PH coronavirus cases pass 200; 3 more patients die

MANILA, Philippines — The Department of Health (DOH) reported on Wednesday that the number of confirmed coronavirus cases in the Philippines has surpassed 200 and that three more patients have died, bringing the local death toll to 17.

It said that as of noon on Wednesday, the total number of confirmed cases was 202, with 15 new cases.

The three fatalities, all of whom died on Tuesday, had underlying ailments, the agency said.

Patient 201, a 58-year-old man from Lanao del Sur, died of acute respiratory distress syndrome. A diabetic, he traveled to Malaysia before he fell ill and was admitted to Amai Pakpak Medical Center on March 10.

He was already dead when the results of his test came out, confirming he had contracted SARS-CoV-2, the virus that causes COVID-19.

The DOH said Patient 57, a 65-year-old man from Pasig City, also died of acute respiratory distress syndrome. He was diabetic and hypertensive, and traveled to London before falling ill and getting confined at The Medical City. Three days after admission, he turned out positive for the coronavirus.

Patient 160, a 86-year-old woman from San Juan City, died of septic shock and pneumonia. She neither traveled abroad nor had been in contact with a confirmed coronavirus case.

The DOH noted, however, that she had multiple underlying ailments like chronic kidney disease, ischemic heart disease and peripheral arterial occlusive disease.

Her test results came back positive for the coronavirus a day before she died.

Also on Wednesday, the DOH said that though it had already seen a connection in some of the confirmed coronavirus cases in the country, it remained unknown how the majority of the patients had fallen ill, indicating that there was indeed a sustained community transmission of the virus.

According to Health Undersecretary Maria Rosario Vergeire, “14 clusters of infection” has been seen, which means that among the confirmed cases, the virus is often transmitted among family members and their close ties.

For instance, the 62-year-old man who frequented a prayer hall in San Juan City and identified by the DOH as the first local coronavirus case also saw his 59-year-old wife go down with the disease. While both suffered from cough, the elderly man (Patient 5) exhibited symptoms two days earlier than his wife (Patient 6).

The DOH earlier said Patient 6 regularly accompanied her diabetic husband. It remains unknown though how Patient 5 contracted the virus since he didn’t travel abroad nor was in close contact with any of the four known positive cases at the time.

Patients 1, 2 and 3 are all Chinese tourists from Wuhan city in central China’s Hubei province, where the virus originated. Patients 1 and 2 were husband and wife. Only the wife recovered though, as the husband died of severe pneumonia.

Patient 4 is a 48-year-old lawyer from Bonifacio Global City who had traveled to Japan before getting sick.

While Patients 5 and 6 were receiving treatment at the Research Institute for Tropical Medicine (RITM), the 29-year-old man (Patient 38) who came in close contact with Patient 5 also fell ill.

Patient 38 was confirmed to have contracted the virus on March 11, the same day that the couple died of acute respiratory distress syndrome.

So far, the largest cluster the DOH has seen is that of Patient 43 from Manila, who is the brother-in-law of Patient 12 (San Juan City) and was the close contact of Patient 35 (Makati City), Patient 84 (Taguig City) and Patient 86 (Quezon City). The husband of Patient 35, identified as Patient 34, and Patient 12’s close contact Patient 42 (Pasig City), who traveled to Taiwan recently, also contracted the virus.

Patient 12 did not travel abroad prior to having fever and cough on Feb. 29.

Biggest cluster

The most number of linked cases in a single household was of Patient 9’s, an 86-year-old American man from Marikina City who recently traveled to the United States and South Korea.

His niece (Patient 27), wife (Patient 29) and two other companions (Patients 28 and 30), who are also husband and wife, were confirmed to have had the virus two days after he himself tested positive.

His attending physician (Patient 31), a 28-year-old woman, also exhibited symptoms of the coronavirus just a day after he was admitted at The Medical City.

The elderly American died of multiple organ failure and acute respiratory distress syndrome on Saturday.

Vergeire pointed out that while the pattern was seen, the majority of the current 202 cases were “unrelated,” which confirmed that there was an ongoing sustained community transmission of the virus.

According to DOH data, 62 of the confirmed cases neither went to any of the 150 infected countries nor had been in close contact with a coronavirus patient. One of these cases (Patient 21), a 58-year-old Filipino man, is the link to three other cases (Patients 65, 66 and 67).

Thirty-two of the confirmed cases traveled abroad two weeks prior to becoming ill, including Patients 9, 18 and 41.

Patient 18’s wife, Patient 19, tested positive despite being asymptomatic, while three of Patient 41’s family members were confirmed to have had the virus, including her sisters—Patients 44 and 87—and another relative, Patient 112.

Two other patients, 25 and 26, also tested positive despite not showing signs and symptoms. Both are crew members of the cruise ship Diamond Princess, which was quarantined off Yokohama, Japan, in February after a number of its passengers tested positive for the virus.

Patient 25 was discharged on Tuesday after he tested negative for the virus twice. To date, seven patients have already recovered—Patients 1, 3, 13, 14, 15, 25 and 26.

The DOH is still verifying the possible exposure of the 49 patients. Thirteen others were found to have been exposed to a positive case, but the DOH has yet to find that person.

Capability to travel

By age group, the confirmed cases are nearly divided equally among three classes.

Middle-aged individuals, or those between 40 and 59 years old, account for 68 cases, while the elderly, or those above 60 years old, make up for another 60. Millennials, or those between 25 and 39 years old, account for 53 cases.

Only six patients are 24 years old and below, with the youngest a 13-year-old girl from Quezon City (Patient135). She is the sister of Patient 51 and the daughter of Patient 134.

Vergeire pointed out that while initial information showed that most of the positive cases belonged to the middle-income to higher-income bracket, this didn’t mean that those from lower-income households should be complacent and see themselves as not at risk.

“This disease does not discriminate against anyone,” she said.

One of the reasons why it appears that the disease is afflicting more people from the middle- and higher-income classes, she said, is these groups travel.

She, however, stressed that this is not a definite conclusion, but based merely on observation of the available data.

Virus makeup

Vergeire said the DOH was still awaiting the results of the gene sequencing done by the RITM on the first few cases to determine the makeup of the coronavirus that they had contracted.

Earlier, health officials explained that this laboratory procedure would help them determine where the patient might have been infected, as the makeup of the virus changes as it travels and gets transmitted.

As of Wednesday, the Philippines had 187 confirmed new coronavirus cases and 14 deaths, nearly two weeks after the first local transmission case was reported.