Coronavirus disease (COVID-19): situation report, 172

Coronavirus disease (COVID-19) Situation Report – 172 Data as received by WHO from national authorities by 10:00 CEST, 10 July 2020 Highlights WHO Director-General Dr Tedros acknowledged how civil society has played a critical role in responding to this pandemic by highlighting the needs of the most vulnerable, fighting for an equitable response, and holding decision-makers to account, in his address to a webinar on “civil society engagement in COVID-19 response at national and local levels”, organised by WHO’s Health Partnerships department. The burden of COVID-19 is overwhelming fragile health systems in Africa, although the accelerating trend of increasing cases is not uniformly distributed across the region. WHO Regional Director for Africa, Dr Matshidiso Moeti emphasized that “if countries continue to strengthen key public health measures such as testing, tracing contacts and isolating cases, we can slow down the spread of the virus to a manageable level.” WHO Regional Director for Europe, Dr. Hans Henri P. Kluge urged countries to stand firm and stay focused on what we know works to hold the virus at bay; step in swiftly at the first sign of local surges; and sign up to be part of a new culture of health during the summer months. Today we include two reports in the ‘Subject in Focus’ below. The first summarizes key points on the updated scientific brief on what we currently know about the transmission of SARS-CoV-2. The second provides an overview of a virtual meeting that was held to share experiences and lessons learnt in COVID-19 preparedness and response at points of entry in Central Africa. Situation in numbers (by WHO Region) Total (new cases in last 24 hours) Globally 12 102 328 cases (228 102) 551 046 deaths (5 565) Africa 428 051 cases (17 307) 7 733 deaths (174) Americas 6 264 626 cases (138 824) 276 370 deaths (3 764) Eastern Mediterranean 1 238 779 cases (16 709) 29 690 deaths (563) Europe 2 868 080 cases (20 193) 202 341 deaths (488) South-East Asia 1 065 093 cases (32 926) 27 382 deaths (574) Western Pacific 236 958 cases (2 143) 7 517 deaths (2) Subject in Focus: Transmission of SARS-CoV-2: implications for infection prevention precautions On 9 July 2020, WHO updated the scientific brief on transmission of SARS-CoV-2, the virus that causes COVID-19. This replaces a previous version of the scientific brief, published on 29 March 2020. As the spread of the virus continues to intensify around the world, we are gaining more knowledge as to how and when the virus is able to spread between people. This is important in order to continuously ensure that the most effective measures to suppress transmission of the virus and prevent associated illness and death are used. Below, we provide the key points of the brief. The full scientific brief and a Q&A are available online. Key points of the brief Main findings • Understanding how, when and in what types of settings SARS-CoV-2 spreads between people is critical to develop effective public health and infection prevention measures to break chains of transmission. • Current evidence suggests that transmission of SARS-CoV-2 occurs primarily between people through direct, indirect, or close contact with infected people through infected secretions such as saliva and respiratory secretions, or through their respiratory droplets, which are expelled when an infected person coughs, sneezes, talks or sings. • Airborne transmission of the virus can occur in healt care settings where specific medical procedures, called aerosol generating procedures, generate very small droplets called aerosols. Some outbreak reports related to indoor crowded spaces have suggested the possibility of aerosol transmission, combined with droplet transmission, for example, during choir practice, in restaurants or in fitness classes. • Respiratory droplets from infected individuals can also land on objects, creating fomites (contaminated surfaces). As environmental contamination has been documented by many reports, it is likely that people can also be infected by touching these surfaces and touching their eyes, nose or mouth before cleaning their hands. • Based on what we currently know, transmission of COVID-19 is primarily occurring from people when they have symptoms, and can also occur just before they develop symptoms, when they are in close proximity to others for prolonged periods of time. While someone who never develops symptoms can also pass the virus to others, it is still not clear to what extent this occurs and more research is needed in this area. • Urgent high-quality research is needed to elucidate: the relative importance of different transmission routes; the role of airborne transmission in the absence of aerosol generating procedures; the dose of virus required for transmission to occur; the settings and risk factors for superspreading events; and the extent of asymptomatic and pre-symptomatic transmission. How to prevent transmission The over-arching aim of the Strategic Preparedness and Response Plan for COVID-19 is to control COVID- 19 by suppressing transmission of the virus and preventing associated illness and death. To the best of our understanding, the virus is primarily spread through contact and respiratory droplets. Under some circumstances airborne transmission may occur (such as when aerosol generating procedures are conducted in healthcare settings or potentially, in indoor crowded poorly ventilated settings elsewhere). More studies are urgently needed to investigate such instances and assess their actual significance for transmission of COVID-19. To prevent transmission, WHO recommends a comprehensive set of measures including: • Identify suspect cases as quickly as possible, test, and isolate all cases (infected people) in appropriate facilities; • Identify and quarantine all close contacts of infected people and test those who develop symptoms so that they can be isolated if they are infected and require care; • Use fabric masks in specific situations, for example, in public places where there is community transmission and where other prevention measures, such as physical distancing, are not possible; • Use of contact and droplet precautions by health workers caring for suspected and confirmed COVID-19 patients, and use of airborne precautions when aerosol generating procedures are performed; • Continuous use of a medical mask by health workers and caregivers working in all clinical areas, during all routine activities throughout the entire shift; • At all times, practise frequent hand hygiene, physical distancing when possible, and respiratory etiquette; avoid crowded places, close-contact settings and confined and enclosed spaces with poor ventilation; wear fabric masks when in closed, over-crowded spaces to protect others; and ensure good environmental ventilation in all closed settings and appropriate environmental cleaning and disinfection. WHO carefully monitors the emerging evidence about this critical topic and will update this scientific brief as more information becomes available. Sharing experiences and lessons learnt in COVID-19 preparedness and response at points of entry in Central African countries Earlier this month, the WHO Regional Office for Africa, through the Emergency Response Programme hub in Dakar, Senegal, organized a series of virtual workshops to share experiences and lessons learnt in preparedness and response to the COVID-19 pandemic in Central Africa, and to strengthen cross-border collaboration. The webinars were conducted in partnership with the International Organization for Migration (IOM), International Civil Aviation Organization (ICAO), Economic Committee of Central African State (ECCAS), and the Organization de Coordination pour la Lutte contre les Endemie en Afrique Central (OCEAC). The objectives of the workshops were to: update participants from countries and partner organizations on recent developments in the COVID-19 response at Points of Entry (PoE); share country experiences in the implementation of COVID-19 preparedness and response at PoE; identify gaps in IHR core capacities, mainly at PoE; and agree on next steps to strengthen Member State cross-border collaboration. The workshops were attended by 99 participants from nine Central African countries including: Burundi, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of the Congo, Equatorial Guinea, Gabon and Sao Tome and Principe, and international and regional partners. Theregional strategy for COVID-19 preparedness and response was established in June with strong political commitment from Central African states. At the workshops, participants provided an update and reported that all countries have carried out COVID-19 preparedness and response activities, put in place active case- finding systems at PoE, and activated cross-border collaboration mechanisms. Participants also talked about opportunities for preparedness and response funding, expressed technical needs for country support, identified challenges, and described some of the lessons learnt over the past six months. Many countries are conducting entry screening and laboratory testing at PoE, have instituted quarantine measures at home or in quarantine facilities, and are monitoring in-coming travellers using community surveillance systems. On the whole, COVID-19 cross-border collaboration mechanisms have been built on already existing bi-lateral and/or multi-lateral cross-border collaboration schemes. Some countries are also reactivating polio cross-border collaboration mechanisms to assist with COVID-19 preparedness and response. However there have been major challenges, including the lack of human and financial resources and constrained infrastructure capacities. WHO will continue to support Member States and partners to reinforce PoE capacity. Some countries have indicated that they are planning to conduct training and simulation exercises to strengthen their PoE capacities. A technical report of these meetings will be disseminated shortly. A comprehensive regional strategy for cross-border collaboration based on data shared during these workshops will be developed as the next step following these meetings. Surveillance Figure 1. Number of confirmed COVID-19 cases reported in the last seven days by country, territory or area, 4 July to 10 July ** **See Annex 1 for data, table and figure notes. Figure 2. Number of confirmed COVID-19 cases, by date of report and WHO region, 30 December through 10 July** **See Annex 1 for data, table and figure notes. Table 1. Countries, territories or areas with reported laboratory-confirmed COVID-19 cases and deaths, by WHO region. Data as of 10 AM CEST, 10 July 2020** Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Africa South Africa 238 339 13 674 3 720 118 Community transmission 0 Nigeria 30 748 499 689 5 Community transmission 0 Ghana 23 463 641 129 0 Community transmission 0 Algeria 17 808 460 988 10 Community transmission 0 Cameroon 14 916 0 359 0 Community transmission 2 Côte d’Ivoire 11 504 0 78 0 Community transmission 1 Kenya 8 975 447 173 4 Community transmission 0 Democratic Republic of the Congo 7 845 109 188 5 Community transmission 0 Senegal 7 784 127 143 2 Community transmission 0 Ethiopia 7 120 147 124 4 Community transmission 0 Guinea 5 881 184 36 2 Community transmission 0 Gabon 5 871 0 46 0 Community transmission 1 Mauritania 5 087 63 139 4 Clusters of cases 0 Central African Republic 4 200 91 52 0 Community transmission 0 Madagascar 3 782 209 33 0 Clusters of cases 0 Mali 2 370 12 120 0 Community transmission 0 South Sudan 2 129 23 41 1 Clusters of cases 0 Congo 2 028 207 47 0 Community transmission 0 Malawi 1 986 44 29 4 Clusters of cases 0 Zambia 1 895 0 42 0 Community transmission 2 Guinea-Bissau 1 790 0 25 0 Community transmission 3 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Sierra Leone 1 598 14 63 0 Community transmission 0 Cabo Verde 1 553 11 19 1 Clusters of cases 0 Benin 1 285 0 23 0 Community transmission 2 Eswatini 1 213 75 17 3 Clusters of cases 0 Rwanda 1 210 16 3 0 Sporadic cases 0 Niger 1 097 0 68 0 Community transmission 1 Mozambique 1 092 21 9 1 Clusters of cases 0 Equatorial Guinea 1 043 0 12 0 Community transmission 47 Burkina Faso 1 005 2 53 0 Community transmission 0 Uganda 1 000 23 0 0 Sporadic cases 0 Liberia 957 31 42 1 Community transmission 0 Zimbabwe 926 41 12 3 Sporadic cases 0 Chad 873 0 74 0 Community transmission 2 Togo 704 9 15 0 Community transmission 0 Namibia 615 22 0 0 Sporadic cases 0 United Republic of Tanzania 509 0 21 0 Community transmission 63 Angola 458 62 23 1 Clusters of cases 0 Sao Tome and Principe 406 2 12 1 Clusters of cases 0 Mauritius 342 0 10 0 Clusters of cases 3 Botswana 314 0 1 0 Clusters of cases 3 Comoros 313 0 7 0 Community transmission 2 Eritrea 232 17 0 0 Sporadic cases 0 Burundi 219 0 1 0 Clusters of cases 1 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Lesotho 134 0 1 0 Sporadic cases 1 Seychelles 100 6 0 0 Clusters of cases 0 Gambia 64 1 3 0 Sporadic cases 0 Territoriesii Mayotte 2 702 14 40 4 Clusters of cases 0 Réunion 566 3 3 0 Clusters of cases 0 Americas United States of America 3 038 325 64 630 131 884 991 Community transmission 0 Brazil 1 713 160 44 571 67 964 1 223 Community transmission 0 Peru 312 911 3 633 11 133 181 Community transmission 0 Chile 306 216 3 133 6 682 109 Community transmission 0 Mexico 275 003 6 995 32 796 782 Community transmission 0 Colombia 128 638 4 144 4 527 168 Community transmission 0 Canada 106 434 267 8 737 26 Community transmission 0 Argentina 87 030 3 604 1 707 53 Community transmission 0 Ecuador 65 018 1 773 4 939 66 Community transmission 0 Bolivia (Plurinational State of) 42 984 1 439 1 577 47 Community transmission 0 Panama 41 251 960 819 20 Community transmission 0 Dominican Republic 40 790 1 202 842 13 Community transmission 0 Honduras 25 978 550 694 17 Community transmission 0 Guatemala 25 411 624 1 053 49 Community transmission 0 El Salvador 8 844 278 243 8 Community transmission 0 Venezuela (Bolivarian Republic of) 8 010 317 75 4 Community transmission 0 Haiti 6 486 54 123 6 Community transmission 0 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Costa Rica 5 836 350 24 1 Community transmission 0 Paraguay 2 554 0 20 0 Community transmission 1 Nicaragua 2 411 0 91 0 Community transmission 1 Cuba 2 403 4 86 0 Clusters of cases 0 Uruguay 974 9 29 0 Clusters of cases 0 Jamaica 751 6 10 0 Clusters of cases 0 Suriname 671 36 17 0 Clusters of cases 0 Guyana 285 1 16 0 Clusters of cases 0 Trinidad and Tobago 133 0 8 0 Sporadic cases 3 Bahamas 106 2 11 0 Clusters of cases 0 Barbados 98 0 7 0 Clusters of cases 3 Antigua and Barbuda 73 3 3 0 Clusters of cases 0 Belize 30 0 2 0 Sporadic cases 5 Saint Vincent and the Grenadines 29 0 0 0 Sporadic cases 22 Grenada 23 0 0 0 Clusters of cases 44 Saint Lucia 22 0 0 0 Sporadic cases 6 Dominica 18 0 0 0 Clusters of cases 27 Saint Kitts and Nevis 16 0 0 0 No cases 4 Territoriesii Puerto Rico 8 862 117 159 0 Community transmission 0 French Guiana 5 558 99 22 0 Community transmission 0 Martinique 249 0 14 0 Clusters of cases 5 Cayman Islands 201 0 1 0 Clusters of cases 7 Guadeloupe 184 0 14 0 Clusters of cases 5 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Bermuda 149 0 9 0 Sporadic cases 1 United States Virgin Islands 144 22 6 0 Clusters of cases 0 Aruba 105 0 3 0 Sporadic cases 3 Sint Maarten 78 0 15 0 No cases 6 Turks and Caicos Islands 55 0 2 0 Clusters of cases 1 Saint Martin 44 0 3 0 Sporadic cases 5 Curaçao 25 0 1 0 Sporadic cases 9 Falkland Islands (Malvinas) 13 0 0 0 No cases 75 Montserrat 11 0 1 0 No cases 87 British Virgin Islands 8 0 1 0 No cases 55 Bonaire, Sint Eustatius and Saba 7 0 0 0 No cases 45 Saint Barthélemy 6 0 0 0 No cases 101 Anguilla 3 0 0 0 No cases 97 Saint Pierre and Miquelon 2 1 0 0 No cases 0 Eastern Mediterranean Iran (Islamic Republic of) 250 458 2 079 12 305 221 Community transmission 0 Pakistan 243 596 2 748 5 058 75 Clusters of cases 0 Saudi Arabia 223 327 3 183 2 100 41 Clusters of cases 0 Qatar 102 110 557 142 4 Community transmission 0 Egypt 79 254 950 3 617 53 Clusters of cases 0 Iraq 69 612 2 170 2 882 103 Community transmission 0 United Arab Emirates 53 577 532 328 1 Community transmission 0 Kuwait 52 840 833 382 3 Clusters of cases 0 Oman 51 725 1 518 236 3 Community transmission 0 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Afghanistan 34 194 541 971 34 Clusters of cases 0 Bahrain 31 528 597 103 5 Clusters of cases 0 Morocco 15 079 308 242 0 Clusters of cases 0 Sudan 10 204 120 649 13 Community transmission 0 Djibouti 4 955 66 56 1 Clusters of cases 0 Somalia 3 038 10 92 0 Sporadic cases 0 Lebanon 2 011 65 36 0 Clusters of cases 0 Libya 1 342 160 38 3 Clusters of cases 0 Yemen 1 328 0 352 0 Community transmission 1 Tunisia 1 231 10 50 0 Sporadic cases 0 Jordan 1 169 0 10 0 Clusters of cases 2 Syrian Arab Republic 372 0 14 0 Community transmission 3 Territoriesii occupied Palestinian territory 5 829 262 27 3 Clusters of cases 0 Europe Russian Federation 713 936 6 635 11 017 174 Clusters of cases 0 The United Kingdom 287 625 642 44 602 85 Community transmission 0 Spain 253 056 543 28 401 5 Clusters of cases 0 Italy 242 363 214 34 926 12 Community transmission 0 Turkey 209 962 1 024 5 300 18 Community transmission 0 Germany 198 178 395 9 054 6 Clusters of cases 0 France 160 783 504 29 886 13 Clusters of cases 0 Sweden 74 333 475 5 500 18 Community transmission 0 Belarus 64 411 187 449 6 Community transmission 0 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Belgium 62 210 0 9 781 3 Community transmission 1 Kazakhstan 54 747 1 726 296 0 Clusters of cases 0 Ukraine 52 043 819 1 345 18 Community transmission 0 Netherlands 50 743 52 6 128 2 Community transmission 0 Portugal 45 277 418 1 644 13 Community transmission 0 Poland 36 951 262 1 551 9 Community transmission 0 Israel 33 903 1 360 346 4 Pending 0 Switzerland 32 501 88 1 685 0 Community transmission 0 Armenia 30 903 557 546 11 Community transmission 0 Romania 30 789 614 1 834 17 Community transmission 0 Ireland 25 565 23 1 743 0 Clusters of cases 0 Azerbaijan 22 464 548 284 10 Clusters of cases 0 Republic of Moldova 18 666 195 627 13 Community transmission 0 Austria 18 613 97 706 0 Community transmission 0 Serbia 17 342 266 352 11 Pending 0 Czechia 12 919 105 352 1 Clusters of cases 0 Denmark 12 916 16 609 0 Community transmission 0 Uzbekistan 11 723 464 52 5 Clusters of cases 0 Kyrgyzstan 9 358 511 122 6 Clusters of cases 0 Norway 8 954 7 252 1 Clusters of cases 0 North Macedonia 7 572 167 362 3 Clusters of cases 0 Finland 7 273 8 329 0 Clusters of cases 0 Bulgaria 6 672 330 262 3 Clusters of cases 0 Tajikistan 6 409 46 54 0 Pending 0 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Bosnia and Herzegovina 6 087 219 213 6 Community transmission 0 Luxembourg 4 719 69 110 0 Community transmission 0 Hungary 4 220 10 591 2 Community transmission 0 Greece 3 672 50 193 0 Clusters of cases 0 Croatia 3 416 91 115 1 Clusters of cases 0 Albania 3 278 90 85 2 Clusters of cases 0 Estonia 2 011 8 69 0 Clusters of cases 0 Iceland 1 882 2 10 0 Community transmission 0 Lithuania 1 857 3 79 0 Community transmission 0 Slovakia 1 851 53 28 0 Clusters of cases 0 Slovenia 1 776 13 111 0 Clusters of cases 0 Latvia 1 154 13 30 0 Sporadic cases 0 Montenegro 1 019 59 19 2 Clusters of cases 0 Cyprus 1 010 2 19 0 Clusters of cases 0 Georgia 973 5 15 0 Sporadic cases 0 Andorra 855 0 52 0 Community transmission 21 San Marino 713 0 42 0 Community transmission 20 Malta 674 1 9 0 Sporadic cases 0 Monaco 99 0 1 0 Sporadic cases 33 Liechtenstein 85 0 1 0 Sporadic cases 3 Holy See 12 0 0 0 Sporadic cases 64 Territoriesii Kosovo[1] 4 264 207 84 8 Community transmission 0 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Isle of Man 336 0 24 0 No cases 49 Jersey 325 0 31 0 Community transmission 2 Guernsey 252 0 13 0 Community transmission 68 Faroe Islands 188 0 0 0 Pending 2 Gibraltar 179 0 0 0 Clusters of cases 3 Greenland 13 0 0 0 Pending 42 South-East Asia India 793 802 26 506 21 604 475 Clusters of cases 0 Bangladesh 175 494 3 360 2 238 41 Community transmission 0 Indonesia 70 736 2 657 3 417 58 Community transmission 0 Nepal 16 531 108 35 0 Clusters of cases 0 Thailand 3 202 0 58 0 Clusters of cases 1 Maldives 2 553 36 13 0 Clusters of cases 0 Sri Lanka 2 350 256 11 0 Clusters of cases 0 Myanmar 321 3 6 0 Clusters of cases 0 Bhutan 80 0 0 0 Sporadic cases 4 Timor-Leste 24 0 0 0 No cases 77 Western Pacific China 85 445 46 4 648 0 Clusters of cases 0 Philippines 51 754 1 395 1 314 0 Community transmission 0 Singapore 45 423 125 26 0 Clusters of cases 0 Japan 20 719 348 982 1 Clusters of cases 0 Republic of Korea 13 338 45 288 1 Clusters of cases 0 Reporting Country/ Territory/Area Total confirmed cases Total confirmed new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Australia 9 059 173 106 0 Clusters of cases 0 Malaysia 8 683 6 121 0 Clusters of cases 0 New Zealand 1 192 2 22 0 Clusters of cases 0 Viet Nam 369 0 0 0 Clusters of cases 3 Mongolia 227 0 0 0 Sporadic cases 1 Brunei Darussalam 141 0 3 0 No cases 63 Cambodia 141 0 0 0 Sporadic cases 11 Fiji 21 0 0 0 Sporadic cases 2 Lao People's Democratic Republic 19 0 0 0 Sporadic cases 88 Papua New Guinea 11 0 0 0 Sporadic cases 14 Territoriesii Guam 302 3 5 0 Clusters of cases 0 French Polynesia 62 0 0 0 Sporadic cases 12 Northern Mariana Islands (Commonwealth of the) 31 0 2 0 Pending 7 New Caledonia 21 0 0 0 Sporadic cases 30 Subtotal for all regions 12 101 587 228 102 551 033 5 565 Other* 741 0 13 0 Not applicable - Grand total 12 102 328 228 102 551 046 5 565 **See Annex 1 for data, table and figure notes. Technical guidance and other resources – To view all technical guidance documents regarding COVID-19, please go to this webpage. – Updates from WHO regional offices – WHO AFRO – WHO PAHO – WHO EMRO – WHO SEARO – WHO EURO – WHO WPRO – Research and Development – Online courses on COVID-19 and in additional national languages – The Strategic Preparedness and Response Plan (SPRP) outlining the support the international community can provide to all countries to prepare and respond to the virus – WHO Coronavirus Disease (COVID-19) Dashboard – Weekly COVID-19 Operations Updates Recommendations and advice for the public – Protect yourself – Questions and answers – Travel advice – EPI-WIN: tailored information for individuals, organizations and communities Case definitions WHO periodically updates the Global Surveillance for human infection with coronavirus disease (COVID-19) document which includes surveillance definitions. Definition of COVID-19 death A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g. trauma). There should be no period of complete recovery between the illness and death. Further guidance for certification and classification (coding) of COVID-19 as cause of death is available here and here. Annex 1: Data, table and figure notes Caution must be taken when interpreting all data presented. Differences are to be expected between information products published by WHO, national public health authorities, and other sources using different inclusion criteria and different data cut-off times. While steps are taken to ensure accuracy and reliability, all data are subject to continuous verification and change. Case detection, definitions, testing strategies, reporting practice, and lag times differ between countries/territories/areas. These factors, amongst others, influence the counts presented, with variable underestimation of true case and death counts, and variable delays to reflecting these data at global level. The designations employed, and the presentation of these materials do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Countries, territories and areas are arranged under the administering WHO region. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. [1] All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999). In the map, number of cases of Serbia and Kosovo (UNSCR 1244, 1999) have been aggregated for visualization purposes. Counts reflect laboratory-confirmed cases and deaths, based on WHO case definitions, unless stated otherwise (see Country, territory, or area-specific updates and errata), and include both domestic and repatriated cases. Other*: includes cases reported from international conveyances. Due to the recent trend of countries conducting data reconciliation exercises which remove large numbers of cases or deaths from their total counts, WHO will now display such data as negative numbers in the “new cases” / “new deaths” columns as appropriate. This will aid readers in identifying when such adjustments occur. When additional details become available that allow the subtractions to be suitably apportioned to previous days, graphics will be updated accordingly. Prior situation reports will not be edited; see covid19.who.int for the most up-to-date data. Additional table notes i Transmission classification is based on a process of country/territory/area self-reporting. Classifications are reviewed on a weekly basis and may be revised as new information becomes available. Differing degrees of transmission may be present within countries/territories/areas; classification is based on the highest category reported within a country/territory/area. Categories: • No cases: with no confirmed cases • Sporadic cases: with one or more cases, imported or locally detected • Clusters of cases: experiencing cases, clustered in time, geographic location and/or by common exposures • Community transmission: experiencing larger outbreaks of local transmission defined through an assessment of factors including, but not limited to: large numbers of cases not linkable to transmission chains; large numbers of cases from sentinel lab surveillance; and/or multiple unrelated clusters in several areas of the country/territory/area • Pending: transmission classification has not been reported to WHO ii “Territories” include territories, areas, overseas dependencies and other jurisdictions of similar status. Country, territory, or area-specific updates and errata • None