Raffin

Yesterday saw the NCR put on just over 2k cases and was a lower 63% of all cases .But we have to take account of the large backlog of unannounced test results. Going back 12 days 17.8k have been held and only 241 announced. My guess is that the bulk of these will be from the NCR. Say the NCR accounts for 60%, that could be about 10k waiting to be announced.

In NCR cities QC's numbers yesterday were up 31%, Manila's by 16%.

For other cities Baguio was notable with nearly double the cases yesterday over the previous day at 138.

Vaccinations

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

Contrast with the UK where only for those with comorbidities. There they are saying only 2 intensive care admissions would be prevented for 1m healthy children vaccinated. Over 50 times greater for those with comorbidities.
Many people, even in the NCR, in groups that spread the virus more readily still unvaccinated.

Getting tough in Cavite on the unvaccinated:

Some difficult conversations looming at the doors, especially with tourists in Tagaytay.
In Bacoor access to government offices restricted and in Kawit a weekly PCR test required. You wonder how they will administer that.

https://www.rappler.com/nation/citie...sons-covid-19/

Cavite is the largest province by population and cases yesterday there increased by 44%.

RedApe

I think Ivermectin (as a veterinary pharmaceutical) was created by, scientists working for and still produced and patented by a big pharma company, Merck.Merck scientists also discovered it's application for use to eliminate River Blindness and lymphatic filariasis in humans. For THAT use they have donated enough doses appropriate to humans to affected countries to eliminate the disease. For that the Merck scienttists involved received the Nobel Prize for Medicine.

Merck has decisively stated that Ivermectin should NOT be used for off-licensed and untested uses, such as for Covid-19. They have found no trial evidence fsupporting its application for Covid.

RedApe

More on that...even the Danish authors say that their study is being misused and is contrary to what they found. They actually say that the mRNA boosters actually improve ones ability to avoid infection against omicron (simply not as much as vs. the Delta variant). They also say there is decisive evidence that the vaccines improve outcomes against serious illness and boosters improve that markedly.

https://www.reuters.com/article/fact...-idUSL1N2TE17B

All this indicates that most people, especially those most likely to have serious illness (the elderly or those with comorbities) should get a booster.

Raffin

The waters are muddy on Ivermectin. Still I think we need not rely on Merck's view ,the drug is out of patent and maybe they're worried about legal liability. All they can see, like everyone else, is a number of small scale studies, some less than rigorous, and some meta -studies. Dr John has done a number of videos, .if you have the time to look back. I've not seen them all but the ones I did watch gave me the view that it is worth a large sale properly run trial. Which is what has been going on now for 6 months. I mentioned it in an earlier post.

I can't find anything about when it will publish results. Paused before Xmas as they had problems getting Ivermectin from the manufacturer!

https://www.ox.ac.uk/news/2021-06-23...rinciple-trial

Raffin

Today saw 26,458 cases announced, a pandemic record, but positivity at a higher 43.7% generated another 7,193. Which makes the log jam in the DOH at over 24k of unannounced cases. Six labs late to submit too.

Recoveries 1,656

Deaths 265, 238 RDs

Active 103,017

Severe 1,462, up 1. Critical 307, down 5

NCR ICU 51%, up 3%. National 34%, up 2%

NCR ward beds 62%.
Up over 16% in two days.

Raffin

Review of yesterday's DOH data:

Given the large number of cases held up in the DOH, equivalent to one day's national total at present, how representative are those that are announced?

When there are late labs the DOH often give you an estimate of how many cases might be missed.
In the same manner they could give an idea of where these unannounced cases are from. But they say nothing. Is it because they're dealing with incomplete and unreliable data a lot of the time?

Yesterday on the figures we have the contribution of the NCR fell by 2% to 61%. But region 4A's rose by the same amount to 21%. Laguna and Rizal provinces led there.

In the NCR the greatest rises were in Taguig, 38% and Paranaque 34%

Elsewhere large % increase in the Central and Western Visayas regions, N Mindanao and Davao, though numbers are still in the low hundreds.

Nearly all other cities outside the NCR had more cases.
Cebu and Davao Cities both doubled their cases over the day before.

Weekly update coming later.

Bealinehx

No adequate testing = No reliable information

Raffin

Weekly update:

For the past week on the previous it's better to use multiples, rather than percentages. The numbers for the week before last, coming from Xmas/New Year must have ben significantly depressed by both demand and supply factors related to testing. And by the usual time lags, those somewhat lengthened by the season.

Top regions by multiple of last week over the week before:

Bicol x14
4A 12
CL 11
NCR 9
Cagayan 8
Ilocos 7
CAR 7
CV 6
EV 6
WV 4

Bicol had 552 cases last week.

The remaining regions, mostly in Mindanao still all had low multiples.

In the NCR multiples for 5 of my tracked cities were between 10 and 15.
But the City of Manila was down at 5.

Provinces around the NCR all between 10 and 14.

OCTA give some of the higher attack rates for the NCR and around:


Infection spreading outwards from the NCR.


For other cities:

Cebu 12
Baguio 10
Cebu 8

Zamboanga City had a creditable 1.4 and only 127 new cases last week.

City numbers outside the NCR not getting very high at present. The highest, Baguio, at 439 last week.

Raffin

Yesterday the case record broken again with 28,707 announced. But positivity at 44.0% on 77.5k tests means the already large number of unannounced cases grew by 5.4k. Also 14 labs were late.....no details given on them.

From reports the test labs in the NCR are sending tests to the provinces. Even when positive results are confirmed the paperwork is often not right. This has always happened but maybe with the rush to get tested now it is happening more.
Always significant lags here with official case data. Now even longer. One hopes those experts in the DOH can work it out with the help of the unpublished data.

Recoveries: 2579

Deaths: 15, 3RDs

Active: 128,114

Severe 1,465, up 3. Critical 309, up 2
Severe cases have added a few lately after many days of falls.

NCR ICU 52%, up 1%. National 35%, up !%

The NCR with 16,924 cases, that's only 700 or so more than on Saturday. Has it peaked there? Hard to tell with all the disruption to testing.

RedApe

"I can't find anything about when it will publish results. Paused before Xmas as they had problems getting Ivermectin from the manufacturer!"

Why would a manufacturer not provide sufficient doses to test the effectiveness of the drug for Covid? That only would require a few hundred doses daily for the test pool.

Hmmm....could it be they are making $$$ hands over fist for the drug right now and are out of stock simply because they are putting everything they have on the open (or black) market? And showing that Ivermectin is not effective would stanch that market?

Raffin

It's all a bit peevish. It's maybe because they are making a new antiviral molnupiravir. Much more expensive than Ivermectin, which has anyway gone generic. As it is out of patent. 108 brands in one list I saw. I couldn't find a price for original Merck Ivermectin but it must be much more than the generic prices.

For example I take a standard beta blocker pill. For some years I bought the main, maybe original, recommended by the doc, brand. But now I buy an Indian generic, one third of the price. No difference.

I think they are worried that if shown to be useful against covid they will be asked to help by govts and orgs like the WHO to make it in large volumes, ship and distribute to developing countries. The generic manufacturers are likely to be smaller and not so multinational to take on that. If they (Merck) refuse to help their image will greatly suffer around the world. All companies like Merck with shareholders just do enough charitable activity to keep their image up. But this could be a huge task and they couldn't name their price for it. At the same time all that cheap Ivermectin could be competing to a great extent against their new antiviral.

Which makes me think they know the drug has some potential against covid 19.

RedApe

If, as you say, the drug is out of patent, then there are myriad local manufacturers and distributors out there. In India alone there are dozens. In fact, the abuse (and subsequent illnes and death) became so widespread that the health authorities withdrew their recommendation for use in severe Covid cases. They withdrew an original recommendation that suggested it could be used as chemoprophylaxis. In any case the benefits were minimal a reduction of risk by 9.7%.

One broad review in July 2021 showed no consistent pattern of success for Ivermectin.
https://pubmed.ncbi.nlm.nih.gov/34318930/
And an more recent one
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8684188/

There are several trials that have just completed and are awaiting results. But a lot of these trials confound the results as they involve cocktails of Ivermectin with antivirals and other treatments.

Given the impact that helminthic and nematodes have on the immune system it would not surprise me that those who have infections with these "worms" that are cleared up prophylactically would have a positive outcome in Covid-19 resistance and outcome. It may not be an antiviral capacity at all. Just eliminating the other features that reduce immune response. And it would primarily be of benefit to those classes and countries where endemic helminthic infestations are occurring. That might account for some of the variation in outcomes. It a lot of those receiving were poor, in areas with poor sanitation or food processing hygeine is low, or untreated water supplies...then you'd see the benefits. In those areas with better conditions, or already treated with anti-helminthic drugs (e.g. river-blindness) or where the recipients were drinking treated water...then the benefits might be limited.

If that's true it might be useful, but not a miracle drug or panacea against Covid, and certainly NOT any rationale to avoid getting vaccinated or a booster. In fact it might also facilitate the immune response to vaccinations, and thus improve antibody loads, and enable (after vaccination) the lymphatic system to produce abetter B cell response to novel variant infections. Fewer chronic debilitating "other infections" and you allow the immine system to respond with more intensity and focus on the Covid-19 viral infection.

Bealinehx

33,169 new cases reported just now. The pattern of the increases is sharper than Europe and N America. Looks like Omicron is, or will be soon the dominant variant.

Raffin

Abuse of ivermectin involves both quantities and trying to use it too late with covid. I recall from a Dr J video.

The big picture is that there are few antivirals, they can be expensive and this is cheap.

We've already talked about all the mostly small random trials that have been done in many countries so we need a large trial from a group working to the highest standards. I don't think I can be accused of being over patriotic if I say that is the one ongoing out of Oxford Uni, running the PRINCIPLE trial:

https://www.principletrial.org/

You make interesting points about its existing use.

Always the messages must be try hard not to be infected in the first place, get vaccinated. But despite both of those people are getting infected and ill. Lately with Omicron it has been much easier to get infected. Illness with Omicron seems generally milder, but the numbers, the implications of them, the age groups, are still being analyzed. What about long covid?

Some people who can't be bothered to get vaccinated, and are anti vaxx, yes, would have another reason, if it is proved to be beneficial, to avoid masking, being vaccinated etc. Never mind, there could be a much greater benefit.

The Oxford trial could have started a lot earlier. This review and meta study looked promising to me when Dr J went through it, though no idea if the paper was later subject to counter argument in other papers

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/.

I don't pretend to fully understand how meta analysis works, but I think it does try to account for biases. Dr J was sufficiently impressed to have Dr Tess Lawrie on again for a long interview.. But as someone else said here he's a nurse. There may well be a to and fro still going on in the medical academic world about that paper which he's not airing on his channel.

So better for us observing from afar to just wait a few months, I would assume, until Oxford or similar trials elsewhere come out with some findings.

Raffin

Today 33,169 new cases announced and more confirmed cases still being held on to by the DOH, but today only 519. Still we await many thousands to come out. Ten labs were late, and today we are told that means that it is likely over 2k cases were missed. Positivity almost becoming irrelevant at 46.0% from 73.2k tests.

If it looks like Omicron....

Recoveries 3,725

Deaths 145, 124 RDs
3 from Nov, 18 Oct, 52 Sep and the rest back to Jan 2021.
The DOH saying this death data splurge mostly from the Cagayan Valley.

Active 157,528

Severe 1,461, down 4. Critical 301, down 8
These figures not reflecting Omicron here... yet.

NCR ICU 52%. National 38%, up 3%
Significant national increase while the NCR stable.

Also:

NCR ward beds now 57%, down 5% from 2 days ago.

One reason for testing delays and chaos may be:

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

The local international picture by new cases yesterday:


Indonesia posted only 529, Malaysia 2,888.