p.3 variant, which in turn related to the aforementioned variant. japan also detected the p.3 variant on a man who traveled from the philippines. as a response to the recent spike in cases, the greater manila area, which the government called "ncr plus", was placed under general community quarantine (gcq) on march 22 and was originally set to expire on april 4. it was further intensified to the stricter enhanced community quarantine (ecq) from march 29 to april 11, when the positivity rate of the area remained high. on march 17, the philippine statistics authority (psa) reported that there have been at least 27,967 deaths caused by, or associated with, covid-19 by the end of 2020. 19,758 of these were tagged "covid-19 virus not identified", while 8,209 were tagged "covid-19 virus identified". the discrepancy between the tallies of the doh and the psa is due to the inclusion of probable and suspect cases in the psa's tally. on april 26, the country surpassed 1 million cases. may to june 2021 on may 11, the country detected its first two cases of delta variant from india. the variant had been confirmed in two filipino seafarers who returned in april. while the infections on metro manila is slowing down, covid-19 infections is surging on other regions. mindanao accounted for a quarter of new cases, higher than metro manila, showing that the pandemic has shifted to the regions far outside of the metropolitan areas. a former mayor and his brother from a nearby town were also admitted at a government hospital in the same city, as dozens of people were being treated for coronavirus outside in makeshift tents, or hooked up to oxygen tanks while sitting in their vehicles, due to the lack of hospital beds. july 2021 as covid-19 surges in indonesia, the philippines banned travels from indonesia amid delta variant threat. roque said travelers from indonesia will be barred from entering the country from july 16 to july 31. on july 16, the country detected 16 new cases of the highly-transmissible covid-19 delta variant, which has become the dominant variant in several countries. of these, 11 are local cases. in a press briefing, health undersecretary maria rosario vergeire said that 15 of the new detected cases had recovered while another died. of these, 10 are females aged 14 to 79. due to rising cases and local transmission of the delta variant, metro manila, ilocos norte, ilocos sur, davao de oro, and davao del norte were placed under general community quarantine with heightened restrictions starting on july 23. on july 29, the department of health (doh) detected 97 new cases of delta variant bringing the total number of delta variant cases to 216. of the newly reported cases, 88 were local cases, six are returning overseas filipinos, while three other cases are still under verification. august 2021 on july 30, the government placed metro manila under enhanced community quarantine (ecq) starting august 6 until august 20 due to rising cases of delta variant. on august 5, the doh detected 116 new cases of delta variant bringing the total number of cases to 331. of the additional delta variant cases, 95 were local cases, one is a returning overseas filipino (rof) while the remaining 20 cases are being verified if they are local or rof cses. the doh said that among the 216 delta variant cases reported last july 29, one case was verified to have been tested in two different laboratories so the doh amended the previous total delta variant cases from 216 to 215. on the same day, president rodrigo duterte approved the recommendation of the iatf to place some provinces under ecq and mecq. laguna, cagayan de oro, and iloilo city will be under ecq from august 6 to 15, while lucena and the provinces of cavite, rizal, and iloilo will be placed under modified enhanced community quarantine (mecq). batangas and quezon, on the other hand, will be under general community quarantine (gcq) with heightened restrictions from august 6 to 15. on august 15, the doh detected the country's first case of the lambda variant. the patient is a 35-year-old female and is currently being validated as to whether she is a local or returning overseas filipino case. the doh said the patient was asymptomatic and tagged as recovered after undergoing the 10-day isolation period. meanwhile, the doh also detected 182 new cases of the delta variant, as well as 41 new cases of the alpha variant, 66 new cases of the beta variant and 40 new cases of the theta variant. of the newly reported cases of the delta variant, 112 cases are local, 36 are returning overseas filipinos, and 34 are still undergoing verification. among the 41 new alpha cases, 38 are local, one is an rof, and two are still being verified. out of the 66 additional beta cases, 56 are local and 10 cases are still undergoing verification. among the 40 new theta variant cases, 37 are local cases and three cases are still being verified. on august 19, the iatf-eid approved to place metro manila and the province of laguna under mecq from august 21 to 31. the world health organization released a statement on august 28, that the delta variant is already the dominant variant of sars-cov-2 in the philippines. september 2021 on september 1, the covid-19 cases in the country surpassed 2 million. on september 3, the philippines food and drug administration (fda) approved the emergency use of moderna's covid-19 vaccine for minors aged 12 to 17. the alert level system (als) was introduced by the government with pilot implementation of the system in metro manila beginning on september 16, 2021. the iatf intends to phase out the old quarantine system, which still remains in use outside metro manila pending the nationwide adoption of the als. the coverage of the als was expanded to include lgus in calabarzon, central visayas, and davao regions on october 20, 2021. october 2021 on october 25, the doh confirmed the presence of the b.1.1.318 variant in the country with one case reported. along with the detection of the b.1.1.318 variant, the doh also detected 380 more cases of the delta variant, as well as 104 cases of alpha variant, and 166 cases of beta variant. the vaccination of minors under the philippine national vaccination also began within the month. november 2021 on november 8, the country detected its first ever case of the b.1.617.1 variant, formerly called kappa variant. the patient is a 32-year-old male from floridablanca, pampanga who experienced a mild case and has since recovered. the alert level system's nationwide adoption was completely realized on november 22. december 2021 the omicron variant was first detected in the philippines on december 15. the cases involved two travelers from nigeria and japan who arrived in the philippines on november 30 and december 1 respectively. by december 28, there are four omicron, all international travellers. january 2022 on january 15, the doh has confirmed that there is already a community transmission of the omicron variant in metro manila. a shortage on paracetamol, other analgesic, and other drugs for flu-like symptoms was reported. the doh and dti maintained there is no shortage, but the latter admitted that there are some areas in the country temporarily ran out of stock due to logistical issues. october 2022 the first confirmed cases of the omicron xbb subvariant and xbc variant were detected in the philippines on october 17. medical response hospital admission policy algorithm for the triage of patients with possible covid-19 infection in health care facilities (as of march 10, 2020) a ward dedicated for covid-19 patients at the philippine general hospital. the doh has issued a reminder, that level 2 and 3 hospitals cannot deny admittance of people suspected or confirmed to have covid-19 infection and refusal of admission is a "violation of the signed performance commitment and shall be dealt with by the philhealth accordingly". the department said that level 2 and 3 hospitals can accommodate individuals with mild covid-19 symptoms while individuals in a serious or critical condition may be transferred to one of the doh's three main referral hospitals, which was increased over time to 75 designated hospitals as of april 13 with a combined bed capacity of 3,194. logo of bida solusyon sa covid-19, the doh's official campaign against covid-19 on march 16, 2020, the doh announced a revision on their protocol on hospital admission for covid-19 positive patients. a week prior, the doh began sending both asymptomatic patients and individuals with mild symptoms back to their homes for quarantine and continued health monitoring until they have been deemed recovered. priority was given to high-risk patients or those with severe symptoms for hospital admission. in mid-2021, the city of makati initiated a program to aim to treat mild cases at home, to reduce pressure on hospitals. vaccine trial participation the philippines, with at least 45 other countries, joined the world health organization (who)'s solidarity trial to study the effectivity of certain drugs in treating covid-19 patients. dr. marissa alejandria of the philippine society of microbiology and infectious disease is the philippines' representative in the study with health undersecretary maria rosario vergeire as the official liaison of the doh in the multinational study. the department of science and technology (dost) announced that it is seeking bilateral collaboration with other countries such as china, russia, south korea, taiwan, and the united kingdom on endeavors related to the vaccine development for covid-19. president rodrigo duterte declared a bounty for anyone who could produce a vaccine against covid-19, an amount later increased to ₱50 million (around $1 million). research on other treatments the philippine council on health research and development at the dost plans to distribute an undisclosed "functional food," while presidential spokesman harry roque also revealed that the dost, philippine general hospital, and the ateneo de manila university, are collaborating with the duke–nus medical school in singapore to evaluate the feasibility of lauric acid from virgin coconut oil, vitex negundo (known locally as lagundi), and euphorbia hirta (known locally as tawa-tawa) as a "dietary regimen supplement" to help covid-19 patients combat the disease. a "functional food" or "dietary regimen supplement" is described as similar to how tawa-tawa is also used as a remedy against dengue by incorporating it to the diet of diagnosed patients. vaccination main article: covid-19 vaccination in the philippines president rodrigo duterte (right) with chinese ambassador to the philippines huang xilian during the ceremonial turnover of covid-19 vaccine coronavac at villamor air base in pasay city on february 28, 2021 supply the philippine government has been negotiating with various foreign vaccine manufacturers to secure the country's covid-19 vaccine supply. these manufacturers include sinovac biotech (china), gamaleya research institute (russia), moderna (united states), and pfizer (united states). the private sector, with government sanction, has secured at least 2.6 million vaccine doses from british-swedish manufacturer astrazeneca. negotiations are also ongoing with american firm novavax which would supply at least 10 million doses from the serum institute of india. the country is projected to at least 164 million doses from various manufacturers in 2021. the procurement efforts of the national government has been a subject of various controversies. health secretary francisco duque has been alleged to "dropped the ball" in a deal with pfizer vaccine deal which could have secured 10 million doses by as early as january 2021. plans to secure 26 million doses from china's sinovac has also been put into scrutiny in the congress due to its reported efficacy rate. late stage trials of sinovac's vaccine in brazil reported an efficacy rate of only 50 percent. there were concerns within the senate that the reported 50-percent efficacy rate of sinovac's vaccine would not garner public trust and would be a waste of government funds. the department of health said that sinovac's vaccine satisfy the world health organization standards of at least 50 percent efficacy rate while the fda pointed out that sinovac is yet to publish an official and published scientific report on their vaccines efficacy rate and that the clinical trial for the vaccine is conducted in different countries and the efficacy rate per country will vary; as low as 50 percent in brazil and as high as above 90 percent in turkey.