COVID-19 situation: 27 April 2020

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Pandemic Threats and Health Emergencies

COVID-19 situation: 27 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-97 by 26 April 2020

  • Public health systems are coming under severe strain as the COVID-19 pandemic continues. Countries must also continue to focus on other health emergencies and make progress against diseases such as malaria or poliomyelitis (polio). A new analysis on malaria supports the call to minimize disruptions to malaria prevention and treatment services during the COVID-19 pandemic. More information is available in the statement from the WHO Regional Office for Africa, the statement from the WHO Regional Office for the Americas and in details on the analysis.
  • The WHO Regional Office for the Americas urges countries to strengthen vaccination against seasonal influenza and measles to prevent respiratory illness and vaccine-preventable disease outbreaks during the COVID-19 pandemic.
  • The core protocol for therapeutics against COVID-19 has been published by the WHO R&D Blueprint Working Group.
  • The WHO Regional Director for Europe has emphasized the need to build sustainable people-centred long-term care in the wake of COVID-19. More information is available here.
  • The WHO Regional Office for Europe has published key considerations for the gradual easing of the lockdown restrictions introduced by many countries in response to the spread of COVID-19 across the European Region.

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

  • Globally 2 804 796 confirmed (84 900) 193 710 deaths (6006)
  • European Region 1 341 851 confirmed (27 185)122 218 deaths (2756)
  • Region of the Americas 1 094 846 confirmed (47 338) 56 063 deaths (2960)
  • Eastern Mediterranean Region 160 586 confirmed (5615) 6887 deaths (137)
  • Western PacificRegion142 639 confirmed (1170) 5943 deaths (37)
  • South-East Asia Region 43 846 confirmed (2773) 1747 deaths (89)
  • African Region 20 316 confirmed (819) 839 deaths (27)

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 26 April 2020
As of 26 April 2020, 1 070 956 cases have been reported in the EU/EEA and the UK: Spain (219 764), Italy (195 351), Germany (154 175), United Kingdom (148 377), France (124 114), Belgium (45 325), Netherlands (37 190), Portugal (23 392), Ireland (18 561), Sweden (18 177), Austria (15 134), Poland (11 273), Romania (10 635), Denmark (8 445), Norway (7 467), Czechia (7 352), Finland (4 475), Luxembourg (3 711), Greece (2 506), Hungary (2 500), Croatia (2 016), Iceland (1 790), Estonia (1 635), Lithuania (1 438), Slovenia (1 388), Slovakia (1 373), Bulgaria (1 247), Cyprus (810), Latvia (804), Malta (448) and Liechtenstein (83).
As of 26 April 2020, 116 417 deaths have been reported in the EU/EEA and the UK: Italy (26 384), France (22 614), Spain (22 524), United Kingdom (20 319), Belgium (6 917), Germany (5 640), Netherlands (4 409), Sweden (2 192), Ireland (1 063), Portugal (880), Romania (575), Austria (536), Poland (524), Denmark (418), Hungary (272), Czechia (218), Norway (193), Finland (186), Greece (130), Luxembourg (85), Slovenia (81), Bulgaria (55), Croatia (54), Estonia (46), Lithuania (41), Cyprus (17), Slovakia (17), Latvia (12), Iceland (10), Malta (4) and Liechtenstein (1).
Situation dashboard: latest available data
Confirmation of COVID-19 in Two Pet Cats in New York
CDC and USDA just announced the first confirmed cases of SARS-CoV-2 (the virus that causes COVID-19 ) infection in two pet cats.
These are the first pets in the United States to test positive for SARS-CoV-2. The cats live in two separate areas of New York state. Both had mild respiratory illness and are expected to make a full recovery.
Full Details at

Don’t panic, experts say after COVID-19 animal killings
Studies in Germany and China find pigs, chickens, ducks not susceptible to SARS-CoV-2
India food safety authority says chicken eggs, meat safe to eat, after poultry culled in China
Expert urges people not to be concerned domestic livestock could become COVID-19 source

Global COVID-19 deaths top 200,000
Brisk activity continues in US hot spots, and in Brazil, hospitals in several major cities are nearing collapse after surges of patients.
More »

Tracking covid-19 excess deaths across countries
Official covid-19 death tolls still under-count the true number of fatalities
Graphic detail

Control Measures
Global leaders unite to ensure everyone everywhere can access new vaccines, tests and treatments for COVID-19
Unprecedented gathering of heads of government, institutions and industry cements commitment to accelerate development and delivery for all populations
“Solidarity” clinical trial for COVID-19 treatments
"Solidarity” is an international clinical trial to help find an effective treatment for COVID-19, launched by the World Health Organization and partners.
The Solidarity Trial will compare four treatment options against standard of care, to assess their relative effectiveness against COVID-19. By enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence.
Until there is sufficient evidence, WHO cautions against physicians and medical associations recommending or administering these unproven treatments to patients with COVID-19 or people self-medicating with them. WHO is concerned by reports of individuals self-medicating with chloroquine and causing themselves serious harm. WHO guidance on compassionate use can be found here.

Update on WHO Solidarity Trial – Accelerating a safe and effective COVID-19 vaccine
COVID-19 and Food Safety: Guidance for competent authorities responsible for national food safety control systems-Interim guidance
Makers turn to their 3D printers to stop COVID-19
Engineers, designers and hobbyists are turning to open-source methods to produce tools for testing and treating coronavirus. Explore some of the most successful designs, the challenges these designs face and how the open-source approach might bring lasting changes to how things are done.
(Nature | 8 min read)

How to build and deploy testing systems at unprecedented scale
Countries will have to do it to end their lockdowns safely
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.

New EU Initiative on Health Security for the EU neighbours
A five-year agreement to implement a new EU Initiative on Health Security to enhance public health preparedness and response capacities of the European Union enlargement and the European Neighbourhood Policy partner countries has been signed between ECDC and the European Commission. The total funding will be 9 million euros.
It’s difficult to grasp the projected deaths from Covid-19. Here’s how they compare to other causes of death

Effect of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China: a modelling study
From Jan 15 to March 3, 2020, seven versions of the case definition for COVID-19 were issued by the National Health Commission in China. We estimated that when the case definitions were changed, the proportion of infections being detected as cases increased by 7·1 times (95% credible interval [CrI] 4·8–10·9) from version 1 to 2, 2·8 times (1·9–4·2) from version 2 to 4, and 4·2 times (2·6–7·3) from version 4 to 5. If the fifth version of the case definition had been applied throughout the outbreak with sufficient testing capacity, we estimated that by Feb 20, 2020, there would have been 232 000 (95% CrI 161 000–359 000) confirmed cases in China as opposed to the 55 508 confirmed cases reported.
Modelling can only tell us so much: politics explains the rest (The Lancet) I've been self-isolating with my family because we developed fevers. Whether this is any illness or coronavirus disease 2019 (COVID-19) is hard to say given the UK Government's position on community testing. How this infection started, how many people I might have infected, and how adhering to public health guidance to remain at home alters patterns of disease transmission is crucial information.

Asymptomatic Transmission, the Achilles’ Heel of Current Strategies to Control Covid-19

Top epidemiologist explains Sweden’s unorthodox strategy
Sweden has stood almost alone in Europe in avoiding a lockdown, and in relying on voluntary, trust-based measures to stem the spread of COVID-19. “As a society, we are more into nudging,” says Anders Tegnell, the epidemiologist behind the controversial strategy. He argues that closing borders is pointless when the disease is already everywhere, and shutting schools has little effect unless it’s done very early in an outbreak.In general, Tegnell is happy with the approach, although he regrets how older people in care homes were not sufficiently protected.
(Nature | 6 min read)
Scientific publications and reports and news
Don’t drink or inject bleach, you could die
Doctors and manufacturers are warning people against injecting or consuming bleach or any household cleaning product after statements by US President Donald Trumpin today’s White House coronavirus task force briefing. Responding to research confirming that disinfectants kill the virus on surfaces, Trump suggested researchers investigate whether “we can do something like that, by injection inside”. Trump responded to evidence that sunlight impedes virus transmission via surfaces by suggesting “we hit the body with a tremendous — whether it's ultraviolet or just very powerful light”. Physician Deborah Birx, the US coronavirus response coordinator, stated in the same briefing that light is not a treatment for coronavirus. (BBC | 6 min read)

Off-label use of medicines for COVID-19- Scientific brief
"Immunity passports" in the context of COVID-19- Scientific Brief
WHO has published guidance on adjusting public health and social measures for the next phase of the COVID-19 response.(1) Some governments have suggested that the detection of antibodies to the SARS-CoV-2, the virus that causes COVID-19, could serve as the basis for an “immunity passport” or “risk-free certificate” that would enable individuals to travel or to return to work assuming that they are protected against re-infection. There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.
Doctors rethink rush to ventilate COVID-19 patients
Mechanical ventilators are crucial for saving the lives of some people with COVID-19 — but physicians are increasingly becoming more hesitant to use them too often. Early data indicate that the survival rates of critically ill people with COVID-19 who are mechanically ventilated appear to be lower than expected. The treatment is invasive — it involves a tube in the airway and sedation — and requires a highly trained operator. “It’s not just about running out of ventilators, it’s running out of expertise,” says pulmonology and critical-care physician David Hill.
(Reuters | 11 min read or in graphic form)

The results of coronavirus ‘serosurveys’ are starting to be released. Here’s how to kick their tires
Experts are raising concerns about the validity of some of the studies, cautioning policymakers not to put too much weight on any one finding.

Researchers take a gamble with antibody tests
Laboratories across the United States have launched initiatives to test hundreds of thousands of people for antibodies against the coronavirus that causes COVID-19. And researchers are telling those people the outcomes — despite uncertainty about what they mean. They’re couching the results in careful terms, but because of the urgent need to stem the outbreak, to prevent more deaths and to reopen businesses, they argue that it’s important to just get going. “One thing we have learned is that we can’t let perfect be the enemy of good — we need to act,” says virologist Keith Jerome.
(Nature | 6 min read)

1,500 people volunteer for controversial vaccine study
A grassroots movement has attracted nearly 1,500 volunteers prepared to take part in controversial ‘human challenge’ trials — which involve intentionally infecting healthy, young volunteers with the coronavirus to test potential vaccines. The effort is not affiliated with vaccine-developing groups or companies, but co-founder Josh Morrison hopes to show them that there is broad support for this kind of trial. “We want to recruit as many people as possible who want to do this and pre-qualify them as likely to be able to participate in challenge trials should they occur,” he says.
(Nature | 3 min read)

The untapped potential of US testing labs
A survey of more than 4,000 researchers suggests that better coordination could make hundreds of thousands more tests for coronavirus available across the United States. Nearly 1,600 of those polled said they had the necessary tools and biosafety conditions, but were not testing. About 95% of labs not currently testing said they needed more information on protocols and regulations. The survey was prompted by a Natureinvestigation revealing that several top US university labs approved to process coronavirus tests are operating at half their potential capacity.
(Nature | 3 min read)

1 in 5 people tested in New York City had antibodies for the coronavirus
A call for action for COVID-19 surveillance and research during pregnancy
Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection A Randomized Clinical Trial
The preliminary findings from the CloroCovid-19 trial suggest that higher dosage of chloroquine should not be recommended for the treatment of severe COVID-19, especially among patients also receiving azithromycin and oseltamivir, because of safety concerns regarding QTc interval prolongation and increased lethality.
After COVID-19—Thinking Differently About Running the Health Care System

Nearly 9 in 10 COVID-19 patients who are put on a ventilator die, New York hospital data suggests
But age made a difference. Around 76% of ventilated patients between the ages of 18 and 65 died, and 97%, of ventilated patients over the age of 65 died, according to the report.
SARS-CoV-2 may be exploiting our immune system's 'first responder' cells

5 reasons it’s safe for kids to go back to school
More evidence has come in and confirmed what the government has been saying for some time. Children do get infected much less than adults with COVID-19 and when they do, they hardly spread it.
Diagnosing malaria and other febrile illnesses during the COVID-19 pandemic

COVID-19 pandemic raises new questions about the health impacts of air pollution

Report: The Impact of COVID-19 Across Africa

Opinion: Why a strong cold chain is more critical than ever to defeat COVID-19
What you need to know about your cats and coronavirus
Cases of cats acquiring coronavirus are rare—and there is no evidence the disease could spread from pets to humans.

When bubonic plague first struck America, officials tried to cover it up
In 1900, the dreaded Black Death showed up in California, setting off a two-year political firestorm. Over the next two years followed an extraordinary struggle between California officials who denied the existence of plague and federal scientists who fought to stop the growing epidemic. The resulting nationwide controversy drew in the president and nearly two dozen governors, and ultimately forced California’s governor from office—but not before a leading scientist was demonized and more than a hundred victims had died of the grisly disease.

A peculiarity of Spanish flu may shed light on covid-19
Age-related mortality is not always what might be expected

Medical experts have a plan to prevent next epidemic – it’s called ‘One Health’
Update: COVID-19 funding. Since April 12, 294 additional initiatives worth $3.1 trillion have been added to the COVID-19 funding database.
Here's who's funding the response.
The U.S. has blocked economic aid for Iran and rejected calls to ease sanctions on the country amid the COVID-19 pandemic, according to EU foreign policy chief Josep Borrell.
Consequences of the Outbreak on society and Economy

Isolating the Sick at Home, Italy Stores Up Family Tragedies
“Stay home” measures have helped Italy control the coronavirus, but home is also a dangerous place that may be propping up the infection curve the lockdown was meant to suppress.

Milan announces ambitious scheme to reduce car use after lockdown
Under the nationwide lockdown, motor traffic congestion has dropped by 30-75%, and air pollution with it. City officials hope to fend off a resurgence in car use as residents return to work looking to avoid busy public transport.

Coronavirus pandemic could hit the billions migrant workers send home in cash
Remittances to low- and middle-income countries are set to drop by nearly $110 billion in 2020 and could see an almost 20% slump amounting to $445 billion due to COVID-19, according to the World Bank.
[The Guardian]

Refugee camps brace for deadly impacts
Close living quarters, widespread underlying health problems and limited access to sanitation and medical care mean that COVID-19 poses an outsized threat to the 70 million refugees, displaced people and asylum seekers around the world. “Any kind of epidemic is never good, but particularly not this one, where physical distancing is impossible and home isolation is a joke,” says Annick Antierens.
(Nature | 3 min read)

Refugees need protection from coronavirus too, and must be released
It is almost impossible for asylum seekers held in detention to practise social distancing. For their protection, and that of the wider community, the government must take action now.
Mental Health Status Among Children in Home Confinement During the Coronavirus Disease 2019 Outbreak in Hubei Province, China
In this study, 22.6% of students reported having depressive symptoms, which is higher than other investigations in primary schools of China (17.2%). During the outbreak of COVID-19, the reduction of outdoor activities and social interaction may have been associated with an increase in children’s depressive symptoms. Our study found that 18.9% of students reported anxiety symptoms, which is higher than the prevalence in other surveys. Severe acute respiratory syndrome in 2003 was also associated with several psychological symptoms among students in China
Why psychiatric wards are uniquely vulnerable to the coronavirus. 
The New Yorker
What happens after you survive
For those people who recover from a severe bout of COVID-19, both the illness and the treatment can have lingering effects. Clinicians are learning lessons from other diseases about the physical, cognitive and mental-health problems that might be in store.
(Science | 5 min read)
On Earth Day, we ask what COVID-19 means for climate action.
With economies on pause and public finance flowing like never before, the pandemic is creating both opportunities and risks.
Coronavirus is a toxic storm of illness and death for black Americans
Almost one-third of infections nationwide have affected black Americans, according to data from the CDC, though blacks represent only 13 percent of the U.S. population. Likewise, nearly one-third of those who have died across the country are black.
Dozens of cruise ships filled with people are still waiting to come home
The ships are floating off the U.S. coast, with tens of thousands of crew members of varying nationalities on board—and with no clear timeline for when and how they will all return to their home countries.

Covid-19: Transplants plummet as overwhelmed hospitals focus on the coronavirus
As hospitals and health care workers focus on battling the Covid-19 outbreak, other health procedures — even essential, lifesaving procedures such as transplants — are being put off. Organ donations have plummeted in the wake of the crisis, and those who are in need of donor organs are having to wait even longer than usual. Some, such as pancreas transplants, are indefinitely on hold, while only the most urgent cases for other organs are being considered, until the crisis abates.


Will the sustainable travel movement survive coronavirus?
Travel experts say the pandemic won’t stop environmentalists’ call for slower trips and fewer flights.
How Capital Markets Can Contain the Coronavirus
As governments and central banks run out of fiscal stimulus options, COVID-19 social bonds could be critical in softening the economic blow.
The Coronavirus Oil Shock Is Just Getting Started
The pandemic is causing crisis for energy-producing governments around the world—and could change the global economy forever.
The COVID-19 Nutritional Crisis: 
Derek Headey and Marie Ruel detail the ways in which the pandemic is a perfect storm for global malnutrition, drastically threatening dietary quality and maternal and child health. They advocate for strengthening multisectoral nutrition coalitions in order to prevent a full-blown nutritional crisis. 
(Read Blog)
Why Gender Matters in COVID-19 Responses: 
National and global health recommendations affect men and women differently in developing countries, from disparities in access to COVID-19 information and the burden of fetching water for handwashing to the impact of health shocks. Agnes Quisumbing, Neha Kumar, Ruth Meinzen-Dick, and Claudia Ringler provide ideas from development research on how to address these disparities. 
(Read Blog)
Dramatic Rise in Poverty and Food Insecurity: 
Rob Vos, David Laborde, and Will Martin estimate the impact of the pandemic globally, finding that over 140 million additional people could fall into extreme poverty in 2020, with an accompanying spike in food insecurity. They call for fiscal stimuli and the expansion of social safety nets.
(Read Blog

Warnings of worsening hunger, malaria emerge as coronavirus cases spike 40% in Africa (The Washington Post)
Africa’s reported number of coronavirus cases soared by more than 40 percent in the last week, stoking concerns that the continent could become the epicenter of the pandemic at a time when hunger is rising and doctors fear a resurgence of malaria deaths.
Risk Communication
Updated WHO Myth buster
WHO WhatsApp health alert launches in Arabic, French and Spanish
WHO hand hygiene campaign day - 5 May
WHO’s Hand Hygiene Day is fast approaching on 5 May. In light of COVID-19, advocating for support to build infrastructures and promoting proper infection, prevention and control measures has never been more important.
WHO Technical Guidance
Safe Ramadan practices in the context of the COVID-19: interim guidance, 15 April 2020

Addressing Human Rights as Key to the COVID-19 Response
WHO Water, sanitation, hygiene, and waste management for the COVID-19 virus Interim guidance 23 April 2020
WHO Guiding principles for immunization activities during the COVID-19 pandemic. Interim guidance 26 March 2020
Guidance on routine immunization services during COVID-19 pandemic in the WHO European Region (2020)
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

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:

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)

R&D Blueprint and COVID-19

Draft landscape of COVID 19 candidate vaccines

Informal consultation on the role of therapeutics in COVID-19 prophylaxis and post-exposure prophylaxis - 16 April 2020

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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