90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 2
With 126 in the last 24 hours, Cebu City had the most number of cases from any individual city overnight. Photo by George Calvelo, ABS-CBN News

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR

On a more positive note, the Department of Health provided full residence information of all new cases—a first in 45 days. BY BENJAMIN CO MD
ANCX | May 01 2020

Infectious diseases and clinical pharmacology expert Dr. Benjamin Co has been thankfully breaking down coronavirus numbers in his personal blog since the outbreak started. The perspective he provides is informative, and comforting in those who are craving for a clear picture of how we are faring against the virus. Dr. Co will share daily updates and analysis of the Department of Health reported numbers with ANCX. 


Refer to the link DOH.gov.ph  or up-to-date data or to COVID19.gov.ph. (The latter is not a secure site.) The new site for the Department of Health is user friendly, provides more information where a COVID19 tracker is seen. Readers can check their official site where Data Drop for raw data can be found. 

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90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 3

Comparison of daily new daily cases, deaths and recoveries. There are now 1,663 closed cases.

There are three parameters in the figure above. New daily cases which are up at 276 new cases, new daily deaths are down at 10 and only 20 new recoveries. This brings the case fatality rate up at 6.6 percent (vs 7.06 percent world average) and the recovery rate steady at 12.35 percent (vs 31.6 percent world average) for the day.

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 4

Doubling time lets us know the number of days it takes for the confirmed cases (or death rates) to double and can be determined linearly or exponentially. The linear scale is used in this report which shows that the median doubling time is 24 days based on the seven-day average daily growth rate of 2.88 percent. (This is approximately 7 days on a logarithmic scale). The lower the growth rate, the longer the doubling time.

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 5

Logarithmic scale of fatality rate in the Philippines. Y axis is the exponential growth since the first 5th death (March 14, 2020) and the X axis shows the number of days since the first fifth case. The doubling time using logarithmic scale is ~7.2 days. 

Provided as added information in real-time is the number of probable cases (2,972), suspect cases (14,556) and number of healthcare workers affected by COVID-19. Of the 1,694 healthcare workers affected, they comprise 20 percent of the confirmed cases. 

The latency in reporting of the Department of Health remains at almost seven days before a death and more than eight days before a recovery is announced publicly. 

Posthumous results stand at 321. 


Are we testing enough?

The figure below shows that a total of 108,680 tests have been done (averaging more than 4500 tests a day) with 97,505 individuals tested. Of the individuals tested, 10,700 tested positive (11 percent), and 86,649 (89 percent) have tested negative. There are, however, only 8,772 confirmed cases. This is explained by the fact that some patients undergo retesting yet remain positive. 

There were less tests done yesterday compared to the previous day and the fluctuations in testing are disturbing because we may need to really test more patients to see the true picture of the pandemic in the country. However, even with more tests available, if the output will create backlogs, it defeats the purpose of having more tests done if results will not be released in real time.

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 6

SARS-CoV-2 Testing in the Philippines

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 7

The figures above show the tests conducted, and the number of people tested. For now, at least 11 percent of patients tested turned out positive while the remaining 89 percent were negative. It is possible that the increase in new confirmed cases may be due to more testing in the past days. The usual turnaround time for RT-PCR averages two to four days.


New cases per day

Flattening of the curve is based on continuous daily data. There needs to be a trend in the reporting of new daily cases so that we know where we are. If there is a long latency time in reporting new cases, new recoveries and new deaths, the quality of the data becomes an unreliable source in determining how effective an intervention (in this case the ECQ) is at lowering the cases in the community. The figure below shows the overall trend of new cases in the Philippines. 

When testing is ramped up, we expect to see some of the cases go up. In order to see if we’ve managed to control the outbreak in the Philippines, we will need to see a decline in the fatality rates.

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 8

Are we flattening the curve?

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 9


New cases based on region

Of the 284 new cases announced by the Department of Health, all had tagged residence information. 151 cases from Luzon (130 from NCR), 130 cases from Central Visayas, 12 cases from Calabarzon, three cases each from the Bicol region and Cagayan Valley, two cases from Western Visayas and one case each from Central Luzon, Cordillera Administrative Region and Bangsamoro Autonomous Region in Muslim Mindanao.

90% of new COVID-19 cases in the last 24 hours came from Cebu City and NCR 10


New cases by City with more than three cases

Cebu City had the most number of cases from any individual city overnight with 126 cases. The National Capital Region had the most number of cases based on region at 130. The cases from the NCR and Cebu City alone contributed to over 90 percent of the total confirmed cases reported in the last 24 hours. 

In cases by city, Cebu City ranks number three in the Philippines, and number four in terms of cities with the most COVID-19 cases per million resident. Davao City has the highest fatality rate among the urban cities, with a CFR of 16 percent (18 deaths in 113 cases).

The reports on demography and by location in general will now be provided every SUNDAY so that the whole week summary is provided. 

The Department of Health hotline is (02)8-6517800 loc 1149-1150. People who present with fever and/or respiratory symptoms are encouraged to get in touch with the DoH.


Global statistics

Update as of 8pm 01 May 2020 (Friday)


TOTAL DEATHS: 234,279 (case fatality rate: 7.06 percent)

TOTAL RECOVERED: 1,048,807 (case recovery rate: 31.6 percent)

Total cases worldwide 

Note that every reference has its own cut-off time for reporting. For the global data, WorldOMeters is used as its reference.

The total cases has crossed the three million mark. The average trend in the past week has averaged ~100,000 confirmed cases daily with more testing being done worldwide. The total number of recoveries has passed the one million mark. 

The United States of America leads globally in the number of total confirmed cases as they cross the million mark at 1,095,023 with a case fatality rate (CFR) of 5.83 percent with 63,856 total deaths recorded. The US had more than 30,000 new cases overnight with close to 6.4M tests done (19,311 tests/M population). The recovery rate for the US is slightly higher at 14.22 percent. Among the states, New York leads almost 310,839 total confirmed cases and 23,780 total deaths with a CFR stable at 7.65 percent. 

While the United States may have the highest number of cases and number of deaths in the world, Belgium (15.71 percent) and the UK (15.56 percent) have the highest case fatality rate. 8 countries with more than > 50 cases AND zero (0) fatalities reported from COVID-19 are: Vietnam, Cambodia, Uganda, Rwanda, Madagascar, Mozambique, Central African Republic and Nepal.

Cambodia has the highest recovery rate at 97.54 percent (119 of 122 cases) and no deaths reported since their first case of COVID-19. Note that Cambodia has had no new case since April 13, 2020. The following countries have the lowest recovery rates: Netherlands (0.32 percent), Norway (0.41 percent), and the United Kingdom (0.50 percent).

The median average of case fatality rates worldwide is now up at 7.11 percent but is predicted to hover at 7 percent. With more recoveries over the whole pandemic cycle, probably the fatality rates should go down to depict the true mortality rate after the pandemic.