COVID-19 situation: 4 April 2020

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Pandemic Threats and Health Emergencies

COVID-19 situation: 4 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-74 by 3 April 2020

  • One new country/territory/areareported cases of COVID-19 in the past24 hours: Malawi.
  • Supporting and protecting older people is everyone’s business: although all age groups are at risk of contracting COVID-19, older people face significant risk of developing severe illness.
  • As cases start to climb in the South-East Asia Region, the Regional Director Dr Poonam Khetrapal Singh held a virtual meeting with Health Ministers of the Region calling for a stronger whole-of-society approach.
  • The Pan American Health Organization (PAHO) launched an appeal yesterday for funds towards priority public health measures to help Latin American and Caribbean countries. The funds will be used to implement PAHO's COVID-19 Response Strategy.
  • Ports, airports and ground crossings require careful monitoring. WHO has produced two online interactive courses to provide guidance for the management of ill travellers and for managing COVID-19 cases or outbreaks on board ships.

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

  • Globally 972303 confirmed (75853) 50321deaths (4822)
  • Western Pacific Region108930 confirmed (1304) 3760 deaths (37)
  • European Region541808confirmed (38802) 37103 deaths (3499)
  • South-East Asia Region 5881confirmed (557) 245 deaths (29)
  • Eastern Mediterranean Region 62236 confirmed (4068) 3438 deaths (159)
  • Region of the Americas 247473 confirmed (30561) 5600 deaths (1061)
  • African Region 5263 confirmed (561)164 deaths (37)

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 4 April 2020
As of 04 April 2020, 517 443 cases have been reported in the EU/EEA and the UK: Italy (119 827), Spain (117 710), Germany (79 696), France (64 338), United Kingdom (38 168), Belgium (16 770), Netherlands (15 723), Austria (11 525), Portugal (9 886), Sweden (6 078), Norway (5 208), Ireland (4 273), Czech Republic (4 190), Denmark (3 757), Poland (3 383), Romania (3 183), Luxembourg (2 612), Finland (1 615), Greece (1 613), Iceland (1 364), Croatia (1 079), Estonia (961), Slovenia (934), Lithuania (771), Hungary (678), Latvia (493), Bulgaria (485), Slovakia (450), Cyprus (396), Malta (202) and Liechtenstein (75).
As of 04 April 2020, 40 903 deaths have been reported in the EU/EEA and the UK: Italy (14 681), Spain (10 935), France (6 507), United Kingdom (3 605), Netherlands (1 487), Belgium (1 143), Germany (1 017), Sweden (333), Portugal (246), Austria (168), Denmark (139), Romania (133), Ireland (120), Poland (71), Greece (59), Czech Republic (53), Norway (44), Hungary (32), Luxembourg (31), Finland (20), Slovenia (20), Bulgaria (14), Estonia (12), Cyprus (11), Lithuania (9), Croatia (8), Iceland (4) and Latvia (1).
Situation dashboard: latest available data

Control Measures

Countries with mandatory tuberculosis vaccines are seeing fewer coronavirus cases and deaths than countries without that requirement, according to preliminary research; several countries are trialing the vaccine in at-risk groups to see if it offers protection against the virus.
A Covid-19 Vaccine Will Need Equitable, Global Distribution
Harvard Business Review (commentary)

Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing
We conclude that viral spread is too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale. A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people. By targeting recommendations to only those at risk, epidemics could be contained without need for mass quarantines (‘lock-downs’) that are harmful to society.

Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma

The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak
The travel quarantine of Wuhan delayed the overall epidemic progression by only 3 to 5 days in Mainland China, but has a more marked effect at the international scale, where case importations were reduced by nearly 80% until mid February. Modeling results also indicate that sustained 90% travel restrictions to and from Mainland China only modestly affect the epidemic trajectory unless combined with a 50% or higher reduction of transmission in the community.

The effect of human mobility and control measures on the COVID-19 epidemic in China
Early on, the spatial distribution of COVID-19 cases in China was explained well by human mobility data. Following the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases were still indicative of local chains of transmission outside Wuhan. This study shows that the drastic control measures implemented in China substantially mitigated the spread of COVID-19.
Countries measures

The U.S. task force on COVID-19 response led by Vice President Mike Pence has begun reviewing USAID shipments of medical equipment and gear amid shortages in the country. [Politico]

The United States leads in coronavirus cases, but not pandemic response
It was reported yesterday that the US Navy relieved Captain Crozier of his command as a result of the letter of Captain Brett Crozier’s letter to senior US Department of Defense leadership calling for additional support to ensure the health and safety of the 5,000 Sailors and Marines onboard.
The Defense Department is no longer publishing official COVID-19 data for individual units or commands; however, the outbreak was reported to be 114 cases yesterday, and the majority of the crew is scheduled to be disembarked from the ship this week. A smaller contingent will remain onboard to continue necessary operations.
The C.D.C. advises all Americans to wear nonmedical masks, President Trump said. He added: “I’m choosing not to do it. It’s only a recommendation.”
He stressed that medical masks should be reserved for health care workers and that masks are not a substitute for social distancing.
The Trump administration had been deeply divided about whether to urge all Americans to wear masks when they leave their homes, with White House advisers and public health officials engaged in a debate that had stalled a public announcement.
Read the latest
The U.K. announces it will postpone this year's U.N. climate change conference in Glasgow to 2021 due to the pandemic.
The United Kingdom’s Minister of Health, Matt Hancock, outlined the roadmap for the UK to move beyond the current restrictive social distancing measures.
The plan includes 5 pillars: scale up diagnostic testing to 25,000 per day for government and hospital laboratories; increase access to commercial diagnostic testing for healthcare workers and other critical infrastructure; develop and deploy serological tests to identify past infections and immunity; improve surveillance to improve situational awareness and support vaccine and therapeutic development; and develop a nationwide mass testing capacity.
The plan also includes an effort to utilize serological tests to identify those with immunity, which can allow them to return to normal activity. This status will reportedly be documented in “immunity passports” to demonstrate their status.

A camp for refugees and asylum-seekers in Greece has been put on lockdown after 20 people tested positive for COVID-19.
Google Community Mobility Platform
Through the use of platforms such as Google Maps, Google has created aggregate mobility reports for a number of countries and regions around the world. These data enable the visualization of the changes in population movement over the course of the COVID-19 pandemic, which can provide insight into the role of social distancing efforts and other impacts of the pandemic on population movement. Google states that the data includes sufficient resolution to illustrate “the change in visits to places like grocery stores and parks.”
Scientific publications and reports and news

Global coalition to accelerate COVID-19 clinical research in resource-limited settings
we propose an international research coalition that brings together existing multinational, multidisciplinary expertise and clinical trial capacity. The coalition will synergise with existing initiatives, such as the COVID-19 Therapeutics Accelerator, the Coalition for Epidemic Preparedness Innovations (CEPI), and the SARS-CoV-2 Diagnostic Pipeline. Our objective is to use our existing research capabilities to support, promote, and accelerate multicentre trials of the safety, efficacy, and effectiveness of interventions against COVID-19 in resource-limited settings. For therapeutics, research in such settings should focus primarily on evaluation of affordable repurposed medicines—ie, those already developed and approved for other indications—and implementable supportive measures. If applicable, testing of new diagnostic tools, vaccines, and other potentially beneficial strategies will be added to the trials.

African nations missing from coronavirus trials
And a new, influential research consortium launches a bid to accelerate trials in low-income countries.
Respiratory virus shedding in exhaled breath and efficacy of face masks
We identified seasonal human coronaviruses, influenza viruses and rhinoviruses in exhaled breath and coughs of children and adults with acute respiratory illness. Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.

Medical student involvement in the COVID-19 response

Fangcang shelter hospitals: a novel concept for responding to public health emergencies
We document the development of Fangcang shelter hospitals during the COVID-19 outbreak in China and explain their three key characteristics (rapid construction, massive scale, and low cost) and five essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, and essential living and social engagement).

Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020
Investigation of all 243 cases of COVID-19 reported in Singapore during January 23–March 16 identified seven clusters of cases in which presymptomatic transmission is the most likely explanation for the occurrence of secondary cases.
What are the implications for public health practice?
The possibility of presymptomatic transmission increases the challenges of containment measures. Public health officials conducting contact tracing should strongly consider including a period before symptom onset to account for the possibility of presymptomatic transmission. The potential for presymptomatic transmission underscores the importance of social distancing, including the avoidance of congregate settings, to reduce COVID-19 spread.

You may be able to spread coronavirus just by breathing, new report finds
The National Academy of Sciences (NAS) has given a boost to an unsettling idea: that the novel coronavirus can spread through the air—not just via the large droplets emitted in a cough or sneeze. Though current studies aren’t conclusive, “the results of available studies are consistent with aerosolization of virus from normal breathing,” Harvey Fineberg, who heads a standing committee on Emerging Infectious Diseases and 21st Century Health Threats, wrote in a 1 April letter to Kelvin Droegemeier, head of the White House Office of Science and Technology Policy.

‘These are answers we need.’ WHO plans global study to discover true extent of coronavirus infections
In an effort to understand how many people have been infected with the new coronavirus, the World Health Organization (WHO) is planning a coordinated study to test blood samples for the presence of antibodies to the virus. Called Solidarity II, the program, which will involve more than half a dozen countries around the globe, will launch in the coming days.
Knowing the true number of cases—including mild ones—will help pin down the prevalence and mortality rate of COVID-19 in different age groups. It will also help policymakers decide how long shutdowns and quarantines should last.

These drugs don’t target the coronavirus—they target us
Gita Ramjee, South African scientist and respected HIV prevention expert, has died from COVID-19 complications.

COVID-19 pandemic in west Africa

Cats can get the new coronavirus, but no evidence that they spread it to humans

Would everyone wearing face masks help us slow the pandemic?
The World Health Organization and U.S. Centers for Disease Control and Prevention (CDC) have both said that only people with COVID-19 symptoms and those caring for them should wear masks. But some health experts, including the director of the Chinese Center for Disease Control and Prevention, think that’s a mistake. Health authorities in parts of Asia have encouraged all citizens to wear masks in public to prevent the spread of the virus, regardless of whether they have symptoms. Even experts who favor masking the masses say their impact on the spread of disease is likely to be modest. Many are also afraid to promote mask buying amid dire shortages at hospitals

Mathematics of life and death: How disease models shape national shutdowns and other pandemic policies

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)
We estimate 86% of all infections were undocumented (95% CI: [82%–90%]) prior to 23 January 2020 travel restrictions. Per person, the transmission rate of undocumented infections was 55% of documented infections ([46%–62%]), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging.

Coronavirus and the ‘Pangolin Effect’: Increased exposure to wildlife poses health, biosafety and global security risks

A planetary health perspective on COVID-19: a call for papers

Developing antibody tests for SARS-CoV-2

COVID-19 in Europe: the Italian lesson
All other European countries appear to be in a similar situation, with just a short time-lag of a couple of weeks (figure). We urge all countries to acknowledge the Italian lesson and to immediately adopt very restrictive measures to limit viral diffusion, ensure appropriate health-system response, and reduce mortality, which appears to be higher than previously estimated, with a crude case-fatality rate of almost 4%.

First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA
Person-to-person transmission of SARS-CoV-2 occurred between two people with prolonged, unprotected exposure while Patient 1 was symptomatic. Despite active symptom monitoring and testing of symptomatic and some asymptomatic contacts, no further transmission was detected.

Essential care of critical illness must not be forgotten in the COVID-19 pandemic
Quality essential care of critical illness could have a large positive effect on mortality even without ICUs. It would ameliorate the fatalism and passivity that arises from an absence of high-resource treatment options. Moreover, provision of essential care could prevent progression to multi-organ failure, reducing the burden on limited ICU capacity. The ability of health services in LRS and throughout the world to provide good quality essential care of critical illness must be greatly and urgently increased.

Covid-19’s death toll appears higher than official figures suggest
Measuring the total number of deaths tells a grimmer tale

Covid-19 and America’s political system
How will a decentralised country that spans a continent fight what is now the world’s largest outbreak?
Consequences of the Outbreak on society and Economy
The Covid-19 crisis too few are talking about: health care workers’ mental health
 STAT (commentary)

How will humans, by nature social animals, fare when isolated?
Covid-19 will harm people’s mental health
COVID-19: Visualizing regional socioeconomic indicators for Europe. 
Click here.

Racism and discrimination in Corona response

Almost half of people in the US feel the COVID-19 pandemic is taking a toll on their mental health, according to anew poll; writing down these feelings may help people cope.
The Washington Post
The daily terrors: Improvising in a makeshift ICU in Spain

IPA, WHO and UNICEF launch Read the World on International Children’s Book Day to support children and young people in isolation
Coronavirus crisis may deny 9.5 million women access to family planning
 The Guardian
A new government initiative in France encourages women to use the code word “mask 19” to report domestic abuse to pharmacists,
CNN reports. Paris’ lockdown measures were followed by a 36% increase in police interventions for domestic violence incidents.
Seattle—one of the first US cities hit hard—tracked a 21% jump in domestic violence reports amid the pandemic
Axios reports.
Lessons from the AIDS Pandemic
Stuart Gillespie and Alan Whiteside look at the body of work on the HIV and AIDS epidemics to tease out lessons that can be applied to COVID-19, including the need for a multi-sectoral response and sufficient social protection for vulnerable people. 
(Read Blog)
HIV complications
It's currently unclear whether HIV-positive people are more at risk of contracting COVID-19, or a more severe case of it. But there are also concerns of disruptions in access to treatment, testing, and supply chains.

‘We have no choice.’ Pandemic forces polio eradication group to halt campaigns
The COVID-19 pandemic is imperiling the worldwide, 3-decade drive to wipe out polio. In an unprecedented move, the Global Polio Eradication Initiative (GPEI) has recommended suspending polio vaccination campaigns to help stop the spread of the novel coronavirus.
Call to action to support COVID-19 response -- Polio Oversight Board Statement

Minimizing project disruption
Global health and development organizations are working to keep critical projects running without endangering staff and spreading the coronavirus.
Logistics in the food chain
How can we ensure this health crisis does not turn into an avoidable food crisis? FAO Director-General Qu Dongyu discusses some ways to help minimize disruptions and logistical bottlenecks in food supply chains.
No to Trade Restrictions
Joseph Glauber, David Laborde, Will Martin, and Rob Vos confirm that global markets for food staples remain well-stocked and make the case for policies that help maintain access to these foods, rather than measures like export bans that could increase the risk of a food price crisis. 
(Read Blog)
Livestock Farms Struggle
Livestock farmers in China have faced unprecedented challenges in the wake of pandemic restrictions, including shortages of raw materials and delivery disruptions, according to a new survey and analysis by Xiaobo Zhang and colleagues. 
(Read Blog)
Another 6.6 million joined the U.S. unemployment ranks, bringing the two-week total to a staggering 10 million as the pandemic upends the economy.
The new claims for unemployment benefits set a grim record for the second straight week. The speed and scale of the job losses is without precedent. Until last month, the worst week for unemployment filings was 695,000 in 1982.
Read the latest

Nations grapple with COVID-19 economic toll amid case escalations
The global total climbs to 1,083,084 cases, and new areas are being hit hard.
More »

What can firms do now in the midst of a pandemic?
Companies need to get study labor laws, take steps to ensure employee health, analyze supply chains, and more.
More »

Bail-outs are inevitable—and toxic
How to design corporate bail-outs to protect taxpayers
Risk communication
Updated WHO Myth buster
WHO WhatsApp health alert launches in Arabic, French and Spanish

Monitoring behavioural insights related to COVID-19
WHO and Rakuten Viber fight COVID-19 misinformation with interactive chatbot
WHO Technical guidance
New guidance
COVID-19: Operational guidance for maintaining essential health services during an outbreak 
Handbook for public health capacity-building at ground crossings and cross-border collaboration
Operational considerations for managing COVID-19 cases/outbreak on board ships
A practical manual about how to set up and manage a severe acute respiratory infections treatment centre and a screening facility in health care facilities
The First Few X cases and contacts (FFX) investigation protocol for coronavirus disease 2019 (COVID-19:
The CDC published new guidance on COVID-19
The US CDC published updated versions a broad scope of COVID-19 guidance and information, including interim guidance for collecting and processing clinical specimens, handling the bodies of deceased persons under investigation (PUIs), operating schools and childcare centers, and infection control for COVID-19 patients.
The CDC also published updated information for vulnerable populations, including individuals with asthma and pregnant women, as well as updated information on caring for COVID-19 patients at home.
Notably, the CDC updated its information regarding SARS-CoV-2 transmission.
The CDC also made substantial updates to guidance regarding how to optimize the supply of personal protective equipment (PPE).

Critical preparedness, readiness and response actions for COVID-19
Responding to community spread of COVID-19
This document provides technical guidance for government authorities, health workers, and other key stakeholders to guide response to community spread. It will be updated as new information or technical guidance become available. For countries that are already preparing or responding, this document can also serve as a checklist to identify any remaining gaps.
- Access the document
Critical preparedness, readiness and response actions
WHO has defined four transmission scenarios for COVID-19:
1. Countries with no cases (No cases);
2. Countries with 1 or more cases, imported or locally detected (Sporadic cases);
3. Countries experiencing cases clusters in time, geographic location and/or common exposure (Clusters of cases);
4. Countries experiencing larger outbreaks of local transmission (Community transmission).
This document describes the preparedness, readiness and response actions for COVID-19 for each transmission scenario.
- Access the document
IASC Guidance on COVID-19 outbreak readiness and response - Food distribution

The Coronavirus Papers unlocked: 5,352 scientific articles covering the coronavirus - fully searchable and free.
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 Center often, as the outbreak is constantly evolving

Supporting coronavirus research with FREE access to over 17,000 Global Health records 
CABI’s Global Health – the go-to bibliographic database for the study and practice of national, regional and international public health – has made relevant content available for free to support the international effort to fight the outbreak of novel coronavirus (2019-nCoV). You can access the free open access content by following this link:
U.S. Department of Health & Human Services, recently developed Novel Coronavirus Resources Page.


Training courses:
Emerging respiratory viruses, including COVID-19: methods for detection, prevention, response and control
Simplified Chinese course
The English version of this course is available here:
La versión en español de este curso está disponible aquí :
La version française de ce cours est disponible sur :

COVID-19 Micro learning 
ECDC has produced series of micro learning activities (5-30 minutes) related to COVID-19.
The short e-learning courses provide guidance on the application of non-pharmaceutical countermeasures and include the following:
1. Introduction to COVID-19 NPC
2. Personal protective equipment against COVID-19
3. Environmental countermeasures against COVID-19
4. Social distancing countermeasures against COVID-19
5. Travel related countermeasures against COVID-19


Research and Development

Global research on coronavirus disease (COVID-19)

Database of publications on coronavirus disease (COVID-19)



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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