for other LGUs where the rise in cases are from symptomatically ill patients.

Health bed utilization is highest in Iloilo City and Polomok (South Cotabato). ICU rates are up in Davao City, Iloilo City, General Santos, Tagum, Polomok (South Cotabato), San Pablo (Laguna), Tuguegarao, Cotabato City, Bacoor (Cavite) and Naga City. As the virus continues to spread throughout the archipelago, it is important for the government to concentrate all efforts on testing – both symptomatic and asymptomatic close contact cases. Vital in the TTIQ-V (Test, Trace, Isolate, Quarantine, Vaccination) algorithm, is the ability to test early (and release results early) so that tracing, isolating and quarantine can be done within a 48-72 hour span. Anything less that this will result in a continued increase in cases. Of course, there are only two ways to bring down the positivity rates – do more testing (100,000/day) or do not test at all. Doing the latter would result in chaos and a breakdown of the healthcare standards of the nation. At this point, as many provinces have very few testing facilities, which result in a very late release of reports, the Health Agency must accept the option of doing rapid antigen tests in patients who are symptomatic as basis for counting and including these patients in the daily data count. When patients are rapid antigen positive, PCR tests should be immediately done, and while waiting for confirmatory results, all contacts of patients who were antigen positive should be quarantined and closely monitored pending the release of the PCR results. Isolation of patients who are antigen positive should also be imposed, similar to patients who are RT-PCR positive. We lose nothing at this point by using these tests because of the outbreak.

The week in review showed how the country continued to plateau in numbers. As of June 19, the Philippines added 44,884 new cases and 889 new deaths for the week of June 13-19. This, as the new cases bounced around the 7,000 average per day for the week and deaths stayed more than 100/day (and considered an underreport).

Testing became challenging as many of the provinces/regions that are seeing rise in cases have limited testing facilities. The Health Agency only counts PCR tested individuals in the daily data. In spite of the 265 accredited testing facilities in the country [https://doh.gov.ph/licensed-covid-19-testing-laboratories], the testing facilities are not enough in areas outside of the NCR and highly urbanized centers (Cebu and Davao, CALABARZON and Central Luzon).

NCR owned 112 of 265 (42.3%) accredited centers in the country but is now seeing only less than 800 new cases per day. Together with the 22 centers in CALABARZON, half the testing centers in the nation are found in these two regions alone.

Compare that with say, Polomok in South Cotabato, Region XII with only 7 testing center – 4 of which are private and 3 public. Two of the testing centers are in Cotabato City, one in Koronadal, two in General Santos City, and two in Sultan Kudarat (both found in Tacurong City). The apparent disequilibrium in testing capacity in the country should be addressed by the government (particularly the IATF and testing czar) as COVID-19 is not a propriety of the urbanized areas alone.

For now, this is how we stand in some select countries in Asia. Many who saw surges have been able to bring down the cases for now. Sadly, our country is still debating the role of face shields in the pandemic.

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