COVID-19 weekly epidemiological update, 30 March 2021

COVID-19 Weekly Epidemiological Update Data as received by WHO from national authorities, as of 28 March 2021, 10 am CET In this edition: • Global overview • Special focus: COVID-19 and Health and Care Workers (HCWs) • Special focus: SARS-CoV-2 variants • WHO regional overviews • Key weekly updates Global overview Globally, new COVID-19 cases rose for a fifth consecutive week, with just over 3.8 million new cases reported in the last week (Figure 1). The number of new deaths increased for the second consecutive week, increasing by 5% compared to last week, with over 64 000 new deaths reported. All regions reported an increase in the number of cases this week, with the largest increases in the South-East Asia, Western Pacific, and African Regions, all of which have been on an upward trajectory in recent weeks. All regions, except for the African Region, reported an increase in the number of deaths, with the largest increase of 21% from the South-East Asia Region, which is on its third week of an increasing trend. The European Region and the Region of the Americas continue to account for approximately 80% of all new and cumulative cases and deaths. Figure 1. COVID-19 cases reported weekly by WHO Region, and global deaths, as of 28 March 2021** **See Annex: Data, table and figure notes 0 20 000 40 000 60 000 80 000 100 000 120 000 0 1 000 000 2 000 000 3 000 000 4 000 000 5 000 000 3 0 -D e c 2 0 -J a n 1 0 -F e b 0 2 -M a r 2 3 -M a r 1 3 -A p r 0 4 -M a y 2 5 -M a y 1 5 -J u n 0 6 -J u l 2 7 -J u l 1 7 -A u g 0 7 -S e p 2 8 -S e p 1 9 -O c t 0 9 -N o v 3 0 -N o v 2 1 -D e c 1 1 -J a n 0 1 -F e b 2 2 -F e b 1 5 -M a r D e a th s C a s e s Reported week commencing Americas South-East Asia Europe Eastern Mediterranean Africa Western Pacific Deaths The highest numbers of new cases were reported from Brazil (533 024 new cases; 5% increase), the United States of America (421 936 new cases; 13% increase), India (372 494 new cases; 55% increase), France (254 228 new cases; 24% increase), and Poland (192 441 new cases; 27% increase). Table 1. Newly reported and cumulative COVID-19 confirmed cases and deaths, by WHO Region, as of 28 March 2021** WHO Region New cases in last 7 days (%) Change in new cases in last 7 days * Cumulative cases (%) New deaths in last 7 days (%) Change in new deaths in last 7 days * Cumulative deaths (%) Americas 1 306 017 (34%) 11% 55 243 776 (44%) 32 176 (50%) 4% 1 331 419 (48%) Europe 1 641 672 (43%) 11% 44 191 579 (35%) 23 778 (37%) 7% 954 829 (34%) South-East Asia 437 060 (11%) 46% 14 619 886 (12%) 2 947 (5%) 21% 217 737 (8%) Eastern Mediterranean 270 884 (7%) 3% 7 395 085 (6%) 3 428 (5%) 5% 156 891 (6%) Africa 62 286 (2%) 22% 3 061 438 (2%) 1 340 (2%) -6% 77 446 (3%) Western Pacific 84 395 (2%) 32% 1 859 933 (1%) 518 (1%) 7% 31 361 (1%) Global 3 802 314 (100%) 14% 126 372 442 (100%) 64 187 (100%) 5% 2 769 696 (100%) *Percent change in the number of newly confirmed cases/deaths in past seven days, compared to seven days prior. Regional percentages rounded to the nearest whole number; global totals may not equal 100%. **See Annex: Data, table and figure notes For the latest data and other updates on COVID-19, please see: • WHO COVID-19 Dashboard • WHO COVID-19 Weekly Operational Update Figure 2. COVID-19 cases per 100 000 population reported by countries, territories and areas, 22-28 March 2021** **See Annex: Data, table and figure notes Special Focus: COVID-19 and Health and Care Workers (HCWs) HCWs have been central to the COVID-19 response since the beginning of the pandemic. Many of their functions and roles put them at risk of exposure to hazards that can impact their working conditions as well as have impact their physical and social well-being. It is therefore critical to monitor the multidimensional factors affecting HCWs as the pandemic continues (Figure 3). Figure 3. Multidimensional factors related to COVID-19 that impact HCWs HCWs continue to face a range of interconnected factors that affect their mental health and stress levels which increase with irregular working hours, higher levels of exposure to illness, fear of infection with COVID- 19 related to exposure, and/or lack of adequate PPE amongst others. Published studies show that the prevalence of mental health conditions among HCWs was significantly higher than other professional groups. HCWs reported a higher level of anxiety (13.0% vs. 8.5%) and depression (12.2% vs. 9.5%)1 as compared to other groups, with insomnia as a risk factor for both. A recent study with data from six countries found that insomnia, sleeping disorders and burnout were significant risk factors for COVID-19 infection among HCWs2. As the pandemic continues, more evidence has been collected to describe the challenging working and psychosocial conditions HCWs face daily (Table 2). 1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409979/ 2 https://nutrition.bmj.com/content/early/2021/03/03/bmjnph-2021-000228 Table 2. A selective summary of the COVID-19 impact dimension on HCWs Dimension Evidence Stigma and discrimination HCWs were at increased risk to experience stigma and bullying, adjusted odds ratio: 1.5 (95% CI 1.2 to 2.0).3 Violence Since the beginning of the outbreak, attacks on health care have continuously been reported and now also include incidents linked to the COVID-19 pandemic across the world. 4 Lack of PPE Lack of PPE for HCWs has been observed in several countries.5,6 Strike actions An independent analysis has identified industrial dispute and strike action in 84 Member States since February 2020; of which 38% and 29% of strikes are due to poor working conditions and lack of PPE, respectively.7 Quarantine and self- isolation In a survey of health professionals and allied employees, 24% of HCWs declared that they had to return to work while still having symptoms of COVID-19.8 Other working conditions Role of privatization in delivery of services, managerial practices in nursing homes exacerbated impact of COVID-19.9 HCWs continue to play an integral role in the pandemic response. It is crucial that HCWs be adequately supported in order to ensure their physical and mental well-being. 3 Dye TD, Alcantara L, Siddiqi S, et al. Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: an analytical cross-sectional global study. BMJ Open 2020;10:e046620. doi: 10.1136/bmjopen-2020-046620 4 https://www.who.int/news-room/feature-stories/detail/attacks-on-health-care-in-the-context-of-covid-19 5 J Cohena, YM Rodgersc. Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Prev Med. 2020 Dec; 141: 106263. 6 https://www.who.int/news/item/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwide 7 https://www.who.int/campaigns/annual-theme/year-of-health-and-care-workers-2021/facts 8 Health professionals and allied employees. Exposed and at risk. HPAE white paper July 2020. 9 Pat Armstrong, Hugh Armstrong, Ivy Lynn Bourgeault, Pat Armstrong. Privatization and COVID-19: A Deadly Combination for Nursing Homes July 2020 In book: Vulnerable: The Policy, Law and Ethics of COVID-19. Publisher: University of Ottawa Press Special Focus: Update on SARS-CoV-2 Variants All viruses, including SARS-CoV-2, change over time resulting in the emergence of new variants, most without a direct benefit to the virus or other public health impacts. WHO, in collaboration with national authorities, institutions and researchers, routinely assesses if variants of SARS-CoV-2 result in changes in transmissibility, clinical presentation and severity, or if they impact public health and social measures (PHSM). Systems have been established to detect “signals” of potential variants of concern (VOCs) or variants of interest (VOIs), as well as unusual events potentially associated with a variant, and assess these based on the risk posed to global public health (see also working definitions). A number of such signals are currently under assessment, and as new VOCs and VOIs are determined, WHO is committed to highlighting these to support prioritization for further monitoring and assessment. National authorities may choose to designate other variants of local interest/concern as every local situation is unique, with different variants circulating, requiring surveillance and response systems to adapt to their local epidemiological situation. Further information on the background of the variants of concern (VOCs) and variants of interest (VOIs) is available in previously published editions of the Weekly Epidemiological Update. Here we provide a brief update on the geographical distribution of the three variants classified as VOCs by WHO as of 30 March 2021 as well as an update on emerging VOIs. As surveillance activities to detect SARS-CoV-2 variant cases are strengthened at local and national levels, including systematic genomic sequencing, the number of countries reporting VOCs has continued to increase (Table 3, Figures 4-6, Annex 2). This information should be interpreted with due consideration of surveillance limitations, including but not limited to differences between countries in sequencing capacity and prioritization of samples for sequencing. WHO continues to advocate for strengthening surveillance and sequencing capacity, and a systematic approach to provide a representative indication of the extent of transmission of SARS-CoV-2 variants based on the local epidemiological situation and capacity, and the detection of unusual events. Table 3: Overview of emerging information on variants of concern, as of 30 March 2021* Nextstrain clade 20I/501Y.V1 20H/501Y.V2† 20J/501Y.V3 PANGO lineage B.1.1.7 B.1.351 B.1.1.28.1, alias P.1† GISAID clade GR GH GR Alternate names VOC 202012/01† VOC 202012/02 - First detected by United Kingdom South Africa Brazil / Japan Earliest sample date 20 September 2020 Early August 2020 December 2020 Key spike mutations H69/V70 deletion; Y144 deletion; N501Y; A570D; and P681H L242/A243/L244 deletion; K417N E484K, N501Y K417T, E484K; N501Y Key mutation in common S106/G107/F108 deletion in Non-Structural Protein 6 (NSP6) Countries reporting cases (newly reported in last week)** 130 (5) 80 (5) 45(4) †While work is ongoing to establish standardized nomenclature for key variants, these are the names by which WHO will refer to them in this publication. **Includes official and unofficial reports of VOCs detections in countries among either travellers (imported cases only) or community samples (local transmission). Figure 4. Countries, territories and areas reporting SARS-CoV-2 VOC 202012/01 as of 30 March 2021 Figure 5. Countries, territories and areas reporting SARS-CoV-2 variant 501Y.V2 as of 30 March 2021 Figure 6. Countries, territories and areas reporting SARS-CoV-2 variant P.1 as of 30 March 2021 Emerging variants of interest (VOIs) Table 4: Overview of variants of interest (VOIs), as of 30 March 2021* Nextstrain clade 20C 20C/S.452R 20B/S.484K Not yet assigned 20C 20C PANGO lineage B.1.525 B.1.427/B.1. 429 B.1.1.28.2, alias P.2 B.1.1.28.3 alias P.3 B.1.526 (with E484K or S477N) B.1 descendant with 9 mutations GISAID clade G/484K.V3 GH/452R.V1 GR Not yet assigned GH GH Alternate names CAL.20C/L45 2R PHL-B.1.1.28 First detected by United Kingdom and Nigeria United States of America Brazil Philippines and Japan United States of America France First appearance December 2020 June 2020 April 2020 February 2021 November 2020 January 2021 Key spike mutations H69-V70 deletion; Y144 deletion; Q52R; E484K; Q677H; D614G; and F888L L452R; W152C; S13I; and D614G L18F; T20N; P26S; F157L; E484K; D614G; S929I; and V1176F 141-143 deletion; E484K; N501Y; and P681H L5F; T95I; D253G; D614G; A701V; and E484K or S477N G142 deletion; D66H; Y144V; D215G; V483A; D614G; H655Y; G669S; Q949R; and N1187D WHO recommendations and working definitions of VOI and VOC The potential for virus mutation increases with the frequency of human and animal infections. Therefore, reducing transmission of SARS-CoV-2 through established disease control methods as well as avoiding introductions to animal populations are crucial aspects of the global strategy to reduce the occurrence of mutations that have negative public health implications. PHSM remain critical to curb the spread of SARS- CoV-2, including new variants. Evidence from multiple countries with extensive transmission of VOCs has indicated that the implementation of PHSM and infection prevention and control (IPC) measures in health facilities has been effective in reducing COVID-19 case incidence, which has led to a reduction in hospitalizations and deaths among COVID-19 patients. Findings from new studies evaluating transmission, severity and impact on medical countermeasures will continue to help inform PHSM and IPC measures employed by Member States. National and local authorities are encouraged to continue strengthening existing PHSM, IPC and disease control activities, including epidemiological surveillance, strategic testing, and systematic sequencing of SARS-CoV-2 where feasible. Additional resources • Proposed working definitions of SARS-CoV-2 Variants of Interest and Variants of Concern • COVID-19 new variants: Knowledge gaps and research • PAHO Epidemiological Update: Variants of SARS-CoV-2 in the Americas - 24 March 2021 • Genomic sequencing of SARS-CoV-2: a guide to implementation for maximum impact on public health • Considerations for implementing and adjusting PHSM in the context of COVID-19 • Disease Outbreak News on SARS-CoV-2 Variants, 31 December 2020 WHO regional overviews African Region After reporting a decline in new cases for two consecutive weeks, the African Region reported a 22% increase in new cases (>62 000 cases) compared to the previous week, and over 1300 new deaths, a 6% decrease. The highest numbers of new cases were reported from Ethiopia (13 153 new cases; 11.4 new cases per 100 000 population; a 14% increase) and Kenya (9167 new cases; 17 new cases per 100 000; a 25% increase). The highest numbers of new deaths were reported from South Africa (566 new deaths; one new death per 100 000 population; a 31% decrease) and Ethiopia (137 new deaths; <0.1 new deaths per 100 000; a 28% increase). Region of the Americas The Region of the Americas reported over 1.3 million new cases and over 32 000 new deaths, an 11% and 4% increase respectively compared to the previous week. Overall, there has been an increasing trend in weekly reported cases in the last five weeks. A slight increase in new deaths has been reported in the last two weeks after a decline in deaths for the six prior weeks. The highest numbers of new cases were reported from Brazil (533 024 new cases; 250.8 new cases per 100 000; a 5% increase), the United States of America (421 936 new cases; 127.5 new cases per 100 000; a 13% increase), and Peru (60 739 new cases; 184.2 new cases per 100 000; a 24% increase). The highest numbers of new deaths were reported from Brazil (16 798 new deaths; 7.9 new deaths per 100 000; a 10% increase), the United States of America (6995 new deaths; 2.1 new deaths per 100 000; a 7% decrease), and Mexico (3643 new deaths; 2.8 new deaths per 100 000; an 8% increase). Eastern Mediterranean Region The Eastern Mediterranean Region reported just under 271 000 new cases and over 3400 new deaths, a 3% and a 5% increase respectively compared to the previous week. Both cases and deaths are on an upward trajectory with new cases increasing for the past seven weeks and deaths for the past five weeks. The highest numbers of new cases were reported from Jordan (55 467 new cases; 543.6 new cases per 100 000; a 4% decrease), the Islamic Republic of Iran (53 118 new cases; 63.2 new cases per 100 000; a 2% decrease), and Iraq (37 767 new cases; 93.9 new cases per 100 000; an 8% increase). The highest numbers of new deaths were reported from Jordan (684 new deaths; 6.7 new deaths per 100 000; a 36% increase), the Islamic Republic of Iran (584 new deaths; 0.7 new deaths per 100 000; similar to last week), and Pakistan (359 new deaths; 0.2 new deaths per 100 000; an 11% increase). European Region The European Region reported over 1.6 million new cases and just under 24 000 new deaths in the past week, an 11% and a 7% increase respectively compared to the previous week. The number of new cases in the Region has been steadily increasing over the past five weeks while the number of new deaths has increased for the past three weeks. The highest numbers of new cases were reported from France (254 228 new cases; 389.5 new cases per 100 000; a 24% increase), Poland (192 441 new cases; 508.5 new cases per 100 000; a 27% increase), and Turkey (186 421 new cases; 221.0 new cases per 100 000; a 47% increase). The highest numbers of new deaths were reported from Italy (2994 new deaths; 5.0 new deaths per 100 000; an 8% increase), the Russian Federation (2710 new deaths; 1.9 new deaths per 100 000; an 8% decrease), and Poland (2584 new deaths; 6.8 new deaths per 100 000; a 22% increase). South-East Asia Region The South-East Asia Region reported over 437 000 new cases and just under 3000 new deaths, a 46% and a 21% increase respectively compared to the previous week. Cases in the Region have been steadily increasing over the past three weeks, with a sharp increase in the past two weeks. Almost 85% of cases in the Region over the past week were from India which reported 372 494 new cases (27 new cases per 100 000; a 55% increase). The other countries reporting the highest numbers of new cases in the Region were Indonesia (36 214 new cases; 13.2 new cases per 100 000; a 12% decrease) and Bangladesh (23 100 new cases; 14.0 new cases per 100 000; an 85% increase). The highest numbers of new deaths were reported from India (1797 new deaths;< 0.1 new deaths per 100 000; a 57% increase), Indonesia (917 new deaths; 0.3 new deaths per 100 000; an 18% decrease), and Bangladesh (201 new deaths; <0.1 new deaths. per 100 000; a 43% increase). Western Pacific Region The Western Pacific Region reported over 84 000 new cases and just over 500 new deaths, a 32% and a 7% increase respectively compared to the previous week. The Region has reported a steep increase in the number of new cases over the past three weeks. The highest numbers of new cases were reported from the Philippines (56 380 new cases; 51.5 new cases per 100 000; a 43% increase), Japan (11 211 new cases; 8.9 new cases per 100 000; a 28% increase), and Malaysia (8929 new cases; 27.6 new cases per 100 000; a 4% decrease). The highest numbers of new deaths were reported from the Philippines (229 new deaths; 0.2 new deaths per 100 000; a 40% increase), Japan (219 new deaths; 0.2 new deaths per 100 000; a 13% decrease), and the Republic of Korea (26 new deaths; <0.1 new deaths per 100 000; a 4% decrease). Key weekly updates WHO Director-General's key message Opening remarks at the media briefing on COVID-19 – 26 March 2021: • A total of 177 countries and economies have started vaccination. In just one month, COVAX has distributed more than 32 million vaccines to 61 countries. • Four more vaccines are currently at different stages in the process of being assessed for WHO Emergency Use Listing, with the hope to approve at least one of them by the end of April. Vaccine publications • Evaluation of COVID-19 vaccine effectiveness, Interim guidance • Sample size calculator for evaluation of COVID-19 vaccine effectiveness (Excel) • COVAX updates participants on delivery delays for vaccines from Serum Institute of India (SII) and AstraZeneca • Joint Statement on prioritization of COVID-19 vaccination for seafarers and aircrew Surveillance of SARS-CoV-2 • Operational considerations to expedite genomic sequencing component of GISRS surveillance of SARS- CoV-2 • COVID-19 new variants: Knowledge gaps and research Technical guidance and other resources • Technical guidance • WHO Coronavirus Disease (COVID-19) Dashboard • Weekly COVID-19 Operational Updates • WHO COVID-19 case definitions • COVID-19 Supply Chain Inter-Agency Coordination Cell Weekly Situational Update • Research and Development • Online courses on COVID-19 in official UN languages and in additional national languages • The Strategic Preparedness and Response Plan (SPRP) outlining the support the international community can provide to all countries to prepare and respond to the virus • Updates from WHO regions: o African Region o Region of the Americas o Eastern Mediterranean Region o South-East Asia Region o European Region o Western Pacific Region • Recommendations and advice for the public: o Protect yourself o Questions and answers o Travel advice • EPI-WIN: tailored information for individuals, organizations and communities • WHO Academy COVID-19 mobile learning app Annex Annex 1. COVID-19 confirmed cases and deaths reported in the last seven days by countries, territories and areas, and WHO Region, as of 30 March 2021** Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Africa 62 286 3 061 438 272.9 1 340 77 446 6.9 Ethiopia 13 153 198 794 172.9 137 2 784 2.4 Community transmission Kenya 9 167 129 330 240.5 117 2 104 3.9 Community transmission Cameroon 8 681 47 669 179.6 133 721 2.7 Community transmission South Africa 7 665 1 544 466 2 604.1 566 52 648 88.8 Community transmission Botswana 2 973 38 466 1 635.7 48 506 21.5 Community transmission Côte d’Ivoire 2 555 42 468 161.0 12 229 0.9 Community transmission Zambia 1 454 87 727 477.2 20 1 198 6.5 Community transmission Madagascar 1 311 23 424 84.6 41 381 1.4 Community transmission Namibia 1 296 43 499 1 711.9 16 508 20.0 Community transmission Mozambique 1 212 67 011 214.4 22 762 2.4 Community transmission Gabon 1 129 18 426 827.9 4 109 4.9 Community transmission Ghana 1 011 90 287 290.6 24 740 2.4 Community transmission Guinea 939 19 501 148.5 8 116 0.9 Community transmission Nigeria 838 162 489 78.8 11 2 041 1.0 Community transmission Togo 837 9 676 116.9 5 107 1.3 Community transmission Senegal 763 38 456 229.7 27 1 034 6.2 Community transmission Algeria 684 116 750 266.2 22 3 077 7.0 Community transmission Cabo Verde 578 17 018 3 060.9 6 165 29.7 Community transmission Rwanda 548 21 309 164.5 13 300 2.3 Community transmission Mali 503 9 773 48.3 16 376 1.9 Community transmission Seychelles 438 4 054 4 122.1 2 18 18.3 Community transmission Democratic Republic of the Congo 419 27 886 31.1 8 734 0.8 Community transmission Angola 335 22 031 67.0 7 533 1.6 Community transmission Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Benin 282 7 100 58.6 0 90 0.7 Community transmission Malawi 242 33 458 174.9 20 1 113 5.8 Community transmission South Sudan 199 10 048 89.8 2 108 1.0 Community transmission Equatorial Guinea 166 6 902 492.0 2 102 7.3 Community transmission Mauritania 158 17 745 381.6 2 448 9.6 Community transmission Burkina Faso 157 12 673 60.6 0 145 0.7 Community transmission Zimbabwe 156 36 818 247.7 9 1 519 10.2 Community transmission Lesotho 151 10 686 498.8 6 315 14.7 Community transmission Gambia 146 5 401 223.5 2 163 6.7 Community transmission Burundi 144 2 757 23.2 0 6 0.1 Community transmission Congo 117 9 681 175.4 1 135 2.4 Community transmission Uganda 116 40 767 89.1 1 335 0.7 Community transmission Chad 91 4 501 27.4 3 160 1.0 Community transmission Eritrea 90 3 208 90.5 2 9 0.3 Community transmission Guinea-Bissau 72 3 630 184.5 6 61 3.1 Community transmission Niger 69 4 987 20.6 0 185 0.8 Community transmission Sao Tome and Principe 68 2 210 1 008.4 0 34 15.5 Community transmission Mauritius 58 870 68.4 0 10 0.8 Clusters of cases Eswatini 35 17 318 1 492.7 1 666 57.4 Community transmission Comoros 25 3 690 424.3 0 146 16.8 Community transmission Sierra Leone 14 3 962 49.7 0 79 1.0 Community transmission Liberia 11 2 053 40.6 0 85 1.7 Community transmission Central African Republic 0 5 087 105.3 0 64 1.3 Community transmission United Republic of Tanzania 0 509 0.9 0 21 0.0 Pending Territoriesiii Réunion 930 15 561 1 738.1 15 102 11.4 Community transmission Mayotte 300 19 306 7 076.6 3 154 56.4 Community transmission Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Americas 1 306 017 55 243 776 5 401.4 32 176 1 331 419 130.2 Brazil 533 024 12 404 414 5 835.7 16 798 307 112 144.5 Community transmission United States of America 421 936 29 859 706 9 021.0 6 995 543 003 164.0 Community transmission Peru 60 739 1 512 384 4 586.9 1 135 51 032 154.8 Community transmission Argentina 56 138 2 291 051 5 069.2 759 55 235 122.2 Community transmission Chile 44 824 969 913 5 073.8 473 22 653 118.5 Community transmission Colombia 42 911 2 367 337 4 652.5 874 62 645 123.1 Community transmission Mexico 31 935 2 219 845 1 721.7 3 643 200 862 155.8 Community transmission Canada 29 586 956 655 2 534.7 209 22 826 60.5 Community transmission Paraguay 14 205 204 704 2 870.0 296 3 958 55.5 Community transmission Uruguay 13 942 92 343 2 658.3 115 875 25.2 Community transmission Ecuador 11 831 322 699 1 829.0 244 16 679 94.5 Community transmission Venezuela (Bolivarian Republic of) 5 760 154 905 544.8 68 1 543 5.4 Community transmission Cuba 5 622 71 584 632.0 22 414 3.7 Community transmission Honduras 4 980 186 337 1 881.3 114 4 536 45.8 Community transmission Bolivia (Plurinational State of) 4 903 268 711 2 302.0 102 12 143 104.0 Community transmission Guatemala 4 474 192 133 1 072.4 90 6 775 37.8 Community transmission Costa Rica 3 275 215 178 4 224.0 35 2 931 57.5 Community transmission Jamaica 3 082 37 747 1 274.7 32 556 18.8 Community transmission Panama 2 797 353 017 8 181.6 52 6 087 141.1 Community transmission Dominican Republic 2 593 251 582 2 319.2 33 3 302 30.4 Community transmission El Salvador 1 235 63 766 983.1 23 1 998 30.8 Community transmission Guyana 521 10 007 1 272.3 13 225 28.6 Clusters of cases Trinidad and Tobago 118 7 939 567.3 1 141 10.1 Community transmission Bahamas 116 9 000 2 288.7 2 188 47.8 Clusters of cases Barbados 91 3 603 1 253.8 2 41 14.3 Community transmission Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Antigua and Barbuda 89 1 122 1 145.7 0 28 28.6 Clusters of cases Saint Lucia 78 4 191 2 282.3 3 58 31.6 Community transmission Belize 40 12 440 3 128.6 1 317 79.7 Community transmission Nicaragua 37 5 288 79.8 1 177 2.7 Community transmission Suriname 33 9 088 1 549.2 1 177 30.2 Clusters of cases Saint Vincent and the Grenadines 27 1 721 1 551.3 1 10 9.0 Community transmission Haiti 22 12 736 111.7 1 252 2.2 Community transmission Dominica 4 161 223.6 0 0 0.0 Clusters of cases Grenada 1 155 137.7 0 1 0.9 Sporadic cases Saint Kitts and Nevis 0 44 82.7 0 0 0.0 Sporadic cases Territoriesiii Puerto Rico 1 734 105 625 3 692.1 17 2 109 73.7 Community transmission Curaçao 1 128 6 648 4 051.4 4 27 16.5 Community transmission Aruba 449 9 073 8 498.0 1 82 76.8 Community transmission Guadeloupe 417 11 512 2 877.1 4 173 43.2 Community transmission Martinique 415 7 679 2 046.3 3 50 13.3 Community transmission Bonaire 302 1 221 5 837.9 4 10 47.8 Community transmission Bermuda 180 947 1 520.7 0 12 19.3 Sporadic cases French Guiana 158 16 922 5 665.6 2 89 29.8 Community transmission United States Virgin Islands 87 2 901 2 778.1 1 26 24.9 Community transmission Saint Barthélemy 81 857 8 669.7 0 1 10.1 Clusters of cases Turks and Caicos Islands 35 2 325 6 005.0 2 17 43.9 Clusters of cases Sint Maarten 25 2 118 4 939.1 0 27 63.0 Community transmission Saint Martin 24 1 657 4 286.2 0 12 31.0 Community transmission Cayman Islands 12 487 741.0 0 2 3.0 Sporadic cases Anguilla 1 23 153.3 0 0 0.0 Sporadic cases British Virgin Islands 0 154 509.3 0 1 3.3 Clusters of cases Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Falkland Islands (Malvinas) 0 51 1 464.3 0 0 0.0 No cases Montserrat 0 20 400.1 0 1 20.0 Sporadic cases Saba 0 6 310.4 0 0 0.0 No cases Saint Pierre and Miquelon 0 24 414.2 0 0 0.0 No cases Sint Eustatius 0 20 637.1 0 0 0.0 No cases Eastern Mediterranean 270 884 7 395 085 1 011.9 3 428 156 891 21.5 Jordan 55 467 582 133 5 705.4 684 6 472 63.4 Community transmission Iran (Islamic Republic of) 53 118 1 846 923 2 198.9 584 62 308 74.2 Community transmission Iraq 37 767 827 157 2 056.5 208 14 177 35.2 Community transmission Pakistan 26 689 649 824 294.2 359 14 158 6.4 Community transmission Lebanon 21 763 458 338 6 715.1 343 6 058 88.8 Community transmission United Arab Emirates 14 431 453 069 4 580.9 44 1 477 14.9 Community transmission Kuwait 9 245 227 178 5 319.6 64 1 279 29.9 Community transmission Libya 5 775 156 116 2 272.0 115 2 602 37.9 Community transmission Bahrain 5 492 140 818 8 275.7 15 513 30.1 Clusters of cases Oman 4 703 153 838 3 012.5 30 1 650 32.3 Community transmission Egypt 4 593 199 364 194.8 288 11 845 11.6 Clusters of cases Tunisia 4 298 249 703 2 112.8 179 8 705 73.7 Community transmission Qatar 3 929 177 135 6 148.3 12 284 9.9 Community transmission Saudi Arabia 3 141 387 794 1 113.9 41 6 643 19.1 Sporadic cases Morocco 2 895 494 358 1 339.3 35 8 798 23.8 Clusters of cases Syrian Arab Republic 1 116 18 356 104.9 74 1 227 7.0 Community transmission Somalia 870 10 838 68.2 69 488 3.1 Community transmission Djibouti 731 7 249 733.7 3 66 6.7 Community transmission Yemen 691 3 973 13.3 95 833 2.8 Community transmission Afghanistan 191 56 294 144.6 7 2 470 6.3 Sporadic cases Sudan 180 31 407 71.6 25 2 028 4.6 Community transmission Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Territoriesiii occupied Palestinian territory 13 799 263 220 5 159.7 154 2 810 55.1 Community transmission Europe 1 641 672 44 191 579 4 734.4 23 778 954 829 102.3 France 254 228 4 435 057 6 794.6 2 271 93 884 143.8 Community transmission Poland 192 441 2 250 991 5 947.7 2 584 51 884 137.1 Community transmission Turkey 186 421 3 179 115 3 769.4 964 30 923 36.7 Community transmission Italy 156 122 3 512 453 5 809.4 2 994 107 636 178.0 Clusters of cases Germany 112 885 2 772 401 3 309.0 1 206 75 870 90.6 Community transmission Ukraine 97 700 1 644 063 3 759.3 2 013 31 954 73.1 Community transmission Russian Federation 62 963 4 519 832 3 097.2 2 710 97 740 67.0 Clusters of cases Hungary 62 265 633 861 6 561.5 1 710 19 972 206.7 Community transmission Netherlands 50 622 1 244 924 7 265.4 189 16 450 96.0 Community transmission Czechia 45 482 1 515 029 14 147.3 1 207 25 874 241.6 Community transmission Romania 39 331 932 179 4 845.6 865 22 997 119.5 Community transmission The United Kingdom 37 909 4 329 184 6 377.1 451 126 573 186.4 Community transmission Serbia 34 721 581 617 8 352.0 251 5 151 74.0 Community transmission Belgium 31 828 870 757 7 513.2 185 22 897 197.6 Community transmission Sweden 30 393 780 018 7 723.5 34 13 402 132.7 Community transmission Bulgaria 25 290 327 770 4 717.2 684 12 650 182.1 Clusters of cases Austria 22 100 530 844 5 894.1 178 8 995 99.9 Community transmission Spain 20 139 3 247 738 6 946.3 178 74 420 159.2 Community transmission Greece 16 979 252 590 2 423.4 405 7 826 75.1 Community transmission Republic of Moldova 11 457 225 660 5 594.0 254 4 785 118.6 Community transmission Bosnia and Herzegovina 11 121 163 875 4 994.9 461 6 278 191.4 Community transmission Croatia 9 583 267 222 6 509.2 120 5 893 143.5 Community transmission Kazakhstan 9 279 292 306 1 556.7 110 3 696 19.7 Clusters of cases Slovakia 9 041 357 910 6 555.6 452 9 496 173.9 Clusters of cases Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Azerbaijan 8 880 254 370 2 508.8 125 3 464 34.2 Clusters of cases Switzerland 8 395 589 486 6 811.2 31 9 577 110.7 Community transmission Belarus 8 338 317 631 3 361.4 63 2 211 23.4 Community transmission Estonia 8 229 103 630 7 812.1 60 847 63.9 Clusters of cases North Macedonia 7 494 126 230 6 058.9 194 3 642 174.8 Community transmission Armenia 6 604 190 317 6 422.6 116 3 464 116.9 Community transmission Slovenia 6 526 212 039 10 199.4 33 4 309 207.3 Clusters of cases Norway 6 381 90 934 1 677.4 8 656 12.1 Community transmission Denmark 5 017 227 049 3 919.9 14 2 413 41.7 Community transmission Lithuania 4 930 213 941 7 858.9 75 3 551 130.4 Community transmission Finland 4 422 75 545 1 363.5 12 817 14.7 Community transmission Ireland 4 106 233 937 4 737.7 68 4 653 94.2 Community transmission Israel 4 008 831 084 9 601.8 81 6 165 71.2 Community transmission Latvia 3 567 100 716 5 339.6 51 1 872 99.2 Community transmission Albania 3 100 123 641 4 296.4 71 2 204 76.6 Clusters of cases Portugal 2 962 820 042 8 042.2 65 16 827 165.0 Clusters of cases Georgia 2 821 280 301 7 026.6 51 3 751 94.0 Community transmission Montenegro 2 454 90 081 14 342.6 42 1 241 197.6 Clusters of cases Cyprus 2 423 44 305 3 669.6 8 250 20.7 Clusters of cases Luxembourg 1 545 60 755 9 705.6 23 738 117.9 Community transmission Uzbekistan 1 001 82 340 246.0 4 626 1.9 Clusters of cases Malta 904 28 808 6 524.4 16 385 87.2 Clusters of cases Kyrgyzstan 703 88 092 1 350.2 5 1 495 22.9 Clusters of cases Andorra 328 11 809 15 283.8 2 115 148.8 Community transmission San Marino 270 4 626 13 630.7 5 84 247.5 Community transmission Monaco 81 2 254 5 743.6 1 28 71.3 Sporadic cases Iceland 66 6 163 1 806.0 0 29 8.5 Community transmission Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Liechtenstein 19 2 731 7 161.0 0 54 141.6 Sporadic cases Holy See 0 26 3 213.8 0 0 0.0 Sporadic cases Tajikistan 0 13 714 143.8 0 91 1.0 Pending Territoriesiii Kosovo [1] 5 675 87 024 4 677.8 78 1 820 97.8 Community transmission Isle of Man 119 1 551 1 824.0 0 26 30.6 No cases Gibraltar 3 4 273 12 682.9 0 94 279.0 Clusters of cases Jersey 1 3 225 2 964.2 0 69 63.4 Community transmission Faroe Islands 0 661 1 352.7 0 1 2.0 Sporadic cases Greenland 0 31 54.6 0 0 0.0 No cases Guernsey 0 821 1 299.1 0 14 22.2 Community transmission South-East Asia 437 060 14 619 886 723.3 2 947 217 737 10.8 India 372 494 11 971 624 867.5 1 797 161 552 11.7 Clusters of cases Indonesia 36 214 1 492 002 545.5 917 40 364 14.8 Community transmission Bangladesh 23 100 591 806 359.3 201 8 869 5.4 Community transmission Sri Lanka 1 993 91 839 428.9 14 558 2.6 Clusters of cases Maldives 1 030 23 403 4 329.5 1 66 12.2 Clusters of cases Thailand 931 28 734 41.2 4 94 0.1 Clusters of cases Nepal 921 276 750 949.8 11 3 027 10.4 Clusters of cases Timor-Leste 209 480 36.4 0 0 0.0 Clusters of cases Myanmar 165 142 377 261.7 2 3 206 5.9 Clusters of cases Bhutan 3 871 112.9 0 1 0.1 Sporadic cases Western Pacific 84 395 1 859 933 94.7 518 31 361 1.6 Philippines 56 380 712 417 650.1 229 13 159 12.0 Community transmission Japan 11 211 466 849 369.1 219 9 031 7.1 Clusters of cases Malaysia 8 929 340 642 1 052.5 22 1 251 3.9 Clusters of cases Republic of Korea 3 100 101 757 198.5 26 1 722 3.4 Clusters of cases Reporting Country/Territory/Areai New cases in last 7 days Cumulative cases Cumulative cases per 100 thousand population New deaths in last 7 days Cumulative deaths Cumulative deaths per 100 thousand population Transmission classificationii Mongolia 1 887 6 693 204.2 1 6 0.2 Clusters of cases Papua New Guinea 1 846 5 205 58.2 9 45 0.5 Community transmission Cambodia 553 2 233 13.4 7 10 0.1 Sporadic cases China 157 102 680 7.0 2 4 851 0.3 Clusters of cases Singapore 104 60 288 1 030.5 0 30 0.5 Sporadic cases Australia 60 29 252 114.7 0 909 3.6 Clusters of cases New Zealand 29 2 126 44.1 0 26 0.5 Clusters of cases Viet Nam 18 2 590 2.7 0 35 0.0 Clusters of cases Brunei Darussalam 1 206 47.1 0 3 0.7 Clusters of cases Fiji 0 67 7.5 0 2 0.2 Sporadic cases Lao People's Democratic Republic 0 49 0.7 0 0 0.0 Sporadic cases Solomon Islands 0 18 2.6 0 0 0.0 No cases Territoriesiii Wallis and Futuna 65 376 3 343.4 3 4 35.6 Sporadic cases French Polynesia 31 18 607 6 623.9 0 141 50.2 Sporadic cases Guam 17 7 587 4 495.3 0 134 79.4 Clusters of cases New Caledonia 5 121 42.4 0 0 0.0 Sporadic cases Northern Mariana Islands (Commonwealth of the) 2 159 276.2 0 2 3.5 Pending Marshall Islands 0 4 6.8 0 0 0.0 No cases Samoa 0 4 2.0 0 0 0.0 No cases Vanuatu 0 3 1.0 0 0 0.0 No cases Global 3 802 314 126 372 442 1 621.2 64 187 2 769 696 35.5 *See Annex: Data, table and figure notes Annex 2. List of countries/territories/areas reporting variants of concern as of 30 March 2021** Country/Territory/Area VOC 202012/01 (B.1.1.7) 501Y.v2 (B.1.351) P.1 (B.1.1.28) Albania Not Verified Algeria Verified Angola Verified Verified Argentina Verified Verified Aruba Verified Verified Verified Australia Verified Verified Not Verified Austria Verified Verified Verified Azerbaijan Verified Bahrain Verified Bangladesh Verified Barbados Verified Belarus Verified Belgium Verified Verified Verified Belize Verified Bonaire Verified Bosnia and Herzegovina Not Verified Botswana Verified Brazil Verified Verified Brunei Darussalam Verified Verified Bulgaria Verified Cabo Verde Verified Cambodia Verified Cameroon Verified Canada Verified Verified Verified Cayman Islands Verified Chile Verified Verified Country/Territory/Area VOC 202012/01 (B.1.1.7) 501Y.v2 (B.1.351) P.1 (B.1.1.28) China Verified Verified Not Verified Colombia Verified Comoros Verified Costa Rica Verified Verified Croatia Verified Not Verified Cuba Verified Curaçao Verified Cyprus Verified Czechia Verified Not Verified Democratic Republic of the Congo Verified Verified Denmark Verified Verified Verified Dominican Republic Verified Ecuador Verified Estonia Verified Not Verified Eswatini Verified Faroe Islands Verified Finland Verified Verified Verified France Verified Verified Verified French Guiana Verified Verified French Polynesia Verified Gambia Verified Georgia Verified Germany Verified Verified Verified Ghana Verified Verified Gibraltar Not Verified Country/Territory/Area VOC 202012/01 (B.1.1.7) 501Y.v2 (B.1.351) P.1 (B.1.1.28) Greece Verified Verified Guadeloupe Verified Verified Verified Hungary Verified Not Verified Iceland Verified India Verified Verified Verified Indonesia Verified Iran (Islamic Republic of) Verified Iraq Verified Ireland Verified Verified Not Verified Israel Verified Verified Italy Verified Not Verified Verified Jamaica Verified Japan Verified Verified Verified Jordan Verified Kazakhstan Not Verified Not Verified Kenya Not Verified Verified Kosovo[1] Verified Kuwait Verified Latvia Verified Verified Lebanon Verified Lesotho Verified Libya Verified Verified Liechtenstein Verified Lithuania Verified Verified Luxembourg Verified Verified Malawi Verified Verified Malaysia Verified Not Verified Country/Territory/Area VOC 202012/01 (B.1.1.7) 501Y.v2 (B.1.351) P.1 (B.1.1.28) Malta Verified Not Verified Martinique Verified Verified Verified Mauritania Verified Verified Mauritius Not Verified Mayotte Verified Verified Mexico Verified Verified Monaco Verified Not Verified Montenegro Verified Morocco Verified Mozambique Verified Namibia Verified Nepal Verified Netherlands Verified Verified Verified New Caledonia Verified New Zealand Verified Verified Not Verified Nigeria Verified North Macedonia Verified Norway Verified Verified Verified occupied Palestinian territory Verified Verified Oman Verified Pakistan Verified Panama Verified Verified Paraguay Verified Peru Verified Verified Philippines Verified Verified Verified Poland Verified Not Verified Country/Territory/Area VOC 202012/01 (B.1.1.7) 501Y.v2 (B.1.351) P.1 (B.1.1.28) Portugal Verified Verified Not Verified Puerto Rico Verified Qatar Verified Verified Republic of Korea Verified Verified Verified Republic of Moldova Not Verified Réunion Verified Verified Verified Romania Verified Verified Verified Russian Federation Verified Not Verified Rwanda Not Verified Not Verified Saint Barthélemy Verified Saint Lucia Verified Saint Martin Verified Verified Verified Saudi Arabia Verified Senegal Verified Serbia Verified Singapore Verified Not Verified Sint Maarten Verified Slovakia Verified Not Verified Slovenia Verified Verified Not Verified South Africa Verified Verified Spain Verified Verified Verified Sri Lanka Verified Verified Country/Territory/Area VOC 202012/01 (B.1.1.7) 501Y.v2 (B.1.351) P.1 (B.1.1.28) Sweden Verified Verified Verified Switzerland Verified Verified Not Verified Thailand Verified Verified The United Kingdom Verified Verified Verified Togo Verified Trinidad and Tobago Verified Tunisia Verified Turkey Verified Not Verified Not Verified Turks and Caicos Islands Verified Uganda Not Verified Ukraine Not Verified United Arab Emirates Verified Verified Verified United Republic of Tanzania Verified United States of America Verified Verified Verified Uruguay Verified Verified Uzbekistan Verified Venezuela (Bolivarian Republic of) Verified Viet Nam Verified Verified Wallis and Futuna Not Verified Zambia Verified Zimbabwe Verified **See Annex : Data, table and figure notes Annex 3. Data, table and figure notes Data presented are based on official laboratory-confirmed COVID-19 case and deaths reported to WHO by country/territories/areas, largely based upon WHO case definitions and surveillance guidance. While steps are taken to ensure accuracy and reliability, all data are subject to continuous verification and change, and caution must be taken when interpreting these data as several factors influence the counts presented, with variable underestimation of true case and death incidence, and variable delays to reflecting these data at global level. Case detection, inclusion criteria, testing strategies, reporting practices, and data cut-off and lag times differ between countries/territories/areas. A small number of countries/territories/areas report combined probable and laboratory-confirmed cases. Differences are to be expected between information products published by WHO, national public health authorities, and other sources. Due to public health authorities conducting data reconciliation exercises which remove large numbers of cases or deaths from their total counts, negative numbers may be displayed in the new cases/deaths columns as appropriate. When additional details become available that allow the subtractions to be suitably apportioned to previous days, graphics will be updated accordingly. A record of historic data adjustment made is available upon request by emailing epi-data-support@who.int. Please specify the country(ies) of interest, time period(s), and purpose of the request/intended usage. Prior situation reports will not be edited; see covid19.who.int for the most up-to-date data. Global totals include 745 cases and 13 deaths reported from international conveyances. The designations employed, and the presentation of these materials do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Countries, territories and areas are arranged under the administering WHO region. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. [1] All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999). In the map, number of cases of Serbia and Kosovo (UNSCR 1244, 1999) have been aggregated for visualization purposes. i Excludes countries, territories, and areas that have never reported a confirmed COVID-19 case (Annex 1), or the detection of a variant of concern (Annex 2). ii Transmission classification is based on a process of country/territory/area self-reporting. Classifications are reviewed on a weekly basis and may be revised as new information becomes available. Differing degrees of transmission may be present within countries/territories/areas. For further information, please see: Considerations for implementing and adjusting public health and social measures in the context of COVID-19: • No (active) cases: No new cases detected for at least 28 days (two times the maximum incubation period), in the presence of a robust surveillance system. This implies a near-zero risk of infection for the general population. • Imported / Sporadic cases: Cases detected in the past 14 days are all imported, sporadic (e.g., laboratory acquired or zoonotic) or are all linked to imported/sporadic cases, and there are no clear signals of further locally acquired transmission. This implies minimal risk of infection for the general population. • Clusters of cases: Cases detected in the past 14 days are predominantly limited to well-defined clusters that are not directly linked to imported cases, but which are all linked by time, geographic location and common exposures. It is assumed that there are a number of unidentified cases in the area. This implies a low risk of infection to others in the wider community if exposure to these clusters is avoided. • Community transmission: Which encompasses a range of levels from low to very high incidence, as described below and informed by a series of indicators described in the aforementioned guidance. As these subcategorization are not currently collated at the global level, but rather intended for use by national and sub-national public health authorities for local decision-making, community transmission has not been disaggregated in this information product. o CT1: Low incidence of locally acquired, widely dispersed cases detected in the past 14 days, with many of the cases not linked to specific clusters; transmission may be focused in certain population sub-groups. Low risk of infection for the general population. o CT2: Moderate incidence of locally acquired, widely dispersed cases detected in the past 14 days; transmission less focused in certain population sub-groups. Moderate risk of infection for the general population. o CT3: High incidence of locally acquired, widely dispersed cases in the past 14 days; transmission widespread and not focused in population sub-groups. High risk of infection for the general population. o CT4: Very high incidence of locally acquired, widely dispersed cases in the past 14 days. Very high risk of infection for the general population. • Pending: transmission classification has not been reported to WHO. iii “Territories” include territories, areas, overseas dependencies and other jurisdictions of similar status.