Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021

Situation summary

(Highlights of the current report) • Out of a total 876,225 confirmed cases reported in the 876,225 Philippines as of today, 54% are male, with the most affected age group 20-29 years (26%) followed by the age group 30-39 years Cases (23.6%) • 44% of the total number of cases are from the National Capital Region (NCR), followed by CALABARZON (17%), Central Luzon 703,625 (7.5%), Central Visayas (6.2%), Western Visayas (3.7%). • Out of the total 15,149 confirmed deaths, 60% are male, with the Recoveries most affected age group over-70 (35.3%) followed by the age group 60-69 years (27.7%). • 37.88% of the total number of deaths reported are from the NCR, 15,149 followed by CALABARZON (12.8%), Central Visayas (12%), Central Luzon (9%), Western Visayas (5%). Deaths • Currently, there are 170 functional laboratories performing tests for COVID-19 using RT-PCR or GenXpert • 1,093,651 individuals have received their 1 st dose of vaccine (576,561 with Sinovac and 517,090 with AstraZeneca) from 2,869 vaccination sites nationwide. 884,367 frontline HCW have received their first dose of vaccine.

Transmission assessment

At national level, the Philippines remains in Stage 2, localised community tr ansmission with some geographic areas showing higher transmission intensity and indications of widespread community transmission. There is ongoing evidence of an increasing trend in the number of cases and higher transmission in Region 3, Region 4A, and in the NCR which are at Stage 3, large scale community transmission . At national level, the bed occupancy rate for COVID-19 allocated beds is currently at 51.6% occupancy, with variation between regions.

Epidemiology As of 12 April 2021, a total of 876,225 confirmed COVID-19 cases and 15,149 deaths have been reported in the Philippines. The case fatality rate is 1.7%. Epi Update Tests Cases Deaths ICU Occupancy COVID-19 676,204 144,331 1,963 65.39% Tests past 14 days Cases in past 14 days Deaths in past 14 days

10,169,468 876,225 15,149 2,228 Cumulative unique Cumulative cases Cumulative deaths ICU beds for individuals tested COVID-19 cases 9.4% Cumulative Positivity Rate Health service 15,866 1,286 30,096 127,587 provision Healthcare worker cases Hospitals admitting Non-ICU beds for TTMF beds for COVID-19 (cumulative) COVID-19 patients COVID-19 cases COVID-19 cases

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Philippines Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021

Strategic approach to COVID-19 Prevention, Detection and Control

Health service delivery WHO Philippines (WHO PHL) continues to support the institutionalization of the One Hospital Command System in the Philippines both on its immediate needs and long-term plan. WHO PHL is regularly providing technical assistance to the Department of Health (DOH) One Hospital Command Center (OHCC) in monitoring the COVID-19 bed allocation and hospital and Temporary Treatment and Monitoring Facility occupancy of NCR and other priority regions. The government and the private sector continue to expand the healthcare capacity in response to the increasing number of cases in NCR Plus (NCR, Bulacan, Cavite, Laguna, Rizal) and other priority areas. As of 11 April 2021, 104 hospitals (private and public) committed to add 164 ICU beds and 1,157 regular beds in NCR Plus. In addition to the hospital beds, modular hospitals in Caloocan and were also built to accommodate moderate and severe cases. New isolation facilities were activated for mild and asymptomatic cases as well as for step-down care. Several tents were provided by WHO PHL and UNICEF for expansion of hospital triage and isolation. For healthcare workforce augmentation, DOH has also deployed several healthcare workers from different regions of the country to NCR hospitals.

A pre-hospital triage system at the local government units is being established to ensure that the beds in the hospitals, both government and private, and isolation facilities will be appropriately utilized. It is critical that the community and facilities adhere to the healthcare pathways resulting to the appropriate referral and back referral systems and efficient and rational utilization of these facilities. Regular collaboration with the Risk Communications and Community Engagement and Regional Outreach Pillar has provided an opportunity to increase awareness of the community on the appropriate healthcare pathway.

Laboratory and Testing At present, the COVID-19 laboratory network is composed of 210 licensed and functional laboratories across the Philippine archipelago. The COVID-19 laboratory network has tested over 10.9 million cumulative samples with a cumulative positivity rate of 9.5%. The average turnaround time of running COVID-19 tests upon receipt of the samples by the laboratory is within 24 to 48 hours.

Using the WHO Training Package, the DOH, led by the Research Institute for Tropical Medicine (RITM) and the Epidemiology Bureau (EB), conducted the training of trainers on proper use of Ag rapid detection tests (Ag RDTs) among local governments in the NCR Plus. The use of Ag RDTs will support accelerate the access to reporting results, decongestion of outpatient departments and additionally support outbreak investigation. Recording and reporting guidelines are being developed.

Bio-surveillance activities continue with weekly 750 samples from across the regions and provinces for genomic sequencing. As of April 10, 2021, a total of 5671 cumulative samples were sequenced nationwide. Among the variants of concern detected, B.1.1.7 variant has the highest number of cases accounting for 392 cases, B.1.351 variant with 344 cases and P.1 variant with 2 cases. In addition, the P.3 variant which was first detected in the Philippines and Japan has increased to 123 cases. Moreover, the Doherty Institute has commenced an initial review of biosurveillance data with the DOH, EB, RITM, UP National Institutes for Health and the Philippine Genome Center. This collaboration aims to set a sustainable whole genome sequencing protocol and meaningful analysis for reporting, policy and action.

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Philippines Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021

Risk Assessment, Surveillance and Contract Tracing Risk assessment The WHO Country Office has been working closely with the Western Pacific Regional Office to develop a transmission stage assessment (TSA) framework and tool to regularly evaluate the level of transmission of Covid-19 at the local, regional, and national levels: Stage 0: no cases; Stage 1: imported case(s); Stage 2: localized community transmission; Stage 3: large-scale community transmission. The assessment is currently being aligned with the DOH risk classification system for local government units (LGUs) to include various indicators such as notification rates, testing rates and severity of infections. This joint assessment has been recommended to DOH to guide response measures on the appropriate level of community quarantine that should be adopted by local chief executives (i.e. governors, mayors) at the provincial, city or municipality level. Further discussions with the Epidemiology Bureau are planned to discuss this joint risk assessment that will adopt the TSA according to the current context of risk classification.

Surveillance Due to the increase in hospital admissions for Covid-19 as a result of the surge of cases since late February, WHO PHL has started to regularly update the analysis on health care utilization bi-weekly to determine the red line of the upper limit of hospital bed capacity through the total bed utilization rate and the ICU bed utilization rate. The resulting analyses is discussed during the WCO IMT meeting and shared with DOH colleagues.

Contact Tracing Contact Tracing and Management’s (CTM) focus is on the tracing speed, identification of sources of transmission, and strict enforcement of quarantine and isolation. The following are the target process indicators set for CTM [Source: CT Handbook for LGUs]: • 100% of cases interviewed with close contacts listed within 24 hours • 70% of close contacts of the cases traced within 24 hours from case interview • 100 % of close contacts quarantines and monitored appropriately during the quarantine period • Suspect cases isolated within 8-24 hours

With the arrival of the vaccines, it is still imperative for the local health systems to strengthen the public health interventions especially the implementation contact tracing and management. CTM will remain to be a key public health measure, not just for the current COVID-19 response, but even for future health emergencies. We are in a critical juncture to establish a nationwide contact tracing system, as well as its implementation and quality assurance on national and sub-national levels.

The focus on CTM now is on the integration of the ICT protocol or the interoperability of different systems and application on CTM. A rapid review of the ICT integration protocol for contact tracing has been provided to Usec Vergeire of DOH and Usec Florece of DILG, as requested. Coordination with Regional Director Balboa of DOH-CHDMM has been undertaken regarding the priorities in the COVID-19 response in the region, with focus on issues and recommendations on contact tracing systems. Coordination with the Baguio City Health Department to assess the contact tracing process and analysis is being done to document good practices in the hope of replicating to other LGUs.

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Philippines Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021

Risk Communication and Community Engagement The WHO Country Office in the Philippines conducted a workshop on social listening and rumour management on 6 April 2021. The workshop included 25 communications experts from the Department of Health and infodemic managers from the Country Office and the Western Pacific Regional Office that co-facilitated the workshop. The workshop aimed to strengthen DOH’s capacity on the use of data and evidence to guide communications and to manage rumours and mis/disinformation around COVID-19 and vaccines. The Country Office team has developed content and materials for various communities (urban poor and faith-based organizations). These social media cards and content have been shared and available upon request.

Community engagement The Country Office team is actively working to strengthen civil society engagement in the COVID-19 response at national and local levels. The Davao Medical School Foundation, Inc. – Institute of Primary Health Care (DMSFI-IPHC) started implementation in March and have conducted several orientation meetings and planning sessions in barangays Sirib and Tamayong in Davao City. The initiative aims to build local capacity, develop a COVID-19 action plan, enhance a community surveillance system and raise awareness of COVID-19 preventive measures and vaccines. The team has also been working with two other partners (Building Inter Tribal Ecodevelopment, Inc. (BITE Inc.) Family Planning and Birthing Clinic and Families Choice) that have finalized their workplans in early April and will start implementation very soon. BITE Inc. aims to enhance COVID-19 and vaccine awareness for staff and patients at birthing/reproductive health facilities and train and develop community champions. The Families Choice initiative aims to enhance COVID-19 response and health support to indigenous and mining communities (small scale miners and their families) and to raise awareness of COVID-19 preventive measures and vaccines.

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Philippines Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021 Vaccines As of 13 April 2021, 1,093,651 Filipinos have been vaccinated with their 1 st dose vaccine against COVID19 within 2, 869 vaccination sites in the country. Of which, 576,561 individuals were vaccinated with Sinovac vaccine while 517,090 received the AstraZeneca vaccine.

There were 884,367 frontline healthcare workers in the Philippines, or 59.1% of the 1,495,315 masterlisted eligible Priority Group A1 population. Furthermore, there are 162,065 priority Group A1 or 10.8% who have completed their 2 nd dose of Sinovac during the said date (Table 1).

Table 1. Percentage of Vaccination Coverage – First Dose and 2nd Completed Dose, per region for Masterlisted Eligible Population Priority A1 as of April 13, 2021, 6 PM

Coverage Rate % (A1) 1ST & 2ND DOSE

Over-all Masterlisted Total Vaccinated Over-all Total Vaccinated Coverage REGION (Priority Group COMPLETED Coverage COMPLETED COMPLETED A1) FIRST DOSE FIRST DOSE 2 DOSES 2 DOSES

NCR 260,791 230,109 88.2% 55,786 21.39% CAR 40,546 28,849 71.2% 6,800 16.8% 1 79,322 39,728 50.1% 7,060 8.9% 2 69,374 23,143 33.4% 7,233 10.4% 3 120,002 97,564 81.3% 6,908 5.8% 4A 121,832 91,564 75.2% 3,058 2.5% Mimaropa 40,546 20,949 51.7% 3,001 7.4% 5 71,510 22,543 31.5% 3,126 4.4% 6 124,994 36,599 29.3% 12,287 9.8% 7 131,781 75,004 56.9% 13,836 10.5% 8 82,047 22,566 27.5% 3,405 4.2% 9 53,294 27,063 50.8% 7,936 14.9% 10 84,733 47,447 56.0% 8,378 9.9% 11 84,692 41,935 49.5% 11,776 13.9% 12 62,328 44,756 71.8% 6,468 10.4% CARAGA 53,362 25,617 48.0% 3,606 6.8% BARMM 14,161 8,931 63.1% 1,401 9.9% PHIL 1,495,315 884,367 59.1% 162,065 10.8%

Several regions have also started to administer the 1st dose of COVID-19 vaccine to 69,551 senior citizens (Priority Group A2). For those under Priority Group A3, a total of 139,733 individuals with comorbidity received their 1st dose of vaccine against COVID-19, as of the above-mentioned date.

Operational Support and Logistics (OSL) The OSL Team has linked up with the DOH to assess the surge capacity of the health system in terms of availability of PPE and essential medicines at the national and subnational levels. The Supply Chain Management Service has already requested their Planning Team to check the inventory of essential medicines, particularly that of Dexamethasone in the CHDs. The OSL Team will continue working closely with DOH to improve the tracking of supplies for detailed stock data.

WHO-PHL received a 2nd request from DOH for the provision of additional 50 units of oxygen concentrator to augment the COVID-19 response in Regions II, III, and IV-A. The Country Office is liaising with WPRO for the release of the items at the regional warehouse. Coordination with the DOH Donations Teams/Office of Civil Defense Warehouse is also being undertaken to deliver the said items to the government warehouse at the earliest possible time. The 2,000 units of WHO-donated temperature monitoring device

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Philippines Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021 (Fridge-tag 2 E) meant to support the COVID-19 vaccination campaign of the Department of Health arrived in the country over the weekend. The Country Office has been closely coordinating with the Supply Chain Management Service of the Department of Health to arrange the transfer of this consignment to DOH Central Office Warehouse.

Partner Coordination In response to the recent surge of COVID-19 cases, UNICEF has provided eight tents for triage and isolation requested by Department of Health Metro Center for Health Development and hospitals. These included seven hospitals across (DOH-Quezon Institute Off-site Modular Hospital, San Lazaro Hospital, Tondo Medical Center, National Kidney and Transplant Institute, Dr. Jose N. Rodriguez Memorial Hospital, Lung Center of the Philippines, and National Center for Mental Health), and Jose B. Lingad Memorial General Hospital in San Fernando, Pampanga.

UNICEF tent in Dr. Jose N. Rodriguez Memorial Hospital

Delivery of UNICEF tent to the Lung Center of the Philippines

One year after the COVID-19 outbreak in the Philippines outbreak, UNICEF gathered insights from young people on how they cope with the pandemic. The video was posted on Facebook and reached 17,000 users and was viewed over 8,000

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Philippines Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021 times. The Voices of Youth video is available here: https://www.facebook.com/unicefphilippines/posts/10159782282265572

On 31 March, UNICEF issued a joint press release with the Embassy of the Japan in the Philippines on the ongoing support to the Philippine Government to strengthen the COVID-19 immunization response in the country. It was picked up widely by online and traditional media and was the top performing post on Facebook, reaching 3.9 million users. The PR is available here: https://www.unicef.org/philippines/press- releases/government-japan-pledges-php190m-agreement-unicef-strengthen-covid-19-immunization

Org Items Delivered Expected Tents for triage and isolation purposes 82 72m 2 and 42m 2 Modular tents for isolation facility 200 Coveralls for health workers 72,380 Face shields 33,000 N95 masks for health workers 35,680 Surgical Masks 406,750 Reusable cloth masks 76,500 Gloves, heavy duty, rubber/nitrile 1,000 Goggles, protective, indirect -side -venti 500 Apron, protection, plastic, resusable 500 Boots, rubber/PVC, reusable, pair 500 UNICEF Coveralls for cleaning and disinfection 1,000 personnel N95 masks for cleaning and disinfection 15,000 personnel Cleaning and Disinfection kits 1,196 100 Water kits 2,738 Hygiene kits 7,540 Handwashing facilities 210 Temporary drinking water facilities 15 Temporary sanitation facilities 67 Chlorine pool testers for water quality 12 monitoring Bulk water storages/bladders 6

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Philippines Coronavirus Disease 2019 (COVID-19) Situation Report #74 1212 April 2021 Data reported by the Department of Health on 12 April 2021

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