Tracker Updates
New Charts to Visualize Date Proxies
New charts to visualize date of onset proxies and date of recovery proxies are now added to the tracker. This is to better understand the 38,075 tagged recoveries in a day last July 30, 2020.
Improved Viewing Experience for Mobile
Replaced iframes with includes to improve viewing experience for mobile devices. Also, removed automargin in the plotly charts to maximize the available space.
COVID-19 Updates
DOH Tags 38k Recoveries
DOH tagged 38,075 recoveries last July 30, 2020 as announced in this post from their official facebook page. According to the post, this is “Due to enhanced data reconciliation efforts with local government units through OPLAN RECOVERY”.
Furthermore, the post explains “Following Department Memorandum No. 2020-0258, as endorsed by clinical practice guidelines and our technical advisory groups, patients with mild or no symptoms are tagged as recovered 14 days from the date of onset of symptoms or by date specimen collection. Current recovery policies now show that at the 10th day of illness, the risk of transmitting the virus to other people is significantly reduced. This clinical recovery protocol is followed by the US CDC, European CDC, and India.”
As expected, this was met with skepticism by the public with some even accusing DOH of data manipulation.
What is Memorandum No. 2020-0258?
Note: You may get a copy of the memo here.
This memorandum, with a subject of “Updated Interim Guidelines on Expanded Testing for COVID-19” and published last May 29, 2020, lists the general guidelines for expanded testing for COVID-19 in the country.
Item number 9 of the general guidelines says the following.
Discharge and recovery criteria for suspect, probable, and confirmed COVID-19 cases shall no longer entail repeat testing. Symptomatic patients who have clinically recovered and are no longer symptomatic for at least 3 days and have completed at least 14 days of isolation either at home, temporary treatment and monitoring facility, or hospital, can be tagged as a recovered confirmed case and reintegrated to the community without the need for further testing, provided that a licensed medical doctor clears the patient. Patients who test RT-PCR positive and remain asymptomatic for at least 14 days can discontinue quarantine and tagged as a recovered confirmed case without need for further testing, provided a licensed medical doctor clears the patient.
WHO Criteria for releasing COVID-19 patients from isolation
Note: The WHO critera is available here.
According to WHO, the following are the criteria ischarging patients from isolation:
- For symptomatic patients: 10 days after symptom onset, plus at least 3 additional days without symptoms (including without fever [2] and without respiratory symptoms)
- For asymptomatic cases: 10 days after positive test for SARS-CoV-2
The scientific basis for this criteria is also explaned in the publication.
Studies using viral culture of patient samples to assess the presence of infectious SARS-CoV-2 are limited. Viable virus has been isolated from an asymptomatic case. A study of 9 COVID-19 patients with mild to moderate disease found no SARS-CoV-2 virus able to be cultured from respiratory samples after day 8 of symptom onset. Three studies of patients with undisclosed or variable degree of illness showed an inability to culture virus after days 7-9 of symptom onset.
It says that based on scientific studies, the risk of transmission is significantly reduced at around 9 days from symptom onset.
Is DOH Manipulating Data?
I don’t think so. The memorandum published last May is based in the WHO and the criteria has a scientific basis. It is only recently that they have begun to ‘clean up’ their data. However, their recent announcement shows that they can barely keep up with the influx of cases that’s coming in every day. Perhaps the right questions to ask are
- Were the health status of all of the patients validated prior to being tagged as recovered?
- How do they monitor the mild and asymptomatic cases? Do they conduct a follow-up with the LGU/BHERT/hospital everyday? It seems that they don’t.
That being said, I still hope that DOH will be able to improve on this soon.