Raffin

I think the demand from people needing travel permits and for employment etc can only add up to a few thousand a day. The rest of the demand to bring the number up to 20 to 40,000 a day must surely come from people found suspect by their LGU health units and it must be either free or heavily subsidised given the income levels of those tending to catch the virus here and the fact that a number of tests are needed during treatment. There was a statement back in March that Philhealth is offering various covid packages for members.

The DOH minister also said this in March:
https://cnnphilippines.com/news/2020...ing-free-.html

Raffin

Yesterday just over 2k cases nationally with only 557 from the NCR. Cases from Calabarzon (region 4A) were for once more at 583. Even when adjusted for backlogs - which were significant with NCR at 77% recent and 4A at 81% recent - 4A had 41 more cases than the NCR. There were 20 labs out of the now 141 Testing Centers not reporting.

For total cases yesterday we have NCR 27% of the total and 4A 28%. For recent cases 25% and 27%. So both together yesterday making up the majority of national cases, but not by much. The epicenter of Manila about a quarter. Following an established trend where Manila cases are declining but cases around Manila are making up some of that. Region 4A is the largest region in the country in terms of population. Also yesterday the latest positivity data shows NCR for once below the national rate, 7.1 compared to 8.3 nationally.

However, the latest testing numbers for two days ago still show a decline at 27.6k individuals. The average over the last 7 days at 34k, down from a peak last month over 40k.It's looking like the DOH are satisfied with announcing around 2k new cases a day whereas they were not when daily figures were 3K or 4k plus. And the media too. They were making headlines at 3k and 4k but are not now about current levels.

The number of labs have increased by about 40 over the last month. So strange that test numbers have declined when positivity is still well over WHO recommended levels and the tracking/tracing performance still patchy Not detecting more cases now means more strain on hospitals in the future and a longer lasting outbreak. Not forgetting the personal toll on people not detected sooner. It could just be the cost or the misplaced idea that a vaccine will come to the rescue soon and perhaps the latest polling data showing over 90% of people seemingly satisfied with the government's handling of the pandemic has also played into this.

Deaths at 25 yesterday nationally, with 9 from the NCR and 6 from Calabarzon.
Another eight previous recoveries now reported as deaths!
Now 1,620 on the critical list, 28 less than yesterday.

Raffin

With 12 labs of the 140 not reporting and 21% of the reports not recent infections t he national total was under 3,000 again, at 2,825. The latest testing data showed a slight increase, but was still under 30k a day two days ago.

The backlog was worst in the NCR...at 28% giving 746 recent cases. Region 4A had a 22% backlog with recent cases closely following at 627.
So the NCR had 33% of national recent cases and 4A 28%. So the two regions made up 61% of total recent cases.

Deaths back up at 60...23 from the NCR with 16 of those late reported back to July. Region 4A had 12 with 10 of those reported late back to July.
Yesterday 1,650 on the critical list...30 more than yesterday.

For what it's worth here is the latest 7 day average national case chart. Looks encouraging but needs to be viewed with lower testing and significant late reporting in mind:


In the headline international total cases league table, the Philippines at just under 330k is in 19th position and still over 4k cases from catching Italy as the former world epicentre is experiencing a second wave. Turkey, in 20th position is only 500 cases behind the Philippines and should really be in front as it has admitted to not be reporting asymptomatic cases. Yesterday here the DOH reported just under 10% of our cases asymptomatic. Other estimates vary eg the US CDC back in July estimated 40%:could be

https://www.foxnews.com/science/cdc-...s-asymptomatic

Raffin

Just about every day a surprise from the DOH. But yesterday two. On new cases we have the normal 2k plus..2,363 and although the latest number of individuals tested shows a rise of nearly 2k it is still under 30k and lower than September's levels of around 33k a day. But yesterday no indication as to how many of the 142 labs reported! Did many not report? Twelve did not the day before yesterday. Is all well with the relationship of labs with the DOH after their difficulties last month?

NCR cases at 734 with 86% recent. Region 4A cases were 419 but with only 62% recent!

Then deaths. Yesterday 144 reported nationally! First of all we must sadly note again there were past "recoveries" which have now been found to have really been deaths! 48!
Linked to that,97 of the national total occurred from September back. The NCR had 96 with 80 back from September, 4A 14 with 3 back from September.

It seems that a big validation effort was completed yesterday and the result was a large daily deaths total which will unfortunately get publicity worldwide.

Obviously these past deaths are the result of large scale under reporting and miss-reporting of cases a few months ago combined with a low average quality of hospital care.

On the critical list yesterday 54 less patients. The greater number of critical than severe covid patients always seen in the hospital data here says a lot about the treatment standard.

Below the latest DOH chart showing NCR cases by date of illness onset: Much better to see what is happening than the standard presentation based on daily announced cases.
The trend line is of announced daily cases. Clearly showing a sharp decline lately, although this is probably exaggerated due to lower testing levels:



...and for Region 4A....showing less of decline...



Deaths by the week in the NCR looking worse back in August:





Deaths by the week in region 4A were also peaking in the second half of August:




Last, deaths in the Central Visayas region peaked in earky July:



But more late reporting might still change the deaths picture!

In the international league table rather than Italy we may well overtake Saudi Arabia in the near future if they continue to report low new case numbers:

Raffin

Whether by design or luck the DOH can tout another day of new cases under 3k. There were 2,996. Although the NCR was over 1k at 1,094 and region 4A not far behind at 806.
But for recent cases the figures in the two regions with the highest cases were 980 and 621 amounting to 63% of national recent cases.

Caveats: 12 labs did not report and the latest daily testing figure is just under 30k...so it wouldn't take much more testing to go well over 3k national total and recent cases. Especially as the latest positivity both nationally and in the NCR is up at 9.4%.

National deaths at 83 with 50 late reported going back from September. Critical list 1,600.
Can't give more detail on deaths as the DOH site down this morning.

Recently I have been saying that the standard of care in hospitals here must be poor given the increasing case fatality rate. But from this news report it seems over half of covid deaths were not admitted into hospitals! About three quarters of critical patients are not in hospital!

So no wonder deaths are at a high level in this young country and that the numbers listed as critical day after day are always much more than those in a severe condition! It also helps to explain the late reporting.as many people are obviously dying at home.

https://www.gmanetwork.com/news/news...story/?just_in

Raffin

Yesterday new cases again under 3k at 2,249 although 17 labs did not report. Latest testing figure at 33.5k. Better. Also a plus in terms of the future trend is that there was late reporting, especially in the NCR where only 84% of new cases were recent.

So yesterday the NCR had just 549 cases and region 4A 446. The two together contributed an unusually low 51% of total new infections.
Region 6 (W Visayas) had 259 recent infections.

Total deaths at 87, bringing the widely looked at Philippines case fatality rate up to 1.85% It can only get higher if so many of those seriously ill are not in hospital until their condition becomes irreversible (see my post yesterday).

NCR deaths were 28 with late reported from September and before at 25! Region 4A had 15 with 9 of them late reported. Linked to this late reporting is that 34 cases previously classed as recoveries are now deaths!

There were 16 deaths from W Visayas.
National critical list lower at 1,583.

These DOH charts show deaths and a trend line for each of the Visayas regions:


Western Visayas


Central Visayas


Eastern Visayas


Central Visayas with Cebu City and adjoining urban areas has by far the most infections..over 22k and deaths over 1,200. The highest death rate at 6%. but with a well established downward trend. Western Visayas including the cities of Bacolod ,Ilo Ilo and Roxas comes next with nearly 14k infections , over 300 deaths but a low death rate of about 2%. The Eastern Visayas (region 8) has only one large city..Tacloban...and the lowest number of infections at just over 5k to date and 95 deaths. In both Western and Eastern Visayas there are signs of a recent downward trend in deaths.

The outbreaks in Central and Eastern Visayas both show well established recent downward trends. But in the Western Visayas a downward trend in new infections is not fully established:


W Visayas

Raffin

Again under, well under 3k cases announced. But 15 labs not reporting and latest testing at 32.7k still too low. Positivity is falling but still well above recommended level of 5% for 2 weeks, when testing can be reduced. It is also possible that testing is avoiding areas of case growth away from Manila and surrounding area.


NCR 650 recent cases, Region 4A 492. There were 2,106 recent cases nationally so the NCR was 31% and 4A 23% of the total. Overall the two regions 54%.
Central Luzon was the third highest area yesterday with 203 recent cases.

Deaths were at 83 nationally with 39 NCR and 17 in 4A. NCR had 30 late reported and 4A had 8 late reported.
W Visayas had 10 deaths.
Linked to this there were again many recoveries reclassified as deaths.....41!

Adjusting for recoveries (as it was a Sunday there were many...17k+...announced) and deaths the number of active cases fell to under 40k...39,945. from 43,642 last Sunday. A welcome low figure, but the increases in deaths helped.
Yesterday 1,558 were critical...25 less than the day before.

Some improvement can be seen in new cases growth in the NCR and to a lesser extent in Region 4A:

NCR:



Region 4A:



The Philippines now 18th in the total cases table, and likely to stay there for some time, unless overtaken by Indonesia:

Raffin

The national total yesterday at 3,564 new cases......with 13 labs not reporting and the individual test number from 2 days ago at a low 26.1k. Could easily be 4k cases if testing had been at the previous day's level of about 32k.

In terms of recent cases NCR was 1,163 and 4A at 786. So Manila plus surrounding area back up at over 60% of total national recent cases.
Also Region 6 had 347 cases.

Just one day's figures but we should not be too quick to assume the improvement in Manila is established.
A computation I have done of seven day moving averages of recent cases since the start of October do not yet show an established downward trend for both the NCR and region 4A.

Deaths 11, nationally with 3 from Calabarzon.
Critical 1,560.

The experts are using a new metric, the "daily attack rate" which looks at recent cases in relation to population to assess potential hotspots.
Notice also they are optimistic about Manila....butt wrongly focus on total cases not recent cases, And then there are yesterday's increased figure.

https://www.gmanetwork.com/news/news...story/?just_in

Raffin

After 3.5k on the 12th yesterday's tally only 2k, but with 17 labs not reporting as against 13 the day before. And the most recent testing number of individuals down to 24k. So the number of cases would be lower.

In the NCR 510 recent cases and Region 4A 473. The two areas yesterday contributing only 54% of national recent cases.
Other areas with high numbers of recent cases were Central Luzon and W Visayas with 143 and 156.cases, N Mindanao reported 158.

While the number of new cases in the NCR and Region 4A is not now rising and the latest NCR daily positivity was at 6%, compared to nationally 7%, it seems reasonable to expect less of a testing effort there. But the testing effort needs to be spread more widely to areas where there is growth in cases and hospital facilities are going to struggle. NCR cities have developed their testing over 7 months to cope with the densely populated area being an epicenter and so it will take time for LGUs in the Provinces to expand their testing effort.

These three charts show the case growth in three areas of Mindanao:


Northern Mindanao


Zamboanga Peninsular


Davao Region

Deaths nationally at 40, but 22 of those late reported from before this month.
Region 4A 10, with a backlog of 7. NCR 3 and W Visayas 13, the latter late reporting 12 of these!
Linked to this the DOH say there are 11 recoveries which are now deaths!

Fewer on the critical list compared to the day before, now 1,529 patients.

Raffin

Just under 2k cases added yesterday with 86% of them recent and 11 labs not reporting. Latest daily test number better....up to 31k.
NCR 564 recent cases, Region 4A 398.
Late reporting in 4A contributed 25% of cases and 115 of its cases, 29%, came from September alone. Nationally 207 cases, 11%, were from September.
As there were 1,639 recent cases nationwide the NCR plus 4A accounted for 59% of total recent cases.

There were 78 deaths nationally with 14 late reported. DOH did not release a case report yesterday where the regional breakdown could be seen.
Past recoveries which turned out to be deaths were at 17!

The country's case fatality rate has risen to just under 1.9% placing us in 95th place out of 178 countries. World average at 2.9%.

Critical were 1,526 patients.

Looks like the Philippines will soon be overtaken by Indonesia:


But the Philippines has surpassed Indonesia in deaths per million recently. One month ago we had 33 per million, but now we are at 59. Indonesia has risen just a little from 43 to 44.

Raffin

Well over 2k cases yesterday at 2,261 with 86% recent and 14 labs not reporting. Latest testing number again at 31k.
For the NCR 456 recent cases only as 81% only were recent ones. Region 4A has 398.

The last 3 seven day moving averages for the NCR recent cases going back: 696,736,761
For Region 4A: 516,459,552

So the latest mini trend for the NCR is a falling one, after a changeable series at the start of the month.
No falling trend for Region 4A.. Between 507 and 552 going further back in October.

Latest national reproduction number is 1.04.
Reflecting the increased national virus spread. Testing may not be able to keep up and this dispute between the Philippine Red Cross and Philhealth will not help. CNN Phil say the Red Cross have done over a quarter of testing here:

https://www.cnnphilippines.com/news/...ealth-OFW.html


Deaths at 50 nationwide with 14 from the NCR and 12 from 4A.
Late reported were 8 from the NCR and 4 from 4A.
Now 1,537 critical.

On the international front the second wave in Europe has now affected Germany and as forecast yesterday Indonesia has surpassed the Philippines. With the result we are now at 20th position:



Likely to stay there for a while, unless Turkey has a second wave and resumes counting its cases properly. At present it has only a slight upward trend. From July it has not included asymptomatic cases.

Raffin

Back to Covid!

Yesterday the headline 3k plus new national cases announced...but read the small print and see that only 2,023 (64%) were from the last two weeks! A third were from September.
Testing steady at 31k most recently and 15 labs not reporting.

NCR recent cases 621 which were 62% of the total there. Region 4A had 72%, recent, 479 cases. So many months old cases in the NCR especially but also elsewhere still being found!

Recent cases for other regions were W Visayas at 214, Central Luzon at 146 and Central Visayas at 102.

Below see the latest DOH weekly new cases graphs for the NCR and Calabarzon.
Look at the bars for recent cases rather than the trend line, which is for total cases.


NCR


Region 4A

They show a pronounced downward trend for the NCR and a shallow less definite one for Region 4A over previous weeks from August.
Looking at recent trends this month only my 7 day recent cases moving averages for October show a similar picture. For the NCR the last three going back are 645,696 and 736. But for Calabarzon going back 496,516 and 459.

There were 34 deaths. Half of them reported were from September and back. Unusually none from the NCR and 2 from Region 4A, which were both late reported from July. The CARAGA region in NE Mindanao reported 7. We should expect deaths from Provincial areas to increase as infections have spread nationally over the last few months:


CARAGA region.


As usual, some of the deaths were previous recoveries. Yesterday 8!

A drop in the critical list of 26 to 1,511.

Raffin

Nationally 2,286 cases with 14 labs not reporting and latest testing number down at only 23.8k.
NCR had 646 recent cases and Region 4A 603. That was 87 and 88% of their total cases. The two made up 55% of national recent cases,
Region 3 (Central Luzon) was next with 267 total cases but 213 recent, so 80% recent only.
Taking into account the lower testing recent cases nationally continue to be high and the reductions seen in Manila are being offset by the Provinces.

Deaths nationally at 73 with 25 back from September. NCR 32 with 17 back from September. Region 4A with 10 and 3 of those late reported.
The DOH chart shows the wide distribution nationally of recent deaths. For the NCR it is relevant to note that again past recoveries are now deaths..14 of them!



Critical now 9 more at 1,520.

Deaths in the NCR now on a long term downward trend:



Region 4A showing the start of a downward trend:




But for Zamboanga Peninsular an upward trend:

Raffin

Yesterday saw 2,379 newly announced cases but only a very low 1,580 of those were recent. There were 14 labs not reporting. The most recent test number went up about 2k to over 26k.
Regionally NCR had only 52% recent at 444. Region 4A 74% at 317. Region 3 (Central Luzon) 56% at 181.

No explanation from the DOH but this must be connected with the dispute between the Philippine Red Cross and Philhealth, as a major group of labs have stopped tests.
So from Manila labs many fewer tests were done, But as usual old results, mostly from September but even all the way back back to March, were submitted.

So not much can be said due to the lack of the latest tests results.

Deaths nationally at 50 with late reported 32 back from September.! There were 31 from the NCR, 7 from Central Luzon, 5 from Calabarzon, 2 from Western Visayas and 5 from Mindanao, Of the total deaths 11 were originally recoveries!

Sunday was another mass recovery day and just under 15k announced.
So active cases were at 39,808. Last Sunday they were at 39,945...so no improvement with the latest national reproduction number estimate over 1 at 1.04.

Region 3 (Central Luzon) has a population of about 14m, 3m or so less than Region 4A and it is more agricultural and less industrial than Calabarzon.
But like Calabarzon it is also closely linked with Manila and Bulacan province adjoins the NCR. It is in fourth position for total cases after the NCR, Region 4A and Central Visayas, with over 20k.
From these DOH charts you can see new infections rose steadily in July and August, though turning downward recently. Deaths rising steeply in August and September, but started to fall earlier this month. As usual look at the bars not the trend line for both recent cases and deaths.
Interesting to note the bump in deaths in March and April given the low infection rate. Maybe imported patients.





Internationally the Philippines is firmly placed in 20th position for total cases.
But we have also been slowly advancing up the case fatality table to 93rd place out of 178 countries, so that we are now getting close to a European Country......Denmark:



It has been announced that although dropped for bikers in general the ridiculous barriers are still needed for motorcycle taxis!

https://www.gmanetwork.com/news/news...-helmet/story/

Bealinehx

I always thought that Ukraine is a European country!