COVID-19 situation: 23 April 2020

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Pandemic Threats and Health Emergencies

COVID-19 situation: 23 April 2020

Welcome to this special issue of the newsletter where we highlight latest research and policy news and literature on COVID-19 situation

Please send your feedback, articles and reports, or questions you would like to share to Dr. Chadia Wannous via email  

Wishing you useful reading!

COVID-19 Outbreak Situation 

Situation updates:
WHO situation report-94 by 23 April 2020

  • The Global Outbreak Alert and Response Network (GOARN) has launched a GOARN COVID-19 Knowledge hub. The hub is designed as a central repository of quality public health information, guidance, tools and webinars which can be accessed freely at any point.
  • •WHO Director-General Dr. Tedros, in his regular media briefing yesterday, cautioned that “we have a long way to go. This virus will be with us for a long time”. He added that “the world cannot go back to the way things were. There must be a “new normal” –a world that is healthier, safer and better prepared”.
  • WHO has published guidance ‘Addressing Human Rights as Key to the COVID-19 Response’. The guidance document highlights the importance of integrating a human rights-based approach into the COVID-19responseand highlights key considerations in relation to addressing stigma and discrimination, prevention of violence against women, support for vulnerable populations, quarantine and restrictive measures, and shortages of supplies and equipment.
  • All available evidence for COVID-19 suggests that SARS-CoV-2 has a zoonotic source. Many researchers have been able to look at the genomic features of SARS-CoV-2 and have found that evidence does not support that SARS-CoV-2 is a laboratory construct. A constructed virus would show a mix of known elements within genomic sequences –this is not the case.

Situation in Numbers
Total (new) cases in last 24 hours

  • Globally 2 544 792 confirmed (73 657) 175 694 deaths (6689)
  • European Region 1 251 458 confirmed (31 972)113 336 deaths (3384)
  • Region of the Americas 957 402 confirmed (32 111) 47 812 deaths (3038)
  • Eastern Mediterranean Region 144 450 confirmed (5101) 6469 deaths (143)
  • Western Pacific Region 137 902confirmed (1632) 5818 deaths (25)
  • South-East Asia Region 36 039 confirmed (2127) 1498 deaths (71)
  • African Region 16829 confirmed (714) 748 deaths (28)

WHO Risk Assessment
Global Level    Very High
Links to the COVID-19 dashboards for most up-to-date figures:
WHO COVID-19 situation dashboard
WHO COVID-19 alerts in African Region
WHO COVID-19 readiness dashboard in African Region
WHO COVID-19 situation dashboard in European Region
WHO COVID-19 weekly surveillance dashboard in European Region
WHO COVID-19 situation dashboard in the Eastern Mediterranean Region
PAHO COVID-19 alerts in the Region of the Americas
All information about COVID- 19 can be found here:
Latest updates - Live press conference (Geneva)

Situation update for the EU/EEA and the UK as of 23 April 2020
As of 23 April 2020, 1 009 762 cases have been reported in the EU/EEA and the UK: Spain (208 389), Italy (187 327), Germany (148 046), United Kingdom (133 495), France (119 151), Belgium (41 889), Netherlands (34 842), Portugal (21 982), Ireland (16 671), Sweden (16 004), Austria (14 924), Poland (10 169), Romania (9 710), Denmark (7 912), Norway (7 250), Czechia (7 136), Finland (4 129), Luxembourg (3 654), Greece (2 408), Hungary (2 284), Croatia (1 950), Iceland (1 785), Estonia (1 559), Lithuania (1 398), Slovenia (1 353), Slovakia (1 244), Bulgaria (1 024), Cyprus (790), Latvia (761), Malta (444) and Liechtenstein (82).
As of 23 April 2020, 108 223 deaths have been reported in the EU/EEA and the UK: Italy (25 085), Spain (21 717), France (21 340), United Kingdom (18 100), Belgium (6 262), Germany (5 094), Netherlands (4 054), Sweden (1 937), Portugal (785), Ireland (769), Romania (508), Austria (494), Poland (426), Denmark (384), Hungary (225), Czechia (210), Norway (169), Finland (149), Greece (121), Luxembourg (80), Slovenia (79), Bulgaria (49), Croatia (48), Estonia (44), Lithuania (38), Cyprus (17), Slovakia (14), Latvia (11), Iceland (10), Malta (3) and Liechtenstein (1).
Situation dashboard: latest available data

Control Measures

UN agencies issue urgent call to fund the global emergency supply system to fight COVID-19
20 April 2020 -- The heads of the United Nations’ major agencies have issued a warning of the risk of COVID-19 to the world’s most vulnerable countries. International donors have pledged around a quarter of the US$2 billion the UN requested in the Global Humanitarian Response Plan for COVID-19 in March.
Countries measures

OECD Country Policy Tracker
What are countries doing to contain the spread of the coronavirus? This Country Policy Tracker helps you navigate the global response.

Director of U.S. agency key to vaccine development leaves role suddenly amid coronavirus pandemic
Rick Bright, one of the nation’s leading vaccine development experts and the director of the Biomedical Advanced Research and Development Authority, is no longer leading the organization, officials told STAT.
The shakeup at the agency, known as BARDA, couldn’t come at a more inopportune time for the office, which invests in drugs, devices, and other technologies that help address infectious disease outbreaks and which has been at the center of the government’s coronavirus pandemic response.

Mike Pompeo accuses China of withholding samples needed to track evolution of coronavirus
The havoc wrought by covid-19 will spark new concern over bio-weapons
The coronavirus that has killed over 180,000 people worldwide was not created with malice. Analysis of its genome suggests that, like many new pathogens, it originated by natural selection rather than human design.

Why these scientists still doubt the coronavirus leaked from a Chinese lab
A Wuhan lab studied SARS-related viruses. But there’s no evidence it discovered or was working on the new virus.

Virus Researchers Cast Doubt On Theory Of Coronavirus Lab Accident

The Untold Story of the Birth of Social Distancing
The idea has been around for centuries. But it took a high school science fair, George W. Bush, history lessons and some determined researchers to overcome skepticism and make it federal policy.

Fearing new virus wave, France refines end of lockdown plans
The Other Time a U.S. President Withheld WHO Funds
President Trump’s decision last week to suspend payments to the WHO wasn’t the first time a U.S. president has withheld funds and criticized the organization early in a historic pandemic.  President Reagan did it in the 1980s as HIV/AIDS began to emerge as a global killer.
Scientific publications and reports and news

United States should allow volunteers to be infected with coronavirus to test vaccines, lawmakers argue

‘It’s noisy’: Competing Covid-19 efforts could hamper progress, experts warn

How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes

New data highlight deadly COVID-19 impact in NYC
Study reveals a 9.7% death rate in hospital patients—88.1% in those needing mechanical ventilators.
More »

UK coronavirus deaths more than double official figure according to FT study
The coronavirus pandemic has already caused as many as 41,000 deaths in the UK, according to a Financial Times analysis of the latest data from the Office for National Statistics. The estimate is more than double the official figure of 17,337 released by ministers on Tuesday, which is updated daily and only counts those who have died in hospitals after testing positive for the virus. The FT extrapolation, based on figures from the ONS that were also published on Tuesday, includes deaths that occurred outside hospitals updated to reflect recent mortality trends

Averting a COVID-19 Security Crisis in Africa
Although COVID-19 does not affect all equally, it does confirm the axiom that, in today’s interconnected world, global challenges require global solutions. The only way to build a safer post-COVID world is to ensure that Africa is not left behind.

Crisis Standards of Care: Ten Years of Successes and Challenges – Proceedings of a Workshop
The pandemic caused by the H1N1 virus that same year became a real-life example of the scarce-resource situations that can result in these scenarios. The first product released, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report, articulated concepts and guidance that can assist professionals in the development of systematic and comprehensive policies and protocols for these types of situations. This current Proceedings of a Workshop captures the discussions from a 2019 workshop reviewing the successes and gaps over the last 10 years of CSC work, in order to inform the next phases of planning and implementation.

New data on Gilead’s remdesivir, released by accident, show no benefit for coronavirus patients. Company still sees reason for hope
Antimalaria drugs
Antimalarials widely used against COVID-19 heighten risk of cardiac arrest. How can doctors minimize the danger?
Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19

More deaths, no benefit from malaria drug in VA virus study

Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study)

Antimalarials widely used against COVID-19 heighten risk of cardiac arrest. How can doctors minimize the danger?

Coronavirus studies: Chloroquine is ineffective and dangerous
Too high a dose of the anti-malarial agent chloroquine can cause severe cardiac arrhythmia in certain patients. Tests on COVID-19 patients in the United States and Brazil have shown increased fatalities.

BARDA head says he was pushed out after questioning malaria drugs for COVID-19
"I rightly resisted efforts to provide an unproven drug on demand to the American public," Bright says.
More »

Trump tones down the hydroxychloroquine hype
His public statements regarding the drug have diminished significantly over the past week for reasons that remain unclear.
Respiratory Support in Novel Coronavirus Disease (COVID-19) Patients, with a Focus on Resource-Limited Settings

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents: A Systematic Review
Most children with COVID-19 presented with mild symptoms, if any, generally required supportive care only, and typically had a good prognosis and recovered within 1 to 2 weeks.

New analysis recommends less reliance on ventilators to treat coronavirus patients
By using ventilators more sparingly on Covid-19 patients, physicians could reduce the more-than-50% death rate for those put on the machines, according to an analysispublished Tuesday in the American Journal of Tropical Medicine and Hygiene.
There is a growing recognition that some Covid-19 patients, even those with severe disease as shown by the extent of lung infection, can be safely treated with simple nose prongs or face masks that deliver oxygen.The latter include CPAP (continuous positive airway pressure) masks used for sleep apnea, or BiPAP (bi-phasic positive airway pressure) masks used for congestive heart failure and other serious conditions. CPAP can also be delivered via hoods or helmets, reducing the risk that patients will expel large quantities of virus into the air and endanger health care workers.

Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection
The study found that 64.4% of participants reported altered sense of taste or smell. The median score for severity was a 4 (with 5 being the most severe change). Among those who provided information regarding the timing of their altered smell/taste, 19.4% indicated that it presented before other symptoms, 37.1% said it presented at the same time as other symptoms, and 43.5% said it presented after other symptoms presented.
Social distancing and lockdowns measures

Strategies combining self-isolation, moderate physical distancing and shielding likely most effective COVID-19 response for African countries

ECDC urges slow steps in relaxing distancing
In its latest risk assessment today, the European Centre for Disease Prevention and Control (ECDC) said stay-at-home policies and other interventions are responsible for the drop in cases and that 20 of the 31 countries it monitors appear to be past the peak of their initial waves. Eight countries reported no change, and three reported increasing trends: Ireland, Sweden, and the United Kingdom.
Deaths are still rising in 27 countries, and considerable excess morality has been reported in several countries, both in younger and older adults.
Acknowledging that the control measures are disruptive, the ECDC said lifting them too quickly could trigger a resurgence of sustained community transmission. Its risk assessment references its roadmap for lifting containment measures that covers public health goals, robust surveillance, expanded testing, contact tracing, enough healthcare capacity, response assessment, and a strong risk communication plan.

The Privacy Factor in Ending the Lockdown
Now, the only generally accepted solution is a gradual relaxation of restrictions, enabled by mass-scale testing, tracking, and contact tracing to identify all those with whom an infected person has interacted. And, because it is not feasible to test 100% of the population, the ultimate solution lies in making track-and-trace systems work. The only realistic way to track and trace at the necessary scale is to use the geolocational data provided by cellphones.
Recent reports show that the slowdown in human activities due to COVID-19 pandemic is actually improving air quality in many places on our planet.
This is an opportunity for planet reboot.
The Pandemic is not a natural disaster

The Coronavirus and Climate Change, the Great Crises of Our Time

Connecting clusters of COVID-19: an epidemiological and serological investigation
As of April 15, 2020, more than 1·9 million cases of coronavirus disease 2019 (COVID-19), and more than 120 000 deaths from the disease, have been recorded worldwide. Many initial cases reported outside of China were imported or were linked to travellers from China. However, as community transmission has become widespread, the source of cases of COVID-19 in several countries has not been established.

Hidden Outbreaks Spread Through U.S. Cities Far Earlier Than Americans Knew, Estimates Say
By the time New York City confirmed its first case of the coronavirus on March 1, thousands of infections were already silently spreading through the city, a hidden explosion of a disease that many still viewed as a remote threat as the city awaited the first signs of spring.
Indoor transmission of SARS-CoV-2  
By early April 2020, the COVID-19 pandemic had infected nearly one million people and had spread to nearly all countries worldwide. It is essential to understand where and how SARS-CoV-2 is transmitted.

Coronavirus found in Paris sewage points to early warning system
By sampling sewage across greater Paris for more than 1 month, researchers have detected a rise and fall in novel coronavirus concentrations that correspond to the shape of the COVID-19 outbreak in the region, where a lockdown is now suppressing spread of the disease.

To Cull, Or Not To Cull, Bat is the Question
In summary, culling bats is an inhumane and ineffective way to mitigate conflict with fruit growers, and is more likely to increase, not decrease, the risk of disease emergence in the human population. Let’s go forth and reflect on the real animals behind that comic silhouette in the sky, and make informed, science-based decisions to protect the bats and the ecosystems they call home.
Consequences of the Outbreak on society and Economy

Vaccine Rates Drop Dangerously as Parents Avoid Doctor’s Visits
Afraid of Covid-19, parents are postponing well-child checkups, including shots, putting millions of children at risk of exposure to preventable deadly diseases.
Not a luxury: a call to maintain sexual and reproductive health in humanitarian and fragile settings during the COVID-19 pandemic

COVID-19 and gender equality

Coronavirus puts women in the frontline
Helplines for victims of violence
The COVID-19 crisis has revealed the burden of care work women carry. The pandemic is likely to increase the unequal distribution of care work between men and women within households.

How Aging Societies Should Respond to Pandemics
Whereas just over 2.5% of the US population was over 70 in 1920, that share is now more than 10%. This shift has major implications for how the coronavirus spreads, how many people will die, and how we should respond to this and future pandemics
An inequity in education:
The COVID-19 pandemic has disrupted learning for more than 1.5 billion children and youth. Those who were marginalized before the pandemic, are now even more at risk..
World Bank predicts sharpest decline of remittances in recent history
Global remittances are projected to decline sharply by about 20 percent in 2020 due to the economic crisis induced by the COVID-19 pandemic and shutdown. The projected fall is largely due to a fall in the wages and employment of migrant workers, who tend to be more vulnerable to loss of employment during an economic crisis in a host country.
COVID-19 shakes commodity markets
Oil prices have plunged, and demand is expected to fall by an unprecedented amount in 2020, according to our Commodity Markets Outlook. Learn how the COVID-19 pandemic has impacted both demand for and supply of commodities.
Poverty and COVID-19
WB estimate that the pandemic could push about 49 million people into extreme poverty in 2020. Here’s what we can do about it.

Could Pandemic Lead to Famine?
While the case for a sensible degree of social distancing to combat COVID-19 in developing countries is strong, the case for a lockdown is not. Lockdowns pose new threats, and could even turn the pandemic response into a famine in some poor places.
Risk communication
Updated WHO Myth buster
WHO WhatsApp health alert launches in Arabic, French and Spanish
WHO Technical guidance
Addressing Human Rights as Key to the COVID-19 Response
The CDC published new guidance on COVID-19
Lancet Coronavirus Resource Centre
This resource brings together new 2019 novel coronavirus (2019-nCoV) content from across The Lancet journals as it is published. All content listed on this page is free to access.
Elsevier’s free health and medical research on novel coronavirus (2019-nCoV)

CIDRAP COVID-19 Resource Center
CIDRAP has created a one-stop comprehensive compilation of the most current, authorititive information available on the novel coronavirus. Visit the Resource Centeroften, as the outbreak is constantly evolving

Training courses:
WHO training

ECDC COVID-19 Micro learning


Research and Development

Global research on coronavirus disease (COVID-19)

Database of publications on coronavirus disease (COVID-19)

Help Fight Coronavirus- Donate Now
Everyone can now support directly the response coordinated by WHO. People and organizations who want to help fight the pandemic and support WHO and partners can now donate through the COVID-Solidarity Response Fund for WHO at



Knowledge Sharing

Thank you for reading. If you have thoughts, feedback, story ideas, or questions you would like to share or interested in partnering with us on a special event coverage, please send a note to Chadia Wannous via email  


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