Bi-weekly COVID-19 situation update 2025

Bi-weekly COVID-19 Situation Update 3 January 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 52, 2024 (the week ending on 29 December 2024), a total of 516 specimens tested for SARS- CoV-2 were submitted to FluNet from one country in the Western Pacific Region. The positivity rate was 0.78% (Figure 1). The country-specific number of testing and calculated positivity rate in week 50-52 of 2024 are presented in Table 1 below. Australia, China, Hong Kong SAR and Singapore reported an increase in their SARS-CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the numbers of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2024 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 50-52 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (50 of 2024) 2 340 45.4 ↑ China, Hong Kong SAR (51 of 2024) 7 600 0.84 ↑ Lao People’s Democratic Republic (51 of 2024) 41 0 - Mongolia (52 of 2024) 516 0.78 ↓ New Caledonia (51 of 2024) 74 1.4 ↓ Singapore (51 of 2024) 165 8.5 ↑ Viet Nam (51 of 2024) 4 0.0 ↓ COVID-19 Situation Update| 2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 3 January 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 61.4% and B.1.1.529 at 38.5% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. The country-specific data is available below for certain countries where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2023-2024 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from the pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In the current transitional phase, some countries have already integrated their COVID-19 surveillance into existing systems while other countries maintain COVID-19 surveillance from the emergency phase of the pandemic. Due to these various approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance are different across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 30 November 2024, 35 new severe COVID-19 cases and 11 deaths were reported from 31 provinces, autonomous regions and municipalities, and Xinjian Production and Construction Corps in China (Figure 3), which is a decrease compared to 57 severe cases and six deaths in October 2024. From 1 to 30 November 2024, the main circulating strains are XDV and JN.1. COVID-19 Situation Update| 3 Figure 3: Severe COVID-19 cases and deaths reported in China, November 2024 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) There is no update for this reporting period. In week 48 (25 November to 1 December), a total of 11 945 new cases per sentinel site were reported. This is an increase from previous week when 8 948 new cases were reported (Figure 4). An increasing trend was seen in the number of new hospitalisations reported from key sentinel sites nationwide with 1 420 new hospitalizations reported in week 48 as compared to 1 138 in week 47 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2024 (Source: Japan National Institute of Infectious Diseases) Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2024 (Source: Japan National Institute of Infectious Diseases) COVID-19 Situation Update| 4 Republic of Korea – COVID-19 cases (sentinel surveillance) In week 52 (the week ending on 28 December 2024), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 2.0%, a decrease from 2.2% in the previous week (Table 2). COVID-19 associated hospital admissions increased in week 52, with 111 hospital admissions as compared to 66 in week 51 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 49-52 of 2024 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 1-52 of 2024 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 52 of 2024 (22 to 28 December 2024), the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 46 as compared to 38 in the preceding week COVID-19 Situation Update| 5 (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was one as compared to two in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 20 December 2024, JN.1 and its descendant lineages remained the most prevalent variant, comprising over 786 of all characterized specimens, where 32.6% belongs to the descendant strain KP.3, 2.1% to KP.3.1.1, and 35.0% to KP.2. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2024 (Source: Hong Kong Centre for Health Protection) Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2024 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has slightly decreased over the past few weeks with 211 cases on 21 December 2024, compared to 246 cases on 14 December 2024 (Figure 9). COVID- 19 related hospital admissions have slightly decreased, with 7-day average of admissions recorded at 60.9 on 21 December, compared to 71.6 on 14 December 2024 (Figure 10). COVID-19 Situation Update| 6 Figure 9: COVID-19 confirmed cases in Malaysia by date, 2023-2024 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2023-2024 (Source: Ministry of Health Malaysia) Viet Nam : COVID-19 cases There is no update for this reporting period. As of the week 48 (from 25 November to 1 December 2024), Viet Nam has reported a cumulative total of 6 751 COVID-19 cases, including one death. Over the past five months, there has been a significant downward trend in case numbers. During week 48, two cases were reported from northern provinces, with no associated deaths. Figure 11: Number of weekly COVID-19 cases by region, as of week 48, 2024, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: The data should be interpreted cautiously as there are some reporting delays and/or retrospective changes. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 hospital admission and deaths (monthly update) The weekly number of cases have gradually increased since week 41, with 5 004 new cases reported in week 52 (23 to 29 December 2024). No deaths were reported since week 50. Four new ICU admissions were reported in week 52 as compared to one ICU admission in week 51 (Figure 12). COVID-19 Situation Update| 7 Figure 12: COVID-19 confirmed cases, deaths and ICU cases, 1 January – 29 December 2024 (Source: International Health Regulations (IHR) National Focal Point , Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Zealand – COVID-19 cases and deaths There is no update for this reporting period. Number of COVID-19 cases in New Zealand has increased since late October, but it has decreased over the last two weeks, with the 7 day-moving average of daily cases per 100 000 population at 2.7 cases on 15 December 2024 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low around 0.02 on 8 December 2024 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2023-2024 (Source: Te Whatu Ora, Health New Zealand) COVID-19 Situation Update| 8 Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2023-2024 (Source: Te Whatu Ora, Health New Zealand) Pacific Island Countries and Areas (PICs) – COVID-19 cases There is no update for this reporting period. From 23 to 29 September 2024, two out of 21 PICs reported COVID-19 cases: Cook Islands and Commonwealth of the Northern Mariana Islands (Table 3). The 7-day rolling average of number of reported cases in 11 PICs has decreased since August 2024 (Figure 15). Table 3: Weekly and cumulative number of COVID-19 cases and deaths in PICs, 23 to 29 September 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) ` COVID-19 Situation Update | 9 Bi-weekly COVID-19 Situation Update 3 January 2025 Figure 15: Epidemic curve of COVID-19 in nine PICs since 1 January 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link ` COVID-19 Situation Update | 10 Bi-weekly COVID-19 Situation Update 3 January 2025 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 ` COVID-19 Situation Update | 11 Bi-weekly COVID-19 Situation Update 3 January 2025 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 ` COVID-19 Situation Update | 12 Bi-weekly COVID-19 Situation Update 3 January 2025 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 ` COVID-19 Situation Update | 13 Bi-weekly COVID-19 Situation Update 3 January 2025 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 ` COVID-19 Situation Update | 14 Bi-weekly COVID-19 Situation Update 3 January 2025 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 tess results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 ` COVID-19 Situation Update | 15 Bi-weekly COVID-19 Situation Update 3 January 2025 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelnies in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

` COVID-19 Situation Update| 1 Bi-weekly COVID-19 Situation Update 17 January 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 1, 2025 (the week ending on 5 January 2025), a total of 10 218 specimens tested for SARS- CoV-2 were submitted to FluNet from seven countries and areas in the Western Pacific Region. The positivity rate was 1.49% (Figure 1). The country-specific number of testing and calculated positivity rate in week 52 of 2024 - week 1 of 2025 are presented in Table 1 below. Australia, Hong Kong SAR, China, Republic of Korea, Mongolia, New Caledonia and Singapore reported an increase in their SARS- CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the numbers of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 52 of 2024- week 1 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (1 of 2025) 718 6.55 ↑ China, Hong Kong SAR (1 of 2025) 8 420 0.84 ↑ Republic of Korea (1 of 2025) 453 2.21 ↑ Lao People’s Democratic Republic (1 of 2025) 27 0 - Mongolia (1 of 2025) 414 0.97 ↑ New Caledonia (1 of 2025) 112 11.61 ↑ Singapore (1 of 2025) 70 10.0 ↑ Philppines (52 of 2024) 16 0 ↓ ` COVID-19 Situation Update| 2 Bi-weekly COVID-19 Situation Update 17 January 2025 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 16 January 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 68.2% and B.1.1.529 at 31.8% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. The country-specific data is available below for certain countries where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from the pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In the current transitional phase, some countries have already integrated their COVID-19 surveillance into existing systems while other countries maintain COVID-19 surveillance from the emergency phase of the pandemic. Due to these various approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance are different across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 31 December 2024, 112 new severe COVID-19 cases and 7 deaths were reported from 31 provinces, autonomous regions and municipalities, and Xinjian Production and Construction Corps in China (Figure 3). Compared to November 2024 (35 severe cases and 11 deaths), severe cases have increased while deaths have slightly decreased. For this reporting period, the predominant circulating strain was XDV accounting for more than 50% of sequenced samples. ` COVID-19 Situation Update| 3 Bi-weekly COVID-19 Situation Update 17 January 2025 Figure 3: Severe COVID-19 cases and deaths reported in China, December 2024 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) There is no update for this reporting period. In week 48 (25 November to 1 December), a total of 11 945 new cases per sentinel site were reported. This is an increase from previous week when 8 948 new cases were reported (Figure 4). An increasing trend was seen in the number of new hospitalisations reported from key sentinel sites nationwide with 1 420 new hospitalizations reported in week 48 as compared to 1 138 in week 47 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2024 (Source: Japan National Institute of Infectious Diseases) Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2024 (Source: Japan National Institute of Infectious Diseases) ` COVID-19 Situation Update| 4 Bi-weekly COVID-19 Situation Update 17 January 2025 Republic of Korea – COVID-19 cases (sentinel surveillance) In week 2 (the week ending on 11 January 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 2.8%, a slight increase from 2.2% in the previous week (Table 2). COVID- 19 associated hospital admissions have also increased in the past few weeks, with 143 hospital admissions reported in week 1 of 2025, as compared to 113 and 66 reported in week 52 and week 51 of 2024, respectively (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 51 of 2024-week 2 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 30 of 2024-week 1 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 2 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 44 as compared to 63 in the preceding week (Figure 7). The weekly number ` COVID-19 Situation Update| 5 Bi-weekly COVID-19 Situation Update 17 January 2025 of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 remained two, same as in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 8 January 2025, JN.1 and its descendant lineages remained the most prevalent variant, comprising over 97% of all characterised specimens, where 58.9% belongs to the descendant strain KP.3, 16.9% to KP.2 and 11.3% to KP.3.1.1. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has plateaued over the recent weeks, with 176 cases reported on 11 January 2025, compared to 175 cases on 4 January 2025 (Figure 9). COVID-19 related hospital admissions have slightly increased, with 7-day average of admissions recorded at 69 on 11 January 2025, compared to 56 on 4 January 2025 (Figure 10). ` COVID-19 Situation Update| 6 Bi-weekly COVID-19 Situation Update 17 January 2025 Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of the week 50 (from 9 to 15 December 2024), Viet Nam has reported a cumulative total of 6 807 COVID-19 cases, including one death. Over the past two months, the trend in the number of reported cases has remained stable, with the low number of cases reported each week. During week 50, four cases were reported, with no associated deaths. Figure 11: Number of weekly COVID-19 cases by region, as of week 50, 2024, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: The data should be interpreted cautiously as there are some reporting delays and/or retrospective changes. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths The weekly number of cases have increased in the past three weeks, with 6 049 new cases reported in week 2 (6 to 12 January 2025). The overall trend of number of deaths reported has decreased since early November 2024, with three deaths reported in week 1 (30 December 2024 to 5 January 2025). Two new ICU admissions were reported in week 2 of 2025, a decrease compared to 12 admissions recorded in week 52 of 2024 (Figure 12). ` COVID-19 Situation Update| 7 Bi-weekly COVID-19 Situation Update 17 January 2025 Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 2 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Zealand – COVID-19 cases and deaths Number of COVID-19 cases in New Zealand has decreased in the past few weeks after a continued increase since November 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 2.8 cases on 11 January 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low around 0.03 on 5 January 2025 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) ` COVID-19 Situation Update| 8 Bi-weekly COVID-19 Situation Update 17 January 2025 Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Pacific Island Countries and Areas (PICs) – COVID-19 cases There is no update for this reporting period. From 23 to 29 September 2024, two out of 21 PICs reported COVID-19 cases: Cook Islands and Commonwealth of the Northern Mariana Islands (Table 3). The 7-day rolling average of number of reported cases in 11 PICs has decreased since August 2024 (Figure 15). Table 3: Weekly and cumulative number of COVID-19 cases and deaths in PICs, 23 to 29 September 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) ` COVID-19 Situation Update|9 Bi-weekly COVID-19 Situation Update 17 January 2025 Figure 15: Epidemic curve of COVID-19 in nine PICs since 1 January 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link ` COVID-19 Situation Update|10 Bi-weekly COVID-19 Situation Update 17 January 2025 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 ` COVID-19 Situation Update|11 Bi-weekly COVID-19 Situation Update 17 January 2025 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 ` COVID-19 Situation Update|12 Bi-weekly COVID-19 Situation Update 17 January 2025 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 ` COVID-19 Situation Update|13 Bi-weekly COVID-19 Situation Update 17 January 2025 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 ` COVID-19 Situation Update|14 Bi-weekly COVID-19 Situation Update 17 January 2025 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 tess results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 ` COVID-19 Situation Update|15 Bi-weekly COVID-19 Situation Update 17 January 2025 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelnies in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

Bi-weekly COVID-19 Situation Update 31 January 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 3, 2025 (the week ending on 19 January 2025), a total of 3 410 specimens tested for SARS- CoV-2 were submitted to FluNet from seven countries in the Western Pacific Region. The positivity rate was 4.57% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 3 of 2025 are presented in Table 1 below. Australia, Mongolia, New Caledonia, Philippines and Singapore reported an increase in their SARS-CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 52 of 2024- week 1 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (3 of 2025) 2 200 5.53 ↑ Lao People’s Democratic Republic (3 of 2025) 34 0 - Mongolia (3 of 2025) 378 0.26 ↑ New Caledonia (3 of 2025) 82 4.88 ↑ Philippines (3 of 2025) 46 4.57 ↑ Singapore (3 of 2025) 70 10.0 ↑ Republic of Korea (3 of 2025) 491 1.83 ↓ COVID-19 Situation Update| 2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 16 January 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 55.6% and B.1.1.529 at 44.3% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 31 December 2024, 112 new severe COVID-19 cases and 7 deaths were reported from 31 provinces, autonomous regions and municipalities, and Xinjian Production and Construction Corps in China (Figure 3). Compared to November 2024 (35 severe cases and 11 deaths), severe cases have increased while deaths have slightly decreased. For this reporting period, the predominant circulating strain was XDV accounting for more than 50% of sequenced samples. COVID-19 Situation Update| 3 Figure 3: Severe COVID-19 cases and deaths reported in China, December 2024 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) In week 1 2025 (30 December 2024 to 5 January 2025), a total of 22 357 new cases per sentinel site were reported. This is a decrease from the previous week where 34 610 new cases were reported (Figure 4). A decreasing trend was seen in the number of new hospitalisations reported from key sentinel sites nationwide with 2 568 new hospitalizations reported in week 1 2025 compared to 2 864 in week 52 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) COVID-19 Situation Update| 4 Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 3 (the week ending on 18 January 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 1.8%, a decrease from 2.8% in the previous week (Table 2). COVID-19 associated hospital admissions have also decreased in the past few weeks, with zero hospital admissions reported in week 4 of 2025, compared to 84 and 138 reported in week 3 and week 2 of 2025, respectively (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 52 of 2024-week 3 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) COVID-19 Situation Update| 5 Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 30 of 2024-week 4 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 4 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 29 compared to 50 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was one compared to zero in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 22 January 2025, JN.1 and its descendant lineages remained the most prevalent variant, comprising over 100% of all characterised specimens, where 46.9% belongs to the descendant strain KP.3, 2.0% to KP.2 and 16.4% to KP.3.1.1. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update| 6 Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has plateaued over the recent weeks, with 98 cases reported on 25 January 2025, compared to 120 cases on 18 January 2025 (Figure 9). COVID-19 related hospital admissions have slightly increased, with the 7-day average of admissions recorded at 53 on 25 January 2025, compared to 67 on 18 January 2025 (Figure 10). Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) COVID-19 Situation Update| 7 Viet Nam - COVID-19 cases and deaths There is no update for this reporting period. As of the week 50 (from 9 to 15 December 2024), Viet Nam has reported a cumulative total of 6 807 COVID-19 cases, including one death. Over the past two months, the trend in the number of reported cases has remained stable, with the low number of cases reported each week. During week 50, four cases were reported, with no associated deaths. Figure 11: Number of weekly COVID-19 cases by region, as of week 50, 2024, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: The data should be interpreted cautiously as there are some reporting delays and/or retrospective changes. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths The weekly number of cases has decreased in the past three weeks, with 4 745 new cases reported in week 3 (13 to 19 January 2025). The overall trend of the number of deaths reported has decreased since early November 2024, with one death reported in week 3 (13 to 19 January 2025). Eleven new ICU admissions were reported in week 3 of 2025, an increase compared to 8 admissions recorded in week 2 of 2025 (Figure 12). COVID-19 Situation Update| 8 Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 2 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Zealand – COVID-19 cases and deaths Number of COVID-19 cases in New Zealand has decreased in the past few weeks after a continued increase since November 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 1.9 cases on 26 January 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low at around 0.03 on 11 January 2025 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) COVID-19 Situation Update| 9 Pacific Island Countries and Areas (PICs) – COVID-19 cases There is no update for this reporting period. From 23 to 29 September 2024, two out of 21 PICs reported COVID-19 cases: Cook Islands and Commonwealth of the Northern Mariana Islands (Table 3). The 7-day rolling average of number of reported cases in 11 PICs has decreased since August 2024 (Figure 15). Table 3: Weekly and cumulative number of COVID-19 cases and deaths in PICs, 23 to 29 September 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Figure 15: Epidemic curve of COVID-19 in nine PICs since 1 January 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link COVID-19 Situation Update|10 • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link COVID-19 Situation Update|11 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 COVID-19 Situation Update|12 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 COVID-19 Situation Update|13 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 COVID-19 Situation Update|14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 COVID-19 Situation Update|15 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 tess results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 COVID-19 Situation Update|16 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelnies in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

` COVID-19 Situation Update| 1 Bi-weekly COVID-19 Situation Update 14 February 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 5, 2025 (the week ending on 9 February 2025), a total of 10 612 specimens tested for SARS- CoV-2 were submitted to FluNet from seven countries in the Western Pacific Region. The positivity rate was 1.79% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 5 of 2025 are presented in Table 1 below. Philippines and Singapore reported an increase in their SARS-CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 2 - 4 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (5 of 2025) 2 260 5.71 ↓ Lao People’s Democratic Republic (5 of 2025) 0 0 - Mongolia (5 of 2025) 250 0 ↓ New Caledonia (5 of 2025) 80 5.00 ↓ Philippines (5 of 2025) 23 8.70 ↑ Singapore (5 of 2025) 131 7.63 ↑ Republic of Korea (5 of 2025) 122 1.64 ↓ ` COVID-19 Situation Update| 2 Bi-weekly COVID-19 Situation Update 14 February 2025 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 13 February 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 73.8% and B.1.1.529 at 26.2% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 31 January 2025, 163 new severe COVID-19 cases and 4 deaths were reported from 31 provinces, autonomous regions and municipalities, and Xinjian Production and Construction Corps in China (Figure 3). Compared to December 2024 (112 severe cases and 7 deaths), severe cases have increased while deaths have slightly decreased. For this reporting period, the predominant circulating strain was XDV accounting for more than 78% of sequenced samples. ` COVID-19 Situation Update| 3 Bi-weekly COVID-19 Situation Update 14 February 2025 Figure 3: Severe COVID-19 cases and deaths reported in China, January 2025 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) There is no update for this reporting period. In week 1 2025 (30 December 2024 to 5 January 2025), a total of 22 357 new cases per sentinel site were reported. This is a decrease from the previous week where 34 610 new cases were reported (Figure 4). A decreasing trend was seen in the number of new hospitalisations reported from key sentinel sites nationwide with 2 568 new hospitalizations reported in week 1 2025 compared to 2 864 in week 52 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) ` COVID-19 Situation Update| 4 Bi-weekly COVID-19 Situation Update 14 February 2025 Republic of Korea – COVID-19 cases (sentinel surveillance) In week 6 (the week ending on 8 February 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 6.8%, a increase from 1.6% in the previous week (Table 2). COVID-19 associated hospital admissions have decreased in the past few weeks, with 66 hospital admissions reported in week 6 of 2025 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week week 3 -6 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 30 of 2024-week 6 of 2025 (Source: Korea Disease Control and Prevention Agency) ` COVID-19 Situation Update| 5 Bi-weekly COVID-19 Situation Update 14 February 2025 Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 6 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 43 compared to 37 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was one compared to one in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 5 February 2025, JN.1 and its descendant lineages remained the most prevalent variant, comprising over 78% of all characterised specimens, where 33.2% belongs to the descendant strain KP.3, 13.6% to KP.2 and 23.1% to KP.3.1.1. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) ` COVID-19 Situation Update| 6 Bi-weekly COVID-19 Situation Update 14 February 2025 Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has plateaued over the recent weeks, with 83 cases reported on 8 February 2025, compared to 73 cases on 1 February 2025 (Figure 9). COVID-19 related hospital admissions have slightly increased, with the 7-day average of admissions recorded at 62 on 8 February 2025, compared to 49 on 1 February 2025 (Figure 10). Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of the week 52 (from 23 to 29 December 2024)Viet Nam has reported a cumulative total of 6 807 COVID-19 cases, including one death. Over the past two months, the trend in the number of reported cases has remained stable, with the low number of cases reported each week. During last two weeks (weeks 51 and 52), no case were reported, with no associated deaths. Figure 11: Number of weekly COVID-19 cases by region, as of week 52, 2024, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: The data should be interpreted cautiously as there are some reporting delays and/or retrospective changes. ` COVID-19 Situation Update| 7 Bi-weekly COVID-19 Situation Update 14 February 2025 Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths The weekly number of cases has decreased in the past three weeks, with 3 316 new cases reported in week 5 (27 January to 2 February 2025). The overall trend of the number of deaths reported has decreased since early November 2024, with two deaths reported in week 5 (27 January to 2 February 2025). Four new ICU admissions were reported in week 5 of 2025, a decrease compared to 8 admissions recorded in week 4 of 2025 (Figure 12). Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 5 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Zealand – COVID-19 cases and deaths Number of COVID-19 cases in New Zealand has decreased in the past few weeks after a continued increase since November 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 1.5 cases on 9 February 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low at around 0.01 on 1 February 2025 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) 0 20 40 60 80 100 120 140 160 0 2000 4000 6000 8000 10000 12000 14000 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 1 3 5 W ee kl y n u m b er o f IC U c as es a n d d ea th s W ee kl y n u m b er o f ca se s Weeks (2024-2025) New Confirmed Cases New Confirmed Deaths New ICU Cases ` COVID-19 Situation Update| 8 Bi-weekly COVID-19 Situation Update 14 February 2025 Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Pacific Island Countries and Areas (PICs) – COVID-19 cases There is no update for this reporting period. From 23 to 29 September 2024, two out of 21 PICs reported COVID-19 cases: Cook Islands and Commonwealth of the Northern Mariana Islands (Table 3). The 7-day rolling average of number of reported cases in 11 PICs has decreased since August 2024 (Figure 15). Table 3: Weekly and cumulative number of COVID-19 cases and deaths in PICs, 23 to 29 September 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) ` COVID-19 Situation Update|9 Bi-weekly COVID-19 Situation Update 14 February 2025 Figure 15: Epidemic curve of COVID-19 in nine PICs since 1 January 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link ` COVID-19 Situation Update|10 Bi-weekly COVID-19 Situation Update 14 February 2025 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 ` COVID-19 Situation Update|11 Bi-weekly COVID-19 Situation Update 14 February 2025 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 ` COVID-19 Situation Update|12 Bi-weekly COVID-19 Situation Update 14 February 2025 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 ` COVID-19 Situation Update|13 Bi-weekly COVID-19 Situation Update 14 February 2025 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 ` COVID-19 Situation Update|14 Bi-weekly COVID-19 Situation Update 14 February 2025 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 tess results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 ` COVID-19 Situation Update|15 Bi-weekly COVID-19 Situation Update 14 February 2025 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelnies in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

Bi-weekly COVID-19 Situation Update 28 February 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 7, 2025 (the week ending on 16 February 2025), a total of 12 343 specimens tested for SARS- CoV-2 were submitted to FluNet from ten countries in the Western Pacific Region. The positivity rate was 1.39% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 7 of 2025 are presented in Table 1 below. Singapore reported an increase in their SARS-CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 7 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (7 of 2025) 2 000 4.54 ↓ China, Hong Kong SAR (7 of 2025) 9 000 0.35 ↓ Mongolia (7 of 2025) 138 0 ↓ New Caledonia (7 of 2025) 39 5.13 - New Zealand (7 of 2025) 49 10.2 ↓ Papua New Guinea (7 of 2025) 8 0 - Philippines (7 of 2025) 37 0 ↓ Singapore (7 of 2025) 256 5.47 ↑ Republic of Korea (7 of 2025) 317 4.73 ↓ Viet Nam (7 of 2025) 12 0 - COVID-19 Situation Update| 2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 27 February 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 52.1% and B.1.1.529 at 47.8% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. However, there is an increase of variant B.1.1.529 in the Region in recent weeks. The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 31 January 2025, 163 new severe COVID-19 cases and 4 deaths were reported from 31 provinces, autonomous regions and municipalities, and Xinjian Production and Construction Corps in China (Figure 3). Compared to December 2024 (112 severe cases and 7 deaths), severe cases have increased while deaths have slightly decreased. For this reporting period, the predominant circulating strain was XDV accounting for more than 78% of sequenced samples. COVID-19 Situation Update| 3 Figure 3: Severe COVID-19 cases and deaths reported in China, January 2025 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) In week 5 2025 (27 January to 2 February 2025), a total of 29 869 new cases per sentinel site were reported. This is a slight decrease from the previous week where 29 920 new cases were reported (Figure 4). A decreasing trend was seen in the number of new hospitalisations reported from key sentinel sites nationwide with 2 062 new hospitalizations reported in week 5 2025 compared to 2 205 in week 4 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) COVID-19 Situation Update| 4 Republic of Korea – COVID-19 cases (sentinel surveillance) In week 8 (the week ending on 22 February 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 4.8%, a slight increase from 4.7% in the previous week (Table 2). COVID-19 associated hospital admissions have increased in the past few weeks, with 89 hospital admissions reported in week 8 of 2025 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week week 5-8 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 30 of 2024-week 8 of 2025 (Source: Korea Disease Control and Prevention Agency) COVID-19 Situation Update| 5 Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 8 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 29 compared to 32 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was zero compared to four in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 12 February 2025, JN.1 and its descendant lineages remained the most prevalent variant, comprising over 92% of all characterised specimens, where 58.9% belongs to the descendant strain KP.3, 22.4% to KP.2 and 8.7% to LP.8.1. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update| 6 Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has decreased over the recent weeks, with 37 cases reported on 22 February 2025, compared to 87 cases on 14 February 2025 (Figure 9). COVID-19 related hospital admissions have consistently decreased, with the 7-day average of admissions recorded at 14 on 22 February 2025, compared to 46 on 14 February 2025 (Figure 10). Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of 9 Feb 2025, the country has reported 17 cases with no deaths. Compared to the same period in 2024 (1 901 cases, no deaths), the number of cases dropped by approximately 99.1%. During the week 6 (3 Feb 2025 to 9 Feb 2025), four cases were reported. Of those, two were from the Southern region, one from the Northern region and one from the Central-coast region. Figure 11: Number of weekly COVID-19 cases by region, as of week 6, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. COVID-19 Situation Update| 7 Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths The weekly number of cases has plateaued in the past three weeks, with 3 730 new cases reported in week 8 (11 February to 17 February 2025). The overall trend of the number of deaths reported has decreased since early November 2024, with zero death reported in week 8 (11 February to 17 February 2025). Seven new ICU admissions were reported in week 8 of 2025, a maintained number of admissions during past four weeks (Figure 12). Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 8 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. 0 20 40 60 80 100 120 140 160 0 2000 4000 6000 8000 10000 12000 14000 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 1 3 5 7 W ee kl y n u m b er o f IC U c as es a n d d ea th s W ee kl y n u m b er o f ca se s Weeks (2024-2025) New Confirmed Cases New Confirmed Deaths COVID-19 Situation Update| 8 New Zealand – COVID-19 cases and deaths Number of COVID-19 cases in New Zealand has decreased in the past few weeks after a continued increase since November 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 1.65 cases on 23 February 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low at around 0.016 on 16 February 2025 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) COVID-19 Situation Update| 9 Pacific Island Countries and Areas (PICs) – COVID-19 cases There is no update for this reporting period. From 23 to 29 September 2024, two out of 21 PICs reported COVID-19 cases: Cook Islands and Commonwealth of the Northern Mariana Islands (Table 3). The 7-day rolling average of number of reported cases in 11 PICs has decreased since August 2024 (Figure 15). Table 3: Weekly and cumulative number of COVID-19 cases and deaths in PICs, 23 to 29 September 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Figure 15: Epidemic curve of COVID-19 in nine PICs since 1 January 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link ` COVID-19 Situation Update|10 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 ` COVID-19 Situation Update|11 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 ` COVID-19 Situation Update|12 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 ` COVID-19 Situation Update|13 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 ` COVID-19 Situation Update|14 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 test results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 ` COVID-19 Situation Update|15 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

Bi-weekly COVID-19 Situation Update 28 March 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 11, 2025 (the week ending on 16 March 2025), a total of 11 320 specimens tested for SARS- CoV-2 were submitted to FluNet from six countries and areas in the Western Pacific Region. The positivity rate was 1.97% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 11 of 2025 are presented in Table 1 below. Republic of Korea and Singapore reported an increase in their SARS-CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 11 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (11 of 2025) 2 000 3.27 ↓ Republic of Korea (11 of 2025) 345 10.43 ↑ Mongolia (11 of 2025) 208 0 - Singapore (11 of 2025) 168 8.93 ↑ COVID-19 Situation Update | 2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 27 March 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 48.5% and B.1.1.529 at 51.2% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. However, there is an increase of variant B.1.1.529 in the Region in recent weeks. The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. COVID-19 Situation Update | 3 Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 28 February 2025, 92 new severe COVID-19 cases and one death were reported from 31 provinces, autonomous regions and municipalities, and Xinjian Production and Construction Corps in China (Figure 3). Compared to January 2025 (163 severe cases and 4 deaths), severe cases and deaths have decreased. For this reporting period, the predominant circulating strain was XDV accounting for more than 68% of sequenced samples. Figure 3: Severe COVID-19 cases and deaths reported in China, February 2025 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) In week 9 2025 (3 to 24 February to 2 March 2025), a total of 21 790 new cases per sentinel site were reported. This is a slight decrease from the previous week where 29 869 new cases were reported (Figure 4). A slight increasingtrend was seen in the number of new hospitalisations reported from key sentinel sites nationwide with 1 994 new hospitalizations reported in week 9 2025 compared to 1 953 in week 8 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) COVID-19 Situation Update | 4 Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2025 (Source: Japan National Institute of Infectious Diseases) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 11 (the week ending on 15 March 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 10.4 %, a increase from 6.0% in the previous week (Table 2). COVID-19 associated hospital admissions have increased in the past few weeks, with 121 hospital admissions reported in week 11 of 2025 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 8-11 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency). COVID-19 Situation Update | 5 Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 30 of 2024-week 11 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 12 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 98 compared to 52 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was four compared to four in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 19 March 2025, JN.1 and its descendant lineages remained the most prevalent variant, comprising over 62% of all characterised specimens, where 60.2% belongs to the descendant strain KP.3. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update | 6 Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has decreased over the recent weeks, with 42 cases reported on 22 March 2025, compared to 53 cases on 15 March 2025 (Figure 9). COVID-19 related hospital admissions have slightly decreased, with the 7-day average of admissions recorded at 17 on 22 March 2025, compared to 39 on 15 March 2025 (Figure 10). Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of 23 March 2025, the country has reported 46 cases with no deaths, reflecting a 98% decrease compared to the same period in 2024 (3 000 cases, no deaths). After minimal fluctuations up to week 11, the trend has stabilized at a low level, with only three cases reported in week 12 (17–23 March 2025). COVID-19 Situation Update | 7 Figure 11: Number of weekly COVID-19 cases by region, as of week 12, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths The weekly number of cases has plateaued in the past three weeks, with 2 741 new cases reported in week 11 (10 to 16 March 2025). The overall trend of the number of deaths reported has decreased since early November 2024, with no death reported in week 11 (10 to 16 March 2025). Two new ICU admissions were reported in week 11 of 2025 (Figure 12). Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 11 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. COVID-19 Situation Update | 8 New Zealand – COVID-19 cases and deaths Number of COVID-19 cases in New Zealand has decreased in the past few weeks after a continued increase since November 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 1.14 cases on 23 March 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low at around 0.01 on 16 March 2025 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) COVID-19 Situation Update | 9 Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link COVID-19 Situation Update | 10 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 COVID-19 Situation Update | 11 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 COVID-19 Situation Update | 12 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 COVID-19 Situation Update | 13 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 COVID-19 Situation Update | 14 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 test results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 COVID-19 Situation Update | 15 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

Bi-weekly COVID-19 Situation Update 11 April 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 13, 2025 (the week ending on 30 March 2025), a total of 11 320 specimens tested for SARS- CoV-2 were submitted to FluNet from four countries and areas in the Western Pacific Region. The positivity rate was 3.2 % (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 13 of 2025 are presented in Table 1 below. Republic of Korea and Singapore reported an increase in their SARS-CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 14 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (13 of 2025) 1 243 2.0 ↓ Republic of Korea (13 of 2025) 431 11.37 ↑ Mongolia (13 of 2025) 150 0 - Singapore (13 of 2025) 1158 9.49 ↑ COVID-19 Situation Update| 2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 11 April 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 67% and B.1.1.529 at 33% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. However, there is an increase of variant B.1.1.529 in the Region in recent weeks. The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. COVID-19 Situation Update| 3 Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 28 February 2025, 92 new severe COVID-19 cases and one death were reported from 31 provinces, autonomous regions and municipalities, and Xinjian Production and Construction Corps in China (Figure 3). Compared to January 2025 (163 severe cases and 4 deaths), severe cases and deaths have decreased. For this reporting period, the predominant circulating strain was XDV accounting for more than 68% of sequenced samples. Figure 3: Severe COVID-19 cases and deaths reported in China, February 2025 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) In week 9 2025 (3 to 24 February to 2 March 2025), a total of 21 790 new cases per sentinel site were reported. This is a slight decrease from the previous week where 29 869 new cases were reported (Figure 4). A slight increasingtrend was seen in the number of new hospitalisations reported from key sentinel sites nationwide with 1 994 new hospitalizations reported in week 9 2025 compared to 1 953 in week 8 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2025 (Source: Japan Institute for Health Security) COVID-19 Situation Update| 4 Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2025 (Source: JapanInstitute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 14 (the week ending on 5 April 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 7.4 %, a decrease from 10.4% in the previous week (Table 2). COVID-19 associated hospital admissions have increased in the past few weeks, with 121 hospital admissions reported in week 11 of 2025 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 11-14 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency). COVID-19 Situation Update| 5 Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 30 of 2024-week 11 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 14 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 255 compared to 195 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was seven compared to three in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 2 April showed an increasing trend in the prevalence of XDV in Hong Kong, comprising 74% of all characterised specimens. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update| 6 Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has decreased over the recent weeks, with 30 cases reported on 5 April 2025, compared to 48 cases on 29 March 2025 (Figure 9). COVID-19 related hospital admissions have slightly decreased, with the 7-day average of admissions recorded at 48 on 29 March 2025, compared to 30 on 5 April 2025 (Figure 10). Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of 6 April 2025, the country has reported 62 cases with no deaths, a 98% decrease compared to the same period in 2024 (3 168 cases, no deaths). During week 14 (31 March to 6 April 2025), four cases were reported, including three cases from the Northern region and one from the Southern region - a 43% decline compared to the previous week (7 cases). COVID-19 Situation Update| 7 Figure 11: Number of weekly COVID-19 cases by region, as of week 14, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths The weekly number of cases has decreased in the past three weeks, with 2 434 new cases reported in week 14 (25 to 31 March 2025). The overall trend of the number of deaths reported has decreased since early November 2024, with no death reported in week 14 (25 to 31 March 2025). No new ICU admissions were reported in week 14 of 2025 (Figure 12). Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 14 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update| 8 New Zealand – COVID-19 cases and deaths Number of COVID-19 cases in New Zealand has decreased in the past few weeks after a continued increase since November 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 0.44 cases on 26 April 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low at around 1.02 on 6 April 2025 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) COVID-19 Situation Update| 9 Pacific Island Countries and Areas (PICs) – COVID-19 cases There is no update for this reporting period. From 23 to 29 September 2024, two out of 21 PICs reported COVID-19 cases: Cook Islands and Commonwealth of the Northern Mariana Islands (Table 3). The 7-day rolling average of number of reported cases in 11 PICs has decreased since August 2024 (Figure 15). Table 3: Weekly and cumulative number of COVID-19 cases and deaths in PICs, 23 to 29 September 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Figure 15: Epidemic curve of COVID-19 in nine PICs since 1 January 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link COVID-19 Situation Update|10 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 COVID-19 Situation Update|11 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 COVID-19 Situation Update|12 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 COVID-19 Situation Update|13 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 COVID-19 Situation Update|14 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 test results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 COVID-19 Situation Update|15 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

` COVID-19 Situation Update| 1 Bi-weekly COVID-19 Situation Update 25 April 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 15, 2025 (the week ending on 13 April 2025), a total of 34 226 specimens tested for SARS- CoV-2 were submitted to FluNet from ten countries and areas in the Western Pacific Region. The positivity rate was 4.5 % (Figure 1). The country and area-specific number of tests and calculated positivity rates in week 15 of 2025 are presented in Table 1 below. Hong Kong, SAR, China reported an increase in their SARS-CoV-2 positivity rate, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 15 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (15 of 2025) 1 243 2.0 ↓ Hong Kong SAR, China (15 of 2025) 24 688 4.83 ↑ Lao PDR (15 of 2025) 91 0 - Mongolia (15 of 2025) 536 0 - New Caledonia (15 of 2025) 77 2.60 - Papua New Guinea (15 of 2025) 43 4.65 - Philippines (15 of 2025) 55 0 - Singapore (15 of 2025) 389 11.05 ↓ Republic of Korea (15 of 2025) 1 304 11.73 ↓ VIet Nam (15 of 2025) 9 11.11 - COVID-19 Situation Update| 2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 25 April 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 53% and B.1.1.529 at 45.7% (Figure 2). JN.1 has been the dominant variant in the Region since January 2024. However, there is an increase of variant B.1.1.529 in the Region in recent weeks. The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 28 February 2025, 92 new severe COVID-19 cases and one death were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to January 2025 (163 severe cases and 4 deaths), severe cases and deaths have decreased. For this reporting period, the predominant circulating strain was XDV accounting for more than 68% of sequenced samples. COVID-19 Situation Update| 3 Figure 3: Severe COVID-19 cases and deaths reported in China, February 2025 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance) There is no update for this reporting period. In week 9 2025 (3 to 24 February to 2 March 2025), a total of 21 790 new cases per sentinel site were reported. This is a slight decrease from the previous week where 29 869 new cases were reported (Figure 4). A slight increasing trend was seen in the number of new hospitalizations reported from key sentinel sites nationwide with 1 994 new hospitalizations reported in week 9 2025 compared to 1 953 in week 8 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2025 (Source: Japan Institute for Health Security) Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2025 (Source: Japan Institute for Health Security) COVID-19 Situation Update| 4 Republic of Korea – COVID-19 cases (sentinel surveillance) In week 16 (the week ending on 19 April 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 7.7 %, a decrease from 10.8% in the previous week (Table 2). COVID-19 associated hospital admissions have slightly increased in the past few weeks, with 173 hospital admissions reported in week 16 of 2025 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 13-16 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency). Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 30 of 2024-week 16 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone Hong Kong SAR, China – laboratory-confirmed COVID-19 cases, severe cases, and deaths In week 16 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 593 compared to 391 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was seven compared to three in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 16 April 2025 KP.3 comprised 53.4% of all characterised specimens, while XDV accounted for 46.1%. COVID-19 Situation Update| 5 Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has increased over the recent weeks, with 81 cases reported on 19 April 2025, compared to 71 cases on 12 April 2025 (Figure 9). COVID-19 related hospital admissions have remained stable, with a 7-day average of 42 admissions recorded on both 12 April and 19 April 2025. (Figure 10). COVID-19 Situation Update| 6 Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths There is no update for this reporting period. As of 6 April 2025, the country has reported 62 cases with no deaths, a 98% decrease compared to the same period in 2024 (3 168 cases, no deaths). During week 14 (31 March to 6 April 2025), four cases were reported, including three cases from the Northern region and one from the Southern region - a 43% decline compared to the previous week (7 cases). Figure 11: Number of weekly COVID-19 cases by region, as of week 14, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths There is no update for this reporting period. The weekly number of cases has decreased in the past three weeks, with 2 434 new cases reported in week 14 (25 to 31 March 2025). The overall trend of the number of deaths reported has decreased since early November 2024, with no death reported in week 14 (25 to 31 March 2025). No new ICU admissions were reported in week 14 of 2025 (Figure 12). COVID-19 Situation Update| 7 Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 14 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. New Zealand – COVID-19 cases and deaths The number of COVID-19 cases in New Zealand has continued to decrease since December 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 0.74 cases on 21 April 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained low at around 0.005 on 14 April 2025 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) COVID-19 Situation Update| 8 Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Pacific Island Countries and Areas (PICs) – COVID-19 cases There is no update for this reporting period. From 23 to 29 September 2024, two out of 21 PICs reported COVID-19 cases: Cook Islands and Commonwealth of the Northern Mariana Islands (Table 3). The 7-day rolling average of number of reported cases in 11 PICs has decreased since August 2024 (Figure 15). Table 3: Weekly and cumulative number of COVID-19 cases and deaths in PICs, 23 to 29 September 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) ` COVID-19 Situation Update | 9 Figure 15: Epidemic curve of COVID-19 in nine PICs since 1 January 2024 (Source: Pacific COVID-19 Weekly Epidemiological Update, WHO Division of Pacific Technical Support) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link ` COVID-19 Situation Update | 10 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 ` COVID-19 Situation Update | 11 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 ` COVID-19 Situation Update | 12 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 ` COVID-19 Situation Update | 13 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 Pacific Island Countries and Areas Cook Islands Confirmed case: Laboratory definitive evidence, satisfying one of the following: • Detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR) • Detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing • Significant rise in IgG antibody level to SARS-CoV-2 between paired sera (when serological testing becomes available). Exhastive surveillance 15,16 Fiji Confirmed case: Meeting one of the following criteria: • A person with a positive RT-PCR or Gene Expert Test • A person with a positive SARS-CoV-2 Ag- RDT AND meeting either the probable case definition or suspected criteria • An asymptomatic contacts of a positive/probable case with a positive SARS- CoV-2 Ag-RDT COVID-19 test results are reported from multiple laboratories from multiple sites (sentinel and non-sentinel). 15 ` COVID-19 Situation Update | 14 Guam Confirmed case: Meeting one of the following confirmatory laboratory evidence • Detection of SARS-CoV-2 ribonucleic acid (RNA) in a post-mortem respiratory swab or clinical specimen using a diagnostic molecular amplification test performed by a Clinical Laboratory Improvement Amendments (CLIA)-certified provider, OR • Detection of SARS-CoV-2 by genomic sequencing COVID-19 test results are reported from multiple laboratories (non-sentinel) at varying times of the day. The Joint Information Center reports cumulative results once a day, unless available. 15, 17 ` COVID-19 Situation Update | 15 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn) 15. WHO Division of Pacific Technical Support (DPS) 16. Cook Islands, Ministry of Health. Surveillance and Testing Plan Coronavirus Disease 2019 (COVID-19) as of April 2021. Available from: https://www.health.gov.ck/wp- content/uploads/2021/07/TMO_SURVTESTPlan_COVID19_April-2021.pdf 17. Guam, Centers for Disease Control and Prevention. National Notificable Disases Surveillance System (NNDSS). Coronavirus Disease 2019 (COVID-19) 2021 Cases Definition. Available from: Coronavirus Disease 2019 (COVID-19) 2021 Case Definition | CDC

` COVID-19 Situation Update| 1 Bi-weekly COVID-19 Situation Update 9 May 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 17, 2025 (the week ending on 27 April 2025), a total of 10 559 specimens tested for SARS- CoV-2 were submitted to FluNet from eight countries and areas in the Western Pacific Region. The positivity rate was 8.1% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 16-17 are presented in Table 1 below. China, Hong Kong SAR and New Zealand reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2020-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 16-17 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (17 of 2025) 2 391 2.1 ↓ China, Hong Kong SAR (17 of 2025) 7 644 10.1 ↑ Cambodia (16 of 2025) 38 0 - Japan (17 of 2025) 4 100 - Republic of Korea (17 of 2025) 406 6.9 ↓ Lao PDR (17 of 2025) 36 0 - Mongolia (16 of 2025) 120 0 - New Caledonia (17 of 2025) 52 0 ↓ New Zealand (16 of 2025) 48 4.2 ↑ Papua New Guinea (17 of 2025) 2 0 - Philippines (17 of 2025) 24 0 ↓ Singapore (16 of 2025) 110 7.3 ↓ VIet Nam (16 of 2025) 8 25 ↓ COVID-19 Situation Update|2 objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Tracking SARS-CoV-2 variants in the Western Pacific Region As of 9 May 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 51.3% and B.1.1.529 at 48.3% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 31 March 2025, 131 new severe COVID-19 cases and seven deaths were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to February 2025 (92 severe cases and one deaths), severe cases and deaths have increased. As of week 13, the predominant circulating strain was XDV, accounting for over 87% of sequenced samples. COVID-19 Situation Update|3 Figure 3: Severe COVID-19 cases and deaths reported in China, March 2025 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance, monthly update) In week 14 of 2025 (from 31 March to 6 April 2025), a total of 10 132 new cases (2.14 cases per sentinel) were reported from all sentinel sites, a decrease from the 14 354 cases (2.92 cases per sentinel) in the previous week (Figure 4). Since the beginning of 2025, a decreasing trend has continued in the number of new hospitalizations reported from designated sentinel sites nationwide, with 1 118 new hospitalizations reported in week 14, compared to 1 336 in week 13 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2023-2025 (Source: Japan Institute for Health Security) COVID-19 Situation Update|4 Figure 5: Weekly number of hospitalizations reported from sentinel sites in Japan, 2023-2025 (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 18 (the week ending on 3 May 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 4.2 %, a decrease from 6.9% in the previous week (Table 2). COVID-19 associated hospital admissions have remained similar in the past two weeks, with 115 hospital admissions reported in week 18 of 2025 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 15-18 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency). COVID-19 Situation Update|5 Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 33 of 2024-week 18 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, labratory-confirmed COVID-19 cases, severe cases, and deaths In week 18 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 972, compared to 838 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was 31, compared to 16 in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 30 April 2025, XDV has become the most prevalent variant, comprising 91.3% of all characterised specimens, while KP.3 accounted for 8.2%. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update|6 Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has continued to increase over the recent weeks, with 114 cases reported on 3 May 2025, compared to 97 cases on 26 April 2025 (Figure 9). COVID-19 related hospital admissions have decreased in the past few weeks, with a 7-day average of 37 admissions recorded on 3 May, compared to 45 on 26 April 2025. (Figure 10). Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths There is no update for this reporting period. As of 6 April 2025, the country has reported 62 cases with no deaths, a 98% decrease compared to the same period in 2024 (3 168 cases, no deaths). During week 14 (31 March to 6 April 2025), four cases were reported, including three cases from the Northern region and one from the Southern region - a 43% decline compared to the previous week (7 cases). COVID-19 Situation Update|7 Figure 11: Number of weekly COVID-19 cases by region, as of week 14, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases, ICU admissions, and deaths There is no update for this reporting period. The weekly number of cases has decreased in the past three weeks, with 2 434 new cases reported in week 14 (25 to 31 March 2025). The overall trend of the number of deaths reported has decreased since early November 2024, with no death reported in week 14 (25 to 31 March 2025). No new ICU admissions were reported in week 14 of 2025 (Figure 12). Figure 12: COVID-19 confirmed cases, deaths and ICU cases, week 1 of 2024-week 14 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. The completeness of information on COVID-19 associated deaths varies, as data is sourced in different ways by state and territories based on their local surveillance system capabilities, definitions, priorities, and needs. Data should be interpreted with caution as the way states and territories source and report COVID-19 associated deaths has also changed throughout the pandemic and may continue to change further. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update|8 New Zealand – COVID-19 cases and deaths The number of COVID-19 cases in New Zealand has continued to decrease since December 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 0.94 cases on 3 May 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population remained very low at below 0.01 (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link COVID-19 Situation Update|9 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 COVID-19 Situation Update|10 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 COVID-19 Situation Update|11 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 COVID-19 Situation Update|12 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 COVID-19 Situation Update|13 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

Bi-weekly COVID-19 Situation Update 23 May 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region As of week 19, 2025 (the week ending on 11 May 2025), a total of 11 614 specimens tested for SARS- CoV-2 were submitted to FluNet from eight countries and areas in the Western Pacific Region. The positivity rate was 9.4% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 16-19 are presented in Table 1 below. Australia, Cambodia, China, Hong Kong SAR, Lao PDR, Singapore and New Zealand reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 16-19 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (19 of 2025) 2 379 3.7 ↑ China, Hong Kong SAR (17 of 2025) 8 468 11.4 ↑ Cambodia (16 of 2025) 80 2.5 ↑ Japan (19 of 2025) - - - Republic of Korea (19 of 2025) 218 2.8 ↓ Lao PDR (19 of 2025) 78 1.3 ↑ Mongolia (18 of 2025) 58 0 - New Caledonia (19 of 2025) 24 0 - New Zealand (18 of 2025) 39 10.2 ↑ Papua New Guinea (18 of 2025) 7 0 - Philippines (19 of 2025) 27 0 - Singapore (19 of 2025) 160 15.6 ↑ VIet Nam (16 of 2025) 8 25 ↓ COVID-19 Situation Update|2 objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Tracking SARS-CoV-2 variants in the Western Pacific Region As of 23 May 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: JN.1 at 58% and B.1.1.529 at 42% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. COVID-19 Situation Update|3 Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 31 March 2025, 131 new severe COVID-19 cases and seven deaths were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to February 2025 (92 severe cases and one deaths), severe cases and deaths have increased. As of week 13, the predominant circulating strain was XDV, accounting for over 87% of sequenced samples. Figure 3: Severe COVID-19 cases and deaths reported in China, March 2025 (Source: China National disease Control and Prevention Administration) Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 18 of 2025 (from 28 April to 4 May 2025), a total of 4 227 new cases (1.0 cases per sentinel) were reported from all sentinel sites, a decrease from the 5 360 cases (1.39 cases per sentinel) in the previous week (Figure 4). Since the beginning of 2025, a decreasing trend has continued in the number of new hospitalizations for COVID-19 reported from designated sentinel sites nationwide, with 591 new hospitalizations reported in week 18, compared to 578 in week 17 (Figure 5). Figure 4: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2024-2025 (Source: Japan Institute of Health Security) COVID-19 Situation Update|4 Figure 5: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 20 (the week ending on 17 May 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 8.6 %, an increase from 2.8% in the previous week (Table 2). COVID-19 associated hospital admissions have increased in the past two weeks, with 146 hospital admissions reported in week 20 of 2025 (Figure 6). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 17-20 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency). COVID-19 Situation Update|5 Figure 6: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 33 of 2024-week 19 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, labratory-confirmed COVID-19 cases, severe cases, and deaths In week 20 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 977, compared to 1 042 in the preceding week (Figure 7). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was 27, compared to 18 in the preceding week (Figure 8). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 14 May 2025, XDV has become the most prevalent variant, comprising 76.5% of all characterised specimens, while KP.3 accounted for 23.0%. Figure 7: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update|6 Figure 8: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has continued to increase in recent weeks, with 114 cases reported on 3 May 2025, compared to 97 cases on 26 April 2025 (Figure 9). COVID-19 related hospital admissions have decreased in the past few weeks, with a 7-day average of 37 admissions recorded on 3 May, compared to 45 on 26 April 2025. (Figure 10). Figure 9: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 10: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of 4 May 2025, the country has reported 143 cases with no deaths, a 95.8% decline compared to the same period in 2024 (3,374 cases, no deaths). During week 18 (28 April to 4 May 2025), 26 cases were reported, a 44% increase compared to the previous week (18 cases). COVID-19 Situation Update|7 Figure 11: Number of weekly COVID-19 cases by region, as of week 18, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has increased in the past three weeks, with 3 999 new cases reported in week 20 (6 May to 12 May 2025). (Figure 12). Figure 12: COVID-19 confirmed cases, week 1 of 2024- week 19 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update|8 New Zealand – COVID-19 cases and deaths The number of COVID-19 cases in New Zealand has continued to decrease since December 2024. The 7 day-moving average of daily cases per 100 000 population was recorded at 0.69 cases on 18 May 2025 (Figure 13). The 7-day moving average of daily attributed deaths per 100 000 population was 0.01 on 7 May 2025. (Figure 14). Figure 13: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 14: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link COVID-19 Situation Update|9 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. 3, 4, 5 COVID-19 Situation Update|10 (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 7, 8 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 9, 10 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection 11 COVID-19 Situation Update|11 of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 12 COVID-19 Situation Update|12 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 13,14 COVID-19 Situation Update|13 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 8. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 9. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 10. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 11. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 12. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 13. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 14. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

Bi-weekly COVID-19 Situation Update 06 June 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 21, 2025 (the week ending on 25 May 2025), a total of 11 989 specimens tested for SARS-CoV- 2 were submitted to FluNet from eight countries and areas in the Western Pacific Region. The positivity rate was 9.6% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 18-21 are presented in Table 1 below. Australia, Cambodia, Indonesia, Republic of Korea, Lao PDR Mongolia, Philippines Singapore and Viet Nam reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Note: Indonesia data is not included in this graph. Table 1: Weekly number of testing and positive rate reported to FluNet, week 18-21 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (21 of 2025) 2 731 5.1 ↑ China, Hong Kong SAR (21 of 2025) 8 869 11.1 ↓ Cambodia (20 of 2025) 88 12.5 ↑ Indonesia (21 of 2025) 68 4.4 ↑ Republic of Korea (21 of 2025) 319 8.8 ↑ Lao PDR (21 of 2025) 64 4.7 ↑ Mongolia (20 of 2025) 49 2.0 ↑ New Caledonia (19 of 2025) 24 0 - New Zealand (19 of 2025) 54 0 ↓ Papua New Guinea (22 of 2025) 29 0 - Philippines (20 of 2025) 24 8.3 ↑ Singapore (20 of 2025) 48 23.6 ↑ Viet Nam (18 of 2025) 5 40 ↑ COVID-19 Situation Update |2 Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Tracking SARS-CoV-2 variants in the Western Pacific Region As of 5 June 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: LP.8.1 at 25.6%, JN.1 at 21% and NB.1.8.1 at 19.6% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure. (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. COVID-19 Situation Update |3 Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 31 May 2025, 606 new severe COVID-19 cases and seven deaths (including 1 death from respiratory failure caused by COVID-19 infection and 6 deaths from underlying diseases combined with COVID-19 infection)were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to April 2025 (340 severe cases and nine deaths), the number of severe cases has increased, whereas death cases has decreased. As of 31 May, the main circulating strain is NB.1.8.1. According to the sampling date, week 19 (May 5-May 11) to the first 22 weeks (May 26 - June 1) the proportions of NB.1.8.1 were 85.3%, 88.4%, 92.1% and 91.9%, respectively. Figure Figure 3: Severe COVID-19 cases and deaths reported in China, May 2025 (Source: China National disease Control and Prevention Administration) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) As of epidemiological week 21 of 2025 (31 May 2025), Indonesia has reported 156 confirmed COVID-19 cases and zero deaths since January 2025. (Figure 4) Figure 4: COVID-19 cases and deaths Week 22 2024 – Week 21 2025 (Source: COVID-19 Dashboard, Emerging Infectious Disease Situation Ministry of Health of the Republic of Indonesia) Note : Konfirmasi= Confirmed; Meninggal= Deaths; and Sembuh=Recovered Death from respiratory failure caused by COVID-19 infection COVID-19 Situation Update |4 Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 20 of 2025 (from 12 May to 18 May 2025), a total of 3 694 new cases (1.02 cases per sentinel) were reported from all sentinel sites, an increase from the 3 604 cases (0.85 cases per sentinel) in the previous week (Figure 5). Since the beginning of 2025, a decreasing trend has continued in the number of new hospitalizations for COVID-19 reported from designated sentinel sites nationwide, with 449 new hospitalizations reported in week 20, compared to 591 in week 19 (Figure 6). Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site in Japan, 2024-2025 (Source: Japan Institute for Health Security) Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security Republic of Korea – COVID-19 cases (sentinel surveillance) In week 22 (the week ending on 31 May 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 7.7 %, a decrease from 8.8% in the previous week (Table 2). COVID-19 associated hospital admissions have decreased in the past two weeks, with 98 hospital admissions reported in week 21 of 2025 (Figure 7). COVID-19 Situation Update |5 Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 19-22 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency). Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 33 of 2024-week 21 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 22 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 644, compared to 846 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was 30, compared to 35 in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 28 May 2025, NB.1.8.1 has become the most prevalent variant, comprising 93.6% of all characterised specimens. COVID-19 Situation Update |6 Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The 7-day daily average of COVID-19 confirmed cases has continued to increase in recent weeks, with 307 cases reported on 31 May 2025, compared to 281 cases on 24 May 2025 (Figure 10). COVID-19 related hospital admissions have increased in the past few weeks, with a 7-day average of 36 admissions recorded on 31 May, compared to 29 on 24 May 2025. (Figure 11). Figure 10: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 11: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) COVID-19 Situation Update |7 Viet Nam - COVID-19 cases and deaths As of 18 May 2025, the country has reported 266 cases with no deaths, a 92.4% decline compared to the same period in 2024 (3,504 cases, no deaths). During week 20 (12 May to 18 May 2025), 93 cases were reported, a 3.1 times increase compared to the previous week (30 cases). Figure 12: Number of weekly COVID-19 cases by region, as of week 20, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has increased in the past three weeks, with 6 442 new cases reported in week 22 (20 May to 26 May 2025). (Figure 13). Figure 13: COVID-19 confirmed cases, week 1 of 2024- week 21 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update |8 New Zealand – COVID-19 cases and deaths Since 12 May 2025, there has been an increase in the number of COVID-19 cases. The 7 day-moving average of daily cases per 100 000 population was recorded at 2.2 cases on 2 June 2025 (Figure 14). The 7-day moving average of daily attributed deaths per 100 000 population was 0.01 on 2 June 2025. (Figure 15). Figure 14: 7-day moving average of daily cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 15: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link • LP.8.1 risk evaluation Link • NB.1.8.1 risk evaluation Link COVID-19 Situation Update |9 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes 3, 4, 5 Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 COVID-19 Situation Update |10 Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats. 2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report. 3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts. Our details reporting systems for Covid-19 present as follow: Data type Reporting system frequency Data uses Individual data New All Record (NAR) The system facilitates near real-time reporting for sentinel and non-sentinel sites; data from sentinel sites are typically reported in weekly pooled batches. Database center, but for sentinel sites also use as trend monitoring Aggregate data EWARS-IBS Weekly Trend monitoring 7, 8 COVID-19 Situation Update |11 Individual and aggregate EWARS-EBS Near-real time Alert and preparedness Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 9, 10 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 11, 12 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. 13 COVID-19 Situation Update |12 D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 15,16 COVID-19 Situation Update |13 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023 8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections. 9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

Bi-weekly COVID-19 Situation Update 20 June 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 23, 2025 (the week ending on 8 June 2025), a total of 11 473 specimens tested for SARS-CoV-2 were submitted to FluNet from six countries and areas in the Western Pacific Region. The positivity rate was 7.0% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 20-23 are presented in Table 1 below. Australia, Indonesia, Republic of Korea, Lao PDR, Mongolia, Singapore and Viet Nam reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 20-23 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (23 of 2025) 2 870 6.6 ↑ China, Hong Kong SAR (23 of 2025) 8 111 7.0 ↓ Cambodia (21 of 2025) 125 12.0 ↓ Indonesia (23 of 2025) 33 6.0 ↑ Republic of Korea (23 of 2025) 242 7.9 ↑ Lao PDR (23 of 2025) 66 7.6 ↑ Mongolia (20 of 2025) 49 2.0 ↑ New Caledonia (22 of 2025) 45 4.4 - Papua New Guinea (22 of 2025) 29 0 - Philippines (22 of 2025) 22 4.6 ↓ Singapore (23 of 2025) 151 19.9 ↑ Viet Nam (20 of 2025) 5 40.0 ↑ COVID-19 Situation Update|2 Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Tracking SARS-CoV-2 variants in the Western Pacific Region As of 13 June 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: B.1.1.529 at 28%, NB.1.8.1 and JN.1 each at 20%, XEC at 12%, KP3.1.1 and LP.8.1. each at 8%, and KP.3 at 4% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure. (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. COVID-19 Situation Update|3 Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 31 May 2025, 606 new severe COVID-19 cases and seven deaths (including 1 death from respiratory failure caused by COVID-19 infection and 6 deaths from underlying diseases combined with COVID-19 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to April 2025 (340 severe cases and nine deaths), the number of severe cases has increased, whereas death cases has decreased. As of 31 May, the main circulating strain is NB.1.8.1. According to the sampling date, week 19 (from 5 to 11 May) to the first 22 weeks (From 26 May to 1 June) the proportions of NB.1.8.1 were 85.3%, 88.4%, 92.1% and 91.9%, respectively. Figure Figure 3: Severe COVID-19 cases and deaths reported in China, May 2025 (Source: China National disease Control and Prevention Administration) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) As of epidemiological week 23 of 2025 (6 June 2025), Indonesia has reported 178 confirmed COVID-19 cases and zero deaths since January 2025. (Figure 4) Figure 4: COVID-19 cases and deaths Week 22 2024 – Week 21 2025 (Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health of the Republic of Indonesia) Note : Kasus= Confirmed; Kematian= Deaths Deaths from underlying conditions with COVID-19 co-infection Deaths from respiratory failure due to COVID-19 infection New severe cases COVID-19 Situation Update|4 Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 22 of 2025 (from 26 May to 1 June 2025), a total of 3 227 new cases (0.84 cases per sentinel) were reported from all sentinel sites, similar to 3 229 cases (0.84 cases per sentinel) reported in the previous week (Figure 5). Since the beginning of 2025, a decreasing trend has continued in the number of new COVID-19-related hospitalizations reported from designated sentinel sites nationwide, with 329 new hospitalizations reported in week 22, compared to 349 in week 21 (Figure 6). Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site, 2024-2025 Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security) (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 24 (the week ending on 14 June 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 9.9%, an increase from 7.9% in the previous week (Table 2). COVID-19 associated hospital admissions have remained similar in the past few weeks, with 93 hospital admissions reported in week 24 of 2025 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 21-24 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) COVID-19 Situation Update|5 Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 34 of 2024-week 24 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 24 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 287, compared to 438 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was 14, compared to 23 in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 11 June 2025, NB.1.8.1 has become the most prevalent variant, comprising 90.3% of all characterised specimens. Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update|6 Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) There is no update for this reporting period. The 7-day daily average of COVID-19 confirmed cases has continued to increase in recent weeks, with 307 cases reported on 31 May 2025, compared to 281 cases on 24 May 2025 (Figure 10). COVID-19 related hospital admissions have increased in the past few weeks, with a 7-day average of 36 admissions recorded on 31 May, compared to 29 on 24 May 2025. (Figure 11). Figure 10: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 11: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) COVID-19 Situation Update|7 Viet Nam - COVID-19 cases and deaths As of 15 June 2025, the country has reported 8 581 cases with no deaths, a 2.2 time higher compared to the same period in 2024 (3 897 cases, no deaths). During week 24 (9 to 15 June 2025), 2 664 cases were reported, a 16.5% decrease compared to the previous week (3 191 cases). Figure 12: Number of weekly COVID-19 cases by region, as of week 24, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to increase since week 17 of 2025, with 7 166 new cases reported in week 24. (Figure 13). Figure 13: COVID-19 confirmed cases, week 1 of 2024- week 24 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update|8 New Zealand – COVID-19 cases and deaths As of 14 June 2025, the number of COVID-19 cases has decreased in the past few weeks after seeing an increase since mid-May. The 7 day-moving average of daily cases per 100 000 population was recorded at 2.4 cases on 14 June 2025 (Figure 14). The 7-day moving average of daily attributed deaths per 100 000 population was 0.02 on 10 June 2025. (Figure 15). Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 15: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link • LP.8.1 risk evaluation Link • NB.1.8.1 risk evaluation Link COVID-19 Situation Update|9 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes 3, 4, 5 Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 COVID-19 Situation Update|10 Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats. 2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report. 3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts. Our details reporting systems for Covid-19 present as follow: Data type Reporting system frequency Data uses Individual data New All Record (NAR) The system facilitates near real-time reporting for sentinel and non-sentinel sites; data from sentinel sites are typically reported in weekly pooled batches. Database center, but for sentinel sites also use as trend monitoring Aggregate data EWARS-IBS Weekly Trend monitoring 7, 8 COVID-19 Situation Update|11 Individual and aggregate EWARS-EBS Near-real time Alert and preparedness Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 9, 10 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 11, 12 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. 13 COVID-19 Situation Update|12 D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 15,16 COVID-19 Situation Update|13 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023 8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections. 9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

` COVID-19 Situation Update| 1 Bi-weekly COVID-19 Situation Update 4 July 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 25, 2025 (the week ending on 22 June 2025), a total of 11 342 specimens tested for SARS-CoV- 2 were submitted to FluNet from six countries and areas in the Western Pacific Region. The positivity rate was 5.4% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 20-23 are presented in Table 1 below. Australia, Indonesia, Republic of Korea, Lao PDR, Mongolia, Singapore and Viet Nam reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 23-25 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (25 of 2025) 2 328 6.7 ↑ China, Hong Kong SAR (25 of 2025) 7 487 4.5 ↓ Cambodia (24 of 2025) 117 18.8 ↑ Indonesia (25 of 2025) 45 2.2 ↓ Republic of Korea (25 of 2025) 291 9.6 ↑ Lao PDR (25 of 2025) 54 18.5 ↑ Singapore (25 of 2025) 137 18.9 ↑ ` COVID-19 Situation Update|2 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Tracking SARS-CoV-2 variants in the Western Pacific Region As of 4 July 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: B.1.1.529 at 21%, NB.1.8.1 at 44%,JN.1 at 12%, XEC at 9%, KP3.1.1 and LP.8.1. each at 6%, and KP.3 at 1% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure. (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 31 May 2025, 606 new severe COVID-19 cases and seven deaths (including 1 death from respiratory failure caused by COVID-19 infection and 6 deaths from underlying diseases combined with COVID-19 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to April 2025 (340 severe cases and nine deaths), the number of severe cases has increased, whereas death cases has decreased. As of 31 May, the main circulating strain is NB.1.8.1. According to the sampling date, week 19 (from 5 to 11 May) to the first 22 weeks (From 26 May to 1 June) the proportions of NB.1.8.1 were 85.3%, 88.4%, 92.1% and 91.9%, respectively. ` COVID-19 Situation Update|3 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Figure Figure 3: Severe COVID-19 cases and deaths reported in China, May 2025 (Source: China National disease Control and Prevention Administration) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) As of epidemiological week 25 of 2025 (21 June 2025), Indonesia has reported 219 confirmed COVID- 19 cases and zero deaths since January 2025. (Figure 4) Figure 4: COVID-19 cases and deaths Week 1 – 25, 2025 (Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health of the Republic of Indonesia) Note : Kasus= Confirmed; Kematian= Deaths Deaths from underlying conditions with COVID-19 co-infection Deaths from respiratory failure due to COVID-19 infection New severe cases ` COVID-19 Situation Update|4 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 25 of 2025 (from 16 to 22 June 2025), a total of 3 841 new cases (1.0 cases per sentinel) were reported from all sentinel sites, increases from 3 455 cases (0.90 cases per sentinel) reported in the previous week (Figure 5). Since the beginning of 2025, a decreasing trend has continued in the number of new COVID-19-related hospitalizations reported from designated sentinel sites nationwide with 334 new hospitalizations reported in week 25, compared to 362 in week 24 (Figure 6). Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site, 2024-2025 (Source: Japan Institute for Health Security) Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 25 (the week ending on 21 June 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 9.6%, a small decrease from 9.9% in the previous week (Table 2). COVID- 19 associated hospital admissions have declined in the past few week, with 63 hospital admissions reported in week 25 of 2025 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 22-25 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) ` COVID-19 Situation Update|5 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 34 of 2024-week 25 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 26 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 264, compared to 250 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was 6, compared to 6 in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 25 June 2025, NB.1.8.1 remains the most prevalent variant, comprising 83.6% of all characterised specimens. Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) 0 200 400 600 800 1,000 1,200 1,400 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 W ee kl y C O VI D- 19 h os pi ta l a dm is si on s Weeks ` COVID-19 Situation Update|6 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) There is no update for this reporting period. The 7-day daily average of COVID-19 confirmed cases has continued to increase in recent weeks, with 307 cases reported on 31 May 2025, compared to 281 cases on 24 May 2025 (Figure 10). COVID-19 related hospital admissions have increased in the past few weeks, with a 7-day average of 34 admissions recorded on 31 May, compared to 29 on 24 May 2025. (Figure 11). Figure 10: COVID-19 confirmed cases in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Figure 11: COVID-19 hospital admissions in Malaysia by date, 2024-2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of 22 Jun 2025, Viet Nam has reported 11 677 COVID-19 cases from 57 out of 63 provinces/cities, including three (3) deaths. This is approx. three times higher than the data reported during the same period in 2024 (3 967 cases and no deaths). During week 25 (from 16 to 22 June 2025), a total of 1 970 cases were reported, with no deaths. This marks the second consecutive week of decline following a peak of 3 189 cases in week 23. ` COVID-19 Situation Update|7 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Figure 12: Number of weekly COVID-19 cases by region, as of week 24, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to increase since week 17 of 2025, with 8 333 new cases reported in week 25. (Figure 13). Figure 13: COVID-19 confirmed cases, week 1 of 2024- week 25 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. 0 2000 4000 6000 8000 10000 12000 14000 W ee kl y nu m be r o f c as es Weeks ` COVID-19 Situation Update|8 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update New Zealand – COVID-19 cases and deaths As of 3 July 2025, the number of COVID-19 cases has increased in the past eight weeks since May 2025. The 7 day-moving average of daily cases per 100 000 population was recorded at 2.5 cases on 29 June 2025 (Figure 14). The 7-day moving average of daily attributed deaths per 100 000 population was 0.02 on 22 June 2025. (Figure 15). Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 15: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others:  Report of the Review Committee regarding standing recommendations for COVID-19 Link  Tracking SARS-CoV-2 variants Link  JN.1 updated risk evaluation Link  LP.8.1 risk evaluation Link  NB.1.8.1 risk evaluation Link ` COVID-19 Situation Update|9 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence  Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence  Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests.  Have clinical manifestations associated with the 2019-nCoV infection;  Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes 3, 4, 5 Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 ` COVID-19 Situation Update|10 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats. 2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report. 3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts. Our details reporting systems for Covid-19 present as follow: Data type Reporting system frequency Data uses Individual data New All Record (NAR) The system facilitates near real-time reporting for sentinel and non-sentinel sites; data from sentinel sites are typically reported in weekly pooled batches. Database center, but for sentinel sites also use as trend monitoring Aggregate data EWARS-IBS Weekly Trend monitoring 7, 8 ` COVID-19 Situation Update|11 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update Individual and aggregate EWARS-EBS Near-real time Alert and preparedness Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 9, 10 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 11, 12 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. 13 ` COVID-19 Situation Update|12 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days  Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days  Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 15,16 ` COVID-19 Situation Update|13 Bi-weekly COVID-19 Situation Update 4 July 2025 Bi-weekly COVID-19 Situation Update References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023 8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections. 9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

Bi-weekly COVID-19 Situation Update 18 July 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 27, 2025 (the week ending on 6 July 2025), a total of 2 841 specimens tested for SARS-CoV-2 were submitted to FluNet from six countries and areas in the Western Pacific Region. The positivity rate was 6.69% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 26-27 are presented in Table 1 below. Japan, Republic of Korea, New Zealand and Singapore reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 26-27 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (27 of 2025) 2 286 5.42 ↓ Japan (27 of 2025) 82 20.73 ↑ Cambodia (26 of 2025) 109 7.34 ↓ Indonesia (27 of 2025) 34 5.88 ↓ Republic of Korea (27 of 2025) 2 841 6.69 ↑ Lao PDR (27 of 2025) 43 11.63 ↓ Singapore (27 of 2025) 135 18.52 ↑ China, Hong Kong SAR (26 of 2025) 7 532 4.05 ↓ New Zealand (26 of 2025) 120 2.5 ↑ COVID-19 Situation Update|2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 16 July 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: B.1.1.529 at 36.36%, NB.1.8.1 at 50%, JN.1 at 3.6%, XEC at 2.7%, KP3.1.1 at 4.09% and LP.8.1. at 3.18% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure. (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 30 June 2025, 384 new severe COVID-19 cases and eight deaths (all deaths from underlying diseases combined with COVID-19 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to May 2025 (606 severe cases and seven deaths), the number of severe cases has decreased, whereas death cases has increased. As of 30 June, the main circulating strain is NB.1.8.1. According to the sampling date, from the week 23 (from 2 to 8 June) to the week 26 (From 23 to 30 June) the proportions of NB.1.8.1 were 94.7%, 95.1%, 94.8% and 96.9%, respectively. COVID-19 Situation Update|3 Figure 3: Severe COVID-19 cases and deaths reported in China, June 2025 (Source: China National disease Control and Prevention Administration) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) As of epidemiological week 27 of 2025 (6 July 2025), Indonesia has reported 25 confirmed COVID-19 cases and zero deaths since January 2025. (Figure 4) Figure 4: COVID-19 cases and deaths Week 1 – 27, 2025 (Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health of the Republic of Indonesia) Note : Kasus= Confirmed; Kematian= Deaths M : epidemiological week COVID-19 Situation Update|4 Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 27 of 2025 (from 30 June to 6 July 2025), a total of 7 615 new cases (1.97 cases per sentinel) were reported from all sentinel sites, increases from 5 405 cases (1.41 cases per sentinel) reported in the previous week (Figure 5). Since the beginning of 2025, a decreasing trend has continued in the number of new COVID-19-related hospitalizations reported from designated sentinel sites nationwide with 616 new hospitalizations reported in week 27, compared to 485 in week 26 (Figure 6). Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site, 2024-2025 (Source: Japan Institute for Health Security) Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 28 (the week ending on 12 July 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 13%, an increase from 6.5% in the previous week (Table 2). COVID-19 associated hospital admissions have decreased compared to week 27, with 100 hospital admissions reported in week 28 of 2025 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 25-28 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) COVID-19 Situation Update|5 Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 36 of 2024-week 28 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 27 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 206, compared to 264 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was 6, compared to 6 in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 25 June 2025, NB.1.8.1 remains the most prevalent variant, comprising 83.6% of all characterised specimens. Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update|6 Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The weekly average of COVID-19 confirmed cases has continued to decrease in recent weeks, from 3 321 cases reported in week 27 to 2 895 cases in week 28, 2025 (Figure 10). Figure 10: COVID-19 confirmed cases in Malaysia by week, 2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of 29 Jun 2025, Viet Nam has reported 13 514 COVID-19 cases including three (3) deaths. This is approx. 3.2 times higher than the data reported during the same period in 2024 (4 235 cases and no deaths). During week 26 (from 23 to 29 June 2025), a total of 1 398 cases were reported, with no deaths. This is a 29.0% decline in comparison with the previous week (1 970 cases, no deaths). COVID-19 Situation Update|7 Figure 12: Number of weekly COVID-19 cases by region, as of week 26, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to decrease since week 25 of 2025, with 5 877 new cases reported in week 28. (Figure 13). Figure 13: COVID-19 confirmed cases, week 1 of 2024- week 25 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update|8 New Zealand – COVID-19 cases and deaths As of 17 July 2025, the number of COVID-19 cases has decreased since July 2025. The 7 day-moving average of daily cases per 100 000 population was recorded at 1.7 cases on 13 July 2025 (Figure 14). The 7-day moving average of daily attributed deaths per 100 000 population was 0.04 on 6 July 2025. (Figure 15). Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 15: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link COVID-19 Situation Update|9 • JN.1 updated risk evaluation Link • LP.8.1 risk evaluation Link • NB.1.8.1 risk evaluation Link COVID-19 Situation Update|10 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes 3, 4, 5 Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 COVID-19 Situation Update|11 Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats. 2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report. 3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts. Our details reporting systems for Covid-19 present as follow: Data type Reporting system frequency Data uses Individual data New All Record (NAR) The system facilitates near real-time reporting for sentinel and non-sentinel sites; data from sentinel sites are typically reported in weekly pooled batches. Database center, but for sentinel sites also use as trend monitoring Aggregate data EWARS-IBS Weekly Trend monitoring 7, 8 COVID-19 Situation Update|12 Individual and aggregate EWARS-EBS Near-real time Alert and preparedness Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 9, 10 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 11, 12 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. 13 COVID-19 Situation Update|13 D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 15,16 COVID-19 Situation Update|14 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023 8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections. 9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

Bi-weekly COVID-19 Situation Update 1 August 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 29, 2025 (the week ending on 6 July 2025), a total of 10 114 specimens tested for SARS-CoV-2 were submitted to FluNet from eight countries and areas in the Western Pacific Region. The positivity rate was 3.44% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 28-29 are presented in Table 1 below. Australia, Indonesia, Japan, New Zealand and Republic of Korea reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 28-29 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (29 of 2025) 2 147 4.89 ↑ Hong Kong SAR, China (29 of 2025) 7 522 2.30 ↓ Indonesia (29 of 2025) 19 10.53 ↑ Japan (29 of 2025) 59 32.2 ↑ Lao PDR (29 of 2025) 73 8.22 ↓ Mongolia (28 of 2025) 31 0.0 - New Zealand (28 of 2025) 54 3.70 ↑ Papua New Guinea (29 of 2025) 2 0.0 - Republic of Korea (29 of 2025) 261 16.48 ↑ Singapore (28 of 2025) 1 105 16.19 ↓ Viet Nam (28 of 2025) 3 0.0 - COVID-19 Situation Update | 2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 1 August 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: B.1.1.529 at 28.19%, NB.1.8.1 at 57.55%, JN.1 at 2.7%, XEC at 2.62%, KP3.1.1 at 4.56% and LP.8.1. at 1.7% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure. (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 30 June 2025, 384 new severe COVID-19 cases and eight deaths (all deaths from underlying diseases combined with COVID-19 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to May 2025 (606 severe cases and seven deaths), the number of severe cases has decreased, whereas death cases has increased. As of 30 June, the main circulating strain is NB.1.8.1. According to the sampling date, from the week 23 (from 2 to 8 June) to the week 26 (From 23 to 30 June) the proportions of NB.1.8.1 were 94.7%, 95.1%, 94.8% and 96.9%, respectively. COVID-19 Situation Update | 3 Figure 3: Severe COVID-19 cases and deaths reported in China, June 2025 (Source: China National disease Control and Prevention Administration) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) As of epidemiological week 29 of 2025 (27 July 2025), Indonesia has reported 15 confirmed COVID-19 cases and zero deaths since January 2025. (Figure 4) Figure 4: COVID-19 cases and deaths Week 1 – 29, 2025 (Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health of the Republic of Indonesia) Note : Konfirmasi= Confirmed; Kematian= Deaths M : epidemiological week Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 29 of 2025 (from 14 to 20 July 2025), a total of 12 069 new cases (1.13 cases per sentinel) were reported from all sentinel sites, increases from 9 263 cases (1.22 cases per sentinel) reported in the previous week (Figure 5). Since week 23, 2025, a increasing trend has continued in the number of new COVID-19-related hospitalizations reported from designated sentinel sites nationwide with 889 new hospitalizations reported in week 29, compared to 707 in week 28 (Figure 6). COVID-19 Situation Update | 4 Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site, 2024-2025 (Source: Japan Institute for Health Security) Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 30 (the week ending on 26 July 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 20.1%, an increase from 16.5% in the previous week (Table 2). COVID-19 associated hospital admissions have increased compared to week 29, with 139 hospital admissions reported in week 30 of 2025 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 27-30 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) COVID-19 Situation Update | 5 Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 36 of 2024-week 30 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 30 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 99, compared to 126 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was four, compared to two in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 23 July 2025, NB.1.8.1 remains the most prevalent variant, comprising 88.1% of all characterised specimens. Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update | 6 Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) There is no update for this reporting period. The weekly average of COVID-19 confirmed cases has continued to decrease in recent weeks, from 3 321 cases reported in week 27 to 2 895 cases in week 28, 2025 (Figure 10). Figure 10: COVID-19 confirmed cases in Malaysia by week, 2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths There is no update for this reporting period. As of 29 Jun 2025, Viet Nam has reported 13 514 COVID-19 cases including three (3) deaths. This is approx. 3.2 times higher than the data reported during the same period in 2024 (4 235 cases and no deaths). During week 26 (from 23 to 29 June 2025), a total of 1 398 cases were reported, with no deaths. This is a 29.0% decline in comparison with the previous week (1 970 cases, no deaths). COVID-19 Situation Update | 7 Figure 12: Number of weekly COVID-19 cases by region, as of week 26, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to decrease since week 30 of 2025, with 4 933 new cases reported in week 20. (Figure 13). Figure 13: COVID-19 confirmed cases, week 1 of 2024- week 25 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update | 8 New Zealand – COVID-19 cases and deaths As of 23 July 2025, the number of COVID-19 cases has decreased since July 2025. The 7 day-moving average of daily cases per 100 000 population was recorded at 1.1 cases on 28 July 2025 (Figure 14). The 7-day moving average of daily attributed deaths per 100 000 population was 0.01 on 14 July 2025. (Figure 15). Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 15: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link • LP.8.1 risk evaluation Link • NB.1.8.1 risk evaluation Link COVID-19 Situation Update | 9 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes 3, 4, 5 Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 COVID-19 Situation Update | 10 Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats. 2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report. 3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts. Our details reporting systems for Covid-19 present as follow: Data type Reporting system frequency Data uses Individual data New All Record (NAR) The system facilitates near real-time reporting for sentinel and non-sentinel sites; data from sentinel sites are typically reported in weekly pooled batches. Database center, but for sentinel sites also use as trend monitoring Aggregate data EWARS-IBS Weekly Trend monitoring 7, 8 COVID-19 Situation Update | 11 Individual and aggregate EWARS-EBS Near-real time Alert and preparedness Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 9, 10 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 11, 12 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. 13 COVID-19 Situation Update | 12 D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 15,16 COVID-19 Situation Update | 13 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023 8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections. 9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

Bi-weekly COVID-19 Situation Update 15 August 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 31, 2025 (the week ending on 3 August 2025), a total of 11 014 specimens tested for SARS-CoV- 2 were submitted to FluNet from ten countries and areas in the Western Pacific Region. The positivity rate was 2.61% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 30-31 are presented in Table 1 below. Japan and Republic of Korea reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 30-31 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (31 of 2025) 2 569 2.92 ↓ Hong Kong SAR, China (31 of 2025) 7 764 1.40 ↓ Indonesia (31 of 2025) 35 5.71 ↓ Japan (31 of 2025) 69 43.48 ↑ Lao PDR (31 of 2025) 50 8.00 ↓ New Caledonia (31 of 2025) 44 2.27 ↓ New Zealand (31 of 2025) 80 0.00 ↓ Republic of Korea (31 of 2025) 275 22.55 ↑ Singapore (31 of 2025) 127 3.94 ↓ Viet Nam (31 of 2025) 1 0.0 - COVID-19 Situation Update |2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 14 August 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: B.1.1.529 at 14.29%, NB.1.8.1 at 78.57%, and KP3.1.1 at 7.14% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure. (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) From 1 to 31 July 2025, 219 new severe COVID-19 cases and two deaths (all deaths from underlying diseases combined with COVID-19 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to June 2025 (384 severe cases and eightdeaths), both the number of severe cases and the number of deaths have decreased. As of 3 August, the main circulating strain is NB.1.8.1. According to the sampling date, from the week 27 (from 30 June to 6 July) to the week 31 (From 28 July to 3 August) the proportions of NB.1.8.1 were 96.3%, 96.4%, 96.7%, 97.1% and 95.2%, respectively. COVID-19 Situation Update |3 Figure 3: Severe COVID-19 cases and deaths reported in China, July 2025 (Source: China National disease Control and Prevention Administration) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) As of epidemiological week 31 of 2025 (3 August 2025), Indonesia has reported 18 confirmed COVID- 19 cases and zero deaths since January 2025. (Figure 4) Figure 4: COVID-19 cases and deaths Week 1 – 31, 2025 (Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health of the Republic of Indonesia) Note : Konfirmasi= Confirmed; Kematian= Deaths M : epidemiological week COVID-19 Situation Update |4 Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 31 of 2025 (from 28 July to 3 Aug 2025), a total of 21,365 new cases (5.53 cases per sentinel) were reported from all sentinel sites, increases from 15 924 cases (4.12 cases per sentinel) reported in the previous week (Figure 5). Since week 23, 2025, a increasing trend has continued in the number of new COVID-19-related hospitalizations reported from designated sentinel sites nationwide with 1 501 new hospitalizations reported in week 31, compared to 1 187 in week 30 (Figure 6). Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site, 2024-2025 (Source: Japan Institute for Health Security) Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 32 (the week ending on 9 August 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 32.0%, an increase from 22.5% in the previous week (Table 2). COVID-19 associated hospital admissions have increased compared to week 31, with 272 hospital admissions reported in week 32 of 2025 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 29-32 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) COVID-19 Situation Update |5 Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 36 of 2024-week 30 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 32 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 70, compared to 76 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was three, compared to four in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 6 August 2025, NB.1.8.1 remains the most prevalent variant, comprising 81.1% of all characterised specimens. Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update |6 Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) There is no update for this reporting period. The weekly average of COVID-19 confirmed cases has continued to decrease in recent weeks, from 3 321 cases reported in week 27 to 2 895 cases in week 28, 2025 (Figure 10). Figure 10: COVID-19 confirmed cases in Malaysia by week, 2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths There is no update for this reporting period. As of 29 Jun 2025, Viet Nam has reported 13 514 COVID-19 cases including three (3) deaths. This is approx. 3.2 times higher than the data reported during the same period in 2024 (4 235 cases and no deaths). During week 26 (from 23 to 29 June 2025), a total of 1 398 cases were reported, with no deaths. This is a 29.0% decline in comparison with the previous week (1 970 cases, no deaths). COVID-19 Situation Update |7 Figure 12: Number of weekly COVID-19 cases by region, as of week 26, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to decrease since week 26 of 2025, with 4 065 new cases reported in week 32. (Figure 13). Figure 13: COVID-19 confirmed cases, week 1 of 2024- week 32 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update |8 New Zealand – COVID-19 cases and deaths As of 9 August 2025, the number of COVID-19 cases has decreased since July 2025. The 7 day-moving average of daily cases per 100 000 population was recorded at 1.03 cases on 9 August 2025 (Figure 14). The 7-day moving average of daily attributed deaths per 100 000 population was 0.01 on 14 July 2025. (Figure 15). Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 15: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link • LP.8.1 risk evaluation Link • NB.1.8.1 risk evaluation Link COVID-19 Situation Update |9 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes 3, 4, 5 Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 COVID-19 Situation Update |10 Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats. 2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report. 3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts. Our details reporting systems for Covid-19 present as follow: Data type Reporting system frequency Data uses Individual data New All Record (NAR) The system facilitates near real-time reporting for sentinel and non-sentinel sites; data from sentinel sites are typically reported in weekly pooled batches. Database center, but for sentinel sites also use as trend monitoring Aggregate data EWARS-IBS Weekly Trend monitoring 7, 8 COVID-19 Situation Update |11 Individual and aggregate EWARS-EBS Near-real time Alert and preparedness Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 9, 10 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 11, 12 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. 13 COVID-19 Situation Update |12 D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 15,16 COVID-19 Situation Update |13 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023 8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections. 9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

Bi-weekly COVID-19 Situation Update 29 August 2025 SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 33, 2025 (the week ending on 17 August 2025), a total of 10 783 specimens tested for SARS-CoV-2 were submitted to FluNet from twelve countries and areas in the Western Pacific Region. The positivity rate was 2.56% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 32-33 are presented in Table 1 below. Hong Kong SAR, China, Indonesia, Philippines, and Singapore reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here. Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025 (Source: GISRS surveillance data reported to FluNet) Table 1: Weekly number of testing and positive rate reported to FluNet, week 32-33 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard) Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources. Countries and areas (most recent week of data) Number of testing for SARS-CoV-2 SARS-CoV-2 positivity rate (%) Trend Australia (33 of 2025) 2 278 2.68 ↓ Hong Kong SAR, China (33 of 2025) 7 913 1.50 ↑ Indonesia (33 of 2025) 35 14.29 ↑ Japan (33 of 2025) 37 13.51 ↓ Lao PDR (33 of 2025) 70 2.86 ↓ Mongolia (33 of 2025) 16 0.00 - New Caledonia (33 of 2025) 25 0.00 ↓ New Zealand (31 of 2025) 80 0.00 ↓ Papua New Guinea (33 of 2025) 3 0.00 - Philippines (33 of 2025) 40 5.00 ↑ Republic of Korea (33 of 2025) 235 31.49 ↓ Singapore (33 of 2025) 127 6.30 ↑ Viet Nam (33 of 2025) 4 0.0 - COVID-19 Situation Update |2 Tracking SARS-CoV-2 variants in the Western Pacific Region As of 28 August 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: NB.1.8.1 at 46.33%, B.1.1.529 at 45.45%, and JN.1 at 3.23% (Figure 2). The country- and area- specific data are available below for certain countries and areas where the information is routinely updated. Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure. (Source: GISAID hCoV-19 Variants Dashboard) COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1. Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 31 July 2025, 219 new severe COVID-19 cases and two deaths (all deaths from underlying diseases combined with COVID-19 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to June 2025 (384 severe cases and eight deaths), both the number of severe cases and the number of deaths have decreased. As of 6 August, the main circulating strain is NB.1.8.1. According to the sampling date, from the week 27 (from 30 June to 6 July) to the week 31 (From 28 July to 3 August) the proportions of NB.1.8.1 were 96.3%, 96.4%, 96.7%, 97.1% and 95.2%, respectively. COVID-19 Situation Update |3 Figure 3: Severe COVID-19 cases and deaths reported in China, July 2025 (Source: China National disease Control and Prevention Administration) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) As of epidemiological week 33 of 2025 (17 August 2025), Indonesia has reported 10 confirmed COVID- 19 cases and zero deaths since January 2025. (Figure 4) Figure 4: COVID-19 cases and deaths Week 1 – 33, 2025 (Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health of the Republic of Indonesia) Note : Konfirmasi= Confirmed; Kematian= Deaths M : epidemiological week Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 33 of 2025 (from 11 to 17 August 2025), a total of 22 288 new cases were reported, a decrease from 23 126 cases in week 32. However, the average number of cases per sentinel site increased to 6.30, compared to 6.13 in the previous week (Figure 5). Since week 23, there has been a continued upward trend in new COVID-19-related hospitalizations reported from designated sentinel sites nationwide, with 1 904 new hospitalizations reported in week 33, compared to 1 729 in week 32 (Figure 6). COVID-19 Situation Update |4 Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site, 2024-2025 (Source: Japan Institute for Health Security) Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025 (Source: Japan Institute for Health Security) Republic of Korea – COVID-19 cases (sentinel surveillance) In week 34 (the week ending on 23 August 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 32.6%, an increase from 31.5% in the previous week (Table 2). COVID-19 associated hospital admissions have increased compared to week 33, with 367 hospital admissions reported in week 34 of 2025 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 31-34 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency) COVID-19 Situation Update |5 Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 34 of 2024-week 34 of 2025 (Source: Korea Disease Control and Prevention Agency) Countries/areas in the tropical zone China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 34 of 2025, the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 75, compared to 91 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was two, compared to five in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 20 August 2025, NB.1.8.1 remains the most prevalent variant, comprising 53.7% of all characterised specimens. Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection) COVID-19 Situation Update |6 Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection) Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) The weekly average of COVID-19 confirmed cases has continued to decrease in recent weeks, from 1 023 cases reported in week 32 to 735 cases in week 33, 2025 (Figure 10). Figure 10: COVID-19 confirmed cases in Malaysia by week, 2025 (Source: Ministry of Health Malaysia) Viet Nam - COVID-19 cases and deaths As of 17 August 2025, Viet Nam reported 12 519 COVID-19 cases, including three deaths in 2025. Compared to the same period in 2024 (6 639 cases including one death), this represents a 1.89-fold increase in cases and two additional deaths in 2025. During week 33 (from 11 to 17 August 2025), 37 cases were reported, with no deaths. This marks a 50% decrease from the previous week’s 74 cases. COVID-19 Situation Update |7 Figure 12: Number of weekly COVID-19 cases by region, as of week 33, 2025, Viet Nam (Source: General Department of Preventive Medicine, Ministry of Health, Viet Nam) Notes: Data reporting data might be delayed or updated; recent data will be subject to revision. Countries in the temperate zone of the southern hemisphere Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to decrease since week 26 of 2025, with 3 939 new cases reported in week 34. (Figure 13). Figure 13: COVID-19 confirmed cases, week 1 of 2024- week 34 of 2025 (Source: International Health Regulations (IHR) National Focal Point, Australia) Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories. COVID-19 Situation Update |8 New Zealand – COVID-19 cases and deaths As of 23 August 2025, the number of COVID-19 cases has decreased since July 2025. The 7 day-moving average of daily cases per 100 000 population was recorded at 0.72 cases on 23 August 2025 (Figure 14). The 7-day moving average of daily attributed deaths per 100 000 population was 0.01 on 14 July 2025. (Figure 15). Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Figure 15: 7-day moving average of daily COVID-19 attributed deaths per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand) Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others: • Report of the Review Committee regarding standing recommendations for COVID-19 Link • Tracking SARS-CoV-2 variants Link • JN.1 updated risk evaluation Link • LP.8.1 risk evaluation Link • NB.1.8.1 risk evaluation Link COVID-19 Situation Update |9 Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region Countries/areas Case definition Surveillance system description Reference Case surveillance Australia Confirmed case: Newly diagnosed cases with laboratory definitive evidence • Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination. Probable case: Individuals who have laboratory suggestive evidence • Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT). COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024. 1, 2 China Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests. • Have clinical manifestations associated with the 2019-nCoV infection; • Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase. COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes 3, 4, 5 Hong Kong SAR, China Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests (Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date. 6 COVID-19 Situation Update |10 Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats. 2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report. 3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts. Our details reporting systems for Covid-19 present as follow: Data type Reporting system frequency Data uses Individual data New All Record (NAR) The system facilitates near real-time reporting for sentinel and non-sentinel sites; data from sentinel sites are typically reported in weekly pooled batches. Database center, but for sentinel sites also use as trend monitoring Aggregate data EWARS-IBS Weekly Trend monitoring 7, 8 COVID-19 Situation Update |11 Individual and aggregate EWARS-EBS Near-real time Alert and preparedness Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported. 9, 10 Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter. 11, 12 Malaysia Suspected case: one of the following options A. A person who meets the clinical AND epidemiological criteria B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization); C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag) Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics. SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted. 13 COVID-19 Situation Update |12 D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular, and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting either the probable case definition or suspected criteria (A) or (B) C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case New Zealand Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting. Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days • Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified. Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths. 14 Viet Nam Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches; fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath. b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a positive SARS-CoV-2 rapid test kit antigen Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis. 15,16 COVID-19 Situation Update |13 References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list 2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/ 3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml 4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml 5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html 6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html 7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023 8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections. 9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html 10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html 11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es 12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do 13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my). 14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition 15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn) 16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

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Bi-weekly COVID-19 Situation Update 12 September 2025

SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 35, 2025 (the week ending on 31 August 2025), a total of 11 494 specimens tested for SARS- CoV-2 were submitted to FluNet from 10 countries and areas in the Western Pacific Region. The positivity rate was 3.0% (Figure 1). The country- and area-specific number of tests and calculated positivity rates in week 34-35 are presented in Table 1 below. Australia, Indonesia, Japan, and Republic of Korea reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here.

Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025

(Source: GISRS surveillance data reported to FluNet)

Table 1: Weekly number of testing and positive rate reported to FluNet, week 34-35 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard)

Countries and areas

(most recent week of data)

Number of testing

for SARS-CoV-2

SARS-CoV-2

positivity rate (%) Trend

Australia (35 of 2025) 2 338 2.1 ↑

Cambodia (34 of 2025) 119 1.7 -

China, Hong Kong SAR (35 of 2025) 8 458 1.3 ↓

Indonesia (35 of 2025) 40 7.5 ↑

Japan (35 of 2025) 79 46.8 ↑

Lao PDR (35 of 2025) 40 2.5 -

Mongolia (35 of 2025) 9 0.0 -

Papua New Guinea (34 of 2025) 10 0.0 -

Philippines (35 of 2025) 22 0.0 -

Republic of Korea (35 of 2025) 369 37.7 ↑

Singapore (35 of 2025) 138 5.1 ↓

Viet Nam (35 of 2025) 1 0.0 -

https://www.who.int/initiatives/global-influenza-surveillance-and-response-system https://www.who.int/initiatives/global-influenza-surveillance-and-response-system https://www.who.int/tools/flunet https://app.powerbi.com/view?r=eyJrIjoiNzc4YTIxZjQtM2E1My00YjYxLWIxMDItNzEzMjkyY2E1MzU1IiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 https://app.powerbi.com/view?r=eyJrIjoiNzdjZTVmY2YtNzY2NC00NTM0LTkzY2QtMWM0MzY0Mjg0YTZjIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9

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Bi-weekly COVID-19 Situation Update 12 September 2025

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Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources.

Tracking SARS-CoV-2 variants in the Western Pacific Region As of 11 September 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: NB.1.8.1 at 58.7%, B.1.1.529 at 23.3%, KP.3.1.1 at 11.0%, and JN.1 at 3.8% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated.

Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure.

(Source: GISAID hCoV-19 Variants Dashboard)

COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries.

In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1.

Countries in the temperate zone of the Northern Hemisphere

China – severe cases and deaths (monthly update) From 1 to 31 August 2025, 187 new severe COVID-19 cases and seven deaths (all deaths from underlying diseases combined with SARS-CoV-2 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to July 2025 (219 severe cases and two deaths), the number of severe cases has decreased while the number of deaths has increased. For the same reporting period,

https://gisaid.org/hcov-19-variants-dashboard/ https://www.chinacdc.cn/jksj/xgbdyq/

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Bi-weekly COVID-19 Situation Update 12 September 2025

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the main circulating strain is NB.1.8.1. According to the sampling date, NB.1.8.1 accounted for 97.5%, 97.8%, 98.2%, and 95.2% of sequenced samples, from week 32 to 35, respectively.

Figure 3: Severe COVID-19 cases and deaths reported in China, August 2025 (Source: China National disease Control and Prevention Administration)

Indonesia - cases and deaths (sentinel and non-sentinel surveillance) In epidemiological week 35 of 2025 (from 25 to 31 August), Indonesia reported seven new confirmed COVID-19 cases with no death. Since the beginning of 2025, a total of 367 confirmed cases have been reported, including no deaths, indicating a low-level of transmission in the country (Figure 4).

Figure 4: COVID-19 cases and deaths, as of week 35, 2025

(Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health, Indonesia)

Note : Konfirmasi= Confirmed, Kematian= Deaths, M= epidemiological week

Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 34 of 2025 (from 18 to 24 August 2025), a total of 33 275 new cases were reported, an increase from 22 288 cases in week 33. The average number of cases per sentinel site increased to 8.73, compared to 6.30 in the previous week (Figure 5). Since week 23, there has been a continued upward trend in new COVID-19-related hospitalizations reported from designated sentinel sites nationwide, with 2 364 new hospitalizations reported in week 34, compared to 1 904 in week 33 (Figure 6).

https://www.chinacdc.cn/jksj/xgbdyq/ https://infeksiemerging.kemkes.go.id/dashboard/covid-19 https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html

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Bi-weekly COVID-19 Situation Update 12 September 2025

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Figure 5: Weekly number of COVID-19 cases reported per sentinel hospital site, 2024-2025

(Source: Japan Institute for Health Security)

Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025

(Source: Japan Institute for Health Security)

Republic of Korea – COVID-19 cases (sentinel surveillance) In week 36 (the week ending on 6 September 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 39.0%, an increase from 37.7% in the previous week (Table 2). COVID-19 associated hospital admissions have increased since week 28, with 433 hospital admissions reported in week 36 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 33-36 of 2025

(Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency)

https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html https://dportal.kdca.go.kr/pot/bbs/BD_selectBbsList.do?q_bbsSn=1010&q_bbsDocNo=&q_clsfNo=2&q_searchKeyTy=&q_searchVal=&q_currPage=1&q_sortName=&q_sortOrder= https://dportal.kdca.go.kr/pot/bbs/BD_selectBbsList.do?q_bbsSn=1010&q_bbsDocNo=&q_clsfNo=2&q_searchKeyTy=&q_searchVal=&q_currPage=1&q_sortName=&q_sortOrder= https://www.phwr.org/journal/archives_Supple.html

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Bi-weekly COVID-19 Situation Update 12 September 2025

Bi-weekly COVID-19 Situation Update

Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 36 of 2024-week 36 of 2025 (Source: Korea Disease Control and Prevention Agency)

Countries/areas in the tropical zone

China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths

In week 36 of 2025 (from 31 August to 6 September), the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 59, compared to 96 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was three, compared to four in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 3 September 2025, NB.1.8.1 remains the most prevalent variant, comprising 76.4% of all characterised specimens.

Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025 (Source: Hong Kong Centre for Health Protection)

https://dportal.kdca.go.kr/pot/is/st/ari.do https://www.chp.gov.hk/en/resources/29/100148.html https://www.chp.gov.hk/en/resources/29/100148.html

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Bi-weekly COVID-19 Situation Update 12 September 2025

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Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection)

Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) There is no update for this reporting period. The weekly average of COVID-19 confirmed cases has continued to decrease in recent weeks, from 1 023 cases reported in week 32 to 735 cases in week 33, 2025 (Figure 10).

Figure 10: COVID-19 confirmed cases in Malaysia by week 33, 2025 (Source: Ministry of Health Malaysia)

Viet Nam - COVID-19 cases and deaths As of 31 August 2025, Viet Nam recorded 12 564 COVID-19 cases, including three deaths in 2025. Compared to the same period in 2024 (6 886 cases including one death), this represents an 82.5% increase in cases and two additional deaths in 2025. During week 35 (from 25 to 31 August 2025), 13

https://www.chp.gov.hk/en/resources/29/100148.html https://data.moh.gov.my/dashboard/covid-19 https://data.moh.gov.my/dashboard/covid-19

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Bi-weekly COVID-19 Situation Update 12 September 2025

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cases were reported, with no deaths. This marks a 56.7% decrease, compared to the previous week (30 cases with no deaths).

Figure 12: Number of weekly reported COVID-19 cases by region, as of week 35 of 2025, Viet Nam (Source: Viet Nam Administration of Disease Preventino (VADP), Ministry of Health, Viet Nam)

Notes: Data reporting might be delayed or updated; recent data will be subject to revision.

Countries in the temperate zone of the southern hemisphere

Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to decrease since week 26 of 2025, with 3 281 new cases reported in week 36 (the week starting on 1 September). (Figure 13).

Figure 13: COVID-19 confirmed cases, week 36 of 2024- week 36 of 2025

(Source: National International Health Regulations (IHR) Focal Point, Australia)

Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia.

New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which

integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories.

https://www.health.gov.au/topics/covid-19/reporting https://www.health.gov.au/our-work/nndss#:~:text=The%20National%20Notifiable%20Diseases%20Surveillance,the%20impact%20of%20these%20diseases.

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Bi-weekly COVID-19 Situation Update 12 September 2025

Bi-weekly COVID-19 Situation Update

New Zealand – COVID-19 cases and deaths The number of COVID-19 cases has decreased since July 2025. The 7 day-moving average of daily cases per 100 000 population was recorded at 0.81 cases on 7 September 2025 (Figure 14). The 7-day moving average of daily attributed hospital admissions per 100 000 population was 0.24 on 31 August 2025. (Figure 15).

Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand)

Figure 15: 7-day moving average of daily COVID-19 attributed hospital admissions per 100 000 population in New Zealand, 2024-2025

(Source: Te Whatu Ora, Health New Zealand)

Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others:

• Report of the Review Committee regarding standing recommendations for COVID-19 Link

• Tracking SARS-CoV-2 variants Link

• JN.1 updated risk evaluation Link

• LP.8.1 risk evaluation Link

• NB.1.8.1 risk evaluation Link

https://tewhatuora.shinyapps.io/covid19/ https://tewhatuora.shinyapps.io/covid19/ https://tewhatuora.shinyapps.io/covid19/ https://tewhatuora.shinyapps.io/covid19/ https://app.powerbi.com/view?r=eyJrIjoiNzdjZTVmY2YtNzY2NC00NTM0LTkzY2QtMWM0MzY0Mjg0YTZjIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports https://data.who.int/dashboards/covid19/cases?n=c https://www.who.int/publications/m/item/report-of-the-review-committee-regarding-standing-recommendations-for-covid-19 https://www.who.int/activities/tracking-SARS-CoV-2-variants https://www.who.int/docs/default-source/coronaviruse/15042024_jn1_ure.pdf?sfvrsn=8bd19a5c_7 https://www.who.int/publications/m/item/risk-evaluation-for-sars-cov-2-variant-under-monitoring-lp81 https://cdn.who.int/media/docs/default-source/documents/epp/tracking-sars-cov-2/23052025_nb.1.8.1_ire.pdf?sfvrsn=7b14df58_4

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Bi-weekly COVID-19 Situation Update 12 September 2025

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Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region

Countries/areas Case definition Surveillance system description

Reference Case surveillance

Australia

Confirmed case: Newly diagnosed cases with laboratory definitive evidence

• Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination.

Probable case: Individuals who have laboratory suggestive evidence

• Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT).

COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024.

1, 2

China

Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests.

• Have clinical manifestations associated with the 2019-nCoV infection;

• Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase.

COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes

3, 4, 5

Hong Kong SAR, China

Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests

(Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date.

6

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Bi-weekly COVID-19 Situation Update 12 September 2025

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Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test

COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health

Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats.

2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report.

3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts.

Our details reporting systems for Covid-19 present as follow:

Data type Reporting system

frequency Data uses

Individual data

New All Record (NAR)

The system facilitates near

real-time reporting for sentinel and

non-sentinel sites; data from sentinel sites are typically

reported in weekly pooled batches.

Database center, but for sentinel sites also use as

trend monitoring

Aggregate data

EWARS-IBS Weekly Trend monitoring

7, 8

https://infeksiemerging.kemkes.go.id/category/situasi-mingguan-infem

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Bi-weekly COVID-19 Situation Update 12 September 2025

Bi-weekly COVID-19 Situation Update

Individual and

aggregate

EWARS-EBS Near-real time Alert and preparedness

Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test

COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Update as of 7 April 2025) With revision

of the sentinel surveillance criteria, influenza and COVID-19 case surveillance has been shifted to acute respiratory infection surveillance (ARI surveillance) with approximately 3 000 medical institutions. Sentinel sites for hospitalizations remain unchanged. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported.

9, 10

Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT

COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter.

11, 12

Malaysia

Suspected case: one of the following options A. A person who meets the clinical AND epidemiological

criteria B. A patient with severe acute respiratory illness (SARI: acute

respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization);

C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag)

Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact

of a probable or confirmed case or is linked to a COVID-19 cluster

COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health

clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics.

13

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B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease

C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause

D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster

Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular,

and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting

either the probable case definition or suspected criteria (A) or (B)

C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case

SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted.

New Zealand

Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days

• Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting.

Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days

• Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified.

Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths.

14

Viet Nam

Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches;

fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath.

b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options

a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a

positive SARS-CoV-2 rapid test kit antigen

Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis.

15,16

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References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated

on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list

2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/

3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml

4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml

5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html

6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html

7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023

8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections.

9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html

10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html

11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es

12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do

13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my).

14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition

15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn)

16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

https://www.health.gov.au/topics/communicable-diseases/nationally-notifiable-diseases/list https://www.health.gov.au/topics/communicable-diseases/nationally-notifiable-diseases/list https://nindss.health.gov.au/pbi-dashboard/ http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html https://123dok.com/id/docs/buku-pedoman-skdr-pp-klb-2023.11883269#google_vignette https://123dok.com/id/docs/buku-pedoman-skdr-pp-klb-2023.11883269#google_vignette https://infeksiemerging.kemkes.go.id/document/surat-edaran-dirjen-p2-nomor-sr-03-01-c-1422-2025-tentang-kewaspadaan-terhadap-peningkatan-kasus-covid-19/view https://infeksiemerging.kemkes.go.id/document/surat-edaran-dirjen-p2-nomor-sr-03-01-c-1422-2025-tentang-kewaspadaan-terhadap-peningkatan-kasus-covid-19/view https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19-surveillance-report.html https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19-surveillance-report.html https://www.kdca.go.kr/board/board.es https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-3985-QD-BYT-2023-Huong-dan-giam-sat-va-phong-chong-COVID19-584373.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-3985-QD-BYT-2023-Huong-dan-giam-sat-va-phong-chong-COVID19-584373.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Thong-tu-54-2015-TT-BYT-che-do-thong-tin-bao-cao-va-khai-bao-benh-dich-benh-truyen-nhiem-299842.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Thong-tu-54-2015-TT-BYT-che-do-thong-tin-bao-cao-va-khai-bao-benh-dich-benh-truyen-nhiem-299842.aspx

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Bi-weekly COVID-19 Situation Update 26 September 2025

SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 37, 2025 (the week ending on 14 September 2025), a total of 11 270 specimens tested for SARS- CoV-2 were submitted to FluNet from 10 countries and areas in the Western Pacific Region. The positivity rate was 2.4% (Figure 1). The country and area-specific number of tests and calculated positivity rates in week 36-37 are presented in Table 1 below. Australia, Cambodia, Indonesia, Philippines, and Republic of Korea reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS-CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here.

Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025

(Source: GISRS surveillance data reported to FluNet)

Table 1: Weekly number of testing and positive rate reported to FluNet, week 36-37 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard)

Countries and areas

(most recent week of data)

Number of testing

for SARS-CoV-2

SARS-CoV-2

positivity rate (%) Trend

Australia (37 of 2025) 2 302 2.48 ↑

Cambodia (36 of 2025) 132 2.27 ↑

China, Hong Kong SAR (37 of 2025) 8 194 0.78 ↓

Indonesia (37 of 2025) 94 1.06 ↓

Japan (37 of 2025) 109 27.52 ↓

Lao PDR (37 of 2025) 65 0.0 -

Mongolia (37 of 2025) 12 0.0 -

Papua New Guinea (37 of 2025) 1 0.0 -

Philippines (37 of 2025) 69 1.45 ↑

Republic of Korea (38 of 2025) 373 31.1 ↑

Singapore (36 of 2025) 146 2.74 ↓

Viet Nam (36 of 2025) 0 0.0 -

https://www.who.int/initiatives/global-influenza-surveillance-and-response-system https://www.who.int/tools/flunet https://app.powerbi.com/view?r=eyJrIjoiNzc4YTIxZjQtM2E1My00YjYxLWIxMDItNzEzMjkyY2E1MzU1IiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 https://app.powerbi.com/view?r=eyJrIjoiNzdjZTVmY2YtNzY2NC00NTM0LTkzY2QtMWM0MzY0Mjg0YTZjIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources.

Tracking SARS-CoV-2 variants in the Western Pacific Region As of 26 September 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: NB.1.8.1 at 22.2%, B.1.1.529 at 63.4%, KP.3.1.1 at 2.7%, and JN.1 at 9.4% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated.

Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure.

(Source: GISAID hCoV-19 Variants Dashboard)

COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries.

In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1.

Countries in the temperate zone of the Northern Hemisphere

China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 31 August 2025, 187 new severe COVID-19 cases and seven deaths (all deaths from underlying diseases combined with SARS-CoV-2 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to July 2025 (219 severe cases and two deaths), the number of severe cases has decreased while the number of deaths has increased. For the same reporting period, the main circulating strain is NB.1.8.1. According

https://gisaid.org/hcov-19-variants-dashboard/ https://www.chinacdc.cn/jksj/xgbdyq/

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Bi-weekly COVID-19 Situation Update 26 September 2025

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to the sampling date, NB.1.8.1 accounted for 97.5%, 97.8%, 98.2%, and 95.2% of sequenced samples, from week 32 to 35, respectively.

Figure 3: Severe COVID-19 cases and deaths reported in China, August 2025 (Source: China National disease Control and Prevention Administration)

Indonesia - cases and deaths (sentinel and non-sentinel surveillance) In epidemiological week 37 of 2025 (from 8 to 14 September), Indonesia reported 15 new confirmed COVID-19 cases with no death. Since the beginning of 2025, a total of 390 confirmed cases have been reported, including no deaths, indicating a low-level of transmission in the country (Figure 4).

Figure 4: COVID-19 cases and deaths, as of week 37, 2025

(Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health, Indonesia)

Note : Konfirmasi= Confirmed, Kematian= Deaths, M= epidemiological week

Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 37 of 2025 (from 8 to 14 September 2025), a total of 31 831 new cases were reported, an increase from 31 329 cases in week 36. The average number of cases per sentinel site increased to 8.43, compared to 8.12 in the previous week (Figure 5). New COVID-19–related hospitalizations reported from designated sentinel sites nationwide had been on an upward trend since week 23, showing a decrease from week 35 onward. In week 37, 1 710 cases were reported, 134 fewer than in the previous week. (Figure 6).

https://www.chinacdc.cn/jksj/xgbdyq/ https://infeksiemerging.kemkes.go.id/dashboard/covid-19 https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Figure 5: Weekly number of COVID-19 cases

reported per sentinel hospital site, 2024-2025 (Source: Japan Institute for Health Security)

Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025

(Source: Japan Institute for Health Security)

Republic of Korea – COVID-19 cases (sentinel surveillance) In week 38 (the week ending on 20 September 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 31.1%, an increase from 30.8% in the previous week (Table 2). COVID-19 associated hospital admissions have increased since week 28, reaching 459 in week 37, and then decreasing to 428 in week 38 (Figure 7). Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 35-38 of 2025

(Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency)

https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html https://dportal.kdca.go.kr/pot/bbs/BD_selectBbsList.do?q_bbsSn=1010&q_bbsDocNo=&q_clsfNo=2&q_searchKeyTy=&q_searchVal=&q_currPage=1&q_sortName=&q_sortOrder= https://dportal.kdca.go.kr/pot/bbs/BD_selectBbsList.do?q_bbsSn=1010&q_bbsDocNo=&q_clsfNo=2&q_searchKeyTy=&q_searchVal=&q_currPage=1&q_sortName=&q_sortOrder= https://www.phwr.org/journal/archives_Supple.html

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 38 of 2024-week 38 of 2025 (Source: Korea Disease Control and Prevention Agency)

Countries/areas in the tropical zone

China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths

In week 38 of 2025 (from 14 August to 28 September), the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 46, compared to 46 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was four, compared to zero in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 17 September 2025, NB.1.8.1 remains the most prevalent variant, comprising 82.0% of all characterised specimens.

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025

(Source: Hong Kong Centre for Health Protection)

Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection)

Malaysia – COVID-19 confirmed cases and hospital admissions (sentinel surveillance) There is no update for this reporting period. The weekly average of COVID-19 confirmed cases has continued to decrease in recent weeks, from 1 023 cases reported in week 32 to 735 cases in week 33, 2025 (Figure 10).

https://www.chp.gov.hk/en/resources/29/100148.html https://www.chp.gov.hk/en/resources/29/100148.html https://data.moh.gov.my/dashboard/covid-19

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Figure 10: COVID-19 confirmed cases in Malaysia by week 33, 2025 (Source: Ministry of Health Malaysia)

Viet Nam - COVID-19 cases and deaths As of 31 August 2025, Viet Nam recorded 12 591 COVID-19 cases, including three deaths in 2025. Compared to the same period in 2024 (7 003 cases including one death), this represents an 79.8% increase in cases and two additional deaths in 2025. During week 38 (from 15 to 21 September 2025), 15 cases were reported, with no deaths. The weekly average in September (10 cases/week) shows a decrease compared to the August average (38 cases/week).

Figure 12: Number of weekly reported COVID-19 cases by region, as of week 38 of 2025, Viet Nam (Source: Viet Nam Administration of Disease Preventino (VADP), Ministry of Health, Viet Nam)

Notes: Data reporting might be delayed or updated; recent data will be subject to revision.

Countries in the temperate zone of the southern hemisphere

Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to decrease since week 26 of 2025, with 2 432 new cases reported in week 38 (the week starting on 15 September). (Figure 13).

https://data.moh.gov.my/dashboard/covid-19

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COVID-19 Situation Update|8

Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Figure 13: COVID-19 confirmed cases, week 36 of 2024- week 38 of 2025

(Source: National International Health Regulations (IHR) Focal Point, Australia)

Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia.

New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which

integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories.

New Zealand – COVID-19 cases and deaths The number of COVID-19 cases has decreased since July 2025. The 7 day-moving average of daily cases per 100 000 population was recorded at 0.38 cases on 20 September 2025 (Figure 14). The 7-day moving average of daily attributed hospital admissions per 100 000 population was 0.17 on 6 September 2025. (Figure 15).

Figure 14: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand)

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Figure 15: 7-day moving average of daily COVID-19 attributed hospital admissions per 100 000 population in New Zealand, 2024-2025

(Source: Te Whatu Ora, Health New Zealand)

Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others:

• Report of the Review Committee regarding standing recommendations for COVID-19 Link

• Tracking SARS-CoV-2 variants Link

• JN.1 updated risk evaluation Link

• LP.8.1 risk evaluation Link

• NB.1.8.1 risk evaluation Link

https://tewhatuora.shinyapps.io/covid19/ https://app.powerbi.com/view?r=eyJrIjoiNzdjZTVmY2YtNzY2NC00NTM0LTkzY2QtMWM0MzY0Mjg0YTZjIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports https://data.who.int/dashboards/covid19/cases?n=c https://www.who.int/publications/m/item/report-of-the-review-committee-regarding-standing-recommendations-for-covid-19 https://www.who.int/activities/tracking-SARS-CoV-2-variants https://www.who.int/docs/default-source/coronaviruse/15042024_jn1_ure.pdf?sfvrsn=8bd19a5c_7 https://www.who.int/publications/m/item/risk-evaluation-for-sars-cov-2-variant-under-monitoring-lp81 https://cdn.who.int/media/docs/default-source/documents/epp/tracking-sars-cov-2/23052025_nb.1.8.1_ire.pdf?sfvrsn=7b14df58_4

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COVID-19 Situation Update|10

Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region

Countries/areas Case definition Surveillance system description

Reference Case surveillance

Australia

Confirmed case: Newly diagnosed cases with laboratory definitive evidence

• Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination.

Probable case: Individuals who have laboratory suggestive evidence

• Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT).

COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024.

1, 2

China

Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests.

• Have clinical manifestations associated with the 2019-nCoV infection;

• Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase.

COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes

3, 4, 5

Hong Kong SAR, China

Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests

(Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date.

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test

COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health

Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats.

2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report.

3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts.

Our details reporting systems for Covid-19 present as follow:

Data type Reporting system

frequency Data uses

Individual data

New All Record (NAR)

The system facilitates near

real-time reporting for sentinel and

non-sentinel sites; data from sentinel sites are typically

reported in weekly pooled batches.

Database center, but for sentinel sites also use as

trend monitoring

Aggregate data

EWARS-IBS Weekly Trend monitoring

7, 8

https://infeksiemerging.kemkes.go.id/category/situasi-mingguan-infem

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COVID-19 Situation Update|12

Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

Individual and

aggregate

EWARS-EBS Near-real time Alert and preparedness

Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test

COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Update as of 7 April 2025) With revision

of the sentinel surveillance criteria, influenza and COVID-19 case surveillance has been shifted to acute respiratory infection surveillance (ARI surveillance) with approximately 3 000 medical institutions. Sentinel sites for hospitalizations remain unchanged. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported.

9, 10

Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT

COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter.

11, 12

Malaysia

Suspected case: one of the following options A. A person who meets the clinical AND epidemiological

criteria B. A patient with severe acute respiratory illness (SARI: acute

respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization);

C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag)

Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact

of a probable or confirmed case or is linked to a COVID-19 cluster

COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health

clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics.

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Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease

C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause

D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster

Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular,

and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting

either the probable case definition or suspected criteria (A) or (B)

C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case

SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted.

New Zealand

Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days

• Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting.

Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days

• Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified.

Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths.

14

Viet Nam

Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches;

fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath.

b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options

a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a

positive SARS-CoV-2 rapid test kit antigen

Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis.

15,16

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COVID-19 Situation Update|14

Bi-weekly COVID-19 Situation Update 26 September 2025

Bi-weekly COVID-19 Situation Update

References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated

on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list

2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/

3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml

4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml

5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html

6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html

7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023

8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections.

9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html

10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html

11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es

12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do

13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my).

14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition

15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn)

16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

https://www.health.gov.au/topics/communicable-diseases/nationally-notifiable-diseases/list https://www.health.gov.au/topics/communicable-diseases/nationally-notifiable-diseases/list https://nindss.health.gov.au/pbi-dashboard/ http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html https://123dok.com/id/docs/buku-pedoman-skdr-pp-klb-2023.11883269#google_vignette https://123dok.com/id/docs/buku-pedoman-skdr-pp-klb-2023.11883269#google_vignette https://infeksiemerging.kemkes.go.id/document/surat-edaran-dirjen-p2-nomor-sr-03-01-c-1422-2025-tentang-kewaspadaan-terhadap-peningkatan-kasus-covid-19/view https://infeksiemerging.kemkes.go.id/document/surat-edaran-dirjen-p2-nomor-sr-03-01-c-1422-2025-tentang-kewaspadaan-terhadap-peningkatan-kasus-covid-19/view https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19-surveillance-report.html https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19-surveillance-report.html https://www.kdca.go.kr/board/board.es https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-3985-QD-BYT-2023-Huong-dan-giam-sat-va-phong-chong-COVID19-584373.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-3985-QD-BYT-2023-Huong-dan-giam-sat-va-phong-chong-COVID19-584373.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Thong-tu-54-2015-TT-BYT-che-do-thong-tin-bao-cao-va-khai-bao-benh-dich-benh-truyen-nhiem-299842.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Thong-tu-54-2015-TT-BYT-che-do-thong-tin-bao-cao-va-khai-bao-benh-dich-benh-truyen-nhiem-299842.aspx

Bi-weekly COVID-19 Situation Update

10 October 2025

SARS-CoV-2 laboratory surveillance in the Western Pacific Region In week 39, 2025 (the week ending on 28 September 2025), a total of 10 970 specimens tested for SARS- CoV-2 were submitted to FluNet from 11 countries and areas in the Western Pacific Region. The positivity rate was 1.8% (Figure 1). The country and area-specific number of tests and calculated positivity rates in week 38 to 39 are presented in Table 1 below. China, Hong Kong SAR, Indonesia, and New Caledonia reported an increase in their SARS-CoV-2 positivity rates, compared to the previous week. Percent positivity is calculated using the number of samples positive and processed for SARS- CoV-2. The data are provided to FluNet by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS. More information on FluNet and its data sharing mechanism are available here.

Figure 1: SARS-CoV-2 tested specimens reported to FluNet from countries, areas and territories, Westen Pacific Region, 2024-2025

(Source: GISRS surveillance data reported to FluNet)

Table 1: Weekly number of testing and positive rate reported to FluNet, week 38 to 39 of 2025 (Source: Integrated influenza and other respiratory viruses surveillance dashboard)

Notes: The quality and consistency of this surveillance data are influenced by changes in health seeking behaviours, routine in sentinel sites, national testing priorities and capacities, and public health and social measures implementation. In addition, test precent positivity from sentinel surveillance can be very different than that of universal surveillance due to varying objectives, case definitions and coverage. Therefore, the data presented here should be interpreted carefully. The data is also subject to change over time, and there can be difference from national public health authorities and other sources.

Countries and areas

(most recent week of data)

Number of testing

for SARS-CoV-2

SARS-CoV-2

positivity rate (%) Trend

Australia (39 of 2025) 2 137 1.5 ↓

Cambodia (38 of 2025) 105 0.0 -

China, Hong Kong SAR (39 of 2025) 7 867 0.7 ↑ Indonesia (39 of 2025) 82 3.7 ↑

Japan (39 of 2025) 50 16.0 ↓

Lao PDR (39 of 2025) 97 1.0 ↓

Mongolia (39 of 2025) 33 6.1 -

New Caledonia (38 of 2025) 22 4.6 ↑

New Zealand (39 of 2025) 67 0.0 - Papua New Guinea (39 of 2025) 4 0.0 -

Philippines (38 of 2025) 12 0.0 ↓

Republic of Korea (39 of 2025) 401 23.2 ↓

Singapore (39 of 2025) 228 1.8 ↑

Viet Nam (39 of 2025) 4 0.0 -

https://www.who.int/initiatives/global-influenza-surveillance-and-response-system https://www.who.int/initiatives/global-influenza-surveillance-and-response-system https://www.who.int/tools/flunet https://app.powerbi.com/view?r=eyJrIjoiNzc4YTIxZjQtM2E1My00YjYxLWIxMDItNzEzMjkyY2E1MzU1IiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 https://app.powerbi.com/view?r=eyJrIjoiNzdjZTVmY2YtNzY2NC00NTM0LTkzY2QtMWM0MzY0Mjg0YTZjIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9

COVID-19 Situation Update|2

Tracking SARS-CoV-2 variants in the Western Pacific Region As of 10 October 2025, relative frequency of circulating variants in the Western Pacific Region is as follows: NB.1.8.1 at 63.9%, B.1.1.529 at 20.9%, KP.3.1.1 at 10.5%, and JN.1 at 3.4% (Figure 2). The country- and area-specific data are available below for certain countries and areas where the information is routinely updated.

Figure 2: Relative frequency (%) of circulating variants in the Western Pacific Region, 2024-2025 Note: Indonesia data is not included in this figure.

(Source: GISAID hCoV-19 Variants Dashboard)

COVID-19 surveillance summary COVID-19 surveillance in the WHO Western Pacific Region reflects the ongoing transition of Member States from pandemic emergency response to sustainable, integrated, and longer-term COVID-19 disease management. In this transitional phase, some countries have already integrated their COVID- 19 surveillance into existing systems, while others maintain surveillance from the emergency phase of the pandemic. Due to these varied approaches, population groups, data formats, and reporting mechanisms of COVID-19 surveillance differ across countries. In the interim, guided by standing recommendations, WHO continues to support Member States in monitoring, assessing and responding to the risks posed by COVID-19. This COVID-19 surveillance summary, therefore, covers countries and areas where routine surveillance is conducted, and the surveillance data is publicly available. A detailed description of COVID-19 surveillance in each country and area included in the report is available in Annex 1. The surveillance data should be interpreted with caution, taking into account various surveillance methodologies and reporting systems described in Annex 1.

https://gisaid.org/hcov-19-variants-dashboard/

COVID-19 Situation Update|3

Countries in the temperate zone of the Northern Hemisphere

China – severe cases and deaths (monthly update) There is no update for this reporting period. From 1 to 31 August 2025, 187 new severe COVID-19 cases and seven deaths (all deaths from underlying diseases combined with SARS-CoV-2 infection) were reported from 31 provinces, autonomous regions and municipalities (Figure 3). Compared to July 2025 (219 severe cases and two deaths), the number of severe cases has decreased while the number of deaths has increased. For the same reporting period, the main circulating strain is NB.1.8.1. According to the sampling date, NB.1.8.1 accounted for 97.5%, 97.8%, 98.2%, and 95.2% of sequenced samples, from week 32 to 35, respectively.

Figure 3: Severe COVID-19 cases and deaths reported in China, August 2025 (Source: China National disease Control and Prevention Administration)

Indonesia - cases and deaths (sentinel and non-sentinel surveillance) In epidemiological week 39 of 2025 (from 22 to 28 September), Indonesia reported seven new confirmed COVID-19 cases with no death. Since the beginning of 2025, a total of 414 confirmed cases have been reported, including no deaths, indicating a low-level of transmission in the country (Figure 4).

Figure 4: COVID-19 cases and deaths, as of week 39, 2025

(Source: COVID-19 Dashboard, Emerging Infectious Disease Situation, Ministry of Health, Indonesia)

Note : Konfirmasi= Confirmed, Kematian= Deaths, M= epidemiological week

https://www.chinacdc.cn/jksj/xgbdyq/ https://www.chinacdc.cn/jksj/xgbdyq/ https://infeksiemerging.kemkes.go.id/dashboard/covid-19

COVID-19 Situation Update|4

Japan – COVID-19 cases (sentinel surveillance, weekly update) In week 38 of 2025 (from 15 to 21 September 2025), a total of 26 631 new cases were reported, a decrease from 31 831 cases in week 37. The average number of cases per sentinel site decrease to 6.9, compared to 8.4 in the previous week (Figure 5). New COVID-19–related hospitalisations reported from designated sentinel sites nationwide was on a downward trend from week 35. In week 38, 1 493 hospitalisations were reported, 217 fewer than in the previous week (Figure 6).

Figure 5: Weekly number of COVID-19 cases reported

per sentinel hospital site, 2024-2025 (Source: Japan Institute for Health Security)

Figure 6: Weekly number of new COVID-19 hospitalizations reported from sentinel sites in Japan, 2024-2025

(Source: Japan Institute for Health Security)

Republic of Korea – COVID-19 cases (sentinel surveillance) There is no update in this reporting period. In week 38 (the week ending on 20 September 2025), the detection rate of SARS-CoV-2 reported from virological sentinel sites was 31.1%, an increase from 30.8% in the previous week (Table 2). COVID-19 associated hospital admissions have increased since week 28, reaching 459 in week 37, and then decreasing to 428 in week 38 (Figure 7).

Table 2: Laboratory-based pathogen surveillance in Republic of Korea: respiratory viruses, week 36-39 of 2025 (Source: Public Health Weekly Report, Korea Disease Control and Prevention Agency)

https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html https://id-info.jihs.go.jp/surveillance/idss/content/teiten_ARI/index.html https://dportal.kdca.go.kr/pot/bbs/BD_selectBbsList.do?q_bbsSn=1010&q_bbsDocNo=&q_clsfNo=2&q_searchKeyTy=&q_searchVal=&q_currPage=1&q_sortName=&q_sortOrder= https://dportal.kdca.go.kr/pot/bbs/BD_selectBbsList.do?q_bbsSn=1010&q_bbsDocNo=&q_clsfNo=2&q_searchKeyTy=&q_searchVal=&q_currPage=1&q_sortName=&q_sortOrder= https://www.phwr.org/journal/archives_Supple.html

COVID-19 Situation Update|5

Figure 7: Weekly COVID-19 hospital admissions reported from acute respiratory infection surveillance system in Republic of Korea, week 38 of 2024-week 38 of 2025 (Source: Korea Disease Control and Prevention Agency)

Countries/areas in the tropical zone

China, Hong Kong SAR, laboratory confirmed COVID-19 cases, severe cases and deaths In week 40 of 2025 (from 28 September to 4 October), the weekly number of newly recorded positive nucleic acid test laboratory detections for SARS-CoV-2 virus was 31, compared to 37 in the preceding week (Figure 8). The weekly number of severe COVID-19 cases including deaths with cause of death preliminarily assessed to be related to COVID-19 was zero, compared to three in the preceding week (Figure 9). Based on the sewage samples collected for surveillance of SARS-CoV-2 variants, as of 29 September 2025, NB.1.8.1 remains the most prevalent variant, comprising 67.5% of all characterised specimens.

Figure 8: Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus, 2023-2025

(Source: Hong Kong Centre for Health Protection)

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https://dportal.kdca.go.kr/pot/is/st/ari.do https://www.chp.gov.hk/en/resources/29/100148.html https://www.chp.gov.hk/en/resources/29/100148.html

COVID-19 Situation Update|6

Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025 (Source: Hong Kong Centre for Health Protection)

Viet Nam - COVID-19 cases and deaths

As of 12 October 2025, Viet Nam recorded 12 617 COVID-19 cases, including three deaths in 2025. Compared to the same period in 2024 (7 046 cases including one death), this represents a 79.0% increase in cases and two additional deaths in 2025. During week 41 (from 6 to 12 October 2025), four cases were reported, with no deaths. This represents a 50.0% derecrease compared to the previous week (eight cases with no deaths) (Figure 10).

Figure 10: Number of weekly reported COVID-19 cases by region, as of week 41 of 2025, Viet Nam (Source: Viet Nam Administration of Disease Preventino (VADP), Ministry of Health, Viet Nam)

Notes: Data reporting might be delayed or updated; recent data will be subject to revision.

https://www.chp.gov.hk/en/resources/29/100148.html

COVID-19 Situation Update|7

Countries in the temperate zone of the southern hemisphere

Australia – COVID-19 confirmed cases The weekly number of confirmed COVID-19 cases has continued to decrease since week 25 of 2025, with 1 898 new cases reported in week 40 (the week starting on 29 September), compared to 2 197 cases in week 39 (Figure 11).

Figure 11: COVID-19 confirmed cases, week 40 of 2024 to week 40 of 2025

(Source: National International Health Regulations (IHR) Focal Point, Australia)

Notes: Due to a reduction in case ascertainment, including changes in testing and reporting requirements, notifications of COVID-19 are underestimate of disease incidence in the community. For more detail, please refer to reports and data considerations published by individual jurisdictions in Australia. New Confirmed Cases per week data is derived from The National Notifiable Diseases Surveillance System (NNDSS) which integrates data from Australia’s eight jurisdictions. The NNDSS is a dynamic system, and data are subject to retrospective revisions as updates are received, particularly for recent weeks. Data may vary from data reported in published NNDSS reports and reports of notification data by States and Territories.

New Zealand – COVID-19 cases and deaths The number of COVID-19 cases is on a decreasing trend since July 2025, with fluctuations. The 7 day- moving average of daily cases per 100 000 population was recorded at 0.23 cases on 21 September 2025 (Figure 12). The 7-day moving average of daily attributed hospital admissions per 100 000 population was 0.07 on 14 September 2025. (Figure 13).

Figure 12: 7-day moving average of daily COVID-19 cases per 100 000 population in New Zealand, 2024-2025 (Source: Te Whatu Ora, Health New Zealand)

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https://www.health.gov.au/topics/covid-19/reporting https://www.health.gov.au/our-work/nndss#:~:text=The%20National%20Notifiable%20Diseases%20Surveillance,the%20impact%20of%20these%20diseases. https://tewhatuora.shinyapps.io/covid19/ https://tewhatuora.shinyapps.io/covid19/ https://tewhatuora.shinyapps.io/covid19/

COVID-19 Situation Update|8

Figure 13: 7-day moving average of daily COVID-19 attributed hospital admissions per 100 000 population in New Zealand, 2024-2025

(Source: Te Whatu Ora, Health New Zealand)

Global COVID-19 situation updates Integrated influenza and other respiratory viruses surveillance outputs COVID-19 monthly epidemiological updates Global COVID-19 dashboard Others:

• Report of the Review Committee regarding standing recommendations for COVID-19 Link

• Tracking SARS-CoV-2 variants Link

• JN.1 updated risk evaluation Link

• LP.8.1 risk evaluation Link

• NB.1.8.1 risk evaluation Link

https://tewhatuora.shinyapps.io/covid19/ https://app.powerbi.com/view?r=eyJrIjoiNzdjZTVmY2YtNzY2NC00NTM0LTkzY2QtMWM0MzY0Mjg0YTZjIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports https://data.who.int/dashboards/covid19/cases?n=c https://www.who.int/publications/m/item/report-of-the-review-committee-regarding-standing-recommendations-for-covid-19 https://www.who.int/activities/tracking-SARS-CoV-2-variants https://www.who.int/docs/default-source/coronaviruse/15042024_jn1_ure.pdf?sfvrsn=8bd19a5c_7 https://www.who.int/publications/m/item/risk-evaluation-for-sars-cov-2-variant-under-monitoring-lp81 https://cdn.who.int/media/docs/default-source/documents/epp/tracking-sars-cov-2/23052025_nb.1.8.1_ire.pdf?sfvrsn=7b14df58_4

COVID-19 Situation Update|9

Annex 1. Summary of COVID-19 surveillance in countries and areas in the Western Pacific Region

Countries/areas Case definition Surveillance system description

Reference Case surveillance

Australia

Confirmed case: Newly diagnosed cases with laboratory definitive evidence

• Laboratory definitive evidence: Detection of SARS-CoV-2 by nucleic amplification acid testing (NAAT); or isolation of SARS-CoV-2 in cell culture, with confirmation using a NAAT; or SARS-CoV-2 IgG seroconversion or a four-fold or greater increase in SARS-CoV-2 antibodies of any immunoglobulin subclass including ‘total’ assays in acute and convalescent sera, in the absence of vaccination.

Probable case: Individuals who have laboratory suggestive evidence

• Laboratory suggestive evidence: Detection of SARS-CoV-2 by rapid antigen testing (RAT).

COVID-19 is a nationally notifiable disease; The National Notifiable Diseases Surveillance System (NNDSS) coordinates national surveillance data for diseases on the National Notifiable Disease List. Every day, the state and territory health authorities report to the NNDSS about new cases of notifiable diseases. (Reporting) COVID-19 data includes both confirmed and probable cases reported to NNDSS. Six jurisdictions have stopped collecting probable cases: Victoria on 1 July 2023, Queensland on 1 September 2023, New South Wales on 1 October 2023, Western Australia on 9 October, NT on 21 October2023 and ACT from 22 December 2023. Point of care tests administered in healthcare or aged care settings continue to be reported to the NNDSS by some jurisdictions. New South Wales ceased notification of hospitalization status for COVID-19 cases to the NNDSS on 5 March 2024.

1, 2

China

Diagnosis should be made based on comprehensive analysis of epidemiological history, clinical manifestations and laboratory tests.

• Have clinical manifestations associated with the 2019-nCoV infection;

• Have one or more of the following pathogenic and serological result: (1) A positive PCR detection of the 2019-nCoV; (2) A positive antigen detection of the 2019-nCoV; (3) A positive 2019-nCoV isolation and cultivation; (4) Four times or more elevated levels of 2019-nCoV-specific IgG antibodies in the recovery phase than in the acute phase.

COVID-19 is a class B notifiable disease: (Case reporting) Medical institutions at all levels and in all categories should report cases in time according to regulations and laws, in line with relevant requirements for information reporting. COVID-19 infection and asymptomatic cases need to be reported directly on China’s network-based infectious disease reporting system within 24 hours of diagnosis. For severe, critical and death cases and other special cases identified, disease prevention and control agencies should conduct epidemiological investigations in a timely manner and upload results as required. (Pathogen monitoring) viral gene sequencing is analyzed for patient samples that test positive for COVID-19, which are collected from outpatients admitted to sentinel hospitals, severe and death cases in emblematic cities, as well as inbound travelers entering through emblematic ports. (Sentinel surveillance) outpatient influenza-like illness (ILI) and inpatient severe acute respiratory infection (SARI) cases will be monitored for COVID-19 in 554 sentinel hospitals for national influenza surveillance. (Surveillance for pneumonia of unknown causes) Cases also can be detected and reported based on the National Plan for Surveillance, Screening and Management of Patients with Pneumonia of Unknown Causes

3, 4, 5

Hong Kong SAR, China

Confirmed case: Laboratory confirmed cases using PCR or antigen-detecting rapid diagnostic tests

(Reporting) COVID-19 is a notifiable disease. Only severe and death cases are required to be reported, with outcomes (serious, critical, and death) within 28 days of the first positive specimen collection date.

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Indonesia Confirmed case: Laboratory-confirmed cases using PCR or rapid diagnostic test

COVID-19 detection in Indonesia through Early Warning Alert and Response System (EWARS) and sentinel surveillance: 1. Routine EWARS: The Directorate of Surveillance and Health

Quarantine, in collaboration with the Public Health Emergency Operation Centre (PHEOC), coordinates the national surveillance of outbreak-prone diseases listed in the National Notifiable Diseases List. Surveillance is carried out through two primary approaches: weekly aggregate reporting via EWARS indicators and near-real-time event-based surveillance. The reporting units for EWARS include primary health centers, hospitals, laboratories, district and provincial health offices, and port health offices. These reporting units are responsible for submitting weekly aggregate data, which contributes to the early detection and response to public health threats.

2. Individual case data is reported through the New All Record (NAR) system by reporting units and laboratory. The COVID-19 weekly report is published in MoH website COVID-19 report.

3. Sentinel sites surveillance: COVID-19 surveillance has been integrated into Indonesia’s existing Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. These sentinel sites have been adapted to incorporate COVID-19 monitoring, thereby serving as an early warning system for emerging respiratory infections. As of the most recent reporting period, Indonesia maintains 39 ILI and 35 SARI sentinel surveillance sites. Data from these sites are also reported through the NAR system, enhancing the comprehensiveness of national surveillance efforts.

Our details reporting systems for Covid-19 present as follow:

Data type Reporting system

frequency Data uses

Individual data

New All Record (NAR)

The system facilitates near

real-time reporting for sentinel and

non-sentinel sites; data from sentinel sites are typically

reported in weekly pooled batches.

Database center, but for sentinel sites also use as

trend monitoring

Aggregate data

EWARS-IBS Weekly Trend monitoring

7, 8

https://infeksiemerging.kemkes.go.id/category/situasi-mingguan-infem

COVID-19 Situation Update|11

Individual and

aggregate

EWARS-EBS Near-real time Alert and preparedness

Japan Confirmed case: Laboratory confirmed cases using PCR or rapid/quantitative antigen test

COVID-19 is a category five sentinel disease; positive cases must be reported every week. (Clinical surveillance) Sentinel surveillance – positive cases from 5,000 sentinel sites at healthcare facilities for both Influenza and COVID-19; hospitalizations from 500 sentinel sites at healthcare facilities. (Update as of 7 April 2025) With revision

of the sentinel surveillance criteria, influenza and COVID-19 case surveillance has been shifted to acute respiratory infection surveillance (ARI surveillance) with approximately 3 000 medical institutions. Sentinel sites for hospitalizations remain unchanged. (Virological surveillance) SARS-CoV-2 genomic surveillance is conducted every week by the National Institute of Infectious Diseases in collaboration with commercial medical laboratories. Public health institutes at a prefectural level also conduct genomic surveillance for GISAID submission. (Reporting) Weekly number of positive cases, hospitalizations (including those requiring ICU admission or mechanical ventilator), and variant data are reported.

9, 10

Republic of Korea Confirmed case: Laboratory confirmed cases using PCR or RAT

COVID-19 is a level four notifiable disease; positive cases must be reported within seven days of confirmation. (Surveillance) COVID-19 surveillance system has been integrated into existing influenza-like illness (ILI), acute respiratory infection surveillance (ARI), and severe acute respiratory infection surveillance (SARI) system. (Reporting) Weekly detection rate from ILI and COVID-19 hospital admissions from ARI and SARI are reported as part of existing Weekly Infectious Disease Sentinel Surveillance Newsletter.

11, 12

Malaysia

Suspected case: one of the following options A. A person who meets the clinical AND epidemiological

criteria B. A patient with severe acute respiratory illness (SARI: acute

respiratory infection with history of fever or measured fever of 38 C°; and cough; with onset within the last 10 days; ad who requires hospitalization);

C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 rapid test kit antigen (RTK-Ag)

Probable case: One of the following options A. A patient who meets clinical criteria above AND is a contact

of a probable or confirmed case or is linked to a COVID-19 cluster

COVID-19 is a notifiable disease. COVID-19 surveillance has transitioned from exhaustive to sentinel surveillance using the existing influenza-like-illness (ILI) and severe acute respiratory infection (SARI) surveillance. All samples meeting the criteria for ILI and SARI case definition undergo testing for COVID-19 as well. ILI surveillance prioritizes outpatient settings and is categorized into two main types: - Clinical or epidemiological surveillance, which encompasses 1 040 health

clinics and eight hospitals, and - Laboratory-based surveillance involving 58 health clinics.

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COVID-19 Situation Update|12

B. A suspected case (described above) with chest imaging showing findings suggestive of COVID-19 disease

C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause

D. Death, not otherwise explained, in an adult with respiratory distress preceding death AND who was a contact of a probable or confirmed case or linked to a COVID-19 cluster

Confirmed case: One of the following options A. A person with a positive NAAT; RT-PCR, Rapid Molecular,

and Gene X-pert B. A person with a positive SARS-CoV-2 RTK-Ag AND meeting

either the probable case definition or suspected criteria (A) or (B)

C. An asymptomatic person with a positive SARS-CoV-2 RTK-Ag AND who is a contact of a probable or confirmed case

SARI surveillance is tailored to hospitalized patients with 16 hospitals where laboratory-based surveillance is conducted.

New Zealand

Confirmed case: Definitive laboratory evidence, without being a confirmed or probable case in the previous 28 days

• Definitive laboratory evidence: SARS-CoV-2 detected from a clinical specimen using a validated NAAT or by RAT in a health care setting.

Probable case: Suggestive laboratory evidence, without being a confirmed or probable case in the previous 28 days

• Suggestive laboratory evidence: SARS-CoV-2 detected through a self-reported RAT where the quality of result cannot be verified.

Exhaustive surveillance: COVID-19 is a notifiable disease under Section 74 of the Health Act 1956, which requires all health practitioners and those in charge of medical laboratories to officially report actual and suspected cases of COVID-19 to the medical officer of health in the local public health service. Self-diagnosed cases detected by RAT are not required to be reported under the Health Act. (Reporting) With widespread community transmission of SARS-CoV-2, reporting priorities to central communicable diseases units should include a) laboratory notification of positive NAAT results, b) self-reporting of positive RAT results, c) case demographics, d) clusters and outbreaks in high-risk settings and communities, e) cases in hospital and intensive care, and f) COVID-19 related deaths.

14

Viet Nam

Suspected case: one of the following options a) A patient who presents symptoms of - fever and cough; or - at least three of following symptoms: fever; body aches;

fatigue; chills; cough; headache; sore throat; runny nose; stuffy nose; reduced or lost sense of smell; reduced or lost sense of taste; nausea; vomiting; diarrhea; shortness of breath.

b) A patient with severe acute respiratory illness (SARI) or severe viral pneumonia (SVP). Confirmed case: one of the following options

a) Laboratory-confirmed cases using PCR b) Suspected case (described above) with a positive result of a

positive SARS-CoV-2 rapid test kit antigen

Since October 2023, COVID-19 has been classified as a group B notifiable disease and monitored through the Electronic Communicable Disease Reporting System (eCDS), managed by the Ministry of Health. Both suspected and confirmed cases are required to be reported to eCDS within 24 hours from the time of diagnosis.

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COVID-19 Situation Update|13

References: 1. Australia, Department of Health and Aged Care. List of nationally notifiable diseases. Updated

on 4 March 2024. Available from: https://www.health.gov.au/topics/communicable- diseases/nationally-notifiable-diseases/list

2. Australia, Department of Health and Aged Care. National Communicable Disease Surveillance Dashboard. Available from: https://nindss.health.gov.au/pbi-dashboard/

3. China, National Health Commission (NHC). National Health Office Medical Emergency Letter. Updated on 6 January 2023. Available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml

4. China, NHC. Joint Prevention and Control Mechanism Comprehensive Issue. Updated on 7 January 2023. Available from: http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml

5. China, National Disease Control and Prevention Administration. List of Notifiable Infectious Diseases. Available from: https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html

6. Hongkong SAR China, Centre for Health Protection (CHP), Communicable Disease Surveillance: Case definitions. Updated on 7 September 2023. Available from: https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html

7. Indonesia Ministry of Health EWARS guidelines 2023. Available from: BUKU PEDOMAN SKDR PP KLB 2023

8. Circular Letter of the Director General of P2 Number SR.03.01/C/1422/2025 concerning Vigilance against Increase in COVID-19 Cases, 28 May 2025. Available from: Emerging Infections.

9. Japan, Ministry of Health, Labour and Welfare (MHLW). Notification by Physicians and Veterinarians under the act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, COVID-19. Available from: https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html

10. Japan, National Institute of Infectious Diseases (NIID). Weekly surveillance report of SARS- CoV-2. Available from: https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19- surveillance-report.html

11. Republic of Korea, Korea Disease Control and Prevention Agency (KDCA). Press release on de- escalation of COVID-19 alert level from 1 May 2024. Available from: https://www.kdca.go.kr/board/board.es

12. Republic of Korea, KDCA. Classification of Notifiable Diseases. Available from: https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do

13. Malaysia, Ministry of Health Malaysia. COVID-19 Management Guidelines in Malaysia. Updated in February 2024. Available from: KKM Guidelines | COVID-19 MALAYSIA (moh.gov.my).

14. New Zealand, Health New Zealand (Te Whatu ora). Communicable Disease Control Manual, COVID-19. Updated in January 2024. Available from: https://www.tewhatuora.govt.nz/for- the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid- 19/#case-definition

15. Decision 3985/QD-BYT 2023 guiding COVID19 surveillance and prevention (thuvienphapluat.vn)

16. Circular 54/2015/TT-BYT on the regime of information on reporting and declaration of the latest infectious diseases (thuvienphapluat.vn)

https://www.health.gov.au/topics/communicable-diseases/nationally-notifiable-diseases/list https://www.health.gov.au/topics/communicable-diseases/nationally-notifiable-diseases/list https://nindss.health.gov.au/pbi-dashboard/ http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a.shtml http://www.nhc.gov.cn/xcs/zhengcwj/202301/bdc1ff75feb94934ae1dade176d30936.shtml https://www.ndcpa.gov.cn/jbkzzx/c100041/common/list.html https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/disease.html https://123dok.com/id/docs/buku-pedoman-skdr-pp-klb-2023.11883269#google_vignette https://123dok.com/id/docs/buku-pedoman-skdr-pp-klb-2023.11883269#google_vignette https://infeksiemerging.kemkes.go.id/document/surat-edaran-dirjen-p2-nomor-sr-03-01-c-1422-2025-tentang-kewaspadaan-terhadap-peningkatan-kasus-covid-19/view https://infeksiemerging.kemkes.go.id/document/surat-edaran-dirjen-p2-nomor-sr-03-01-c-1422-2025-tentang-kewaspadaan-terhadap-peningkatan-kasus-covid-19/view https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou11/01-shitei-01.html https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19-surveillance-report.html https://www.niid.go.jp/niid/ja/2019-ncov/2484-idsc/12015-covid19-surveillance-report.html https://www.kdca.go.kr/board/board.es https://ncov.kdca.go.kr/pot/ii/sttyInftnsds/sttyInftnsds.do https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/communicable-disease-control-manual/covid-19/#case-definition https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-3985-QD-BYT-2023-Huong-dan-giam-sat-va-phong-chong-COVID19-584373.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-3985-QD-BYT-2023-Huong-dan-giam-sat-va-phong-chong-COVID19-584373.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Thong-tu-54-2015-TT-BYT-che-do-thong-tin-bao-cao-va-khai-bao-benh-dich-benh-truyen-nhiem-299842.aspx https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Thong-tu-54-2015-TT-BYT-che-do-thong-tin-bao-cao-va-khai-bao-benh-dich-benh-truyen-nhiem-299842.aspx

SARS-CoV-2 laboratory surveillance in the Western Pacific Region Tracking SARS-CoV-2 variants in the Western Pacific Region COVID-19 surveillance summary Countries in the temperate zone of the Northern Hemisphere China – severe cases and deaths (monthly update) Indonesia - cases and deaths (sentinel and non-sentinel surveillance) Japan – COVID-19 cases (sentinel surveillance, weekly update)

Countries/areas in the tropical zone Figure 9: Weekly number of Severe COVID-19 cases including deaths, 2023-2025

Countries in the temperate zone of the southern hemisphere New Zealand – COVID-19 cases and deaths Global COVID-19 situation updates