President Rodrigo Duterte’s claim that the Philippines has a “low rate” of coronavirus disease (COVID-19) mortality based on population needs context.
STATEMENT
In his late-night press briefing on May 28, Duterte cited COVID-19 cases recorded so far in the country, saying:
“I would just like to announce to the public, as of today we have a total number of COVID cases of 15,588. Now the recoveries, 92 new ones, with the total of something like 3,598 to date. Ang patay po [The dead] is 921. So you would see that Philippines has ratio and proportion vis-à-vis with the population, we have a low rate of mortality here in this country. The total active cases is 11,069. So ang [the] NCR is topnotcher which is 330 or 61 percent. Then we have Region VII, 55; others. All in all, para sa akin, hindi naman masama ito [for me, it’s not that bad].”
Source: Presidential Communications Operations Office, Talk to the People of President Rodrigo Roa Duterte on Coronavirus Disease 2019 (COVID-19), May 28, 2020, watch from 30:10 to 31:36
FACT
In Southeast Asia, the Philippines has the second highest case fatality rate (CFR) at 5.9 percent as of May 28, next only to Indonesia at 6.1 percent, based on data from the World Health Organization (WHO).
The global CFR average is 6.27 percent, according to WHO’s situation report released on May 29. The CFR divides the number of deaths by the number of confirmed cases.
In terms of mortality per 100,000 population, the Philippines ranked first among Southeast Asian neighbors with an estimated 0.86 mortality rate on the same date.
Mortality rate references the country’s general population. It measures the probability of an individual in the population dying from the disease, not just those who are infected or confirmed with the disease.
It is usually calculated per 1,000 or 100,000 population “for a specific period.”
It is not clear which type of measurement Duterte used to gauge the state of the country’s COVID-19 fatalities, but, based on Johns Hopkins University and Our World in Data trackers, there are two ways of doing so: CFR and mortality per 100,000 people.
CFR is not constant because it changes with the context, depending on factors such as the location and characteristic of the infected population, like age and sex.
Healthcare expert Nemuel Fajutagana of the Medical Action Group (MAG) said the number of confirmed COVID-19 cases could depend on a country’s population pyramid or distribution of various age groups in a population.
Older people and individuals with pre-existing medical conditions are more susceptible to the virus than the rest of the population. (See VERA FILES FACT CHECK: Post on PH having ‘fewer’ COVID-19 cases vs Italy MISLEADING)
CFR may also “decrease or increase” over time as the responses to the COVID-19 changes.
A country’s health system, testing capacity and strategy to detect cases, method of reporting cases and deaths, and standard of care, among many factors, contribute to the varying CFR.
Epidemiologist Julia Racquel Rimando-Magalong, MAG board member, said “it’s hard to compare” among countries as they differ in approaches:
“Probably, hindi sila nag-quarantine agad [they did not quarantine immediately] so the spread was not curtailed earlier, kaya nag-spread for a while ‘yung virus [that’s is why the virus spread for a while] and affected more people. Depende rin sa bilis na ma-detect ‘yung case and bilis na makarating sa hospital para ma-treat [It also depends on how swift cases are detected and how fast these patients reach hospitals for treatment]…”
Asked which measurement best describes the current situation, Fajutagana said “CFR is still the most appropriate” for COVID-19 at this time.
Fajutagana explained that mortality rates are commonly measured for a specified population over a specified period, “usually a year” for regularly occurring diseases, like tuberculosis and measles. “This is COVID-19’s first appearance as a disease pattern” and, therefore, “may not be appropriate to use at this point.”
Both Fajutagana and Rimando-Magalong said it all boils down to how “[well], accurate, and reliable” the COVID-19 data is reported.
Sources
Presidential Communications Operations Office, Talk to the People of President Rodrigo Roa Duterte on Coronavirus Disease 2019 (COVID-19), May 28, 2020
RTVMalacañang Youtube, Meeting on COVID-19 Concerns and Talk to the People on COVID-19, May 28, 2020
Johns Hopkins University and Medicine, Maps and Trends: Mortality Analyses on May 28, 2020 Retrieved on June 4, 2020
Our World in Data, Case-fatality Ratio in Southeast Asian Region, June 3, 2020
World Health Organization, Coronavirus disease: Situation Report – 130, May 29, 2020
World Health Organization-Philippines, Personal communication, June 10, 2020
The World Bank, Population, total – Philippines, Indonesia, Brunei Darussalam, Singapore, Malaysia, Thailand, Myanmar, Cambodia, Vietnam, Lao PDR, Timor-Leste, Retrieved on June 11, 2020
Centers for Disease Control and Prevention, Mortality Frequency Measures: Case-fatality rate
Our World In Data, Mortality Risk of COVID-19: Interpreting the case fatality rate, June 4, 2020
Vox.com, Did the coronavirus get more deadly? The death rate, explained, March 11, 2020
World Economic Forum, 3 reasons we can’t compare countries’ coronavirus responses, May 5, 2020
Department of Health, COVID-19 FAQs: Who are most likely to present with severe symptoms?, March 2, 2020
Centers for Disease Control and Prevention, Frequently Asked Questions: Higher Risk, Who is at higher risk for serious illness from COVID-19, June 2, 2020
BBC News, Coronavirus: Why are international comparisons difficult?, May 18, 2020
Journal of Korean Medical Science, Understanding and Interpretation of Case Fatality Rate of Coronavirus Disease 2019, March 27, 2020. Retrieved on June 4, 2020
Encyclopedia Britannica, Case fatality rate, May 5, 2020
Oxford COVID-19 Evidence Service Research, Global Covid-19 Case Fatality Rates, March 17, 2020
Medical Action Group, Personal communication with Dr. Julia Racquel Rimando-Magalong, June 8, 2020
Medical Action Group, Personal communication with Dr. Nemuel Fajutagana, June 9, 2020
World Health Organization, Global Tuberculosis Report 2019. Retrieved on June 9, 2020
World Health Organization, Measles: Key facts, Dec. 5, 2019
(Guided by the code of principles of the International Fact-Checking Network at Poynter, VERA Files tracks the false claims, flip-flops, misleading statements of public officials and figures, and debunks them with factual evidence. Find out more about this initiative and our methodology.)
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