COVID-19 mortality in the Philippines: a province-level analysis, 2020-2023

ObjectiveTo investigate the COVID-19 mortality in Philippine provinces from 2020 to 2023. MethodsWe calculated the crude (CMR) and age-standardised mortality rates (ASMR) of the Philippine provinces from the national COVID-19 surveillance data from January 18, 2020 to May 9, 2023. With Spearmans method, we then performed a correlation analysis between the rates and four independent variables, namely, poverty incidence, population density, hospital beds per 100 000 population and proportion of elderly population ([≥] 65). ResultsThe province with the highest ASMR is Benguet with 207.83 deaths per 100 000 population, followed by Cagayan, Bataan, Nueva Vizcaya, Quirino, National Capital Region, Isabela, Cebu, Aurora and Davao del Sur. Meanwhile, the province with the lowest ASMR is Tawi-Tawi with 2.22 deaths per 100 000 population, followed by Sulu, Masbate, Misamis Occidental, Camarines Norte, Sarangani, Camiguin, Sultan Kudarat, Southern Leyte, Catanduanes and Batanes. Among the independent variables, poverty incidence and hospital beds per 100 000 population were found to independently predict CMR and ASMR. DiscussionThe results of this analysis provides a starting point for the investigation of COVID-19 mortality in Philippine provinces. The ranking of provinces by ASMR reveals the provinces with the highest and lowest rates, while the results of the correlation analysis, linked with findings from previous studies, explain the ranking, including surveillance issues that are related to health-care access and health-seeking behaviour. Our study paves the way for investigating factors that need to be considered and more closely investigated to get a clearer picture to inform decision-making, which affects millions of lives in communities across the Philippines provinces.