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BARMM Has Been Decimated: 23% Excess Deaths In 2020. 91% Excess Deaths in 2021! In 2021, Lanao Del Sur Had 160% and Maguindanao had 212% Excess Deaths!
Extreme vaccine hesitancy has been reported in this region which is targeted for vaccine uptake promotion! Excess Deaths though devastatingly soared. Only Tawi-Tawi had negative excess deaths in 2021.
Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), is an administrative region under the the Mindanao island group. It includes the 5 provinces of Basilan, Lanao del Sur, Maguindanao, Sulu, and Tawi‑Tawi. The regional center is the City of Cotabato (under Maguindanao) which is also under the jurisdiction of BARMM. In 2020 it had a population by census of 4,404,288, representing 4.04% of the population of the Philippines.
I have conducted an evaluation of the expected1 and excess2 mortality in BARMM. Expected mortality rates for 2020 and 2021 were calculated using the Excel Forecast tool, using 5-year historical all cause mortality data, and compared against the actual 2020 and 2021 deaths. The excel forecast gives a forecast deaths based on historical patterns and a confidence upper and lower bound. The forecast mortality is a more accurate way to assess actual deaths than simply comparing to one or more previous years, because it is adjusted over time and with reference to typical patterns of deaths. Covid-19 deaths are presented with respect to total and excess deaths in 2020 and 2021. All source data are official public domain Philippines Government data3.
BARMM Has Very High Excess Mortality In Both 2020 and 2021
Overall data for BARMM is set out in the first figure. These show relatively low Covid-19 deaths across the region, though with some spiking in May and then in August through to October 2021.
While most regions in the Philippines did not have excess deaths in 2020, this region shows nearly 23% excess deaths; that is, the deaths of 858 people more than would have been expected based on historical trending (4,626 deaths instead of the forecast 3,768 deaths). Clearly this province had a really tough time in the first year of Covid-19 public health measures with lockdowns and all their flow on consequences.
It got far worse for BARMM in 2021! This region has the highest excess deaths of any in the Philippines, by far! Deaths in 2021 were 91% higher than the forecast expected deaths. That is 6,662 deaths instead of the forecast 3,493! That is 3,169 excess deaths! Almost double! In BARMM, in 2020 and 2021 combined, 4,026 people who were not expected to be lost were!!
Please bear in mind that 2019 registered deaths in the BARMM were somewhat low with respect to historical data (refer to the 3rd figure below). However, I still used 2019 as the comparator year in the figure of this evaluation to remain consistent with my evaluation of all other regions in previous reports.
2021 deaths across the year were consistently FAR HIGHER than any ever recorded since 2015, as shown below. Deaths from March onwards were more than 2x 2019 levels. They reached an astounding 5.2x 2019 levels in September (713 lost instead of 137) when deaths spiked to their highest levels!
Summary table for deaths and excess excess deaths and Covid-19 deaths in 2021 is provided. Note that every province had excess deaths in 2020, ranging from 13% to 51.4% above forecast. Every province except Tawi-Tawi had excess deaths in 2021 with the highest excess being 212% above forecast in Maguindinao.
Basilan is a small province. It had a population of 426,207 in the 2020 Census. As is common with small populations, the death rates are quite variable. Death rates in both 2020 and 2021 were within the upper end of the forecast bounds at 17.3 and 12.8% above the forecast levels. They had few reported Covid-19 deaths.
Lanao Del Sur had 233 Covid-19 deaths since the beginning of the pandemic. However, not only did they have 47% excess deaths in 2020 (1,328 instead of the forecast 903), they had nearly 160% excess deaths in 2021. This is an astounding 1,153 excess deaths instead of the expected 724, and total deaths of 1,877. The deaths in September 2021 were a staggering 9.5x higher than 2019 with 247 deaths instead of 26 (note: 2019 deaths were on the low side; if a more typical 64 September average deaths (2015-2018) was considered excess death are still 3.9x expected levels).
Maguindanao had only 278 Covid-19 Attributed deaths up to July 2022. However, they have a combined 2,787 excess deaths from 2020 (556 and 51.4% above forecast) and 2021 (2,231 at 212% above forecast). Maguindanao’s forecast deaths for 2020 were 1,082, instead they lost 1,638 people. In 2021 forecast deaths were 1,053, instead they lost 3,284 people! That may get worse in the final compilation!
The province of Sulu had 13% excess deaths in 2020 and 47.1% excess deaths in 2021. Deaths, including historical deaths are highly variable in this small province. End of year data may still be incomplete.
Tawi-Tawi has reported only 6 Covid-19 deaths up to July 2022.
They had nearly 15% excess deaths in 2020 when they experienced 507 deaths instead of the forecast 442, with 65 extra unexpected deaths. Note the green line showing that deaths particularly soared from July to December.
Historical trends in Tawi-Tawi show 123 deaths in 2015, 160 in 2016, 146 in 2017, 332 in 2018, and 368 in 2019. This may reflect either a growing population and the increased deaths that come with more people, or an ageing population where more people die due to natural causes with age.
Unlike every other province in the entire Philippines, registered deaths went down in 2021 at only 303 instead of the forecast 511 (even below the 404 lower confidence bound of the forecast)!
Exploration of what was different in Tawi-Tawi in 2020 and 2021 compared to the rest of the region should be a priority for population scientists.
BARMM Has Low Covid-19 Vaccine Uptake
I did not expect to see the data that appeared as I compiled the annual and most recent data. BARMM has been repeatedly called out for having a low covid-19 vaccine uptake rate.
There have been many articles lamenting low uptake since 2021; here in July 2021 claiming on 28,254 fully vaccinated, here in December 2021, here on April 7 2022 reporting only 27% fully vaccinated and 2.2% boostered, and this 15th August 2022 Article is still pushing to vaccinate the hesitant region.
BARMM has different all cause mortality data than all of the other provinces I have reviewed and is a study in contrasts in death patterns for 2020 and 2021.
They have excess deaths across the board in 2020 in every province, the first year of the pandemic. Most other regions in the Philippines, outside of major urban centers, did not have any excess deaths in 2020.
For 2021, they combine both a reported “low” vaccination uptake and very high excess deaths in all localities except Tawi-Tawi, and to a lesser extent Basilan! Deaths spiked in September 2021. This still matches with the big push of covid-19 vaccination to the general population.
What was different in Tawi-Tawi? Tawi-Tawi had moderate excess deaths in 2020, but a large negative excess in 2021?
What was different in Basilan? It did have excess deaths in both 2020 and 2021, but deaths were within the forecast bounds of expectations.
Final death data may increase over that discussed in this and all prepared reports as delayed registrations are accounted. Increase in death data will strengthen the excess deaths trending.
I was very affected compiling this data! I mourned for all those people lost before their appointed time. The causes must be identified! This must never be allowed to happen again!
The vaccines are not relieved from responsibility for these deathss. The particular signal is the across the board, Philippines wide, spike in deaths in September of 2021!
Please share this with all interested persons! Please particularly share this with people from and who have ties with BARMM. The people and their officials need to know and see what is happening!
This is the last of my series for every province of the Philippines! I will provide an overall summary in the the next few days!
May God open the eyes of and guide all who read these reports! May God give you strength to stand up in love, and compassion to take necessary actions against what is happening!
Expected All Cause Mortality are the normal deaths seen in any population. These are due to aging, accidents, typical illness patterns. Expected mortality is typically stable over time, changing only gradually as the population’s demographics change. Year on year changes are typically only a few low single digit % points.
Excess Mortality: these are deaths higher or above that which is expected from the normal historical trends. Typical causes can be war, natural catastrophe, an outbreak of infectious disease. When vulnerable persons in any place die earlier than expected, their deaths will show as an excess mortality. However, excess mortality is followed by a period of lower than usual mortality, while a new vulnerable population builds up. It is highly unusual for excess mortality in any population to be sustained over a long period. Excess mortality is an excellent indicator of overall population health and well being.
All source data are from official Philippines Government data, taken directly and sorted for presentation. Vital statistics on deaths were taken from Philippines Statistics Authority (psa.gov.ph) public domain data with latest release for 2021 deaths on 13 August 2022. All Covid-19 death data is taken from the Philippines Department of Health (DOH) Covid-19 Tracker (last data release on 30 July 2022).