Bealinehx

Perhaps the next wheeze will be a full body length shield for pedestrians.

Raffin

A member of the government here, one not in favour, talked yesterday about the lack of confidence in government policies on Covid and a lack of clarity .These silly rules always come out of the IATF. The technical and scientific guidance comes from various sub groups of experts buried deep in government. I always imagined the IATF to be a small body so quick decisions can be made on a fast moving pandemic, but just look on Wikipedia:

https://en.wikipedia.org/wiki/Inter-...tious_Diseases

There's also an operational task force. Even if only half of them turn up, very unwieldy and filled with busy cabinet members.. So I think no one at these meetings has the guts or even the time to shoot down suggestions like the motorcycle shield, now morphed into the motorcycle helmet policy. Confusing and contradictory statements come out which take several days to clarify.

Our face shields were made in China, though some people must be doing well on their importation I don't think they are in government. They may be their friends,
but the bike shield idea actually came from a politician in IloIlo, a member of the President's party. So I think all this is just what you get with the politics here now.

They're now stuck with this structure but I think It would have been better if they could have had a small health and scientific group which made some public appearances to explain and justify some of their policy recommendations to the public. I don't think the more ridiculous ideas like the shields, or that it's unsafe to have more than 10 at a church mass, would then survive.

Gazza-d

It reminds me of the saying " when god made the Philippines he took 100 million children and sprinkled them over 7000 island saying now run them like a country ".

Raffin

https://philippineslifestyle.com/fla...ust-september/

It's "flattening the curve" time......again!

https://newsinfo.inquirer.net/127039...epidemiologist

Most people just read or hear the headlines, not the caveats. Until they have better data best the forecasters keep quiet. But the government wants to see optimistic headlines.

As of yesterday, with 6 days to go this month, both the numbers of cases and active cases have doubled since August 1. Though in the last 10 days cases have "only" increased by 22%, one of the reasons to say there may be a curve flattening coming soon. But against that in the same period active cases have increased by a much greater 47%.

The idea behind aiming for "flattening the curve" is to make the outbreak more manageable. But given its poor hospital provision, especially in the NCR and surrounding region, the Philippines probably needs to do much more than flatten to manage the inevitable increase in hospital patients from the increased cases.

Especially because of a lack of nurses. A UN report I put up here earlier this month showed a paltry 2 per 10,000 population. By far the worst in SE Asia. The result of years of nurse exports. Some wanted to emigrate but many just wanted better pay, which has never been forthcoming here. Over the last few years the military and police have been favoured with good pay increases.Teachers and nurses left out. The government is trying to improve recruitment, though with little success, and there is even a deployment ban in force for nurses going abroad to work:

https://mb.com.ph/2020/08/25/dole-re...or-600-nurses/

Raffin

Where are the most covid cases in Metro Manila? Looking at city announcements and ABS-CBN news online you would think Manila has the most with 14k,

https://rappler.com/nation/coronavir...august-25-2020

But Rappler reports that from DOH data one of the cities of Metro Manila, Quezon City, is showing double the number of cases...20k not 10k. They say that the QC health department won't accept the DOH's attribution of a case to their city unless they have checked it out. QC say they can't do that using the DOH's online system due to incomplete information and that their direct enquiries don't get anywhere. Lab data is incomplete. That is a common criticism. Thousands of positive lab test results are unattributed to a location.

Obviously no city wants to double their cases, it looks bad. But presumably the DOH has some good reasons to record these cases as from QC? No other city seems to be disputing their cases with the DOH in such a major way. QC is the biggest city in MM, both by area and population. Up to Marcos's time it was the capital, then lost that status to Manila. Maybe that has something to do with QCs attitude?

Noteworthy that ABS-CBN and GMA online news are not reporting the QC data discrepancy.. Both their TV stations are situated in QC. That sort of thing wouldn't happen in somewhere like London!

More meaningful to look at cases per million, as calculated by Rappler:

1. Pateros - 16,212.41
2. Navotas - 15,336.94
3. San Juan - 15,149.78
4. Makati - 11,359.38
5. Pasay - 10,890.18
6. Malabon - 10,505.44
7. Mandaluyong - 10,137.82
8. Taguig - 8,013.27
9. Manila - 7,893.16
10. Parañaque - 7,827.92
11. Muntinlupa - 7,201.06
12. Quezon City - 6,814.10
13. Valenzuela - 6,613.24
14. Pasig - 6,584.138
15. Marikina - 5,175.92
16. Las Piñas - 4,909.20
17. Caloocan - 4,495.

QC is now only middle ranking due to its large population. Pateros is a small municipality with a big covid problem.
San Juan a bit suprising,.. but not Makati...it has many packed, poor areas away from the business towers, hotels and Malls. Including in a panhandle to the East, unknown to many.

For greater detail on covid by location you can look on the GMA covid-19 dashboard:

https://www.gmanetwork.com/news/spec...-19-dashboard/

RedApe

Thanks for the update and analysis. I wonder what the testing protocol is in these areas. Only those who are symptomatic? Are there good contact-testing procedures? Is the testing equally available for those in wealthier vs. less wealthy areas? Does anyone who shows a fever t a restaurant or a mall get tested...or simply told that they cannot enter and go home?


That said, in the USA the CDC has just issued a recommendation that asymptomatic/presymptomatic individuals need not be tested in contact tracing! "Only test those with symptoms" is the new mantra...issued while Fauci was absent, getting surgery in the hospital.

Seems Trump wants those numbers to go down quickly and "testing hurts my numbers". So he's willing to inculcate a third wave (hidden, infectious individuals) to get the infection rate down and his polling numbers up!

Raffin

On testing they are only doing about 30k a day at present in the whole country. In Manila concentrating on certain areas. They say they need to recruit 10k more tracers in Manila and the Testing Czar from Baguio has given a barely passing grade to what they are doing now. We're living in a middle class/wealthy area and haven't had any offers of testing. But unless they change the requirement we will need to get tested through City Hall in a few weeks time to travel out of the NCR.

Seems to be no requirement for businesses to test asymptomatics, but some high ranking govt officials get tested regularly.

Our local Puregold Jr. has recently erected a small isolation tent outside.

I don't think there's any Trump like pressure to reduce testing here. Other reasons why not enough is being done. But maybe some pressure was put on the DOH to maximize recovery numbers.

Gazza-d

The only testing I'm aware of is OFWs coming in and going out. Perhaps that is largely the extent of it.

RedApe

The funny thing about testing - as Trump says..."your numbers of infected go up'...but the Mortality rate will inevitably go down as the folks you identify are unlikely to be severe cases. And if you identify and hospitalize (or simply quarantine if they are ambulatory and asymptomatic), until the patient tests negative, and release...you can embellish your "recovery rates". If you are only testing the seriously ill your mortality rates will shoot upward, You can't have it both ways.

I know that lesser developed countries will simply not have the testing capacity to deal with a full fledged outbreak. It's not just the number of tracers. It's having sufficient reagents, lab personnel and test kits that actually work.

That said, I'm in favor of as much testing as is possible in a fairly dispersed (and non-privileged) manner. That's the only way you'll have any idea of where the actual hotspots and risk groups are. If the wealthy areas or a particular island are at low risk and Covid-free (after sufficient testing) there's no need to allocate a lot of resources to those areas.You stop the fire at the source, you don't park the firetruck outside the Governor's mansion.

Raffin

The Philippines, like a non league team reaching the later stages of the FA Cup.

Hopefully temporary. The figure here yesterday was higher than the 7 day average of about 4k. And many countries are obviously covering up on their covid data and may deserve more to be in the top ten.

Really better in the long term for a country to find out the extent of the problem and treat those found positive. But politicians are often not interested in the long term. Let's see how the testing goes here. It's been averaging about 33k a day up to recently, but has mysteriously declined over the last three days. Despite increases in the number of labs and promises to increase it.





The second straight day reported Philippine deaths were close to 100. Though the seven day moving average is lower at 49 per day. Difficult to see the trend as most of those reported dead yesterday were lagged deaths from many weeks ago. Late reporting again in common with other covid data here. But as of yesterday as many as 1367 patients were reported in a severe or critical condition so daily deaths will likely continue at least at the recent elevated avearge level with spikes due to late reports.

Whether the Philippines is in an international covid "top ten" or close to it perceptions of the country relative to its neighbours among tourists and investors will be adversely affected. Also by the reports of all the corruption linked to the outbreak here.

Bealinehx

Raffin,
As always your persistence in providing accurate information is greatly appreciated.
It makes a change from the daily dose of drivel the general population is exposed to
There is no curve to flatten as the accuracy of daily recording is haphazard at best and criminal at worst
Keep safe one and all

Raffin

Thank you!
Yes, you have got to be confident in the curve before you talk of flattening it or much else.
In the UK they have the expertise, better data collection, the NHS, ONS etc:

https://www.bbc.com/news/health-53949080

So they have a good idea what's happening in England. Here a reduced and mainly uncritical media can see graphs like these from the most recent DOH data:






The blue and yellow lines show 7 day moving averages which smooth out the highly variable daily data.....ok.....but they also include the significant backlogs, most to July but sometimes stretching back as far as March and April. So the curves you see are always lower in the past and higher now than they really should be. But if you think that the virus is out of control then you should also assume the recent figures are also underestimated! From looking at other data, especially on testing. Also from other research on the extent of under-reporting.

In addition to backlogs there is constant "data cleaning" going on eg recoveries changed to deaths and vice versa.

The DOH also puts out data on time of onset of disease. Using that with knowledge on the time to show symptoms after being infected they could produce a much more accurate curve.

But even if they do that it's too late. Decisions have already been taken from the picture shown by the basic curve. Palace spokesman and some experts have even sometimes used the numbers to threaten.

Anyway, my impression is those in charge here have adopted Trump's "It is what it is" attitude and seem happy to wait for a vaccine to solve the problem. Although cases are high compared to some other SE Asian countries they're not on a par with the US or Europe. Deaths are low. A public just trying to survive, no election soon, uncritical media and plenty of major distracting issues. I can't see an enquiry ever being held into the handling of the outbreak here.

As an example of this attitude here is what the DOH Under Secretary says about the long term effects of covid. Important as every so often many cases here are taken off the active list and trumpeted as recoveries:

https://newsinfo.inquirer.net/132847...vered-patients

No evidence? I don't think they are seriously looking. This article sets out well what is known so far:

https://www.itv.com/news/2020-08-12/...-for-sufferers

Raffin

The recent trends of a constant level of new cases and deaths continued yesterday.

The epicentre of Manila contributed 56% and Calabarzon (the 4 industrialized provinces near Manila) 17%.of new cases. A backlog of 18% included up to mid August.

While cases are constant the NCR labs daily positivity rate is 14.8%. Up from 14.3% yesterday. Meaning that more testing will likely continue to find many new cases.

Deaths in the NCR and Calabarzon were at 68 out of 94 nationwide. Ten of those go back to July! Deaths at the current level are the result of the surge from re-opening in July. With over 1,400 patients now severe or critical deaths at this level are unfortunately likely to continue for some time, with a small moderating effect from the 2 week MECQ in early August being seen next month.

Some Mayors in the NCR are showing the way. This article shows what Paranaque City is doing on quarantine facilities:

https://manilastandardtoday.com/news...acilities.html

Paranaque announced 119 more confirmed cases yesterday on top of about 5,700 already. Its covid incidence per 100,000 population is mid table for the cities in MM.
The City say their existing 8 isolation facilities are close to capacity. The containers will add about 150 patients. They seem to be pushing through with testing so those may also be full fairly soon. So it's good the government is converting the nearby Nayong Pilipino site for isolation. If you were here in the 1970s, 80s or 90s you may remember that tourist attraction.

Raffin

Another week has passed. A slight improvement in confirmed cases. Average down by about 500 a day on the previous week. But there was a drop in testing on some days. Resulting in a slight drop in the weekly growth rate. Deaths last week now at 70/day up from 52 in the previous week. Th Philippines is now one of 31 countries being monitored on deaths, along with S Korea, Japan and Indonesia in Asia.

R estimated at 0.95 compared to 1.05 the previous week. Not significant given that the positivity rate yesterday for the country was at 11.2% with Manila at 14.5%.

A good chart with a log scale to make some E Asian comparisons:



Recent upturns in Singapore and Japan seem to be reversed, not yet in S Korea. Some doubts about Japan as they have only done about 1.5m tests (Philippines now at 2.4m).
Both the Philippines and Indonesia on an upward trend and for both it is probably much worse due to under reporting.

Sunday is recovery adjustment day for the DOH and over 22,000 active cases were deemed to have recovered. The DOH insist they are following WHO guidelines:

https://rappler.com/newsbreak/explai...rus-recoveries

But they are getting out of following up dumped cases with further testing, using the Philippines status as a developing country. Also some doctors here may not be averse to signing off people they already know or can be influenced by.

jaygee68

Hi Raffin,and thanks for your ongoing efforts.

Myself and a friend have been talking about the global Covid -19 situation in terms of a league table for some time now.Both of us certainly never had the Philippines as "non-league" also rans.With a population of over 100,000,000 people,many of whom are living in densely populated urban areas,the Filis was always going to be a "force to be reckoned with" in the league table.Of course we also factored in mind what type of guy is running the country (a guy cut from the same cloth as Trump and Bolsonaro).If anything,i am surprised by the relatively small official number of deaths in the country,but,sadly we all know that it's still "early days" as they say,in any football season,and things could easily get much worse.I think if any country can be described as being "non-league" over achievers,it has to be Peru.

PS,Are the USA going to run away with the title,or could India still catch them??

Cheers.