PH continues to flatten the curve despite test backlogs – expert

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Metro Manila (CNN Philippines, May 5)— The Philippines continues to see a slowdown in the rate of COVID-19 infections, according to a leading epidemiologist and public health specialist.

Dr. John Wong, a member of the sub technical working group tapped by Inter-Agency Task Force for Emerging Infectious Diseases in creating projections on COVID-19 scenarios, said the epidemic curves for new cases and deaths are flattening.

Wong presented this graph to the members of the media on Tuesday.

From a reproduction time of one to two days at the beginning of the outbreak in March, the number of coronavirus infections has slowed down to at least every four days, he said.

The first green square in the graph marks the day when the government implemented the enhanced community quarantine in Luzon. Wong said it took at least two weeks to see the lockdown’s effects.

As seen in the second green box, the infection rate started to slow down by April 1.

“When April 1 came around, you see the curve started to flatten," Wong explained. "From doubling every less than three days, now it’s doubling around four days.”

“The deaths started very fast.. then we start to see it flattening," he added. "Deaths are flattening at a more dramatic rate. Near the 7-day line."

Wong said there are very little new deaths in the National Capital Region. Most of the people dying from the virus recently are from the provinces, he noted.

The view on the case trends was shared by Malacañang, which said that the country is beginning to see the "flattening" in the past few days.

"Even in the charts that we show in our press briefings, bagamat merong bahagyang pagtaas, nakikita niyo naman na kahit papaano sa new confirmed cases, hindi na tumataas beyond 'yung bilang na 300," Presidential Spokesperson Harry Roque said in his virtual media briefing.

[Translation: Even in the charts that we show in our press briefings, despite mild increase, you can see that in the new confirmed cases, the number does not go beyond 300.]

"In a way, we can say it has begun to flatten," the spokesperson added, attributing it to the lockdown measures implemented in March.

But like the other experts, Wong warned that “although we see some flattening or improvements now…we should be careful about resurgence.”

DOH: It’s not just the numbers

The Department of Health has said that flattening the curve is not solely based on the number of cases. The health system’s capacity is a big determining factor as well, according to spokesperson Maria Rosario Vergeire. This includes the improvement of testing capacity, and the ability to manage suspect, probable, and confirmed cases, she said.

Ang strategy na we have prioritized the severe and critical," she said. "Ang vulnerable population tsaka symptomatic, 'yun ang una natin tinetest....talagang very piling pili ang tinetest natin."

[Translation: Our strategy is that we have prioritized the severe and critical. We first test the vulnerable population as well as the symptomatic. We just really handpick those who will be prioritized.]

"Ang taas ng positivity rate natin," Vergeire added. "Pero ngayon nakakapagtest na tayo, medyo lumawak ang capacity natin, nadidilute na symptomatic, mild na talagang hindi nagpopositibo. Nakikita natin na bumababa ang positivity rate natin which is a good indication again for all of us."

[Translation: Our positivity rate was very high. But now that we can conduct the tests, we have widened our capacity. We can see that our positivity rate is going down, which is a good indication for all of us.]

But there are still a lot of work to do.

As of posting, Vergeire admitted that although the Intensive Care Units (ICU) nationwide are utilized at 40 percent, the isolation and ICU beds in Metro Manila is near maximum capacity.

Delayed test results also remain a problem. There is also a backlog of COVID-19 tests: 600 at the Research Institute for Tropical Medicine,and 200 at the UP-NIH laboratory. The average turnaround time for the test results are between 48 to 92 hours.

The government is also behind its target to process 8,000 samples a day by April 30. The 20 accredited COVID-19 laboratories nationwide have been able to process about 5,000 samples daily.

A total of 117,853 individuals have been tested since January until May 4, which translates to roughly one percent of the population.

However, Wong said the testing backlogs do not affect the current case doubling time.

“Even if you have 8,000 backlog specimens, not all of them are expected to be positive no?" he pointed out. "At the current positivity rate we only expect 10% to be positive. That's about 800 cases. So 800 cases would not affect the case doubling time that much.”

Aside from managing confirmed cases and strengthening the healthcare system, Wong cited another key in fighting the pandemic: taking care of the uninfected.

“We should also focus on how we should manage the 99% who are uninfected," Wong said. "How do we teach them to observe social distancing, cough ettiquete and hygiene, how do we motivate them and engage them that…during ECQ they'll know how to behave and we’ll be able to delay and prevent another resurgence."

Wong, a faculty member of the Ateneo de Manila University's School of Science and Engineering's Health Sciences Program, received the 2016 Roux Prize from the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington in Seattle, USA.

He received the $100,000 prize given annually to individuals who use data from IHME's Global Burden of Disease (GBD) Study in their research to improve population health. Wong used the GBD data to identify the top 48 diseases in the Philippines with the highest measures of global burden of disease.