Raffin

An instalment of 382 today.

Raffin

Cases today come from the previous weekend testing and it was an Easter weekend, even so 9,373 cases reported and 10 labs not reporting. Positivity at 19.9% and a backlog of nearly 4k past results included. A modest 31.4k tests on the way.

Death numbers have been constipated for some time and a lot were finally expelled all together yesterday. I think many did not die in primary hospitals, they couldn't get in them. So reporting slowed up. The obviously slow, error prone reporting system here for deaths, shown since the start of the pandemic also played a large part in explaining what the DOH yesterday called a "technical issue". All the more serious as the Philippine's death record is a poor one.

Deaths 382 with 166 of them RDs.

For primary hospitals 763 severe, down 99. Critical up 44 to also 763. ??

Location detail:


Bicol 18, OFW 16, E Visayas 15, other Mindanao 34









Regionally: NCR with 3,768 cases at a much lower 40% of national cases. Regions 4A, Cagayan Valley, Central Luzon and the CAR all had higher cases. Ilocos region seems to be displacing Central Visayas in 6th position. It also had more cases. The irony is that the DOH is trying to get health workers from Ilocos and other N Luzon regions to help in the NCR bubble.
The NCR+ bubble contributed nearly 57% of total cases, 6% less than yesterday. Whereas the top 6 regions had 91% of total cases, about the same as the day before.
The NCR had a lower 13 of its cities in the top 20.
OCTA group estimate the NCR R at 1.53, down from 1.88. But the effect of falls in R on future case growth there is unclear to the DOH:

https://news.abs-cbn.com/video/news/...not-slowed-dow



Ilocos Region

For the NCR cities 10 had modest increases and 4 with falls...QC, Pasig, Taguig and Pateros. QC still reported 906 cases. Notable increase in Muntinlupa City of 40% on the day before.

Regionally bubble provinces Bulacan, Cavite, Laguna and Rizal all had more cases. So did Pampanga. La Union also had more than the day before with 354 cases. Batangas had less.
A look at the top 10 table shows the increasing presence of N Luzon provinces with Isabela leading, La Union, Pampanga at 6th and 8th positions. Cagayan, Benguet and Mountain Province were also in the top 10.

Baguio City was at a higher 158 in 8th position, Santiago City in Isabela at 178 at 9th.
Cebu City again lower at 58.
Davao City at 56.
Both out of the top 20 urban areas.

Variant news:

https://news.abs-cbn.com/video/news/...ent-of-samples

More evidence of the likelihood of community spread in certain areas.

Vaccine news:

https://news.abs-cbn.com/news/04/06/...-covid-19-jabs

https://news.abs-cbn.com/news/04/06/...ne-cooperation

Chinese vaccine supplies are assured as it is obvious the Philippines leader will continue to kow tow over Chinese bullying.

Treatments:

https://www.gmanetwork.com/news/news..._picks&order=2



Dr John has reported a great deal on Ivermectin. What Sen Defensor is coming up against here is similar to the responses in the UK.
This is the short precis video on DR Lawrie's report on Ivermectin, from 4 weeks ago.
She even says the case for using it is so strong it would be unethical to go ahead with a randomized controlled trial, where some would just get the placebo.

Raffin

Not so Jolly here....the only Jolibee in Tagaytay closed to both dine in and take out, only drive in operating. In line with all other restos in Tagaytay, closed even for take out.
Tagaytay had only 36 new cases in the last week.
Our local fresh market needs a pass, one person per household, with each area restricted to certain days. It's well outside the town of Alfonso, which had only 29 cases last week.
Another local market town, Mendez, is restricting entry at a checkpoint.. It had just 7 new cases in the last week.
Further away there are places near Tagaytay with more genuine concerns eg Amadeo with 63 cases last week and Silang had 89 cases last week.
In terms of population Tagaytay has 80k, but is not densely populated. Silang has 200k population over a big area, but the poblacion is maybe only 50k.
Amadeo has only 40k. Alfonso 50k and Mendez 30k population.

Gazza-d

Herd immunity at 70% is a bit of wishful thinkings. Figures I've see puts it more like 85% giving the current VOCs.

Raffin

Wikipedia gives it as 60-75% from two papers published last year. I don't know whether they allowed in their estimates for the variants, which can be given more freedom to emerge by vaccination and for the refusal to be vaccinated,/mask wear. Those who see that as a loss of freedom, a government control measure, seem to be remarkably unable to be reasoned with and you wonder if some US states can get there.

Raffin

Again low case numbers at 6,414, 5 labs did not report. The reason is still lower testing over Easter. Positivity slightly lower at 18.2%. For the first time in a while no backlog included, indeed nearly 400 cases being kept for later reporting for some reason. Good to see a much higher number of individual tests on the way at 46k.

Deaths splurge again at 242 with 133 of them the infamous RDs.
Philippines case fatality rate rises to 1.72%. It will eventually rise a lot more, probably to well over 2%, when the case growth falls off.

Severe and Critical reports both up 31 to make both 794 patients.
NCR at 79 and 70% for ICU and Isolation beds.

Some location detail:

All regions down significantly and a very big drop in reports from the CAR from the day before.
NCR at 50% of the national tally.
The NCR+ bubble at 72% was a much bigger contribution compared to the day before.
The top 6 regions, which again included Ilocos and not the CAR, gave again well over 90% of national cases. Central Visayas in sixth place had only 100 cases.

For NCR cities 11 fell significantly. The big falls were in Mandaluyong, Manila, Marikina, Muntinlupa, Pasig and QC, the latter had 367 less cases than the day before. Manila had 155 less. Navotas, Valenzuala and Taguig had many more cases, the latter having 125 more.

Provincially only Batangas stood out as having a lot more cases, otherwise in region 4A Cavite and Laguna had about the same, Rizal had less. The other Bubble province Bulacan had nearly 150 cases less. In the North and outside Bulacan, La Union had over 300 less and Pampanga 73 less cases.

For other cities Baguio had a very low report of 3.
Cebu City with only 27.
Davao City only 11.
Santiago City in Isabela reported 71 less at 107.



An OCTA update on the provincial situation. Cebu the only bright spot with a very bad situation in all Bubble areas except Laguna and also outside in Batangas, Benguet, Pampanga and Isabela.

For cities OCTA look at new cases 1 week growth rate and the attack rate per 100k:
The hospital figures are all bad when you also read about the lack of staff. The WHO talking about the Philippines health system near a "red line".
So I just picked out cities with a combination of high case growth and attack rate:

QC 23% and 37 per 100k
Pasig 13 and 45
Valenzuala 16 and 26
Muntinlupa 48 and 30
Dasmarinas 42 and 14
Malabon 19 and 37
Baguio 29 and 31

Note: whereas in the UK many attack rates per 100k are still over 50 and of concern, here it seems it is 30 and over.

The AZ vaccine in the news over blood clots, a very rare side effect. Netherlands, Germany and Sweden are not giving it to under 30 year olds, but the UK does still recommend it for the majority of them. There's a lot on this on the BBC news site. Liked this graphic , which puts it into perspective:

Raffin

Thought some of you might be interested in seeing what the in excess of 600 Philippine deaths last 2 days have done to the latest DOH by date of death chart:
(ignore trend line)


Also you may like to watch the latest Dr John video with Dr Lawrie, which explains clearly why the WHO are not recommending Ivermectin as a covid treatment despite the good results from her meta-analysis:

Raffin

Getting back to normal with testing and results with another 9,216 cases, 5 labs did not report. A smaller backlog included of 902. Positivity from 40k tests at a higher 20.8%. Tests on the way at a much higher 49.6k.
60 more deaths and 28 of them RDs.

Active cases are now well over 167k, 20% of total cases, one of the higher world figures.
Severe and Critical both up 42 so both categories reach 836 ????
NCR ICU beds at 81%. of capacity.

Location detail:


Plus MIM 51, Unknown 45, OFW 21, other Mindanao 21








Regionally: NCR cases back up by a third to 47% of the national total. Region 4A up by 376 cases. The NCR bubble gave 71% of national cases.
All the top regions from yesterday were up with the exception of Ilocos.
The top 6 regions contributed nearly 90% of national cases, whereas yesterday over 92%. Zamboanga Pen, E Visayas and Bicol all showing more cases than usually recently.

In the NCR there were big rises in cases for Caloocan, Manila and QC, all adding 200 or over cases on the day. Makati, Mandaluyong, Marikina, Pasig and Pateros also had significant case rises. Navotas cases fell by over 100 compared to the day before. Pasay has cooled off after its surge last month with cases now only in the 100s, 132 yesterday and 119 the day before.
The NCR cities occupied 14 of the top 20 urban area places.

In the provinces case Cavite led the case reports with nearly 400 more on the day.. Bulacan had nearly 200 more and Rizal over 150 more compared to the day before. Pampanga 100 more.
Isabela Province led the table on April 6 with over 600 cases, 2 days later its daily total is still high but down at 349.

Baguio City with a higher 130
Cebu City still lower than last month but up at 88
Davao City 26
City of Santiago, Isabela down at 49

So although the focus is on the NCR+ bubble area considerable case growth is being seen in other areas of N Luzon and there are also rises in Batangas, Quezon Province and parts of the Visayas, Bicol and Mindanao.

https://news.abs-cbn.com/news/04/08/...ailalim-sa-gcq


Quezon Province


Bicol

https://www.msn.com/en-ph/news/natio...g?ocid=BingHPC

Good they are doing that to prepare for the worsening economic situation. There's a lot of spending here which could be re-allocated.

Philippines internationally close to overtaking Israel:

Raffin

Case numbers now somewhere around what you would expect with current testing and positivity levels, although results are still behind tests with a 3,744 backlog.
Total announced 12,225 and a higher than lately 10 labs did not report. Tests coming along at 49.6k. much better but even more are recommended by most observers. Rapid tests are to be greatly increased but PCR tests will be needed to confirm cases still.

Media attention has been somewhat away from cases over the last few days due to the high number of deaths announced.
Deaths yesterday 401 and 213 of them were RDs.
I had a quick look at the charts to try to see where the latest tranche of 400 came from in terms of date. The great majority seem to be from the last two months, just a few going back to January. As usual no questions from the media and no explanation from the DOH on the RDs. Apart from these numbers coming out later than they should recoveries over the past two months or so have been over 1k less than advertised.
As for the numbers of deaths it is just showing up even more the poor state of primary care here. Last year it was found that only a minority of patients who died had made it to hospital, many of them getting there too late anyway. The improved covid treatments that in many other countries are improving outcomes cannot help those who end up in small infirmaries and the like.

Active cases now at 178,351.
In Primary hospitals in a Severe condition 892, up 56 and 713 reported Critical, down 123.

Some location details:

The top 6 regions:

NCR 5,689
4A 2,479
C Luzon 1,321
Cag V 591
C Visayas 400
W Visayas 375

NCR 46.5% of cases, down a little.
The NCR+ bubble area: 68%, again down a little
The top 6 also down a little on the day before.

Out of the top 6 regions CAR, Ilocos and Bicol were all up on the day before. N Mindanao and Davao regions also reported more cases.

In the NCR Caloocan, Las Pinas, Makati, Malabon, Mandaluyong, Manila, Muntinlupa, Navotas, Paranaque, San Juan, Pasay and QC all reported significantly more cases. The greatest increases were in QC, with nearly 400 more, followed by Caloocan, Las Pinas, Malabon and San Juan, the latter having over 200 more. It has the second smallest population in the 17 NCR cities.
Taguig was about the same.
Marikina, Pasig and Pateros reported less.

Provincially most showed moderate increases, except Bulacan which added more than 200 more cases compared to the day before. Cavite added 63 more. La Union 100 more.

Baguio City added nearly the same as the day before, 129.
In the Central Visayas the 3 main Cebu cities added 201 cases, half of the region's cases.
Davao City higher at 47 added.
Santaigo City, Isabela also higher with 68 added.

Latest OCTA update:


Although it has picked up in the last couple of days.



For recent case growth BARMM leads with 131%, then CAR 113 and Ilocos 119.
CARAGA, Cagayan, Bicol, W Visayas and Zamboanga all showing moderate recent growth.
Central Visayas and Davao showing substantial decreases.





For the top urban areas, all but 5 from the NCR, there are 8 NCR cities showing negative growth and 6 showing moderate growth increases. I would also include Bacoor City in Cavite. Muntinlupa City is showing high weekly growth at 68%. As are Baguio City and Santiago City.

But this was the Easter week so we await future OCTA reports covering periods of lockdown only, no holidays, to see a more reliable picture especially as testing increases after the Easter falls.

Raffin

Yesterday 12,674 more cases, only 3 labs not reporting. Second highest ever. Positivity at 20.7%, Includes a backlog of well over 4k cases. Nearly 41k individuals were tested and 51k tests are coming along.

A large backlog of deaths figure again:

Deaths 225 including 49 RDs.

The DOH have been forced to do some explaining.
They gave detail on April 9's 401 deaths:

Last year 13
January 7
February 45
March 287
April 49

So it seems that most of these deaths are from a few weeks agp. An improvement on 2020 when many more were from several months back.

Regarding location for March and April deaths nearly half, 46%, were from Central Luzon!
Region 4A gave 23%, NCR 13% and Central Visayas 10%. About 8% from the rest of the country.

Such a large proportion especially from Central Luzon and also from Region 4A, relative to that from the NCR. Reflecting the provision and standard of health facilities?
Maybe , but the latest Central Luzon hospital data shows 77.5% ICU bed occupancy and 36 of its 172 health facilities at the highest level of stress. For region 4A 76.4% ICU and 75 out of its 196 facilities in a critical situation. The NCR figures are a lot worse

https://www.gmanetwork.com/news/news..._picks&order=3

The DOH also talked to the media about how they deal with covid deaths. Despite the headline if you read through it you won't find an explanation of why so many cases are initially recorded as recoveries and later become deaths. Well over 1k this year already and about 2k last year!

Active cases are now over 190k with Severe up 59 at 951, Critical up 48 at 761.
NCR ICU % now at 86. Effectively at full capacity if you take staff into account.

Some location detail:

NCR 5,920
4A 2,517
C Luzon 1,515
Ilocos 500
Cagayan 487
W Visayas 484

NCR up slightly to 46.7% of the total, about the same as the day before.
The NCR+ "bubble"...a wrong description!....also at about the same level at 68.6%.
The contribution of the top 6 regions 1% higher at 90%.

For the NCR cities changes were nearly all moderate. Eight cities went up, 8 down.
Makati was about the same.
Biggest movers: Caloocan went up by 134 and Taguig by 135 cases. Malabon fell by 123 on the day.

For the provinces Bulacan stood out with a 100 increase to 734 cases.
Batangas and Cavite both fell, Cases in Laguna, Rizal and Quezon province all rose on the day.
Further away from the NCR to the north case numbers went up in La Union, down in Pampanga and were stable in Pangasinan.

Baguio City 33
Cebu City at 78. Together with LapuLapu and Mandaue Cities the total was 139, 47% of the regional daily total.
Davao City 57
Santiago City lower at 43.

A hi tech approach tp contact tracing in CDO city:

https://www.rappler.com/nation/cagay...andatory-firms

Raffin

Yesterday's DOH charts:












Top 20 urban areas:

NCR cities in first 13 places and in 15 places of the table.
In last 7 places Antipolo, Bacoor ,Imus, Cainta all with between 128 and 151 cases. San Fernando, La Union in last place with 111 cases.

Raffin

Yesterday 11,681 new cases announced, consistent with recent test levels and positivity rates. As usual lately around a third of cases were a backlog, nearly 4k yesterday. Tests on the way at a higher 51.3k.
Another large tranche of deaths after a dearth of announcements in March and back.
Deaths: 201
Yesterday was another mass recovery day with 55.2k announced.
Active cases now at 146.5k, that's 11k more than last Sunday, an 8% increase. But a lot lower increase than during the previous week.
For the week April 4-10 the Philippines had nearly 70k new cases.

Severe cases down 72 to 879, Critical down 28 to 733.
NCR ICU beds occupancy now up to 86%
Isolation beds at 69%.
Figures challenged by those running the hospitals and hospital associations for being too low. and ignoring staff shortages.

Some location data:

NCR 5,651
4A 2,291
C Luzon 1,106
Cagayan 709
Ilocos 454
W Visayas 351
C Visayas 200

NCR down a little but up, at 48.4%, for the percentage of national cases on the day before.
All other regions down except Cagayan, up by over 200.

NCR "bubble" at 69%, top 6 at 90.4% of national cases. Both about the same as the day before.

For NCR cities 8 went down: Caloocan by 300, Las Pinas by nearly 100, Mandaluyong, Manila, Navotas, San Juan, Valenzuala and Pateros also all down.
Taguig rose by 88 on the day before, Pasig by 78 and Paranaque had more than 50 more. QC, Muntinlupa, Marikina and Malabon all also reported more.
Pasay and Makati reported about the same.

Provincially all bubble provinces and others adjacent to them reported less cases, except Pangasinan and Quezon provinces.

Baguio City 50
Cebu City 45. The 3 main Cebu Cities had 79 out of the 200 regional total. A low 39.5%.
Davao City about the same at 61.
Santiago City, Isabela was much higher at 192.

The NCR bubble was downgraded to MECQ until the end of the month. The main benefit will be the new curfew from 8pm to 5am at least in MM. Malls re-opening and some dining allowed on outdoor areas. Also in N Luzon under MECQ are Santiago City, Quirino province and Abra province.

Some other areas are under GCQ:

• Cordillera Administrative Region
• Cagayan, Isabela, and Nueva Vizcaya provinces in Region 2
• Batangas and Quezon provinces in Region 4-A
• Tacloban City in Region 8
• Iligan City in Region 10
• Davao City in Region 11
• Lanao del Sur in the Bangsamoro Region

All other areas are in Modified GCQ.

The irksome traffic checkpoints will apparently continue in the NCR bubble but the rules will be "more relaxed". We await for more information on that.

Update on variants here:



Above Sweden.



Doing much worse than many of our neighbours.

Raffin

Again a large new case total 11-12k and 6 labs not reporting. Positivity slightly lower at 19.5% from only 27.4k tests. Testing not keeping up, backlog yesterday at over 6k cases. Tests being prepared down at 32.8k, that being due to the regular lower weekend testing.

Another large deaths announcement: 204 including 34 RDs.
Primary hospital data: Severe cases up 66 to 945, Critical cases up 54 to 787

Location detail:


Unidentified 67, E Visayas 50, OFW 13, other Mindanao 114







Regionally: NCR was down on the day at a lower 45% of national cases.
But the next largest regions, 4A and Central Luzon were both up.
For the smaller regions for cases W Visayas and the CAR were both up
Cagayan and Ilocos were both down.
The contribution of the NCR bubble area was down to 67%, the top 6 also gave a lower 87.8% of national cases.

In the NCR the main covid case cities, QC, Manila and Caloocan all had less cases. As did Taguig, Paranaque, Marikina, Pasay, Muntinlupa, Malabon and Navotas cities.
Mandaluyong added more than 100 more cases on the day. Pasig, Las Pinas and San Juan cities also added significant numbers of cases.

Provincially Bulacan had more than 100 more cases and Batangas also added more on the day.
Cavite, Laguna and Rizal all had less cases than the day before.. La Union had 71 less.

Negros Occidental has been showing lately in the top 10 provinces table:


Negros Occidental, steep rise


Biggest city Bacolod City, small uptick for now...

Urban areas: NCR cities occupied the top 12 places and had 13 in the top 20. A bit lower than usual.
Baguio City had a higher 141 cases.
In the lower places Kawit, Cavite was a new entrant with 151 cases. Bacoor in Cavite had 123 cases.
San Pedro, Laguna was also a new entrant with 120 cases in 19th position.

Cebu City had 53 cases and the 3 main Cebu cities together reported only 103 out of the region's 289 cases, a lower 36% compared to 40% the day before.
Davao City with 45 reporting less on the day.

https://news.abs-cbn.com/news/04/12/...says-otherwise

Despite the MMDA announcing expanded curfew hours the PNP rigidly following the need for the correct paperwork, and, as you can see from the photo still keeping a checkpoint on the Rizal/NCR border, despite the area being designated a bubble.

Cavite curfew adjusted much more, up to 4.30 am - 10 pm.

You may be interested to look at the many categories of frontliners drawn up for vaccination priority, when their turn finally comes, after health workers, seniors and those with comorbidities:

A4.1 - Commuter transport (land, air, and sea), including logistics
A4.2 - Frontline government workers in justice, security, transport and social protection sectors
A4.3 - Public and private wet and dry market vendors; frontline workers in grocery, supermarkets; delivery services
A4.4 - Workers in manufacturing for food, beverage, medical and pharmaceutical products
A4.5 - Frontline workers in food retail, including food service delivery
A4.6 - Frontline government workers
A4.7 - Frontline workers in Financial Services
A4.8 - Teaching and related personnel in medical and allied medical courses of higher education institutions, including personnel handling laboratories
A4.9 - Frontline workers in hotels and accommodation
A4.10 - Priests, pastors, religious leaders regardless of denomination
A4.11 - Construction workers in government infrastructure projects
A4.12 - Security guards/personnel assigned in the establishments, offices, agencies, and organizations identified in Table 1
A4.13 - OFWs not classified above, and scheduled for deployment within two months

Those included in the A4 group are supposedly workers with “high levels of interaction with or exposure to the public” and those part of sectors “needed to ensure security, consumer and worker safety, and those working in priority government projects.”

No surprise that so little has reached the poor by now, the 3rd week of enhanced quarantine in the NCR bubble:

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

Bealinehx

To go one stage further only senior citizens who are Filipino Citizen by birth, Naturalised or a Dual Citizen are eligible for COVID 19 vaccinations.
Same conditions as for SSDC.
Latest information from OSCA Marikina.So it could be a long wait unless you have the means to pay privately when vaccines are available.
Before deciding check on the efficacy of any vaccine that is offered.

Raffin

Further weight to the idea that Expats here are only tolerated although the public health principle tells them to vaccinate as many in the country as they can If they have thought about it at all they're probably working on the assumptions that we can all afford to get one privately plus anyway we won't spread covid. around much. Both have some validity but shouldn't enter their thinking as the main aim is to get to herd immunity. Even if you can afford it you may not like to go to a private hospital these days and it's much easier to get one from the LGU.

Yes, if you're offered Sinovac's vaccine its trials so far suggest it protected well against severe illness, but overall protection results varied a lot. I watched the latest Dr John video where he revised downwards his opinion following trials data, after initially expressing confidence in it, due to its older tried and tested formula. Better trials data might still come but I suspect private hospitals won't even offer it to better off people here who keep up with the news.