MANILA, Philippines — Health Undersecretary Maria Rosario Vergeire said the DOH was looking into several factors and analyzing data to properly explain why Central Visayas was reporting more fresh cases than Metro Manila, which until recently had been recording the largest numbers of infections since local transmission began in March.
“We are studying the state of Central Visayas because admittedly if you look at our data these past few days, it has exceeded [Metro Manila] in some of the days that we have reported. But we can’t be certain yet on our interpretation. We have to be cautious,” Vergeire told reporters in an online press briefing.
Except on June 4, Central Visayas has reported more fresh daily cases than Metro Manila since Tuesday last week. Fresh cases are those patients who tested positive within the last three days.
Of the total 1,937 fresh cases recorded in the past week, Central Visayas accounted for 850, while Metro Manila had 524.
But for the late cases, or those who tested positive for SARS-CoV-2, the new coronavirus that causes the severe respiratory ailment COVID-19, from at least four days earlier, Metro Manila remains to be on top. In the same week, the DOH recorded 1,899 late cases, of which 552 came from Metro Manila and 364 from Central Visayas, which is composed of the provinces of Cebu, Bohol, Negros Oriental and Siquijor.
According to Vergeire, the aggressive contact tracing efforts and testing being implemented, particularly in Cebu, may be driving the increase in the number of cases in the region.
But she noted that this did not necessarily mean the virus was spreading faster there.
“We have already instructed our Epidemiology Bureau to plot the onset of illness of cases there so we could be able to see the trend,” Vergeire said.
“Although we are talking about fresh cases here, these cases are [identified] based on the laboratory results. That means that a sample may have been taken from five days ago but was only tested and [the results were] released within the last three days,” she added.
A patient’s onset of illness, Vergeire said, was “the most accurate” basis to determine if a case is a new infection or not.
Metro Manila quarantine
On June 1, the government started easing quarantine measures, particularly in major urban areas like Metro Manila. Incidentally, the number of fresh cases since then have been increasing, with reported cases in the last three days reaching more than 300.
Presidential spokesperson Harry Roque said that if the number of fresh infections continued to rise, quarantine restrictions in Metro Manila may not be relaxed further on June 15.
The Inter-Agency Task Force on Emerging Infectious Diseases will meet on Wednesday to decide recommendations to the President for easing or tightening restrictions next Monday, when the current relaxed quarantine level would end.
“If the cases continue to rise, there is a possibility that we won’t graduate to the next phase,” Roque said, adding that if the trend continued, Metro Manila might revert to strict quarantine measures.
But Vergeire said the rising cases may be due to the more timely reporting by the laboratories.
“Just because fresh cases are increasing these past days doesn’t mean that recorded cases are spiking,” she said.
“Let us be cautious in interpreting the results,” Vergeire added, pointing out that there are still “weaknesses” in the DOH information system.
For one, only 60 percent of the patients’ case investigation form indicate the onset of illness.
In the absence of that information, the DOH relies on the date when the sample was taken. If both of these dates are not provided, the case is categorized according to the date the result was released.
Reporting gap
“When we reviewed some of the cases, the onset of illness and the release of test results were far in between,” Vergeire said, giving assurance that the health department was looking for ways to close the gap so the task force would be provided with better information on the epidemic.
On Tuesday, the DOH reported 518 new infections, pushing the national caseload to 22,992.
Of the new cases, 280 were patients who tested positive for the new coronavirus within the last three days. Central Visayas accounted for the largest number of these cases, 82, followed by Metro Manila with 61.
There were 238 late cases, of which 89 came from Metro Manila.
The DOH reported that 99 more patients had recovered, raising the number of COVID-19 survivors to 4,736. The death toll, however, increased to 1,017 with the deaths of six more patients.
Higher numbers of infections may be expected in coming days as the government deploys more contact tracers.
In his 11th report to Congress on Monday on his response to the coronavirus crisis, President Duterte said more than 15,000 contact tracers had been trained to strengthen the DOH search for carriers of the virus.
Vergeire earlier said the Philippines needed 94,000 more contact tracers to meet the World Health Organization standard of one contact tracer to 800 people.
—WITH A REPORT FROM JULIE M. AURELIO