The country recorded the highest number of deaths in a single year in 2021 at 879,429, as the Philippine Statistics Authority (PSA) released on August 13 its annual report on causes of death for the said year.

 The said figure, according to the Commission on Population and Development (POPCOM), is higher by 265,493 than in 2020—the first year of the COVID-19 pandemic—which posted the total number of mortalities at 613,936, and represented a 43% increase.

Highest number of mortalities in a 12-month period earlier reported was in 2019 at 620,414, with more than 1,700 daily. In 2021, there were about 2,700 deaths every day.  

 POPCOM observed that regularly, “in normal years,” the rise in the number of deaths is only at around 1% to 5%.

 For 2021, the crude death rate (CDR)—the ratio of the number of deaths occurring within one year to the mid-year population expressed per 1,000 population, as defined by the PSA—was estimated by POPCOM at 8.02 per thousand Filipinos, which was a sharp rise from the rate of 5.6 per thousand in 2020.

 “It took 20 years for the CDR to go up by 1 per thousand from 2000 when it was 4.8, to 2019 when it climbed to 5.8,” noted Undersecretary for Population and Development Juan Antonio Perez III, MD, MPH, POPCOM’s executive director. “The last time the country had a CDR that high was in 1958, when it was at 8.4 per 1,000 population.” 

The month which topped the number of deaths was September 2021, when 119,758 Filipinos perished. Almost 4,000 Filipinos died every day that month (3,992), and almost three every minute (2.7). 

COVID deaths up from 2020: A major contributor to 2021’s excess mortalities—the difference between expected numbers of deaths based on a mortality schedule in a given period and the actual deaths in the same period as defined by the United States’ Center for Disease Control and Prevention or CDC—was attributed to COVID-19, as pandemic-related deaths combined for 105,723 lost lives. It was 71% higher than the 30,188 overall “COVID” deaths in 2020.

As of May 21, 2022, registered deaths due to COVID-19 accounted for a total of 10,226 deaths, or 6.5 percent of the total registered deaths from January to April 2022, according to the PSA. For almost 2.5 years since January 2020, there have been 146,137 COVID-associated mortalities.

Dr. Perez noted however that there were 159,770 excess mortalities unrelated to COVID-19, but were rather caused by other diseases that claimed more lives along with the deadly viral infection in 2021. These were attributed to ischemic heart disease (or heart attacks, up by 29.7%); cerebrovascular disease (or strokes, up by 15.3%); diabetes mellitus (up by 21%); and hypertensive disease (or hypertension, up by 31.5%) as among the top causes of deaths in the country. 

Deaths due to malnutrition also increased by 47%. On the other hand, those triggered by neoplasms, or various forms of cancers, were down 10.3%.

“Many of the diseases that caused increased mortality are preventable at the primary level of care, but the health system was not flexible enough to treat and care for both COVID and non-COVID patients,” Dr. Perez inferred. “On the other hand, the decrease in cancer-related deaths was most likely due to the lack of tertiary level of diagnostic and therapeutic care, as ‘COVID’ cases crowded out actual and undiagnosed cancer patients.”

The POPCOM chief believes that from top to bottom, the Philippine health system was severely challenged in 2021, thus: “Its recovery requires more resources in the immediate future.”