CPBRD Policy Brief

No. 2020 - 05

A Risk Assessment on the Covid-19

Situation in the Philippines:
Implications on the ECQ Policy

Congressional Policy and Budget Research Department

House of Representatives
 Abstract

COVID-19 risk assessment is multi-faceted. The highly infectious nature of the virus in a naïve
population, the high case fatality rate and health system over-burdening each need to
be considered in developing a strategy to control the spread of the virus and mitigate its
health and economic consequences. This note provides a framework for classifying LGUs by
degree of risk and identifies policy options for each risk scenario. It urges the Department
of Health (DOH) to: (i) re-assess risk levels of local government units (LGUs), (ii) undertake a
100 percent identification of place of residence of all COVID-19 confirmed cases and 100
percent reporting of number of isolation beds and ventilators by all hospitals, and (iii) develop
and immediately implement a COVID-specific disease surveillance protocol, including mass
testing, contact tracing, and quarantine. Careful and diligent implementation of these
protocols will allow a gradual yet cautious and informed re-opening of the economy.
The views, opinions, and interpretations in this report do not reflect the perspectives of the House of
Representatives as an institution or its individual Members.
 1

A Risk Assessment on the Covid-19 Situation in the Philippines:

Implications on the ECQ Policy

by SA. Quimbo, PhD1 , CT. Latinazo2 , JW. Peabody, MD, PhD3

COVID-19 risk assessment is multi-faceted. The highly infectious nature of the virus in a
naïve population, the high case fatality rate and health system over-burdening each need
to be considered in developing a strategy to control the spread of the virus and mitigate its
health and economic consequences. This note provides a framework for classifying LGUs
by degree of risk and identifies policy options for each risk scenario. It urges the Department
of Health (DOH) to: (i) re-assess risk levels of local government units (LGUs), (ii) undertake
a 100 percent identification of place of residence of all COVID-19 confirmed cases and 100
percent reporting of number of isolation beds and ventilators by all hospitals, and (iii) develop
and immediately implement a COVID-specific disease surveillance protocol, including mass
testing, contact tracing, and quarantine. Careful and diligent implementation of these protocols
will allow a gradual yet cautious and informed re-opening of the economy.

1. ECQ Policy

On 25 April 2020, it was announced that the Enhanced Community Quarantine (ECQ) will be
extended until 15 May 2020 in NCR, Region 3 (excluding Aurora), Region 4-A, and the following
provinces: Pangasinan, Benguet, the Island of Mindoro, Albay, Catanduanes, Antique, Iloilo,
Cebu, and Davao del Norte.

All other areas will be under General Community Quarantine, but will be classified as under
review, low risk area, or moderate risk area.

This note provides technical inputs on guidelines for implementing the various types of
quarantine.

2. Estimates of Covid-19 Incidence

Current testing is limited in the Philippines; that is, the number of actual cases and deaths from
COVID-19 are unknown. Without more testing of every symptomatic patient and conducting
estimates of infection in the population, the true number of infections is difficult to know and
harder to project. Experience from other countries may be helpful. In one analysis, 88 percent
of all deaths were in patients with two co-morbidities. In another analysis, which accounts
for the large number of asymptomatic patients who are infected, the overall death rate is 0.5
percent. These data not only underscore the importance of rapidly scaling up testing, they
highlight why we use prevalence and hospital readiness for these quarantine guidelines.

1
Representative, Second District of Marikina City, House of Representatives; former Professor, UP School of Economics
2
Head, Economic Policy Research Unit, Office of Representative SA. Quimbo, House of Representatives
3
President and Founder, QURE Healthcare Professor; Professor, UCSF and UCLA
 2

3. Risk Assessment

Following Cadena et al. (2020), two types of risk assessment are needed the LGU level: the
risk of virus spread and the risk of over-burdening the health system in the provision of needed
medical care for those found to be infected as they continue caring for other non-COVID-19
patients.

Risk of virus spread is measured by: (i) the number of confirmed cases per 10,000 population,
and (ii) the average land area per confirmed case, as a measure of the ability to practice social
distancing.

Risk of health system over-burdening is measured by: (i) the number of isolation rooms per
active case (defined as total number of symptomatic cases less recoveries less deaths), and
(ii) the number of ventilators per active case. Local and global standards are adopted to define
what constitutes a minimum requirement for isolation beds and ventilators per active case.

The choice of indicators per type of risk is determined partly by data availability. This note uses
data on confirmed COVID-19 cases from 30 January to 25 April 2020 and the latest reported
capacity of health facilities, sourced from the online COVID-19 Data Drop of the DOH.

LGUs will be ranked on the basis of the risk indicators above. The rankings will form a score
for each type of risk, with equal weights assigned to each indicator for each type of risk. By
classifying each score as either Low, Medium, or High, each LGU will be assigned a specific
cell in a 3 x 3 matrix of risks.

For example, an LGU that ranks poorly in terms of both a high number of confirmed cases per
10,000 population and a low average land area per confirmed case will be considered as “high
risk” for virus spread. If this LGU has more than 1 isolation room and 1 ventilator per active
case, it is classified as “low risk” for health system over-burdening. Hence, this LGU shall be
in the cell for “high risk of virus spread”/ “low risk of health system over-burdening.”

For COVID-free provinces, risk of virus spread is assessed on the basis of (i) proportion of
population aged 60 years old and above, and (ii) population density.

In cases where the risk classification may be ambiguous due to other important considerations,
the higher risk classification holds, but will be subject to disease surveillance (DS) and possible
eventual re-classification into the higher or lower risk category, whichever is warranted by the
results of DS.

Key elements of DS include reporting to the DOH on the basis of (i) contact tracing, (ii) area-
based mass testing, and (iii) work-based mass testing.

This matrix will be regularly updated. When provinces become COVID-free on a sustained
basis (14 days of no reported new cases), they will no longer be included in the risk assessment
matrix, but will still subject to the health protocols for COVID-free provinces (largely, for DS).

Policy recommendations will be identified for each cell.

 3

4. Risk of Virus Spread

The total number of COVID-19 cases as of 25 April 2020 has reached 7,294 (see Table 1).
NCR accounts for close to 60 percent of all cases, followed by Region 4-A (9.8 percent),
Region 3 (8.7 percent), and Region 7 (5.4 percent). Relative to population, these same 4
regions have the highest number of infections. Moreover, the average land area per case is
lowest for the same regions. Hence, at the regional level, these 4 regions – NCR, 3, 4-A, and
7 – appear to be at the highest risk level. In the case of Region 7, however, since 98 percent
of the cases are in a single province (Cebu), Region 7 can be downgraded in terms of risk
level, but subject to DS. With an increased number of provinces with infections, Region 7 can
be reclassified as “high risk.”

At the region level, for risk of virus spread:

• NCR, Regions 3, and 4-A are high-risk areas

Table 1
Number of Covid-19 Cases and Other Indicators, by Region
Number of
Number of provinces
2020 Land area per
Number Land Area cases per accounting for at
Region Population number of
of cases (sq km) 10,000 least 90 percent
(estimated) cases
population of cases
(total with cases)
NCR 4,359 14,020,962 619.54 3.109 0.14 13
CAR 26 1,874,948 19,818.12 0.139 762.24 1
Region 1 48 5,472,530 12,964.62 0.088 270.10 2
Region 2 28 3,757,951 29,836.88 0.075 1,065.60 3
Region 3 638 12,214,533 21,906.19 0.522 34.34 5
Region 4-A 714 15,695,039 16,576.26 0.455 23.22 3
Region 4-B 17 3,226,554 29,606.25 0.053 1,741.54 3
Region 5 37 6,311,855 18,114.47 0.059 489.58 2
Region 6 61 8,205,736 20,778.29 0.074 340.63 4
Region 7 399 8,053,862 15,872.58 0.495 39.78 1
Region 8 8 4,834,507 23,234.78 0.017 2,904.35 2
Region 9 11 3,952,166 16,904.03 0.028 1,536.73 1
Region 10 12 5,105,788 20,458.51 0.024 1,704.88 3
Region 11 116 5,327,924 20,433.38 0.218 176.15 2
Region 12 16 4,948,970 22,786.08 0.032 1,424.13 3
BARMM 10 4,117,235 36,650.95 0.024 3,665.10 1
CARAGA 3 2,827,339 21,120.56 0.011 7,040.19 1
Residence not
yet identified 791
TOTAL 7,294
 4

It is noteworthy that 791 (11 percent) of all confirmed cases have unknown places of residence.
This means that contact tracing cannot be properly implemented. As a result, COVID-19
suspects cannot be properly identified, forestalling the conduct of testing and quarantine
protocols.

Table 2 shows the: (i) 20 provinces with the highest number of cases, (ii) provinces not among
the top 20 but were included by the Inter-agency Task Force (IATF) as candidates for extended
ECQ, and (iii) all other provinces with at least one confirmed case. All but 3 of the 25 provinces
in (i) and (ii) were classified as “high risk” by the IATF, with 8 of these “high risk” provinces as
being subject to evaluation or government rechecking. The remaining 3 of these 25 provinces
were classified as “moderate risk,” with 2 being subject to evaluation.

The 20 provinces with the highest number of cases account for about 87 percent of all cases.
Among provinces, Metro Manila has the highest number of cases, followed by Cebu and
Rizal, with 4359, 391, and 339 cases, respectively. In terms of number of cases per 10,000
population and average land area per case, the top 4 provinces at highest risk of virus
spread are Metro Manila, Cebu, Rizal, and Laguna. Bataan has a relatively high number of
cases relative to population size, although its larger land area somehow mitigates the risk of
COVID-19 transmission. On the other hand, while Cavite does not have the highest number
of cases per 10,000 population, its relatively small land area increases its risk of COVID-19
transmission.

Provinces including Pangasinan, Benguet, the Island of Mindoro, Catanduanes, Antique,

Iloilo, and Davao del Norte have been identified as candidates for extended ECQ. As Table 2
indicates, these provinces may not be “high risk” for virus spread areas based on the chosen
metrics.

To illustrate, at the province level, for risk of virus spread:

• Metro Manila, Cebu, Rizal, Laguna and Cavite are high-risk areas

The risk classification of each province with confirmed COVID-19 cases will be shown in
section 6.

Table 2
Number of Covid-19 Cases and Other Indicators, by Province

Region Province IATF Status Estimated Land area Number of Land

Cases
2020 (square km) cases/10k area/number
Population population of cases

Top 20 Provinces

NCR Metro Manila High risk 4359 13,280,900 619.54 3.28 0.14
High risk, subject to
7 Cebu evaluation 391 4,916,300 5,342.00 0.80 13.66

4-A Rizal High risk 339 3,152,000 1,182.65 1.08 3.49

4-A Laguna High risk 296 3,266,500 1,928.23 0.91 6.49

 5

Region Province IATF Status Table 2Estimated Land area Number of Land
Cases
Number of Covid-19 Cases and Other Indicators, 2020 (square km) cases/10k
by Province area/number
(Continued)
Population population of cases
Region Province IATF Status Estimated Land area Number of Land
Cases
Top 20 Provinces
2020 (square km) cases/10k area/number
Population population of cases
NCR Metro Manila High risk 4359 13,280,900 619.54 3.28 0.14
High risk, subject to Top 20 Provinces
7 Cebu evaluation 391 4,916,300 5,342.00 0.80 13.66
NCR Metro Manila High risk 4359 13,280,900 619.54 3.28 0.14
4-A Rizal Highsubject
High risk, risk to 339 3,152,000 1,182.65 1.08 3.49
7 Cebu evaluation 391 4,916,300 5,342.00 0.80 13.66
4-A Laguna High risk 296 3,266,500 1,928.23 0.91 6.49
4-A Rizal High risk 339 3,152,000 1,182.65 1.08 3.49
4-A Cavite High risk 236 3,894,200 1,526.28 0.61 6.47
4-A Laguna High risk 296 3,266,500 1,928.23 0.91 6.49
3 Bulacan High risk 107 3,579,500 2,783.69 0.30 26.02
4-A Cavite High riskrisk,
Moderate 236 3,894,200 1,526.28 0.61 6.47
11 Davao del Sur subject to evaluation 100 2,834,700 4,607.59 0.35 46.08
3 Bulacan High risk 107 3,579,500 2,783.69 0.30 26.02
4-A Batangas High riskrisk,
Moderate 85 2,795,600 3,115.05 0.30 36.65
11 Davao del Sur subject to evaluation 100 2,834,700 4,607.59 0.35 46.08
3 Bataan High risk 75 799,000 1,372.98 0.94 18.31
4-A Batangas High risk 85 2,795,600 3,115.05 0.30 36.65
3 Pampanga High risk 58 2,700,900 2,064.59 0.21 35.60
3 Bataan High risk 75 799,000 1,372.98 0.94 18.31
4-A Quezon High risk 54 2,334,200 8,824.05 0.23 163.41
3 Pampanga High risk 58 2,700,900 2,064.59 0.21 35.60
3 Nueva Ecija High risk 48 2,234,900 5,689.69 0.21 118.54
4-A Quezon High risk,
Highsubject
risk to 54 2,334,200 8,824.05 0.23 163.41
1 Pangasinan evaluation 32 3,293,100 5,450.59 0.10 170.33
3 Nueva Ecija Highsubject
High risk, risk to 48 2,234,900 5,689.69 0.21 118.54
3
Region Tarlac
Province evaluation
HighIATF
risk,Status
subject to 27 1,450,400
Estimated 3,046.49
Land area 0.19 of
Number 112.83
Land
1 Pangasinan Highevaluation
risk, subject to Cases
32 3,293,100 5,450.59 0.10 170.33
2020 (square km) cases/10k area/number
6 Iloilo Highevaluation
risk, subject to 26 2,554,800
Population 5,075.98 0.10
population 195.23
of cases
3 Tarlac evaluation 27 1,450,400 3,046.49 0.19 112.83
High risk, subject to
36 Zambales
Iloilo evaluation 26 883,000
2,554,800 3,815.35
5,075.98 0.29
0.10 146.74
195.23
5 Albay High risk 25 1,476,700 2,574.91 0.17 103.00
High risk, subject to 5,387.09
CAR Benguet evaluation 23 868,100 0.26 234.22
Negros
6 Occidental Moderate risk 15 3,394,100 8,004.83 0.04 533.66

Moderate risk,
2 Cagayan subject to evaluation 14 1,281,400 9,398.07 0.11 671.29
Other provinces considered for ECQ
High risk, subject to
6 Antique evaluation 8 672,000 2,730.67 0.12 341.33

5 Catanduanes High risk 2 306,500 1,492.16 0.07 746.08

Occidental
4-B Mindoro High risk 6 566,300 5,851.09 0.11 975.18
Oriental
4-B Mindoro High risk 6 972,200 4,238.38 0.06 706.40
Davao del High risk, subject to
11 Norte evaluation 11 1,135,200 3,422.61 0.10 311.15
 High risk, subject to
3 Zambales evaluation 26 883,000 3,815.35 0.29 146.74
5 Albay High risk 25 1,476,700 2,574.91 0.17 103.00
High risk, subject to 5,387.09
CAR Benguet evaluation 23 868,100 0.26 234.22
6 Negros
6 Occidental Moderate risk 15 3,394,100 8,004.83 0.04 533.66

Moderate risk, Table 2

2Number Cagayan subject
of Covid-19 Cases to evaluation
and Other 14 Indicators,
1,281,400 9,398.07
by Province0.11
(Continued)671.29
Other provinces considered for ECQ
Region Province HighIATF
risk,Status
subject to Estimated Land area Number of Land
Cases
6 Antique evaluation 8 672,000
2020 2,730.67
(square 0.12
km) cases/10k 341.33
area/number
Population population of cases
5 Catanduanes High risk 2 306,500 1,492.16 0.07 746.08
Occidental Moderate risk,
4-B1 Ilocos Norte
Mindoro subjectHigh
to evaluation
risk 46 602,600
566,300 3,418.75
5,851.09 0.07
0.11 854.69
975.18
Oriental Moderate risk,
4-B Marinduque
Mindoro subjectHigh
to evaluation
risk 46 273,100
972,200 952.58
4,238.38 0.15
0.06 238.15
706.40
Davao del Moderate
High risk, to
risk, subject
12
11 SouthNorte
Cotabato subject to eval
evaluation 4
11 1,667,300
1,135,200 4,285.90
3,422.61 0.02
0.10 1071.48
311.15
Samar Other provinces with COVID-19 cases
(Western Moderate
Moderate risk,
risk,
18 LaSamar)
Union subject
subject to
to evaluation
evaluation 4
11 894,500
827,900 6,048.03
1,499.28 0.04
0.16 1512.01
115.33
Zamboanga del Moderate risk,
Moderate risk,
CAR
9 Abra
Sur subject
subject to
to evaluation
evaluation 3
11 264,700
2,122,400 4,199.72
4,484.21 0.11
0.05 1399.91
407.66
Agusan del Moderate risk,
CARAGA
5 Norte Sur subjectLow
Camarines risk
to evaluation 3
10 791,900
2,248,800 3,427.63
5,511.90 0.04
0.04 1142.54
551.19
11
BARMM Davao
LanaoOriental
del Sur Moderate
Moderate risk
risk 39 1,135,200
1,216,600 5,679.64
15,055.51 0.03
0.07 1893.21
1672.83
8 Leyte Low risk
Moderate risk, 3 2,132,800 6,536.44 0.01 2178.81
12 Misamis
North Cotabato Moderate
subject risk,
to evaluation 9 1,519,600 9,317.30 0.06 1035.26
10 Oriental subject to evaluation
Moderate risk, 3 1,677,300 3,543.52 0.02 1181.17
2
12 Isabela
Sultan Kudarat subject to evaluation
Moderate risk 38 385,900
918,200 13,102.05
5,363.86 0.21
0.03 1637.76
1787.95
Compostela Moderate risk,
Moderate risk,
6
11 Aklan
Valley subject to evaluation
subject to evaluation 27 627,400
836,700 1,760.30
4,560.09 0.11
0.02 251.47
2280.05
7 Misamis
Negros Oriental Moderate
Moderate risk,
risk 7 1,511,000 5,420.57 0.05 774.37
10 Occidental subject to evaluation
Moderate risk, 2 665,200 2,006.63 0.03 1003.32
27 Nueva Vizcaya
Bohol subjectLow
to evaluation
risk 16 498,900
1,516,800 4,813.88
4,772.52 0.12
0.01 802.31
4772.52
Region Province Moderate
IATF risk,
Status Estimated Land area Number
10 Bukidnon Low risk 1
Cases 1,513,600 10,498.59 0.01 of Land
10498.59
6 Capiz subject to evaluation 5 810,700
2020 2,594.64
(square km) 0.06
cases/10k 518.93
area/number
10 Camiguin
Lanao del Low riskrisk,
Moderate 1 100,300
Population 241.44 0.10
population 241.44
of cases
1
10 Ilocos
NorteSur Low risk
subject to eval 15 722,000
1,125,700 2,596.00
4,167.53 0.01
0.04 2596.00
833.51
Moderate risk,
BARMM
1 Maguindanao
Ilocos Norte subject to evaluation 14 1,204,900
602,600 9,968.31
3,418.75 0.01
0.07 9968.31
854.69
Northern Moderate risk,
8
4-B Samar
Marinduque subjectLow risk
to evaluation 14 734,600
273,100 3,694.96
952.58 0.01
0.15 3694.96
238.15
4-B Palawan Moderate
Low riskrisk, 1 1,253,200 17,030.75 0.01 17030.75
12 South Cotabato subject to eval 4 1,667,300 4,285.90 0.02 1071.48
4-B Romblon Low risk 1 345,200 1,533.45 0.03 1533.45
Samar
Total
(Western Moderate risk, 6,503* 32,145,000 168,086 2.02 25.85
8 Samar) subject to evaluation 4 894,500 6,048.03 0.04 1512.01
Moderate risk,
CAR Abra subject to evaluation 3 264,700 4,199.72 0.11 1399.91
Agusan del
CARAGA Norte Low risk 3 791,900 3,427.63 0.04 1142.54
11 Davao Oriental Moderate risk 3 1,135,200 5,679.64 0.03 1893.21
8 Leyte Low risk 3 2,132,800 6,536.44 0.01 2178.81
Misamis Moderate risk,
10 Oriental subject to evaluation 3 1,677,300 3,543.52 0.02 1181.17
12 Sultan Kudarat Moderate risk 3 918,200 5,363.86 0.03 1787.95
Compostela Moderate risk,
11 Valley subject to evaluation 2 836,700 4,560.09 0.02 2280.05
Misamis Moderate risk,
10 Occidental subject to evaluation 2 665,200 2,006.63 0.03 1003.32
7 Bohol Low risk 1 1,516,800 4,772.52 0.01 4772.52
10 Bukidnon Low risk 1 1,513,600 10,498.59 0.01 10498.59
 Moderate risk,
12 South Cotabato subject to eval 4 1,667,300 4,285.90 0.02 1071.48
Samar
(Western Moderate risk,
8 Samar) subject to evaluation 4 894,500 6,048.03 0.04 1512.01
7
Moderate risk,
CAR Abra subject to evaluation 3 264,700 4,199.72 0.11 1399.91
Agusan del
CARAGA NorteLow risk Table
3 2791,900 3,427.63 0.04 1142.54
Number of Covid-19 Cases and Other Indicators, by Province (Continued)
11 Davao Oriental Moderate risk 3 1,135,200 5,679.64 0.03 1893.21
8
Region Leyte
Province LowStatus
IATF risk 3 2,132,800
Estimated 6,536.44
Land area 0.01 of
Number 2178.81
Land
Misamis Moderate risk, Cases
2020 (square km) cases/10k area/number
10 Oriental subject to evaluation 3 1,677,300
Population 3,543.52 0.02
population 1181.17
of cases
12 Sultan Kudarat Moderate risk 3 918,200 5,363.86 0.03 1787.95
Compostela Moderate risk,
1
11 Ilocos Norte
Valley subject to evaluation 42 602,600
836,700 3,418.75
4,560.09 0.07
0.02 854.69
2280.05
Misamis Moderate risk,
4-B
10 Marinduque
Occidental subject to evaluation 42 273,100
665,200 952.58
2,006.63 0.15
0.03 238.15
1003.32
7 Bohol Moderate
Low riskrisk, 1 1,516,800 4,772.52 0.01 4772.52
12 South Cotabato subject to eval 4 1,667,300 4,285.90 0.02 1071.48
10 Bukidnon Low risk 1 1,513,600 10,498.59 0.01 10498.59
Samar
10 Camiguin
(Western Low riskrisk,
Moderate 1 100,300 241.44 0.10 241.44
81 Samar)
Ilocos Sur subjectLow
to evaluation
risk 41 894,500
722,000 6,048.03
2,596.00 0.04
0.01 1512.01
2596.00
Moderate risk,
CAR
BARMM Abra
Maguindanao subject to evaluation 31 264,700
1,204,900 4,199.72
9,968.31 0.11
0.01 1399.91
9968.31
Agusan del
Northern
CARAGA
8 Norte
Samar Low risk 31 791,900
734,600 3,427.63
3,694.96 0.04
0.01 1142.54
3694.96
11
4-B Davao Oriental
Palawan Moderate
Low riskrisk 31 1,135,200
1,253,200 5,679.64
17,030.75 0.03
0.01 1893.21
17030.75
8
4-B Leyte
Romblon Low risk 31 2,132,800
345,200 6,536.44
1,533.45 0.01
0.03 2178.81
1533.45
Misamis
Total Moderate risk, 6,503* 32,145,000 168,086 2.02 25.85
10
*Excluding Oriental
the 791 subject to evaluation
cases with unidentified places of residence3 1,677,300 3,543.52 0.02 1181.17
12 Sultan Kudarat Moderate risk 3 918,200 5,363.86 0.03 1787.95
Within NCR,Compostela
Quezon CityModerate
and the risk,city of Manila account for the highest number of cases,
11 Valley subject to evaluation 2 836,700 4,560.09 0.02 2280.05
accounting for 25.5 and 13.4 percent of all cases, respectively (see Table 3). However,
Misamis Moderate risk,
San10Juan, Occidental
Mandaluyong, Makati,
subject and Paranaque
to evaluation 2 have the highest
665,200 2,006.63 number
0.03 of cases per 10
1003.32
thousand
7
population.
Bohol
TheseLow cities
risk
– particularly,
1
San Juan, Mandaluyong,
1,516,800 4,772.52
and Makati
0.01
– have
4772.52
the smallest land area per case.
10 Bukidnon Low risk 1 1,513,600 10,498.59 0.01 10498.59
10 city level
At the Camiguin
in the NCR, Low risk of virus spread:
for risk 1 100,300 241.44 0.10 241.44
1 Ilocos Sur Low risk 1 722,000 2,596.00 0.01 2596.00
• San Juan, Mandaluyong, Makati are high-risk areas
Moderate risk,
BARMM Maguindanao subject to evaluation 1 1,204,900 9,968.31 0.01 9968.31
Northern
Table 3
8 Samar
Number Low
of risk 1
Covid-19 Cases 734,600
and Other3,694.96
Indicators0.01 3694.96
4-B Palawan Lowby
risk City/Municipality
1 1,253,200 17,030.75
in NCR 0.01 17030.75
4-B Romblon Low risk 1 345,200 1,533.45 0.03 1533.45
2020 Number of Land
City/Municipality
Total Land
6,503* 32,145,000 area
168,086 cases/10k
2.02 25.85
Cases Population area/number
(square km)
(estimated) population of cases

Quezon City 1,110 3,028,151 171.71 3.67 0.15

City of Manila 591 1,835,948 24.98 3.22 0.04
City of Paranaque 375 686,693 46.57 5.46 0.12
City of Makati 371 600,864 21.57 6.17 0.06
City of Mandaluyong 323 398,384 9.29 8.11 0.03
City of Pasig 261 778,975 48.46 3.35 0.19
Taguig City 225 830,146 45.21 2.71 0.20
City of San Juan 213 126,010 5.95 16.90 0.03
Caloocan City 186 1,633,629 55.80 1.14 0.30
Pasay City 155 429,578 13.97 3.61 0.09
City of Las Pinas 151 607,353 32.69 2.49 0.22
City of Muntinlupa 138 520,323 39.75 2.65 0.29
 2020 Number of Land
City/Municipality Land area
Cases Population cases/10k area/number
(square km)
(estimated) population of cases
8
Quezon City 1,110 3,028,151 171.71 3.67 0.15
City of Manila 591 1,835,948 24.98 3.22 0.04
City of Paranaque 375 Table 3
686,693 46.57 5.46 0.12
City of Makati Number of
371Covid-19 Cases and Other
600,864 21.57 Indicators
6.17 0.06
by City/Municipality in NCR (Continued)
9.29
City of Mandaluyong 323 398,384 8.11 0.03
City of Pasig 261 2020
778,975 48.46 Number
3.35 of Land
0.19
City/Municipality Land area
Taguig City Cases
225 Population
830,146 45.21km) cases/10k
2.71 area/number
0.20
(square
(estimated) population of cases
City of San Juan 213 126,010 5.95 16.90 0.03
Quezon
CaloocanCity
City 1,110
186 3,028,151
1,633,629 171.71
55.80 3.67
1.14 0.15
0.30
City
PasayofCity
Manila 591
155 1,835,948
429,578 24.98
13.97 3.22
3.61 0.04
0.09
City of Las
Paranaque
Pinas 375
151 686,693
607,353 46.57
32.69 5.46
2.49 0.12
0.22
City of Makati
Muntinlupa 371
138 600,864
520,323 21.57
39.75 6.17
2.65 0.06
0.29
Mandaluyong
City of Marikina 323
114 398,384
464,870 9.29
21.52 8.11
2.45 0.03
0.19
Pasig
City of Valenzuela 261
66 778,975
639,870 48.46
47.02 3.35
1.03 0.19
0.71
Taguig
City City
of Malabon 225
30 830,146
376,983 45.21
15.71 2.71
0.80 0.20
0.52
City of Navotas
San Juan 213
28 126,010
257,283 5.95
8.94 16.90
1.09 0.03
0.32
Caloocan
Pateros City 186
22 1,633,629
65,841 55.80
10.40 1.14
3.34 0.30
0.47
Pasay
Total City 155
4,359 429,578
13,280,900 13.97
619.54 3.61
68 0.09
4
City of Las Pinas 151 607,353 32.69 2.49 0.22
City of Muntinlupa 138 520,323 39.75 2.65 0.29
5.City
Risk of Health System Over-Burdening
of Marikina 114 464,870 21.52 2.45 0.19
City of Valenzuela 66 639,870 47.02 1.03 0.71
Based on DOH data, 65 percent
City of Malabon 30 of all confirmed
376,983 COVID-19
15.71 cases have0.80been admitted
0.52 to a
hospital. Moreover, according28to the WHO
City of Navotas (2020), about8.94
257,283 5 percent of1.09
COVID-19 cases0.32 will
require
Pateros critical care and ventilation.
22 These correspond
65,841 to a 0.65
10.40 isolation
3.34bed to active
0.47 case
ratio
Totaland a 0.05 ventilator to 4,359
active case13,280,900
ratio, respectively. Accounting for
619.54 68 an additional4 buffer
for capacity, an isolation bed to active case ratio of 0.80 and a ventilator to active case ratio
of 0.10, together, are adopted as minimum standards. Among the provinces with the highest
number of total cases, namely, Metro Manila, Cebu, Laguna, Rizal and Cavite, only Cebu
meets the minimum standards for isolation beds and ventilators per number of active cases
(see Table 4).

At the province level, for risk of health system over-burdening:

• Metro Manila, Laguna, Rizal, and Cavite are high-risk areas

 Quezon 47 0.62 0.06
Pampanga 46 3.48 1.89
Nueva Ecija 43 1.63 0.47
Batangas 40 1.18 1.05
Bataan 34 3.79 0.44
9
Davao del Sur 30 6.97 1.63
Pangasinan 25 6.44 1.24
Tarlac 24 3.42 0.92
Zambales 20
Table 4 1.85 0.70
Health Sector Capacity Indicators, by Province (Continued)
Albay 13 3.00 0.31
La UnionProvince Active
8 Isolation beds
13.63per active Ventilators per active
3.00
Benguet symptomatic 7 cases symptomatic
13.43 case symptomatic
3.00 case
Metro
CamarinesManilaSur 2,9737 0.45
9.29 0.18
0.86
Cebu
Iloilo 293 7 0.82
34.57 0.22
5.14
Laguna
Negros Occidental 265 6 0.20
26.17 0.05
6.17
Rizal
Aklan 251 5 0.31
4.80 0.07
1.20
Cavite
Davao del Norte 179 5 0.37
19.00 0.13
0.60
Bulacan
Zamboanga del Sur 77 5 1.91
40.40 0.26
4.20
Quezon
Cagayan 47 2 0.62
59.00 0.06
8.00
Pampanga
Catanduanes 46 2 3.48
9.50 1.89
1.50
Nueva Ecija
Ilocos Norte 43 2 1.63
51.00 0.47
2.50
Batangas
Lanao del Sur 40 2 1.18
7.50 1.05
1.50
Bataan
Leyte 34 2 3.79
74.00 0.44
3.00
Davao del
Nueva Vizcaya Sur 30 2 6.97
41.50 1.63
2.00
Pangasinan
Oriental Mindoro 25 2 6.44
36.50 1.24
4.00
Tarlac
Western Samar 24 2 3.42
11.00 0.92
0.50
Zambales
Agusan del Norte 20 1 1.85
56.00 0.70
3.00
Albay
Antique 13 1 3.00
10.00 0.31
2.00
La Union
Bukidnon 81 13.63
106.00 3.00
10.00
Benguet
Capiz 71 13.43
99.00 3.00
8.00
Camarines
CompostelaSur Valley 71 9.29
7.00 0.86
0.00
Iloilo
Ilocos Sur 71 34.57
70.00 5.14
5.00
Negros
Isabela Occidental 61 26.17
117.00 6.17
16.00
Aklan
Lanao del Norte 51 4.80
49.00 1.20
11.00
Davao del Norte
Negros Oriental 51 19.00
69.00 0.60
3.00
Zamboanga del Sur
Occidental Mindoro 51 40.40
36.00 4.20
6.00
Cagayan
Romblon 21 59.00
52.00 8.00
2.00
Catanduanes
South Cotabato 21 9.50
82.00 1.50
25.00
Ilocos
*Data Norteon self-reported data from health2 care facilities
is based 51.00 2.50
Lanao del Sur 2 7.50 1.50
Leyte 2 74.00
Within NCR, not all the cities have sufficient numbers of isolation beds and ventilators 3.00 per
Nueva Vizcaya 2 41.50
active case, as reported to DOH (see Table 5). Since the NCR population is fairly mobile, 2.00
Oriental Mindoro 2 36.50 4.00
however, COVID-19 patients who reside in Metro Manila can choose to be admitted to
Western Samar 2 11.00 0.50
hospitals
Agusan del outside
Norte their place of residence. 1 Mandaluyong56.00 and Navotas appear to 3.00 be at highest
risk of health system over-burdening.
Antique 1 Overall, NCR has fewer than the required2.00
10.00 0.8 isolation
beds
Bukidnonper case. The DOH must endeavor 1 to complete 106.00
data on isolation beds and 10.00ventilators
Capiz 1 99.00
(especially from San Juan and Pateros) in order for a more accurate assessment on risk of 8.00
Compostela Valley 1 7.00 0.00
health system over-burdening to be done.
Ilocos Sur 1 70.00 5.00
Isabela 1 Table 5 117.00 16.00
Lanao del NorteHealth Sector Capacity 1 Indicators, by City/Municipality
49.00 in NCR11.00
Negros Oriental 1 69.00 3.00
Active Total COVID-19
Occidental Mindoro 1Isolation beds per active 36.00 Ventilators
6.00per active
Symptomatic beds per active
Romblon City/Municipality 1 symptomatic case 52.00 symptomatic
2.00 case
Cases symptomatic case
South Cotabato 1 82.00 25.00
Quezon City 765 0.70 1.12 0.27
City of Manila 398 0.70 1.15 0.31
City of Paranaque 248 0.06 0.14 0.06
City of Makati 243 0.29 0.35 0.12
City of Mandaluyong 238 0.04 0.12 0.00
City of Pasig 156 0.85 1.78 0.29
Taguig City 163 0.71 1.06 0.21
City of San Juan 132 no data no data no data
Caloocan City 132 0.88 2.58 0.40
 10
Active Total COVID-19
Isolation beds per active Ventilators per active
Symptomatic beds per active
City/Municipality symptomatic case symptomatic case
Cases symptomatic case
Table 5
Quezon
HealthCity Sector Capacity 765 Indicators,0.70 by City/Municipality 1.12 in NCR (Continued)
0.27
City of Manila 398
Active 0.70 Total 1.15
COVID-19 0.31
City of Paranaque 248 Isolation beds
0.06 per active 0.14 Ventilators
0.06per active
Symptomatic beds per active
City/Municipality symptomatic case symptomatic case
City of Makati Cases
243 0.29 symptomatic
0.35 case 0.12
Quezon City
City of Mandaluyong 765
238 0.70
0.04 1.12
0.12 0.27
0.00
City of Manila
Pasig 398
156 0.70
0.85 1.15
1.78 0.31
0.29
City of Paranaque
Taguig City 248
163 0.06
0.71 0.14
1.06 0.06
0.21
City of Makati
San Juan 243
132 no0.29
data no0.35
data no0.12
data
City of Mandaluyong
Caloocan City 238
132 0.04
0.88 0.12
2.58 0.00
0.40
City
PasayofCity
Pasig 156
118 0.85
0.20 1.78
0.28 0.29
0.05
Taguig CityPinas
City of Las 163
114 0.71
0.64 1.06
0.76 0.21
0.22
City of San Juan
Muntinlupa 132
105 no0.60
data no1.48
data no0.71
data
Caloocan City
City of Marikina 132
66 0.88
0.44 2.58
0.53 0.40
0.11
Pasay
City ofCity
Valenzuela 118
41 0.20
0.78 0.28
1.02 0.05
0.37
City of Las Pinas
Malabon 114
20 0.64
0.75 0.76
0.75 0.22
0.10
City of Muntinlupa
Navotas 105
19 0.60
0.05 1.48
0.32 0.71
0.00
City of Marikina
Pateros 66
15 no0.44
data no0.53
data no0.11
data
City
Totalof Valenzuela 41
2,973 0.78
0.51 1.02
0.88 0.37
0.21
City of Malabon 20 0.75 0.75 0.10
City of Navotas 19 0.05 0.32 0.00
6. COVID-19 Risk Matrix
Pateros 15 no data no data no data
Total 2,973 0.51 0.88 0.21
The risk classification of each province with at least 1 active COVID-19 case is found in the
matrix below (see Figure 1).

Figure 1
Risk Classification among Provinces with Active Covid-19 Cases
 11

Among the provinces which are COVID-free, a risk of virus spread may still arise, depending
on the degree of effectiveness of border control and level of testing to detect cases. Such risk
will still vary across localities, depending on their population characteristics and health sector
capacity. Risk of virus spread is measured by population density and share of population aged
60 years and older.4 In more population dense areas, social distancing will be more difficult to
achieve. In areas where the share of the elderly to total population is higher, the risk of virus
spread is higher. The same measures of the risk of health system over-burdening are utilized.
The risk classification among provinces with no active COVID-19 cases is found in the matrix
below (see Figure 2). The reader is cautioned that while we use the same labels for degrees of
risk (low, medium, and high), these are to be interpreted differently from the degrees of risk for
non-COVID-free provinces. Here, “risk of virus spread” means “risk of first detecting a case,
and then spreading.”

Figure 2
Risk Classification among Covid-Free Provinces

This type of analysis can be performed at any LGU level, e.g., cities or barangays, especially
if there are indicators of disease transmission in sub-provincial clusters.

4
Age is used as a proxy for co-morbidities
 12

7. Policy Recommendations

COVID-19 risks are multi-faceted. Both risk of virus spread and risk of health system over-
burdening need to be considered. As IATF conducts its final evaluation for ECQ-related
decisions, it may wish to undertake further re-assessments of its initial risk classification of
provinces, with guidance from the indicators below (see Table 6).

Table 6
Comparison of Risk Assessment,
by IATF and Quimbo-Latinazo-Peabody (QLP) Risk Indicators
QLP

Region Province IATF STATUS Risk of health Recommendation

Risk of virus
system over-
spread
burdening
NCR* Metro Manila High risk High High
High risk,
7 Cebu High Medium Re-assess
subject to evaluation
4-A* Rizal High risk High High
4-A* Laguna High risk High High
4-A* Cavite High risk High High
3* Bulacan High risk High Medium Re-assess
Moderate risk,
11 Davao del Sur High Medium Re-assess
subject to evaluation
4-A* Batangas High risk High Medium Re-assess
3* Bataan High risk High Medium Re-assess
3* Pampanga High risk High Medium Re-assess

4-A* Quezon High risk High High

3* Nueva Ecija High risk High Medium Re-assess
High risk, subject to
1 Pangasinan Medium Medium Re-assess
evaluation
High risk, subject to
3* Tarlac High Medium Re-assess
evaluation
High risk, subject to
6 Iloilo Medium Low Re-assess
evaluation
High risk, subject to
3* Zambales High Medium Re-assess
evaluation
5 Albay High risk High Medium Re-assess
High risk, subject to
CAR Benguet High Low Re-assess
evaluation
6 Negros Occidental Moderate risk Low Low Re-assess
Moderate risk,
2 Cagayan Medium Low Re-assess
subject to evaluation
High risk, subject to
6 Antique Medium Medium Re-assess
evaluation
 13

Table 6
Comparison of Risk Assessment,
by IATF and Quimbo-Latinazo-Peabody (QLP) Risk Indicators (Continued)
QLP

Region Province IATF STATUS Risk of health Recommendation

Risk of virus
system over-
spread
burdening
5 Catanduanes High risk Medium Medium Re-assess
4-B Occidental Mindoro High risk Medium Low Re-assess
4-B Oriental Mindoro High risk Medium Low Re-assess
High risk, subject to
11 Davao del Norte Medium Medium Re-assess
evaluation
Moderate risk,
1 La Union High/Medium Low Re-assess
subject to evaluation
Moderate risk,
9 Zamboanga del Sur Medium Low Re-assess
subject to evaluation
Moderate risk,
5 Camarines Sur Low/Medium Medium
subject to evaluation
BARMM Lanao del Sur Moderate risk Low Medium Re-assess
Moderate risk,
2 Isabela Medium Low Re-assess
subject to evaluation
Moderate risk,
6 Aklan Medium Medium
subject to evaluation
7 Negros Oriental Moderate risk Low Low Re-assess
Moderate risk,
2 Nueva Vizcaya Medium Medium
subject to evaluation
Moderate risk,
6 Capiz Medium Low Re-assess
subject to evaluation
Moderate risk,
10 Lanao del Norte Low Low Re-assess
subject to evaluation
Moderate risk,
1 Ilocos Norte Low Low Re-assess
subject to evaluation
Moderate risk,
12 South Cotabato Low Low Re-assess
subject to evaluation
Moderate risk,
8 Western Samar Medium Low Re-assess
subject to evaluation
CARAGA Agusan del Norte Low risk Low Low
8 Leyte Low risk Low Low
Moderate risk,
11 Compostela Valley Low High Re-assess
subject to evaluation
10 Bukidnon Low risk Low Low
1 Ilocos Sur Low risk Low Low
4-B Romblon Low risk Low Low
Moderate risk,
12 North Cotabato NO ACTIVE CASES Re-assess
subject to evaluation
14

Table 6
Comparison of Risk Assessment,
by IATF and Quimbo-Latinazo-Peabody (QLP) Risk Indicators (Continued)

QLP
Region Province IATF STATUS Risk of health Recommendation
Risk of virus
system over-
spread
burdening
Moderate risk,
14 Marinduque subject to NO ACTIVE CASES Re-assess
evaluation
Moderate risk,
CAR Abra subject to NO ACTIVE CASES Re-assess
evaluation
11 Davao Oriental Moderate risk NO ACTIVE CASES Re-assess
Moderate risk,
10 Misamis Occidental subject to NO ACTIVE CASES Re-assess
evaluation
Moderate risk,
10 Misamis Oriental subject to NO ACTIVE CASES Re-assess
evaluation
12 Sultan Kudarat Moderate risk NO ACTIVE CASES Re-assess
7 Bohol Low risk NO ACTIVE CASES
10 Camiguin Low risk NO ACTIVE CASES
Moderate risk,
BARMM Maguindanao subject to NO ACTIVE CASES Re-assess
evaluation
8 Northern Samar Low risk NO ACTIVE CASES
4-B Palawan Low risk NO ACTIVE CASES
3* Aurora Low risk COVID-FREE Re-assess
CAR Ifugao Low risk COVID-FREE Re-assess
5 Sorsogon Low risk COVID-FREE Re-assess
CARAGA Surigao del Norte Low risk COVID-FREE Re-assess
8 Southern Leyte Low risk COVID-FREE Re-assess
5 Camarines Norte Low risk COVID-FREE Re-assess
9 Zamboanga del Norte Low risk COVID-FREE Re-assess
8 Biliran Low risk COVID-FREE Re-assess
CARAGA Agusan del Sur Low risk COVID-FREE Re-assess
2 Batanes Low risk COVID-FREE Re-assess
CARAGA Surigao del Sur Low risk COVID-FREE Re-assess
CAR Mountain Province Low risk COVID-FREE Re-assess
BARMM Sulu Low risk COVID-FREE Re-assess
CAR Apayao Low risk COVID-FREE Re-assess
 15

Table 6
Comparison of Risk Assessment,
by IATF and Quimbo-Latinazo-Peabody (QLP) Risk Indicators (Continued)
QLP
Region Province IATF STATUS Risk of health Recommendation
Risk of virus
system over-
spread
burdening
5 Masbate Low risk COVID-FREE Re-assess
11 Davao Occidental Low risk COVID-FREE Re-assess
7 Siquijor Moderate risk COVID-FREE Re-assess
6 Guimaras Low risk COVID-FREE Re-assess
CARAGA Dinagat Islands Low risk COVID-FREE Re-assess
8 Eastern Samar Low risk COVID-FREE Re-assess
9 Zamboanga Sibugay Low risk COVID-FREE Re-assess
12 Sarangani Low risk COVID-FREE Re-assess
2 Quirino Low risk COVID-FREE Re-assess

BARMM Tawi-tawi Low risk COVID-FREE

Re-assess
BARMM Basilan Low risk COVID-FREE Re-assess
* For this table, ”COVID-free” refers to provinces that have not ever reported COVID-19 cases. “No active cases” refers to
provinces where all COVID-19 patients previously reported have either recovered or died.

Table 7 summarizes policy recommendations for each COVID-19 risk type of LGU. The
general approach to the re-opening of the economy should be at the province-level, gradual,
and supported by evidence from disease surveillance. Under all risk scenarios, the following
are imperative:

(i) social distancing protocol,

(ii) contact tracing and quarantine (i.e., mandatory isolation of all COVID-19 suspects, to
be defined by DOH for varying risk levels of virus spread),
(iii) (provincial) border control, and
(iv) area-based and work-based mass-testing.

Social distancing, to date, is the most effective policy to control the rate of rise in COVID-19
incidence and to decrease the number of cases.

Contact tracing mitigates the risk of new outbreaks and allows for social distancing to be
more targeted and quarantine requirements to be strictly implemented. Contact tracing thus
decreases the demands of an already over-burdened health system. Based on various news
reports, the Philippines has established 10 quarantine facilities, with 3,299 beds in total. Ten
more facilities are awaiting completion.

The presence of 791 confirmed cases with unknown residence behooves us to take a cautious
stance with respect to lifting of the CQ, even in COVID-free provinces. This indicates that
contact tracing needs significant improvement. The first step of contact tracing - identification
 16

of the place of residence – has to be completed (100%). The second step in contact tracing is
to identify all close contacts and test these individuals as well. All those that test positive need
to be quarantined for 14 days after recovery. DOH must therefore review its contact tracing
protocol and demand its strict implementation by the local health offices.

The importance of border control is critical. The purpose of border control is to ensure that the
population that is being protected is not exposed from in-migration. For a COVID-free province
to remain such, it must ensure that there are no new entrants into the province, or if they do
enter a province, these entrants are properly screened and quarantined as necessary.

Mass testing is key to any economy re-opening strategy. All infected individuals, whether
symptomatic or not, need to be properly diagnosed. For symptomatic individuals, proper
diagnosis is required for treatment. For the asymptomatic individuals, proper diagnosis is
needed to ensure that the virus does not spread when such could have been easily prevented
through contact tracing and quarantine. Mass testing is of utmost importance in identifying the
asymptomatic cases. With this in place, COVID-free communities and workplaces become
relatively safe and economic liberalization is feasible.

For COVID-free provinces, the lifting of the ECQ can be done in phases (2 one-week phases),
beginning with those that are low or medium risk with respect to both virus spread and health
system over-burdening. The next phase will include the remaining provinces. By 15 May,
results from disease surveillance will inform whether or not it is safe for provinces that are
not COVID-free to reduce restrictions. Regardless, lifting restrictions needs to be gradual, in
select areas of the economy such as schools, farming, and construction with social distancing
practiced diligently. As we proceed with the gradual re-opening of our economy and improve our
knowledge on how to control virus spread, liberalizing work-related policies can be achieved in
stages. With the lifting of the ECQ, all economic activity can resume.

For non-COVID-free provinces, the various risk scenarios will differ largely in terms of policies
with respect to allowing individuals to go to the workplace. For non-COVID-free provinces, only
selected economic activities can resume, in phases. For this purpose, mass-testing should
be undertaken in geographic areas and workplaces so that hot spots are rapidly identified
and contained. In high risk areas, such as NCR, some increased economic activity can be
tolerated provided that a protocol to ensure COVID-free workplaces, including COVID-free
transport of workers to workplaces, is in place and can be properly enforced. This will require
regular testing and strict hygiene and social distancing measures. Adopting the same strict
protocol for lower risk areas allows the resumption of all economic activities, in phases.

In sum, three types of work-related policies are identified, depending on the risk category:
allow work in (i) selected workplaces in selected sectors, (ii) all workplaces in selected sectors,
and (iii) all work in all sectors.
 17

Table 7
Summary of Policy Recommendations, by QLP Risk Scenario
Province-level Community Social Contact Border Mass Mass Allow work only in
classification Quarantine Distancing Tracing Control testing testing COVID-free Work Sites
(CQ) Status and (area- (work-
Quarantine based) based)
Not COVID-free; Extended √ √√* √ √ General rule:
High risk of virus spread Enhanced No work in ECQ “non-essential”
+ CQ businesses**
Medium/High risk of
health system over- Exception:
burdening Allow work in COVID-free
workplaces with COVID-free
worker transport, in select sectors
Not COVID-free; General √ √√ √ √ √ Allow work by sector,
High risk of virus spread CQ*** in 4 phases****
+
Low risk of health system
over-burdening
Not COVID-free; General √ √√ √ √ √ Allow work by sector,
Medium risk of virus CQ in 4 phases
spread
+
Medium/High risk of
health system over-
burdening
Not COVID-free; General √ √√ √ √ √ Allow work by sector,
Medium risk of virus CQ in 3 phases
spread
+
Low risk of health system
over-burdening
Not COVID-free; General √ √ √ √ √ Allow work by sector,
Low risk of virus spread CQ in 2 phases
+
High risk of health system
over-burdening
Not COVID-free; Lifted √ √ √ √ √ Allow all work
Low risk of virus spread (Phase 2,
+ depending
Low/Medium risk of on Phase 1
health system over- results)
burdening
All COVID-free (including Lifted √ √ √ √ √ Allow all work
those with no active (Phase 1, in
cases) 2 phases)
* Expanded contact tracing, in terms of levels of contact
**Exception is for worksites that are certified COVID-free: where workers are housed on site, with strict 14-day quarantine prior to
start of work and mass testing of workers, or an equivalent protocol, subject to clearance from the DOH.
***Under a General CQ, workers are allowed to leave their homes, subject to company compliance with health standards imposed
by the DOH; “essential businesses” will be expanded to include additional retail activity.
**** Each phase shall last for one week.

A statistical analysis (see Annex) suggests that the lockdown appears to have effectively
contained the spread of the virus within the household. With any degree of re-opening of the
economy, we must ensure that we maintain such manageable spread of the virus. This can
 18

be done most effectively by mass testing. With mass testing, we are able to ensure that as
individuals leave their households, their physical presence in transportation networks and
workplaces will not cause the further spread of the virus.

Given the foregoing, DOH must develop and immediately implement a regional and national
disease surveillance protocol for COVID-19.

References
Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK – eighth update. (2020).
Retrieved from: https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-rapid-risk-assessment-coronavirus-
disease-2019-eighth-update-8-april-2020.pdf

Cadena, A. et. Al. (2020). How to restart national economies during the coronavirus crisis. McKinsey & Company.

World Health Organization (2020). Clinical management of severe acute respiratory infection
(SARI) when COVID-19 disease is suspected. Retrieved rom: https://www.who.int/docs/default-source/coronaviruse/
clinical-management-of-novel-cov.pdf
 19

Annex

Interpret with Caution,

Estimates Adjusted and Validated Daily,
do not Cite without Authors’ Permission

This Annex presents results of regression analysis performed on time series data on total
COVID-19 cases in the Philippines, beginning 11 March to 24 April 2020.

The analysis was conducted for purposes of predicting the total number of reported COVID-19
cases outside the period covered by the sample.

The dependent variable is total COVID-19 cases (ever infected), as reported by the DOH.
Given the protocol adopted by the DOH for testing, the number of cases can be presumed to
be the number of symptomatic cases (which required testing, and possibly hospital admission).

The independent variables include a time trend (cubic form), a dummy variable for the lockdown
period, a variable that proxies for detection of severe cases (total cases as a proportion of
deaths divided by a mortality rate of 0.04), a variable that proxies for rate of transmission
(defined as number of cases divided by number of cases 14 days prior), and a proxy for health
system capacity (defined as number of recoveries divided by number of deaths) including its
interaction with detection.

The model fits actual data very well (r-squared of 99 percent).

The parameters are used to predict out-of-sample, with the following assumptions:

- Detection rate gradually increases from 60 percent to 80 percent

- The ratio of number of cases to number of cases 14 days prior increases from the
current level of 1.5 during the lockdown to 16 after the lockdown (after May 15)

The results indicate that the peak of total serious cases is at about 11,000, with the growth of
cases stabilizing at around the third week of May.

The regression results also suggest that the R0, without the lockdown, is between 2 to 2.5.
(The regression coefficient of the rate of transmission proxy variable is about 20). That is,
within 14 days, every case will predict another 20 cases. With an R0 of 2, every new case
will produce a total of 16 cases through 4 levels of transmission (Level 1: individual to 2
family members; Level 2: family members to other household members; Level 3: household
members to community members; Level 4: community members to the workplace).

Moreover, with the lockdown, the R0 is vastly diminished, with every new case predicting a
total of only about 5 cases. The lockdown appears to have effectively limited transmission to
within the household only.

In the approach to lifting the lockdown, it is important that community and workplace
transmission is controlled via disease surveillance through mass testing and contact tracing.
20

Regression Results: Total Number of Reported Cases

Variable Definition Coef. P>t

Time t=1,2, … -1469.7 0.000
Time squared 20.46182 0.000
Time cubed -0.08092 0.000
Number of cases at time
Spread t/number of cases at
time t-14 20.26006 0.033
Spread x Indicator
variable for lockdown
Spread X Lockdown period -14.8802 0.084
Cases/
(Deaths/Global Mortality
Detection Rate) 1084.756 0.000
Detection x
(Recovery to death ratio) -395.807 0.002
Constant 31634.7 0.000
Number of observations 55
R-squared 0.9953

Figure 3
Actual Vs. Predicted Number of Covid-19 Cases in the Philippines

12000

10000

8000

6000

4000

2000

0
3/21/20 3/28/20 4/4/20 4/11/20 4/18/20 4/25/20 5/2/20 5/9/20 5/16/20 5/23/20

Predicted number of reported cases

Actual number of reported cases
 21

Notes
22

Notes
 23

Notes
24

Congressional Policy and Budget Research Department

3/F Main Building, House of Representatives
Batasan Hills, Quezon City, Metro Manila, Philippines
Tel. No. (DL) 8-931-60-32 (Fax) 8-931-65-19
Website: cpbrd.congress.gov.ph