The first 11 months of 2021 saw more registered deaths across the Philippines, which stood at 768,504—higher by 154,562 than all of 2020.

This number hiked the country’s mortality rate to 6.98 per thousand, as against 5.8 per thousand in 2020, according to the Commission on Population and Development (POPCOM), with initial data from the Philippine Statistics Authority (PSA).

This latest release already shows a 25% increase in mortality, with still a month-and-a-half worth of data to be reckoned for 2021. This also set a record in the number of Filipinos dying in a year since post-World War 2.

Covid-19, classified either as “identified” or “unidentified” by medical practitioners, was the underlying cause of death (COD) for 75,285 Filipinos—higher than the 30,140 deaths from the same cause from March to December 2020.

It was the second-leading COD to ischemic heart disease responsible for 110,332 deaths up to October 2021 from 86,164 the previous year.

Aside from both CODs, mortalities were also up for cerebrovascular disease (from 53,082 to 58,880) hypertension (from 26,079 to 32,614) and diabetes mellitus (from 32,830 to 38,584).

Meanwhile, neoplasms (from 55,700 to 48,937) were markedly down from January 2021 to October 2021. Overall, there was increased mortality in five of the 10 leading CODs last year.

“The increasing number of deaths indicate a health system severely challenged by the pandemic and its consequences,” explained Dr. Juan A. Perez III, Undersecretary for Population and Development. “Diseases with higher mortalities are also those causing the highest incidences of illnesses in the entire population, since respiratory diseases, hypertension and diabetes contribute to heavy caseloads of clinics and health centers nationwide. If consultations for these are delayed, exacerbations and complications happen.”

“The fact that neoplasms are down should not be a comforting thought, as hospitals are heavily burdened with Covid-19,” the POPCOM executive director noted. “Diagnosis of all forms of cancers may also be delayed or remain undiagnosed, leading to deaths attributed to other causes.”

About 105,425 deaths, or 11.04% of 954,585 deaths from April 2020 to October 2021, were classified as caused by Covid-19. Death rate tagged to the disease was 95.8 per 100,000 population.

Classifying Covid

Dr. Perez explained that there are two kinds of Covid-19 affecting the country: Covid-19 “identified,” which can be confirmed via RT-PCR tests, and Covid-19 “unidentified,” with laboratory tests or clinical findings by a doctor indicative of Covid-19, but without a confirmatory test up to the time of death. Both are considered valid CODs, and are methods accepted by the World Health Organization to report the disease.

From zero deaths in March 2020, Perez said Covid-19 became the fifth-leading COD that year. In the first 10 months of 2021, the PSA reported 51,514 deaths from Covid-19 “identified” and 23,771 as Covid-19 “unidentified,” for a total of 75,285. In 2020 there were only 9,300 Covid-19 “identified,” and 20,840 Covid-19 “unidentified.” This showed an improved testing capacity for Covid-19 in 2021.

“Thus, the statistics above elevated Covid-19 as the second-deadliest killer of Filipinos in 2021,” the POPCOM chief further stated. “We are expecting more numbers from November and December of last year. We can presume that there were about 800,000 deaths or more then.”

With the January-November 2021 births only at 1,076,770, Dr. Perez said the Philippines’ year-end population growth rate will be markedly lower than 2020. Based on the latest release by PSA there were 308,266 more births than deaths up to November 2021.

Highest in 60+ years

Dr. Perez estimated that the 2021 number of deaths already indicate the highest annual death statistic in the Philippines’ recorded medical history: “In 2019 and 2020, the mortality rate was about the same at 5.8 per 1,000 Filipinos. By the end of 2021, I believe it reached 7.5 or 8 per 1,000—not the highest mortality rate ever in the country, but certainly the highest number of Filipinos dying in a single year.”

Referencing the Department of Health’s earlier editions of Philippine Health Statistics, POPCOM’s executive director disclosed that the last time the Philippines experienced the same level of mortality rates were in 1958 to 1959, where it reached between 7.3 and 8.4, but at that time “only 218,816 died.”

From a health standpoint, he enjoined concerned national and local governments agencies to increase investments in the health workforce and public-health programs dealing with increased morbidity of the leading causes of disease which require improving primary health-care systems throughout the country. Mortalities at high numbers also indicate the need for acute health-care services at higher levels of care, such as provincial hospitals and regional medical centers.

“The challenge to the Philippine health system is both acute and unprecedented. Local health systems would need to be augmented by additional investments in health systems capacity and its resilience to respond to acute health crises,” Dr. Perez recommended. (PR)