COVID-19 situation: 7 September 2020
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Pandemic Threats and Health Emergencies
COVID-19 situation: 7 September 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 email@example.com
Wishing you useful reading!
WHO global Weekly Epidemiological Update- 4 September
COVID-19 dashboards for most up-to-date figures:
Global dashboard https://covid19.who.int/
Updates from WHO regional offices
COVID-19 in Africa: marking six months of response
September 5th, 2020 15:00 (EST)
An additional 144,427 cases and 3,383 deaths were reported in the past 24 hours, representing a 1.04% relative increase in cases and a 0.70% relative increase in deaths, compared to the previous day.
In Brazil, the disease is present in 99.1% of the municipalities in the country, however 3,780 of the cities (more than half) report less than 100 cases. Regarding deaths, 4,052 cities had records (72.7%), and 854 of them had only one confirmed death.
All information about COVID- 19 can be found here:https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Latest updates - Live press conference (Geneva)
Evaluating the effectiveness of travel bans
The results indicate that cross-country transmission processes, specifically via international flight connections, played a particularly important role in the early stages of the virus’ spread and that the shutdown of international airports and border closures were indeed important policies to prevent further spillovers across countries. It appears that governments, who took early action to reduce cross-border air passenger traffic, did in fact do the right thing to prevent the spread of infection. The research also supports anecdotal evidence that countries that delayed closing their borders to air traffic have higher infection rates. Also interesting to note is the fact that the spread between countries could mostly be explained by international flight connections between them, rather than shared borders (land-travel transmission). The researchers point out that this could also explain why Austria was relatively more affected by the virus than, for instance, neighboring countries in Eastern Europe, even though they share land borders with Austria.
Q&As guidance on the use of masks for children in the context of COVID-19
European Citizens' Initiative: Commission decides to register ‘Right to Cure' initiative
The ECI lists the following objectives:
- Ensure that intellectual property rights, including patents, do not hamper the accessibility or availability of any future COVID-19 vaccine or treatment;
- Ensure that EU legislation on data and market exclusivity does not limit the immediate effectiveness of compulsory licenses issued by Member States;
- Introduce legal obligations for beneficiaries from EU funds to share COVID-19 health technology related knowledge, intellectual property and/or data in a technology or patent pool;
- Introduce legal obligations for beneficiaries from EU funds regarding transparency on public contributions, production costs, as well as accessibility and affordability clauses combined with non-exclusive licenses.
COVID spikes in India, resurges in South Korea, Europe
India continues to see the highest daily number of new COVID-19 cases, reporting 78,537 new cases yesterday, with 1,045 deaths. The country's total case number is now at more than 3.7 million. The biggest contributor to the surge in cases has been large cities like Mumbai and Delhi, where millions live in densely packed slums. But the virus has also spread into smaller cities and more rural areas of the country.
Despite the surge in infections, the government is still going ahead with plans to ease restrictions, the BBC reports. Gatherings of as many as 100 people will be allowed at cultural, entertainment, and sports events, and subways will reopen in big cities.
In South Korea, the Korea Centers for Disease Control yesterday reported 267 new infections, bringing the country's total to 20,449 infections, with 326 deaths. After curtailing the spread of the coronavirus for several months and being held up as a model for the rest of the world, South Korea's daily caseload of new infections has been in the triple digits since Aug 14.
Vice Health Minister Kim Gang-lip told reporters that 40% of new cases are in people older than 60, according to Reuters. He also said the government is scrambling to add hospital beds because of concerns that many of the new cases could be severe.
In Europe, where new COVID-19 infections are again on the rise in several countries after trending downward for much of the summer, the European Union (EU) today warned countries not to reduce the 14-day quarantine period for those who've been infected. The warning from the head of the European Centre for Disease Control and Prevention (ECDC) came after Germany said last week that it planned to shorten the quarantine period, a move that has also been made by Norway and the Netherlands.
Reuters reports that Andrea Ammon, MD, told EU lawmakers that this week's data showed there were 46 cases per 100,000 people across Europe. "We are almost back to numbers we have seen in March," she said.
Among the European countries seeing a surge in new infections are Spain, Russia, France, and Ukraine, CNBC reports.
Case fatality rate analysis
the case fatality, both globally and for individual continents, is converging around 3%. However, there remains considerable variation between countries. Six (6) countries continue to report COVID-19 case fatality greater than 10%. Notably, 4 of these countries—Belgium, France, Italy, and the UK—were severely affected early in the pandemic, and all 4 are reporting decreasing trends.
Yemen is reporting the world’s highest case fatality (29%). Yemen faces numerous major challenges to its COVID-19 response that undoubtedly contribute to its elevated COVID-19 case fatality, including its ongoing civil war, which has destroyed critical healthcare and public health infrastructure, and other ongoing health emergencies, such as the largest cholera epidemic in recorded history. Iran and Egypt have both reported increasing case fatality since approximately mid-June.
Mexico’s case fatality has largely leveled off since early August, holding steady at approximately 11%. Mexico has lost 1,320 health workers to COVID-19—more than any other country, Amnesty International said Thursday, AP reports.
A number of other countries around the world are reporting case fatality greater than 5%. The majority of these countries are reporting decreasing trends.
Situation in India
Over the past several months, India’s daily COVID-19 incidence has steadily increased, now #1 globally with more than 78,000 new cases per day (nearly 30% of the global daily total). Early in the epidemic, the Indian government implemented a nationwide lockdown in an effort to contain the spread of the virus. Toward the end of the lockdown, public health experts expressed concern that relaxing the restrictions was risky. At that time, some experts believed that India had not sufficiently limited community transmission, and there was concern that lifting the restrictions would result in a rapid increase in social interaction and travel. Like many countries, India has struggled to balancehealth and safety and economic activity. Recent analysis indicates that India’s economy contracted by approximately 20% in April-June compared to last year, and forecasts project that the annual GDP could decrease by more than 5% for 2020. Earlier this year, India’s Ministry of Finance announced that it will implement a US$265 billion stimulus package—equivalent to approximately 10% of India’s GDP—but some economists fear that only a small fraction of that will ultimately be spent and that it will have minimal effect on the economy.
Even as India works to gain control of its epidemic, efforts are ongoing to establish and scale up manufacturing capacity for future SARS-CoV-2 vaccines. India accounts for more than 60% of vaccines distributed to developing countries, and it is home to the world’s largest vaccine manufacturer, the Serum Institute of India (Pune). The Serum Institute has finalized an agreement with AstraZeneca to produce 1 billion doses of its vaccine (developed in collaboration with the University of Oxford). Notably, India will be able to keep half of its production capacity for domestic use, and it will distribute the other half to developing countries.
Scientific Publications, Reports and News
Can we become immune to SARS-CoV-2?
Right now, we just don’t know whether the human immune system can mount a lasting defence against SARS-CoV-2. The question is crucial to understanding whether a vaccine will provide adequate protection, whether those who have recovered from COVID-19 can return to pre-pandemic behaviours and how readily the world can reduce the threat posed by the disease. A handful of accounts of reinfection — people who recovered from COVID-19, only to test positive for the disease again later — has fed concerns that immunity might be short-lived. Researchers say there is one big reason to be optimistic: SARS-CoV-2 seems to trigger a comfortingly normal reaction from our immune systems. “We’re seeing great immune responses and fantastic-looking antibodies. We just don’t know the longevity of that response yet,” says viral immunologist Mehul Suthar. “Unfortunately, that will take time.”
Nature | 8 min read
The summer sun didn’t stop covid-19. Here’s why.
The Washington Post (commentary)
COVID-19 solutions coming from South, conference hears
‘Carnage’ in a lab dish shows how the coronavirus may damage the heart
When SARS-CoV-2 virus was added to human heart cells grown in lab dishes, the long muscle fibers that keep hearts beating were diced into short bits.
Raging Campus Outbreaks Send Students Home Across the U.S.
Panelists Named to Join the Independent Panel for Pandemic Preparedness and Response The Independent Panel
Wildlife markets in the pandemic: Prohibit or preserve them? Ban or promote them?
One Health legislation: Contributing to pandemic prevention through law
Air pollution is returning to pre-covid levels
Saliva COVID-19 Test as Good as, Perhaps Beats, Nasal Swab: Study
Testing for responses to the wrong SARS-CoV-2 antigen?
Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results
Tracking covid-19 excess deaths across countries
In many parts of the world, official death tolls undercount the total number of fatalities
Steroids cut death rates among critically ill COVID-19 patients, major study finds
Treating critically ill COVID-19 patients with corticosteroid drugs reduces the risk of death by 20%, an analysis of seven international trials found on Wednesday, prompting the World Health Organisation to update its advice on treatment.
Doctors chase treatment for kids threatened by dangerous COVID-19 syndrome
Emergency Use Authorizations During the COVID-19 PandemicLessons From Hydroxychloroquine for Vaccine Authorization and Approval
Creepy images show airway cells teeming with SARS-CoV-2
Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19The CoDEX Randomized Clinical Trial
Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19A Meta-analysis
Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial
Corticosteroids in COVID-19 ARDSEvidence and Hope During the Pandemic
WHO recommends systemic corticosteroids for the treatment of patients with severe and critical COVID-19. We suggest not to use corticosteroids in the treatment of patients with non-severe COVID-19. Treatment should be under supervision of a clinician
Early trials of Russian COVID-19 vaccine show safety, immune response
The Lancet published the results of two nonrandomized trials (called Sputnik V) of a Russian COVID-19 vaccine candidate, which showed no serious adverse events and demonstrated that the vaccine elicited an antibody response in study participants within 21 days of administration. The phase 1/2 trials were conducted in 76 healthy adults.
No serious adverse events were noted in the 42 days. Mild events included pain at the injection site (44 of 76 participants; 58%), hyperthermia (50%), headache (42%), and muscle and joint pain (24%). There were key limitations, however. Older adults were excluded from the trials, and only 2 participants were not white. A planned phase 3 trial of 40,000 people should help gather information about how the vaccine performs in the wider population.
Sep 4 Lancet study
Sep 4 Lancet commentary
Experts unveil ethics-based strategy for distributing COVID-19 vaccines
A team of 19 global health experts, led by Ezekiel Emanuel, MD, PhD, chair of Medical Ethics and Health Policy in the Perelman School of Medicine at the University of Pennsylvania, propose a new framework for distributing a future COVID-19 vaccine: focus on preventing premature deaths. The framework appeared yesterday in Science.
Sep 3 Science article
Sep 3 University of Pennsylvania news release
Russian coronavirus vaccine produces immune response in early trials
US officials assure COVID vaccine decisions won't be political
Two thirds of Americans say they will not get a vaccine as soon as it's available.
The European Commission and Japan recently indicated that they will join and support the COVID-19 Vaccine Global Access Facility (COVAX), a global initiative run by the WHO, Gavi, and CEPI to increase accessibility of a COVID-19 vaccine, particularly among low- and middle-income countries. The deadline for binding commitments to the program is September 18, and the first round of payments will be due no later than October 9. The European Commission has pledged €400 million (~US$475 million), but Japan has not yet specified the magnitude of its commitment. The initiative focuses on funding the development and scale-up of vaccine production capacity with the goal of ensuring that low- and middle-income countries can have access to at least 2 billion doses by the end of 2021, enabling immunization coverage for at least 20-30% of their populations. COVAX aims to pool resources so that lower-income countries are able to better compete financially against higher-income countries to procure initial doses of the vaccine. A total of 172 countries have pledged to engage in the initiative. Notably, 80 of these countries are high-income, self-financing countries that have only submitted “non-binding expressions of interest.” Funding from these countries will be critical for financing COVAX, so the next several weeks will be extremely important in terms of determining the future of the COVAX effort. The US government has declined to contribute to the program due to the involvement of the WHO. As of last week, approximately US$1 billion was still urgently needed to move the program forward.
India will make vaccines for the world — but might struggle to immunize its own people
As one of the world’s biggest vaccine manufacturers, India is likely to supply much of the doses of any future SARS-CoV-2 vaccine. Several companies have agreements to make coronavirus vaccines being developed by international drug companies. The Indian government says some of these doses can be exported, as long as a proportion remains in India. But even with this commitment, researchers say vaccine-makers might struggle to produce enough doses fast enough to control the country's huge outbreak — currently the world’s third largest. Distributing vaccines to rural parts of the country with weak health-care systems will be a huge challenge.
Nature | 6 min read
The state of COVID-19 vaccines now
As of today, there are 321 confirmed COVID-19 vaccine candidates, 32 of which have already entered clinical trials. Get a firm grip on this incredibly fast-moving field with a short, data-driven overview by four experts at the Coalition for Epidemic Preparedness Innovations (CEPI), one of the world’s leading vaccine funders. This is an update on CEPI’s last review, recommended in the Briefing in April, when an eye-watering 78 vaccines were already in progress.
Nature Reviews Drug Discovery | 7 min read
WHO doesn’t expect a COVID-19 vaccine to be ready—with all the necessary safety checks— until mid-2021. The agency said today the day after US officials said a vaccine could be ready as soon as October.
Placebo arms aren’t needed for challenge trials of Covid-19 vaccines
CEO says Pfizer won't cut corners in COVID vaccine race
"We will never submit ... any vaccine before we feel that it is safe and effective."
Access on the Rocks
Among the myriad challenges of distributing a COVID-19 vaccine across remote swathes of Africa, South America, and Asia: keeping vaccines cold. Some of the most promising vaccine candidates may need to be stored at “Antarctic-level temperatures.” Outside of the 25 most advanced countries—where a third of the global population lives—making the necessary upgrades to cold storage will be a mammoth logistical challenge.
Manufacturers are aiming to compensate by making their product hold up longer in transit. But even with a cold chain that only requires temperatures of -8C, huge portions of Africa would still be left without reliable access.
Regulatory Decision-making on COVID-19 Vaccines During a Public Health Emergency
Consequences of the Outbreak on Society and Economy
Don’t break the clean tech chain
COVID-19’s effects have caused global supply chains to buckle and break — including those that make clean energy cheap. Abandoning them puts the climate at risk, argue public-policy researchers Andreas Goldthau and Llewelyn Hughes. Economic recovery — and laudable efforts to make global trade more just — must not cost us time that we do not have to save the world.
Nature | 9 min read
Schooling disrupted, schooling rethought:
How the Covid-19 pandemic is changing education. This new report is co-authored is based on more than 1300 responses to a global survey conducted by the Harvard Graduate School of Education and the OECD.
Read the report
‘I hope that real change comes out of this moment’
The coronavirus pandemic has ripped away the blinders that were obscuring the structural racism in health care in the United States, says physician-scientist Uché Blackstock. “Here, right now, [as of Aug 18], one in 1125 Black Americans have died from coronavirus,” she says. “And there's another statistic: if Black Americans had died at the same rate as White Americans, it is estimated that about 19 500 Black people would still be alive.” Blackstock hopes that these bitter truths will inspire work towards a more just future. “I have to feel that way because this moment feels so painful, and also so tenuous, but it's also a moment when people are having conversations that they never had before.”
The Lancet | 5 min read
Addressing the structural inequities behind COVID-19 disparities
In the rush to find technological ways to battle the spread of COVID-19, untested tools, from tracking apps to infrared cameras, are being rolled out across Europe
Experts warn: High-tech tools to fight COVID-19 pose their own risks
Covid-19 is spurring the digitisation of government
It has accelerated the adoption of online services for everything from welfare to weddings
COVID-19 vaccines and neglected pregnancy
On India's COVID-19 frontline, female health workers push for fair pay
India’s rural health workers take home about 4,000 rupees ($54) a month on average despite new coronavirus responsibilities. Many of India's one million all-women ASHA workers - who have conducted door-to-door checks to trace coronavirus patients in addition to their usual duties - went on strike this month to demand job recognition, better pay and proper protective gear.
Hitting women hard, pandemic makes gender poverty gap wider
More women than men will fall into extreme poverty due to the pandemic as they bear the economic brunt of COVID-19 and face bigger job losses.
'No options' for El Salvador's pregnant girls raped in lockdown
In El Salvador, 114 girls aged 10 to 14 became pregnant as a result of rape during the country’s strict lockdown but the abortion ban means they have no safe options, reproductive rights campaigners say
COVID-19 hitting health workers hard in Americas
PAHO Director Carissa Etienne, MBBS, MSc, said that nearly 570,000 healthcare workers in the Americas have fallen ill with COVID-19, and more than 2,500 have died.
COVID-19 tied to poorer parent and child mental health
Three studies show that parent and child well-being has taken a serious hit during the pandemic.
Pandemic Triples Depression Prevalence
COVID-19 stressors driven depression symptoms in the US up by 3X—to 27.8% from 8.5% pre-pandemic, according to a new survey in JAMA Network Open. At-risk people include those with lower incomes, <$5000 in savings, and exposure to more stressors like unemployment, according to the survey of 1,441 US adults from March 31-April 13, 2020, compared to an earlier survey from 2017-2018. Women, people who are single, widowed, divorced, or separated, and Asians also reported more symptoms, CIDRAP reports.
The COVID-Chronic Stress Connection
Researchers are also investigating the role of chronic stress in severe cases of COVID-19,
“High levels of cortisol are associated with poor [COVID-19] outcomes, and drugs that block the hormone seem to improve outcomes,” says Kavita Vedhara, a University of Nottingham professor who is researching stress and the coronavirus.
The pandemic is ruining our sleep. Experts say ‘coronasomnia’ could imperil public health. – The Washington Post
How to report misinformation online
You can help to stop the spread of misinformation. If you see content that you believe to be false or misleading, report it to the hosting social media platform. Let's beat COVID-19 together!
Updated WHO Myth buster
EPI-WIN: tailored information for individuals, organizations and communities
WHO Technical guidance
The CDC published new guidance on COVID-19
Sex, gender and COVID-19: overview and resources
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
COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv
Research and Development
Global research on coronavirus disease (COVID-19)
Database of publications on coronavirus disease (COVID-19)
“Solidarity” clinical trial for COVID-19 treatments
“Solidarity II” global serologic study for COVID-19
Accelerating a safe and effective COVID-19 vaccine
COVID-19 technology access pool
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 www.COVID19ResponseFund.org.
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