COVID-19 weekly epidemiological update, edition 42, 1 June 2021

1 COVID-19 Weekly Epidemiological Update Edition 42, published 1 June 2021 In this edition: • Global overview • Special focus: Update on SARS-CoV-2 Variants of Interest (VOIs) and Variants of Concern (VOCs) • Special focus: Early lessons from country implementation of COVID-19 vaccination • WHO regional overviews • Key weekly updates Global overview Data as of 30 May 2021 The number of new COVID-19 cases and deaths continues to decrease, with over 3.5 million new cases and 78 000 new deaths reported globally in the past week; a 15% and 7% decrease respectively, compared to the previous week (Figure 1). The European and South-East Asia Regions reported the largest decline in new cases and deaths in the past week, while case incidence increased in the African and Western Pacific regions (Table 1). The numbers of cases reported by the Americas and Eastern Mediterranean Regions were similar to those reported in the previous week. An increase in death incidence was reported in the African Region, whereas the Europe and the Eastern Mediterranean Regions reported decreases, and the reported death incidence in the Western Pacific and the Americas Regions was similar to the death incidence in the previous week. Although the number of global cases and deaths continued to decrease for a fifth and fourth consecutive week respectively, case and death incidences remain at high levels and significant increases have been reported in many countries in all regions. Figure 1. COVID-19 cases reported weekly by WHO Region, and global deaths, as of 30 May 2021** **See Annex 3: Data, table and figure notes 0 10 000 20 000 30 000 40 000 50 000 60 000 70 000 80 000 90 000 100 000 0 1 000 000 2 000 000 3 000 000 4 000 000 5 000 000 6 000 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r 0 5 -A p r 2 6 -A p r 1 7 -M a y D e a th s C a s e s Reported week commencing Americas South-East Asia Europe Eastern Mediterranean Africa Western Pacific Deaths 2 The highest numbers of new cases were reported from India (1 364 668 new cases; 26% decrease), Brazil (420 981 new cases; 7% decrease), Argentina (219 910 new cases; 3% increase), the United States of America (153 587 new cases; 18% decrease), and Colombia (150 517 new cases; 40% increase). Table 1. Newly reported and cumulative COVID-19 cases and deaths, by WHO Region, as of 30 May 2021** WHO Region New cases in last 7 days (%) Change in new cases in last 7 days * Cumulative cases (%) New deaths in last 7 days (%) Change in new deaths in last 7 days * Cumulative deaths (%) Americas 1 198 427 (34%) -2% 67 178 933 (40%) 31 286 (40%) -1% 1 646 407 (47%) Europe 430 945 (12%) -26% 54 244 552 (32%) 11 113 (14%) -17% 1 148 766 (33%) South-East Asia 1 516 572 (43%) -24% 31 605 221 (19%) 29 477 (37%) -8% 401 754 (11%) Eastern Mediterranean 212 568 (6%) -1% 10 076 696 (6%) 3 556 (5%) -18% 201 642 (6%) Africa 52 710 (1%) 22% 3 497 924 (2%) 1 143 (1%) 11% 87 107 (2%) Western Pacific 139 234 (4%) 6% 3 000 768 (2%) 2 090 (3%) -2% 45 148 (1%) Global 3 550 456 (100%) -15% 169 604 858 (100%) 78 665 (100%) -7% 3 530 837 (100%) *Percent change in the number of newly confirmed cases/deaths in past seven days, compared to seven days prior **See Annex 3: Data, table and figure notes For the latest data and other updates on COVID-19, please see: • WHO COVID-19 Dashboard • WHO COVID-19 Weekly Operational Update and previous editions of the Weekly Epidemiological Update 3 Figure 2. COVID-19 cases per 100 000 population reported by countries, territories and areas, 24 May – 30 May 2021** **See Annex 3: Data, table and figure notes 4 Special Focus: Update on SARS-CoV-2 Variants of Interest (VOIs) and Variants of Concern (VOCs) WHO, in collaboration with national authorities, institutions and researchers, routinely assesses if variants of SARS-CoV-2 alter clinical presentation and severity, or if they show increases in transmissibility that require national health authorities to implement strengthened public health and social measures (PHSM) to control disease spread. Systems have been established in WHO to detect “signals” of potential Variants of Concern (VOCs) or Variants of Interest (VOIs) and assess these based on the risk posed to global public health. Here we provide updates on new WHO labels and classifications of VOCs and VOIs, as well as the updated geographical distribution of VOCs. National authorities may choose to designate other variants of local interest/concern. New easy-to-say VOI and VOCs labels for public communication On 31 May 2021, WHO announced new easy-to-say/easy-to-remember VOI and VOC labels to facilitate public communication about SARS-CoV-2 variants. The need for easy-to-say labels of SARS-CoV-2 VOI and VOC arose for several reasons, including: • the existence of different genomic nomenclature systems, which serve important scientific purposes but complicate public communication around variants due to the complexities of the labels assigned (e.g., B.1.617.2, 21A/S:478K), • the common but potentially stigmatizing use of the name of the country or area of first detection of a variant as an easily recognizable label. WHO has now assigned labels based upon the Greek alphabet to globally classified VOCs and VOIs (Table 2), and will sequentially assign new labels for newly-designated global VOCs and VOIs in the future. If all 24 letters become assigned, other lists of labels will be announced by WHO. As VOIs and VOCs are reclassified based on the evolving situation, it is expected that these will retain their label, and labels of formed VOIs/VOCs will not be reused for labeling new emerging variants. We recommend Member States, health authorities, media and others communicating on SARS-CoV-2 variants to adopt the WHO labels in public communication as soon as practical. Importantly, these labels do not replace the three current nomenclature systems for tracking and scientific reporting of SARS-CoV-2 genetic evolution: GISAID, Nextstrain, and Pango – these systems remain critical and will continue to be used in scientific communications. Recent changes to the VOIs and VOCs classifications As the global public health risks posed by specific SARS-CoV-2 variants becomes better understood and evolves, WHO will continue to update the list of global VOIs and VOCs. This is necessary to adjust to the emergence of new variants, their changing epidemiology (e.g., the incidence of some variants is rapidly declining), and our understanding of their phenotypic impacts as new evidence becomes available and is shared. First, available information allows for the delineation of VOC B.1.617. B.1.617 viruses are divided in three lineages: B.1.617.1, B.1.617.2 and B.1.617.3. Available findings for lineages B.1.617.1 and B.1.617.2 were initially used to designate B.1.617 a global VOC on 11 May 2021. Since then, it has become evident that greater public health risks are currently associated with B.1.617.2, while lower rates of transmission of other lineages have been observed. To reflect this updated information, B.1.617 has been delineated as follows: 5 • B.1.617.2 remains a VOC and labelled variant Delta – we continue to observe significantly increased transmissibility and a growing number of countries reporting outbreaks associated with this variant. Further studies into the impact of this variant remain a high priority for WHO. • B.1.617.1 has been reclassified to a VOI and labelled variant Kappa – while also demonstrating increased transmissibility (in specified locations), global prevalence appears to be declining. This variant will continue to be monitored and reassessed regularly. • B.1.617.3 is no longer classified as either a VOI or VOC – relatively few reports of this variant have been submitted to date. Second, variant B.1.616, which was first detected in France following investigations into an unusual cluster of cases in a hospital, is no longer classified as a VOI. Local authorities have reported that the outbreak has been controlled, and no further detections within or outside of France have been reported since late-April 2021.1 Further local and regional monitoring remains prudent, given B.1.616 was associated with potential increased disease severity and reduced detections via nasopharyngeal samples.2 Variants no longer classified as VOCs or VOIs will continue to be monitored as part of the overall evolution of SARS-CoV-2, and may be reassessed pending new evidence indicating an increased public health risk. Table 2: SARS-CoV-2 Variants of Concern (VOCs) and Variants of Interest (VOIs), as of 31 May 2021 WHO label Pango lineage GISAID clade Nextstrain clade Earliest documented samples Date of designation Variants of Concern (VOCs) Alpha B.1.1.7 GRY (formerly GR/501Y.V1) 20I/501Y.V1 United Kingdom, Sep-2020 18-Dec-2020 Beta B.1.351 GH/501Y.V2 20H/501Y.V2 South Africa, May-2020 18-Dec-2020 Gamma P.1 GR/501Y.V3 20J/501Y.V3 Brazil, Nov-2020 11-Jan-2021 Delta B.1.617.2 G/452R.V3 21A/S:478K India, Oct-2020 VOI: 4-Apr-2021 VOC: 11-May-2021 Variants of Interest (VOIs) Epsilon B.1.427/ B.1.429 GH/452R.V1 20C/S.452R United States of America, Mar-2020 5-Mar-2021 Zeta P.2 GR 20B/S.484K Brazil, Apr-2020 17-Mar-2021 Eta B.1.525 G/484K.V3 20A/S484K Multiple countries, Dec-2020 17-Mar-2021 Theta P.3 GR 20B/S:265C Philippines, Jan-2021 24-Mar-2021 Iota B.1.526 GH 20C/S:484K United States of America, Nov-2020 24-Mar-2021 Kappa B.1.617.1 G/452R.V3 21A/S:154K India, Oct-2020 4-Apr-2021 1 Santé publique France, COVID-19 : point épidémiologique du 27 mai 2021. https://www.santepubliquefrance.fr/maladies-et- traumatismes/maladies-et-infections-respiratoires/infection-a-coronavirus/documents/bulletin-national/covid-19-point- epidemiologique-du-27-mai-2021 2 Fillatre et al. A new SARS-CoV-2 variant poorly detected by RT-PCR on nasopharyngeal samples, with high lethality (preprint). https://www.medrxiv.org/content/10.1101/2021.05.05.21256690v1 6 Geographic distribution As surveillance activities to detect SARS-CoV-2 variants are strengthened at local and national levels, including by strategic genomic sequencing, the number of countries/areas/territories (hereafter countries) reporting VOCs has continued to increase (Figures 3, Annex 2). This distribution should be interpreted with due consideration of surveillance limitations, including differences in sequencing capacities and sampling strategies between countries. WHO recommendations Virus evolution is expected, and the more SARS-CoV-2 circulates, the more opportunities it has to evolve. Reducing transmission through established and proven disease control methods such as those outlined in the COVID-19 Strategic Preparedness and Response Plan, as well as avoiding introductions into animal populations are crucial aspects of the global strategy to reduce the occurrence of mutations that have negative public health implications. PHSM remain critical to curb the spread of SARS-CoV-2 and its variants. Evidence from multiple countries with extensive transmission of VOCs has indicated that the PHSM, including infection prevention and control (IPC) measures in health facilities has been effective in reducing COVID-19 case incidence, which has led to a reduction in hospitalizations and deaths among COVID-19 patients. National and local authorities are encouraged to continue strengthening existing PHSM, IPC and disease control activities. Authorities are also encouraged to strengthen surveillance and sequencing capacities and apply a systematic approach to provide a representative indication of the extent of transmission of SARS- CoV-2 variants based on the local context, and to detect unusual events. Additional resources • Tracking SARS-CoV-2 variants • Working definitions of SARS-CoV-2 Variants of Interest and Variants of Concern • COVID-19 new variants: Knowledge gaps and research • Genomic sequencing of SARS-CoV-2: a guide to implementation for maximum impact on public health • Considerations for implementing and adjusting PHSM in the context of COVID-19 • COVID-19 Situation Reports from WHO Regional Offices and partners: AFRO, AMRO/PAHO, EMRO, EURO/ECDC, SEARO, WPRO • ACT accelerator diagnostic pillar, FIND test directory 7 Figure 3. Countries, territories and areas reporting variants Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1) and Delta (B.1.617.2), as of 1 June 2021** *Includes countries/territories/areas reporting the detection of B.1.617 without further specification of lineage at this time. These will be reallocated as further details become available. **Countries/territories/areas highlighted include both official and unofficial reports of VOC detections, and do not presently differentiate between detections among travellers (e.g., at Points of Entry) or local community cases. Please see Annex 2 for further details. 8 Special focus: Early lessons from country implementation of COVID-19 vaccination Safe and effective vaccines, together with non-pharmaceutical interventions are a game-changing tool in the response to the COVID-19 pandemic. As of 26 May 2021, over 1.5 billion vaccine doses have been administered globally, and over 736 million individuals have received at least one dose (see the WHO COVID- 19 Dashboard for the latest figures). However, vaccination rates are not uniform across countries. The lowest- income countries had access to vaccines later than higher-income countries, and have vaccinated a substantially lower proportion of their target populations.3 We briefly summarize early lessons learned by thematic areas and share qualitative insights gained during the early phases of rolling out COVID-19 vaccines, based on anecdotal reports from regional early learning webinars and discussions with countries, particularly in low-and-middle-income countries (LMICs). Planning and coordination Most LMICs prepared National Deployment and Vaccination Plans in anticipation of vaccine supply becoming available. They also established governance structures and coordination processes for planning and overseeing deployment of vaccination activities as part of national response plans. In several countries, engaging with the offices of heads of state facilitated collaboration across health programmes and sectors, which enabled coordinated vaccination. Identifying and prioritizing groups at the highest risk of exposure or severe outcomes facilitated operational planning. While many countries were able to roughly estimate the size of their priority target groups, information on who they are and where they resided was often unknown. Several countries established digital platforms and used community mobilizers to identify and pre-register priority target groups to facilitate vaccine delivery. The findings from scenario-based simulation exercises or drills helped identify unanticipated operational bottlenecks, and were used to update operational plans. At the subnational level, micro plans facilitated vaccine roll-out and session planning, through estimation of the target population size at each administrative level, requisite resources including vaccine doses, supplies and human resources. When such micro plans did not exist or were inadequately prepared at the district and lower administrative levels, it contributed to delayed or slower vaccine roll-out. Costing and financing While costing tools were developed to assist countries in estimating vaccine and operational costs, these tools were complex, and many countries lacked the capacity to use them to develop timely and robust cost estimates. Some LMICs were quickly able to mobilize domestic resources to support vaccine rollout, whereas other LMIC governments did not allocate adequate domestic resources. In the past, vaccination for epidemics was accompanied by external support to partially cover operational costs. This was not the case with the COVID-19 vaccine roll-out. The dependency on donors and failure to secure funds in time led to delays in conducting health worker training, compromise on the quality of these trainings, or lowered motivation among health workers due to delayed payment of salaries. In addition, disbursement and distribution of funds to the lowest administrative levels was not streamlined in some countries, leading to a lack of funds, even though funds were available at the national level. 3 pandem-ic. 2021.Vaccination by income. Available from: https://pandem-ic.com/vaccination-trackers/ 9 Supply chain and logistics Most LMICs utilized findings from national Effective Vaccine Management (EVM) assessments and benefited from support by Gavi, the Vaccine Alliance, to optimize their cold chain equipment. Therefore, most had sufficient cold chain capacity to handle the initial shipment of vaccines. Several countries also successfully managed vaccines requiring ultra-cold chain storage and transport; some of them using equipment procured for Ebola vaccines. Several countries had multiple vaccine products through donations, the COVAX facility, and direct procurement from manufacturers. Managing multiple vaccines with different cold chain requirements without vaccine vial monitors led to logistical challenges. A few of these products had not received WHO Emergency Use Listing and countries did not have the requisite information on product characteristics to enable logistical planning. The initial doses of vaccines that countries received had a relatively short shelf-life of six months at the time of release, often with a shorter shelf-life at the time of delivery to countries. Where there was slow roll-out of vaccines, it was challenging to use them in a timely manner. On occasion, vaccines were re-distributed to other countries to avoid wastage. Vaccine delivery While most LMICs had experience with conducting mass vaccination campaigns, Infection Prevention and Control (IPC) at vaccination sites added some challenges to maintain a smooth workflow. Countries provided safe spaces for observation of vaccinees for severe allergic reactions following vaccination, and trained personnel and provided supplies to manage such reactions. Several countries reported lower than expected turn-out at sessions due to vaccine hesitancy, resulting in a high volume of open vials to be wasted. Demand creation and hesitancy Early communication to create awareness and prepare communities for the vaccine roll-out, as well as public vaccination of the political and religious leaders improved vaccine uptake. Several countries also successfully utilized social media to heighten public awareness. However, not all countries had the capacity to cope with the magnitude of misinformation or disinformation being disseminated on media platforms and to mount a timely and comprehensive response. Hesitancy, especially among health and care workers, driven by fear of adverse effects of specific products reported in the media, further fuelled by suspension of some vaccines in high-income countries contributed to low vaccine uptake. Hesitancy among health and care workers was reported to have a ripple effect in other priority groups. Digital monitoring Digital registration and data monitoring systems played a key role in monitoring vaccination, generating digital vaccination certificates in several countries, and sending reminders for follow-up vaccination. Digital pre-registration systems, where established, also improved operational flow and enabled the achievement of vaccination targets for each session. However, the lack of digital tools for data entry at the service delivery points impeded data collection in a few countries. In at least one country where hybrid paper-based and digital platforms were used, the lack of proper planning led to inadequate numbers of data entry clerks and delayed data entry and transmission. Several countries reported delayed and incomplete reporting from the lower administrative levels and the limited granular and timely data may have prohibited operational decisions. Safety monitoring Most countries leveraged the existing safety surveillance system for immunization to establish reporting of adverse events following vaccination and regularly reported data to WHO and global pharmacovigilance 10 databases. A few countries lacked the capacity to investigate and conduct causality assessments of serious adverse events and in some, key information was not collected to enable adequate investigation. In other instances, decisions to halt vaccination following a reported death contributed to misperceptions about the safety of the vaccine. Lessons learned Lessons learned from the early phases of vaccine introduction will inform ongoing vaccination activities. Sharing early lessons through periodic webinars and peer-to-peer exchanges allowed countries to adopt best practices or successfully implement solutions to operational challenges. Additionally, WHO and partner agencies have used these insights to develop or update guidance and information notes to support countries. In the area of costing and financing, the COVID-19 Vaccine Introduction and deployment Tool (CVIC) was updated and a mechanism to provide direct technical support to countries was established to help improve operational cost estimates. New sources of funding are being developed to support LMICs with filling budgetary gaps to meet immediate operational needs and longer-term financing. Insights from the early introduction of COVID-19 vaccination can further be leveraged to create more resilient immunization systems, foster greater integration in primary health care delivery, and accelerate the implementation of the life-course approach to deliver a package of primary health care interventions. 11 WHO regional overviews African Region The African Region reported over 52 000 new cases and over 1100 new deaths, a 22% and an 11% increase respectively compared to the previous week. Case incidence increased after four consecutive weeks of a plateau in new weekly cases. The highest numbers of new cases were reported from South Africa (26 498 new cases; 44.7 new cases per 100 000 population; a 24% increase), Uganda (2424 new cases; 5.3 new cases per 100 000; a 191% increase), and Kenya (2377 new cases; 4.4 new cases per 100 000; a 13% decrease). The highest numbers of new deaths were reported from South Africa (591 new deaths; 1.0 new deaths per 100 000 population; similar to the number reported in the previous week), Kenya (92 new deaths; 0.2 new deaths per 100 000; a 92% increase), and Ethiopia (75 new deaths; 0.1 new deaths per 100 000; an 18% decrease). Region of the Americas The Region of the Americas reported just under 1.2 million new cases and over 31 000 new deaths, figures similar to those of the previous week. The number of new cases has remained relatively stable for a fourth consecutive week, while the number of deaths has remained stable for a third consecutive week. The highest numbers of new cases were reported from Brazil (420 981 new cases; 198.1 new cases per 100 000; a 7% decrease), Argentina (219 910 new cases; 486.6 new cases per 100 000; a 3% increase), and the United States of America (153 587 new cases; 46.4 new cases per 100 000; an 18% decrease). The highest numbers of new deaths were reported from Brazil (12 736 new deaths; 6.0 new deaths per 100 000; a 7% decrease), the United States of America (4596 new deaths; 1.4 new deaths per 100 000; a 14% increase), and Colombia (3488 new deaths; 6.9 new deaths per 100 000; similar to the number reported in the previous week). 0 5 000 10 000 15 000 20 000 25 000 30 000 35 000 40 000 45 000 50 000 0 500 000 1 000 000 1 500 000 2 000 000 2 500 000 3 000 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r 0 5 -A p r 2 6 -A p r 1 7 -M a y D e a th s C a s e s Reported week commencing Cases Deaths 0 1 000 2 000 3 000 4 000 5 000 6 000 0 20 000 40 000 60 000 80 000 100 000 120 000 140 000 160 000 180 000 200 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r 0 5 -A p r 2 6 -A p r 1 7 -M a y D e a th s C a s e s Reported week commencing Cases Deaths 12 Eastern Mediterranean Region The Eastern Mediterranean Region reported over 212 000 new cases, similar to the number reported in the previous week, and over 3500 new deaths, an 18% decrease compared to the previous week. While small decreases have been seen in case incidence for the past three weeks, death incidence continued a steep decline for a fifth consecutive week. The highest numbers of new cases were reported from the Islamic Republic of Iran (69 331 new cases; 82.5 new cases per 100 000; a 17% decrease), Iraq (29 459 new cases; 73.2 new cases per 100 000; an 8% increase), and Bahrain (20 829 new cases; 1224.1 new cases per 100 000; a 32% increase). The highest numbers of new deaths were reported from the Islamic Republic of Iran (1360 new deaths; 1.6 new deaths per 100 000; a 22% decrease), Pakistan (503 new deaths; 0.2 new deaths per 100 000; a 29% decrease), and Tunisia (392 new deaths; 3.3 new deaths per 100 000; a 3% decrease). European Region The European Region reported just under 431 000 new cases and over 11 000 new deaths, a 26% and a 17% decrease respectively compared to the previous week. The number of cases and deaths have steeply decreased for the past six and seven weeks respectively. The highest numbers of new cases were reported from the Russian Federation (61 937 new cases; 42.4 new cases per 100 000; similar to the number reported in the previous week), France (60 600 new cases; 93.2 new cases per 100 000; a 26% decrease), and Turkey (57 330 new cases; 68.0 new cases per 100 000; a 20% decrease). The highest numbers of new deaths were reported from the Russian Federation (2680 new deaths; 1.8 new deaths per 100 000; a 3% increase), Turkey (1200 new deaths; 1.4 new deaths per 100 000; a 22% decrease), and Ukraine (1104 new deaths; 2.5 new deaths per 100 000; a 15% decrease). 0 1 000 2 000 3 000 4 000 5 000 6 000 7 000 0 50 000 100 000 150 000 200 000 250 000 300 000 350 000 400 000 450 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r 0 5 -A p r 2 6 -A p r 1 7 -M a y D e a th s C a s e s Reported week commencing Cases Deaths 0 5 000 10 000 15 000 20 000 25 000 30 000 35 000 40 000 45 000 0 500 000 1 000 000 1 500 000 2 000 000 2 500 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r 0 5 -A p r 2 6 -A p r 1 7 -M a y D e a th s C a s e s Reported week commencing Cases Deaths 13 South-East Asia Region The South-East Asia Region reported over 1.5 million new cases and over 29 000 new deaths, a 24% and an 8% decrease respectively compared to the previous week. Case incidence continued to follow a sharp decline for a third consecutive week, and death incidence decreased for the first time since early March 2021, primarily driven by trends reported in India. The highest numbers of new cases were reported from India (1 364 668 new cases; 98.9 new cases per 100 000; a 26% decrease), Nepal (47 779 new cases; 164.0 new cases per 100 000; an 18% decrease), and Indonesia (39 986 new cases; 14.6 new cases per 100 000; a 20% increase). The highest numbers of new deaths were reported from India (26 706 new deaths; 1.9 new deaths per 100 000; an 8% decrease), Indonesia (1057 new deaths; 0.4 new deaths per 100 000; a 15% decrease), and Nepal (1010 new deaths; 3.5 new deaths per 100 000; a 22% decrease). Western Pacific Region The Western Pacific Region reported over 139 000 new cases, a 6% increase compared to the previous week and just under 2100 new deaths, a similar number to the previous week. The numbers of both cases and deaths remain at the highest levels since the beginning of the pandemic. The highest numbers of new cases were reported from Malaysia (53 419 new cases; 165.0 new cases per 100 000; a 38% increase), the Philippines (38 362 new cases; 35.0 new cases per 100 000; a 4% decrease), and Japan (27 400 new cases; 21.7 new cases per 100 000; a 24% decrease). The highest numbers of new deaths were reported from the Philippines (776 new deaths; 0.7 new deaths per 100 000; a 13% decrease), Japan (684 new deaths; 0.5 new deaths per 100 000; a 12% decrease), and Malaysia (451 new deaths; 1.4 new deaths per 100 000; a 35% increase). 0 5 000 10 000 15 000 20 000 25 000 30 000 35 000 0 500 000 1 000 000 1 500 000 2 000 000 2 500 000 3 000 000 3 500 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r 0 5 -A p r 2 6 -A p r 1 7 -M a y D e a th s C a s e s Reported week commencing Cases Deaths 0 500 1 000 1 500 2 000 2 500 0 20 000 40 000 60 000 80 000 100 000 120 000 140 000 160 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r 0 5 -A p r 2 6 -A p r 1 7 -M a y D e a th s C a s e s Reported week commencing Cases Deaths 14 Key weekly updates WHO Director-General's key messages • In his opening remarks at the media briefing on COVID-19 – 28 May 2021, the Director-General called on world leaders to support a massive push to vaccinate at least 10% of the population of every country by September, and 30% by the end of the year. If countries immediately share doses with COVAX, and if manufacturers prioritize COVAX, this target can be reached and lives saved. • Ultimately, the fastest way to bring this pandemic to an end is to dramatically increase global manufacturing of vaccines, tests, treatments and other medical supplies, and ensure equitable access. A year ago, more than 40 Heads of State joined WHO to form C-TAP, the COVID-19 Technology Access Pool. • In his closing remarks at the 74th World Health Assembly, the Director-General reminded that the theme of this Assembly was “Ending this pandemic, preventing the next: building together a healthier, safer and fairer world” while stressing that we still have a lot of work to do to end this pandemic. The tailored and consistent use of public health measures, in combination with equitable vaccination, remains the way out. Updates and publications • COVAX Joint Statement: Call to action to equip COVAX to deliver 2 billion doses in 2021 • Technical note on delayed shipments for theChAdOx1-S [recombinant] vaccines: what are the implications for the administration of second doses? • Critical preparedness, readiness and response actions for COVID-19 • Operational guide for engaging communities in contact tracing • World Health Assembly recommends reinforcement of measures to protect mental health during public health emergencies • Improving family medicine in China and battling COVID-19 with smart systems • A New Commitment for Vaccine Equity and Defeating the Pandemic 15 Technical guidance and other resources • Technical guidance • WHO Coronavirus Disease (COVID-19) Dashboard • Weekly COVID-19 Operational Updates • WHO COVID-19 case definitions • COVID-19 Supply Chain Inter-Agency Coordination Cell Weekly Situational Update • Research and Development • Online courses on COVID-19 in official UN languages 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 • Updates from WHO regions: o African Region o Region of the Americas o Eastern Mediterranean Region o South-East Asia Region o European Region o Western Pacific Region • Recommendations and advice for the public: o Protect yourself o Questions and answers o Travel advice • EPI-WIN: tailored information for individuals, organizations and communities • WHO Academy COVID-19 mobile learning app 16 Annex Annex 1. COVID-19 confirmed cases and deaths reported in the last seven days by countries, territories and areas, and WHO Region, as of 30 May 2021** Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Africa 52 710 3 497 924 311.8 1 143 87 107 7.8 South Africa 26 498 1 659 070 2 797.3 591 56 363 95.0 Community transmission Uganda 2 424 45 931 100.4 12 362 0.8 Community transmission Kenya 2 377 170 485 317.1 92 3 141 5.8 Community transmission Ethiopia 2 299 271 200 235.9 75 4 143 3.6 Community transmission Botswana 2 162 56 313 2 394.6 47 831 35.3 Community transmission Angola 2 031 34 180 104.0 42 757 2.3 Community transmission Namibia 1 947 54 659 2 151.2 55 818 32.2 Community transmission Algeria 1 805 128 456 292.9 49 3 460 7.9 Community transmission Zambia 1 645 94 751 515.4 9 1 276 6.9 Community transmission Cameroon 1 226 77 982 293.8 40 1 270 4.8 Community transmission Cabo Verde 1 075 30 273 5 444.9 7 263 47.3 Community transmission Seychelles 982 11 415 11 606.9 2 40 40.7 Community transmission Democratic Republic of the Congo 553 31 416 35.1 3 782 0.9 Community transmission Madagascar 454 41 234 148.9 36 829 3.0 Community transmission Rwanda 356 26 780 206.8 1 349 2.7 Community transmission Mauritania 349 19 463 418.6 5 463 10.0 Community transmission Senegal 308 41 331 246.8 9 1 138 6.8 Community transmission Nigeria 306 166 285 80.7 4 2 071 1.0 Community transmission Burundi 260 4 754 40.0 0 6 0.1 Community transmission Gabon 258 24 365 1 094.7 3 150 6.7 Community transmission Zimbabwe 254 38 933 261.9 8 1 594 10.7 Community transmission Côte d’Ivoire 253 47 195 178.9 3 301 1.1 Community transmission Ghana 192 93 775 301.8 1 784 2.5 Community transmission 17 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Guinea 184 23 172 176.4 3 161 1.2 Community transmission Congo 182 11 658 211.3 3 153 2.8 Community transmission Mozambique 156 70 724 226.3 5 836 2.7 Community transmission Eritrea 129 4 061 114.5 0 14 0.4 Community transmission Equatorial Guinea 93 8 529 607.9 5 118 8.4 Community transmission Togo 80 13 432 162.2 0 125 1.5 Community transmission Central African Republic 75 7 085 146.7 2 98 2.0 Community transmission Mauritius 71 1 393 109.5 0 17 1.3 Clusters of cases Malawi 55 34 329 179.5 1 1 154 6.0 Community transmission Niger 46 5 410 22.3 0 192 0.8 Community transmission Eswatini 39 18 589 1 602.3 0 672 57.9 Community transmission Liberia 37 2 179 43.1 1 86 1.7 Community transmission Benin 33 8 058 66.5 0 101 0.8 Community transmission Mali 29 14 265 70.4 5 517 2.6 Community transmission Sierra Leone 23 4 140 51.9 0 79 1.0 Community transmission Lesotho 19 10 825 505.3 6 326 15.2 Community transmission South Sudan 18 10 688 95.5 0 115 1.0 Community transmission Burkina Faso 16 13 430 64.2 1 166 0.8 Community transmission Gambia 15 5 993 248.0 1 179 7.4 Community transmission Guinea-Bissau 12 3 761 191.1 0 68 3.5 Community transmission Sao Tome and Principe 11 2 345 1 070.0 1 37 16.9 Community transmission Comoros 9 3 949 454.1 0 146 16.8 Community transmission Chad 5 4 928 30.0 0 173 1.1 Community transmission United Republic of Tanzania 0 509 0.9 0 21 0.0 Pending Territoriesiii Réunion 1 335 24 901 2 781.3 13 189 21.1 Community transmission Mayotte 24 19 325 7 083.6 2 173 63.4 Community transmission 18 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Americas 1 198 427 67 178 933 6 568.3 31 286 1 646 407 161.0 Brazil 420 981 16 391 930 7 711.7 12 736 459 045 216.0 Community transmission Argentina 219 910 3 702 422 8 192.0 3 302 76 693 169.7 Community transmission United States of America 153 587 32 916 501 9 944.5 4 596 588 292 177.7 Community transmission Colombia 150 517 3 342 567 6 569.1 3 488 87 207 171.4 Community transmission Chile 46 343 1 369 756 7 165.4 661 29 047 151.9 Community transmission Peru 31 989 1 947 555 5 906.7 1 409 68 978 209.2 Community transmission Uruguay 23 658 282 198 8 123.8 358 4 118 118.5 Community transmission Canada 22 154 1 374 275 3 641.2 278 25 440 67.4 Community transmission Paraguay 20 955 348 184 4 881.6 777 8 892 124.7 Community transmission Bolivia (Plurinational State of) 18 500 364 570 3 123.2 520 14 377 123.2 Community transmission Mexico 16 034 2 408 778 1 868.2 1 816 223 072 173.0 Community transmission Costa Rica 14 883 314 102 6 166.0 197 3 962 77.8 Community transmission Venezuela (Bolivarian Republic of) 9 105 230 147 809.4 112 2 595 9.1 Community transmission Cuba 8 255 140 087 1 236.8 80 943 8.3 Community transmission Dominican Republic 7 841 290 526 2 678.2 22 3 628 33.4 Community transmission Ecuador 6 901 424 741 2 407.4 305 20 485 116.1 Community transmission Guatemala 6 731 253 837 1 416.9 125 8 121 45.3 Community transmission Honduras 4 891 236 451 2 387.3 151 6 284 63.4 Community transmission Trinidad and Tobago 3 685 22 620 1 616.3 110 458 32.7 Community transmission Panama 3 546 376 854 8 734.1 44 6 365 147.5 Community transmission Suriname 1 563 14 305 2 438.5 39 282 48.1 Community transmission El Salvador 1 026 73 246 1 129.3 30 2 241 34.6 Community transmission Guyana 981 16 724 2 126.2 31 380 48.3 Community transmission Haiti 523 14 258 125.0 27 307 2.7 Community transmission Jamaica 475 48 374 1 633.6 30 942 31.8 Community transmission 19 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Bahamas 246 11 745 2 986.7 4 229 58.2 Clusters of cases Nicaragua 102 5 833 88.1 1 186 2.8 Community transmission Saint Lucia 100 5 035 2 742.0 0 77 41.9 Community transmission Saint Vincent and the Grenadines 54 2 027 1 827.1 0 12 10.8 Community transmission Belize 27 12 791 3 216.8 1 324 81.5 Community transmission Barbados 24 4 009 1 395.0 0 47 16.4 Community transmission Saint Kitts and Nevis 22 68 127.8 0 0 0.0 Clusters of cases Antigua and Barbuda 4 1 259 1 285.6 0 42 42.9 Clusters of cases Dominica 4 188 261.1 0 0 0.0 Clusters of cases Grenada 0 161 143.1 0 1 0.9 Sporadic cases Territoriesiii French Guiana 983 23 763 7 956.0 4 116 38.8 Community transmission Puerto Rico 875 138 485 4 840.7 28 2 499 87.4 Community transmission Guadeloupe 357 16 874 4 217.2 0 255 63.7 Community transmission Martinique 190 11 979 3 192.1 2 95 25.3 Community transmission Saint Martin 114 2 009 5 196.7 0 15 38.8 Community transmission United States Virgin Islands 96 3 442 3 296.1 0 27 25.9 Community transmission Aruba 65 10 957 10 262.6 1 107 100.2 Community transmission Sint Maarten 58 2 404 5 606.1 1 28 65.3 Community transmission British Virgin Islands 41 289 955.8 0 1 3.3 Clusters of cases Cayman Islands 7 581 884.1 0 2 3.0 Sporadic cases Saint Barthélemy 7 1 023 10 349.0 0 1 10.1 Clusters of cases Bonaire 5 1 585 7 578.3 0 17 81.3 Community transmission Curaçao 5 12 271 7 478.1 0 122 74.3 Community transmission Turks and Caicos Islands 4 2 412 6 229.7 0 17 43.9 Clusters of cases Bermuda 3 2 491 4 000.1 0 32 51.4 Community transmission Anguilla 0 109 726.6 0 0 0.0 Clusters of cases 20 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Falkland Islands (Malvinas) 0 63 1 808.8 0 0 0.0 Sporadic cases Montserrat 0 20 400.1 0 1 20.0 No cases Saba 0 7 362.1 0 0 0.0 Sporadic cases Saint Pierre and Miquelon 0 25 431.4 0 0 0.0 No cases Sint Eustatius 0 20 637.1 0 0 0.0 No cases Eastern Mediterranean 212 568 10 076 696 1 378.8 3 556 201 642 27.6 Iran (Islamic Republic of) 69 331 2 893 218 3 444.6 1 360 79 741 94.9 Community transmission Iraq 29 459 1 193 608 2 967.5 176 16 334 40.6 Community transmission Bahrain 20 829 235 699 13 851.8 130 939 55.2 Community transmission Pakistan 18 771 916 239 414.8 503 20 680 9.4 Community transmission United Arab Emirates 12 747 567 263 5 735.5 25 1 673 16.9 Community transmission Tunisia 9 275 343 374 2 905.4 392 12 574 106.4 Community transmission Kuwait 8 494 306 717 7 182.1 40 1 764 41.3 Community transmission Saudi Arabia 8 437 448 284 1 287.7 97 7 334 21.1 Community transmission Egypt 7 969 260 659 254.7 331 15 001 14.7 Clusters of cases Oman 5 442 215 366 4 217.4 65 2 321 45.5 Community transmission Jordan 5 433 735 139 7 205.0 86 9 443 92.5 Community transmission Afghanistan 5 033 70 761 181.8 117 2 919 7.5 Community transmission Morocco 2 056 518 868 1 405.7 19 9 138 24.8 Community transmission Libya 1 916 184 815 2 689.7 11 3 116 45.3 Community transmission Lebanon 1 914 540 132 7 913.5 48 7 718 113.1 Community transmission Qatar 1 881 217 041 7 533.4 11 554 19.2 Community transmission Sudan 408 35 479 80.9 60 2 628 6.0 Clusters of cases Syrian Arab Republic 388 24 440 139.7 34 1 763 10.1 Community transmission Yemen 82 6 735 22.6 15 1 320 4.4 Community transmission Djibouti 36 11 527 1 166.7 2 154 15.6 Community transmission 21 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Somalia 30 14 653 92.2 1 768 4.8 Community transmission Territoriesiii occupied Palestinian territory 2 637 336 679 6 599.7 33 3 760 73.7 Community transmission Europe 430 945 54 244 552 5 813.6 11 113 1 148 766 123.1 Kosovo [1] 169 107 339 4 2 233 Community transmission Russian Federation 61 937 5 063 442 3 469.7 2 680 121 162 83.0 Clusters of cases France 60 600 5 557 673 8 545.1 811 108 543 166.9 Community transmission Turkey 57 330 5 235 978 6 208.2 1 200 47 271 56.0 Community transmission Germany 30 190 3 679 148 4 423.8 1 026 88 406 106.3 Community transmission Italy 24 865 4 213 055 7 064.0 849 126 002 211.3 Clusters of cases Netherlands 22 068 1 644 633 9 447.8 81 17 615 101.2 Community transmission The United Kingdom 20 499 4 480 949 6 600.7 59 127 775 188.2 Community transmission Ukraine 18 951 2 201 472 5 033.8 1 104 50 472 115.4 Community transmission Spain 16 066 3 663 176 7 739.2 78 79 888 168.8 Community transmission Kazakhstan 12 081 441 801 2 352.9 172 7 321 39.0 Clusters of cases Belgium 11 493 1 061 196 9 209.8 91 24 935 216.4 Community transmission Greece 11 466 400 395 3 735.5 290 12 024 112.2 Community transmission Sweden 7 831 1 068 473 10 345.8 5 14 451 139.9 Community transmission Belarus 6 864 391 637 4 144.6 60 2 821 29.9 Community transmission Denmark 6 775 279 434 4 799.0 9 2 516 43.2 Community transmission Poland 6 328 2 871 950 7 566.1 810 73 738 194.3 Community transmission Georgia 6 030 343 603 8 613.4 135 4 757 119.2 Community transmission Switzerland 3 670 689 924 7 971.7 12 10 196 117.8 Community transmission Portugal 3 402 848 213 8 238.3 6 17 023 165.3 Clusters of cases Lithuania 3 350 274 199 9 813.5 72 4 257 152.4 Community transmission Austria 3 301 640 162 7 192.0 54 10 334 116.1 Community transmission 22 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Norway 3 275 124 029 2 310.7 2 783 14.6 Clusters of cases Czechia 3 266 1 661 159 15 533.6 84 30 104 281.5 Community transmission Ireland 2 899 261 157 5 260.6 0 4 941 99.5 Community transmission Serbia 2 373 712 046 10 279.7 78 6 844 98.8 Community transmission Hungary 2 360 804 032 8 230.0 149 29 624 303.2 Community transmission Latvia 2 206 132 918 6 967.5 47 2 370 124.2 Community transmission Romania 2 190 1 077 426 5 574.2 362 30 247 156.5 Community transmission Croatia 2 155 356 141 8 775.9 111 8 014 197.5 Community transmission Kyrgyzstan 2 044 104 555 1 602.6 52 1 803 27.6 Clusters of cases Slovenia 1 967 253 496 12 095.1 8 4 692 223.9 Clusters of cases Uzbekistan 1 673 100 124 299.2 10 690 2.1 Clusters of cases Bulgaria 1 656 418 221 6 016.3 170 17 657 254.0 Clusters of cases Azerbaijan 1 488 333 723 3 291.4 52 4 903 48.4 Clusters of cases Estonia 894 129 486 9 743.3 11 1 251 94.1 Clusters of cases Slovakia 855 389 690 7 140.0 47 12 339 226.1 Clusters of cases Finland 839 92 244 1 669.5 16 948 17.2 Community transmission Armenia 688 222 636 7 513.3 40 4 432 149.6 Community transmission Bosnia and Herzegovina 685 203 938 6 216.1 105 9 222 281.1 Community transmission Republic of Moldova 504 255 105 6 323.9 28 6 100 151.2 Community transmission Luxembourg 344 69 889 11 162.5 4 814 130.0 Community transmission Cyprus 323 72 159 8 126.0 4 357 40.2 Clusters of cases Montenegro 314 99 597 15 857.8 9 1 583 252.0 Clusters of cases North Macedonia 218 155 246 7 451.6 102 5 398 259.1 Clusters of cases Israel 141 839 454 9 698.5 4 6 408 74.0 Community transmission Albania 121 132 297 4 597.2 7 2 449 85.1 Clusters of cases Andorra 84 13 693 17 722.1 0 127 164.4 Community transmission 23 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Malta 30 30 529 5 933.0 2 419 81.4 Clusters of cases Iceland 20 6 576 1 805.9 1 30 8.2 Community transmission Liechtenstein 9 3 099 7 998.0 0 57 147.1 Sporadic cases Monaco 2 2 503 6 378.0 0 32 81.5 Sporadic cases San Marino 1 5 090 14 997.9 0 90 265.2 Community transmission Holy See 0 26 3 213.8 0 0 0.0 Sporadic cases Tajikistan 0 13 714 143.8 0 91 1.0 Pending Territoriesiii Faroe Islands 36 712 1 457.1 0 1 2.0 Sporadic cases Gibraltar 7 4 293 12 742.3 0 94 279.0 Clusters of cases Greenland 6 40 70.5 0 0 0.0 No cases Jersey 5 3 243 3 008.5 0 69 64.0 Community transmission Isle of Man 1 1 592 1 872.2 0 29 34.1 No cases Guernsey 0 822 1 275.1 0 14 21.7 Community transmission South-East Asia 1 516 572 31 605 221 1 563.5 29 477 401 754 19.9 India 1 364 668 27 894 800 2 021.4 26 706 325 972 23.6 Clusters of cases Nepal 47 779 553 422 1 899.4 1 010 7 163 24.6 Community transmission Indonesia 39 986 1 809 926 661.7 1 057 50 262 18.4 Community transmission Thailand 24 807 154 307 221.1 236 1 012 1.4 Clusters of cases Sri Lanka 19 351 180 593 843.4 227 1 405 6.6 Clusters of cases Bangladesh 9 660 797 386 484.2 201 12 549 7.6 Community transmission Maldives 8 541 62 906 11 637.5 35 158 29.2 Clusters of cases Timor-Leste 1 271 6 752 512.1 5 16 1.2 Community transmission Myanmar 298 143 526 263.8 0 3 216 5.9 Clusters of cases Bhutan 211 1 603 207.7 0 1 0.1 Clusters of cases Western Pacific 139 234 3 000 768 152.7 2 090 45 148 2.3 Malaysia 53 419 558 534 1 725.7 451 2 650 8.2 Community transmission 24 Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Philippines 38 362 1 216 569 1 110.2 776 20 722 18.9 Community transmission Japan 27 400 741 674 586.4 684 12 920 10.2 Clusters of cases Mongolia 4 690 56 621 1 727.2 24 268 8.2 Clusters of cases Cambodia 4 199 29 404 175.9 33 209 1.3 Sporadic cases China 4 052 110 765 7.5 82 4 945 0.3 Clusters of cases Republic of Korea 3 989 139 910 272.9 26 1 957 3.8 Clusters of cases Viet Nam 1 789 6 908 7.1 6 47 0.0 Clusters of cases Papua New Guinea 714 15 901 177.7 6 162 1.8 Community transmission Singapore 204 62 003 1 059.8 0 32 0.5 Sporadic cases Fiji 154 360 40.2 0 4 0.4 Sporadic cases Lao People's Democratic Republic 126 1 908 26.2 1 3 0.0 Sporadic cases Australia 79 30 083 118.0 0 910 3.6 Clusters of cases New Zealand 9 2 316 48.0 0 26 0.5 Sporadic cases Brunei Darussalam 5 241 55.1 0 3 0.7 Sporadic cases Solomon Islands 0 20 2.9 0 0 0.0 No cases Territoriesiii Guam 22 7 918 4 691.5 0 139 82.4 Clusters of cases French Polynesia 16 18 860 6 713.9 1 142 50.6 Sporadic cases New Caledonia 3 128 44.8 0 0 0.0 Sporadic cases Northern Mariana Islands (Commonwealth of the) 2 183 317.9 0 2 3.5 Pending Marshall Islands 0 4 6.8 0 0 0.0 No cases Samoa 0 1 0.5 0 0 0.0 No cases Vanuatu 0 3 1.0 0 0 0.0 No cases Wallis and Futuna 0 454 4 037.0 0 7 62.2 Sporadic cases Global 3 550 456 169 604 858 78 665 3 530 837 *See Annex 3: Data, table and figure notes 25 Annex 2. List of countries/territories/areas reporting Variants of Concern as of 1 June 2021** Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Afghanistan ● - - - - Albania ● - - - - Algeria ● - - ● - Angola ● ● - - - Argentina ● ● ● ● - Armenia ○ - - - - Aruba ● ● ● ● - Australia ● ● ● ○ - Austria ● ● ● ● - Azerbaijan ● - - - - Bahrain ● ● - ● - Bangladesh ● ● - ● - Barbados ● - - - - Belarus ● - - - - Belgium ● ● ● ● - Belize ● - - - - Bolivia (Plurinational State of) ● - ●* - - Bonaire ● - - - - Bosnia and Herzegovina ○ - - - - Botswana - ● - ● - Brazil ● ● ● ● - Brunei Darussalam ● ● - - - Bulgaria ● - - - - Burkina Faso ●* - - - - Cabo Verde ● - - - - Cambodia ● - - - ●* Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Cameroon ● ● - - - Canada ● ● ● ● - Cayman Islands ● - - - - Central African Republic ● - - - - Chile ● ● ● - - China ● ● ● ○ - Colombia ● - ● - - Comoros ●* ● - - - Congo ● - - - - Costa Rica ● ● ● - - Croatia ● ● - - - Cuba ● ● - - - Curaçao ● - ● - - Cyprus ● ● - - ● Czechia ● ● - ●* - Côte d’Ivoire ● ● - - - Democratic Republic of the Congo ● ● - ● - Denmark ● ● ● ● - Dominica ● - - - - Dominican Republic ● - ●* - - Ecuador ● ● ● - - Egypt ● - - - - Equatorial Guinea ● ● - - - Estonia ● ● ○* - ○* Eswatini - ● - - - Ethiopia ○ - - - - Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Faroe Islands ●* - ● - - Fiji - - - - ● Finland ● ● ● ● - France ● ● ● ● - French Guiana ● ● ● - - French Polynesia ● - ● - - Gabon ● ○ - - - Gambia ● - - ●* - Georgia ● - - - ○* Germany ● ● ● ● - Ghana ● ● - ● - Gibraltar ● - - - - Greece ● ● - ● - Grenada ● - - - - Guadeloupe ● ● - - - Guam ● - - - - Guinea ● ● - - - Guinea-Bissau ● ● - - - Guyana - - ● - - Haiti ● - ● - - Hungary ● ○ - - ○* Iceland ● - - - - India ● ● ● ● - Indonesia ● ● - ● - Iran (Islamic Republic of) ● ● - - ● Iraq ● - - - - 26 Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Ireland ● ● ● ● - Israel ● ● ● ● - Italy ● ● ● ● - Jamaica ● - - - - Japan ● ● ● ● - Jordan ● ● ● ● - Kazakhstan ○ ○ - - - Kenya ● ● - ● - Kosovo[1] ● - - - - Kuwait ● - - - - Kyrgyzstan ● ● - - ● Lao People's Democratic Republic ● - - - - Latvia ● ● ● - ○* Lebanon ● - - - - Lesotho - ● - - - Liberia ● - - - - Libya ● ● - - - Liechtenstein ● - - - - Lithuania ● ● ● - - Luxembourg ● ● ● ● - Madagascar - ● - - - Malawi ● ● - - - Malaysia ● ● - ○ - Malta ● ○ ● - - Martinique ● ● - - - Mauritania ●* ●* - ●* - Mauritius ○ ● - - - Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Mayotte ● ● - - - Mexico ● ● ● ● - Monaco ● ○ - - - Montenegro ● - - - - Morocco ● - - - ● Mozambique - ● - - - Namibia - ● - - - Nepal ● - - ●* - Netherlands ● ● ● ● - New Caledonia ● - - - - New Zealand ● ● ○ ○ - Niger ● - - - - Nigeria ● - - ●* - North Macedonia ● ● - - - Norway ● ● ● ● - Occupied Palestinian Territory ● ● - - - Oman ● - - - - Pakistan ● ● ● - - Panama ● ● ● - ●* Paraguay - - ● - - Peru ● - ● - - Philippines ● ● ● ○ - Poland ● ○ ● ● - Portugal ● ● ● ○ - Puerto Rico ● ● ● ●* - Qatar ● ● - ●* - Republic of Korea ● ● ● ○ - Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Republic of Moldova ○ - - - - Romania ● ● ● ● - Russian Federation ● ● - ● - Rwanda ● ○ - - - Réunion ● ● ● ○ - Saint Barthélemy ● - - - - Saint Lucia ● - - - - Saint Martin ● ● - - - Sao Tome and Principe ●* - - - - Saudi Arabia ● ● - - - Senegal ● ●* - - - Serbia ● - - - - Seychelles - ● - - - Singapore ● ● ● ● - Sint Maarten ● ● - - - Slovakia ● ● - - - Slovenia ● ● ● ● - South Africa ● ● - ● - Spain ● ● ● ● - Sri Lanka ● ● - ○ - Suriname ● ● ● - - Sweden ● ● ● ● - Switzerland ● ● ○ ● - Thailand ● ● ● ● - Togo ● ● - - - Trinidad and Tobago ● - ● - - Tunisia ● ● - - - Turkey ● ● ● ●* - 27 Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Turks and Caicos Islands ● - - - - Uganda ● ● - ● - Ukraine ● ○ - - - United Arab Emirates ● ● ● - - United Kingdom ● ● ● ● - Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ United Republic of Tanzania - ● - - - United States of America ● ● ● ● - Uruguay ● - ● - - Uzbekistan ● ● - - - Country/Territory/Area A lp h a B e ta G am m a D e lt a D e lt a+ Venezuela (Bolivarian Republic of) - - ● - - Viet Nam ● ● - ● - Wallis and Futuna ● - - - - Zambia - ● - ●* ○ Zimbabwe - ○ - ● - *Newly reported in this update. Columns for B.1.617.1 (Kappa) and B.1.617.3 were removed this week according to changes in VOC designation. “Delta+” reflects countries/territories/areas reporting detection of B.1.617 without further specification of lineage at this time. These will be reallocated as further details become available. “●” indicates that information for this variant was received by WHO from official sources. “○” indicates that information for this variant was received by WHO from unofficial sources and will be reviewed as more information become available. Variants Gamma for Bangladesh and Delta for Panama were excluded this week based on further information received. **Includes countries/territories/areas reporting the detection of VOCs among travelers (e.g., imported cases detected at points of entry), or local cases (detected in the community). Efforts are ongoing to differentiate these in future reports. See also Annex 3: Data, table and figure notes. 28 Annex 3. Data, table and figure notes Data presented are based on official laboratory-confirmed COVID-19 case and deaths reported to WHO by country/territories/areas, largely based upon WHO case definitions and surveillance guidance. While steps are taken to ensure accuracy and reliability, all data are subject to continuous verification and change, and caution must be taken when interpreting these data as several factors influence the counts presented, with variable underestimation of true case and death incidence, and variable delays to reflecting these data at global level. Case detection, inclusion criteria, testing strategies, reporting practices, and data cut-off and lag times differ between countries/territories/areas. A small number of countries/territories/areas report combined probable and laboratory-confirmed cases. Differences are to be expected between information products published by WHO, national public health authorities, and other sources. Due to public health authorities conducting data reconciliation exercises which remove large numbers of cases or deaths from their total counts, negative numbers may be displayed in the new cases/deaths columns as appropriate. When additional details become available that allow the subtractions to be suitably apportioned to previous days, graphics will be updated accordingly. A record of historic data adjustment made is available upon request by emailing epi-data-support@who.int. Please specify the country(ies) of interest, time period(s), and purpose of the request/intended usage. Prior situation reports will not be edited; see covid19.who.int for the most up-to-date data. Global totals include 758 cases and 13 deaths reported from international conveyances. 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. i Excludes countries, territories, and areas that have never reported a confirmed COVID-19 case (Annex 1), or the detection of a variant of concern (Annex 2). ii 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. For further information, please see: Considerations for implementing and adjusting public health and social measures in the context of COVID-19. iii “Territories” include territories, areas, overseas dependencies and other jurisdictions of similar status.