Coronavirus disease (COVID-19): situation report, 189

Coronavirus disease (COVID-19) Situation Report – 189 Data as received by WHO from national authorities by 10:00 CEST, 27 July 2020 Highlights This Thursday it will be six months since WHO declared COVID-19 a Public Health Emergency of International Concern. At today’s press briefing WHO Director-General Dr Tedros reiterated the basic measures that are needed to suppress transmission and save lives -- to find, isolate, test and care for cases; and trace and quarantine their contacts. “Where these measures are followed, cases go down. Where they’re not, cases go up”. The Subject in Focus today highlights the Second Global Research and Innovation Forum which was hosted virtually by WHO on 1 and 2 July 2020. This followed on from the first forum held in February 2020. Approximately 1200 participants from nearly 100 countries convened to review the science, to establish what we know now that we didn’t know at the start of the pandemic, and to set priorities for the COVID-19 research agenda. Situation in numbers (by WHO Region) Total (new cases in last 24 hours) Globally 16 114 449 cases (254 274) 646 641 deaths (5 490) Africa 712 920 cases (16 713) 11 900 deaths (192) Americas 8 610 134 cases (150 089) 337 439 deaths (3 715) Eastern Mediterranean 1 482 315 cases (12 336) 37 932 deaths (450) Europe 3 234 043 cases (17 409) 210 518 deaths (257) South-East Asia 1 786 145 cases (53 897) 40 615 deaths (829) Western Pacific 288 151 cases (3 830) 8 224 deaths (47) Subject in Focus: Second Global Research Forum, 1-2 July 2020 Following on from the first Global Research and Innovation Forum hosted by WHO on 11-12 February, a second follow-up forum was convened virtually on 1-2 July. The first forum in February brought together over 350 scientists and public health experts from around the world to define the research priorities for COVID-19. A coordinated Global Research Roadmap was developed ,using the WHO R&D Blueprint framework and based on the deliberations from the Forum. The research roadmap prioritized nine thematic areas of research based on agreed research questions and critical science gaps as they relate to COVID-19. This forum enabled thematic working groups to be established to carry work forward – each composed of experts led by an external chair, with WHO acting as the Secretariat for each. Since February, this global collaboration and coordination has been pivotal in promptly delivering results and research findings to the global community. Without it, the consolidation of knowledge related to the virus and disease could simply not have happened as efficiently, effectively and quickly. On 1-2 July 2020, the second Global Research and Innovation Forum was held virually, allowing 1,200 participants from nearly 100 countries, representing all six WHO regions. An important element of this second Forum was to sustain the momentum generated during the February meeting within the global scientific community, and to ensure regional and country office counterparts have the opportunity to engage and be updated on research progress for COVID-19. The follow-up forum took stock of the progress made; reviewed critical research findings against the nine thematic areas of research; discussed new emerging research questions and science gaps; and defined the research priorities for the remainder of the year and beyond. Specifically, the forum reviewed the accumulated scientific knowledge around the following areas: o Clinical characterization and the effect of support therapies in survival o Transmission, severity, susceptibility, and control and mitigation measures o Zoonotic sources and new animal reservoir with ability to transmit to humans o Viral shedding and transmission dynamics o Protecting health care workers and the public from the virus during the pandemic o Repurposing existing drugs to treat severe hospitalized cases of COVID-19 o The social sciences of COVID-19 including the effects on mental health and others In addition, the forum discussed the following prioity research questions: o How to continue to develop robust evidence to inform standard of care? o How can epidemiological studies further contribute to controlling the virus? o How to tailor the selection and evaluation of therapeutics to increased understanding of the disease? o How to ensure most candidate vaccines are adequately evaluated until they fail ? o For clinical trials for vaccines, what study designs need to be considered? o What are the key methodological considerations to achieve speed and rigour in the development of a vaccine? This Forum helped to highlight that research continues to be a critical tool to inform the response to the COVID-19 pandemic. This research is helping to save lives now and will continue to do so in the future. In a time of global crisis, the spotlight and the eyes of the world are on science to help control the current pandemic and to better safeguard our future with measures that can help prevent another outbreak. The media briefing on the outcomes of the Forum are available on this link: https://www.youtube.com/watch?v=yjdiGRRAxjg Forum presentations are available for the next two weeks on: https://www.dropbox.com/sh/wllc2fv9sxx11mr/AABs8t137XCnZ_i2Z7BA3FE-a?dl=0 Surveillance Figure 1. Number of confirmed* COVID-19 cases reported in the last seven days by country, territory or area, 21 July to 27 July ** **See Annex 1 for data, table and figure notes. Figure 2. Number of confirmed* COVID-19 cases, by date of report and WHO region, 30 December through 27 July** **See Annex 1 for data, table and figure notes. Table 1. Countries, territories or areas with reported laboratory-confirmed* COVID-19 cases and deaths, by WHO region. Data as of 10 AM CEST, 27 July 2020** Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Africa South Africa 445 433 11 233 6 769 114 Community transmission 0 Nigeria 40 532 555 858 2 Community transmission 0 Ghana 32 437 586 161 0 Community transmission 0 Algeria 27 357 1 198 1 155 19 Community transmission 0 Cameroon 17 110 402 391 6 Community transmission 0 Kenya 16 643 0 278 0 Community transmission 1 Côte d’Ivoire 15 596 102 96 2 Community transmission 0 Ethiopia 13 968 720 223 14 Community transmission 0 Senegal 9 681 129 191 4 Community transmission 0 Madagascar 9 295 429 85 7 Community transmission 0 Democratic Republic of the Congo 8 830 64 203 3 Community transmission 0 Guinea 7 008 81 43 1 Community transmission 0 Gabon 6 984 0 49 0 Community transmission 2 Mauritania 6 171 55 156 0 Community transmission 0 Central African Republic 4 598 0 59 0 Community transmission 1 Zambia 4 481 153 139 0 Community transmission 0 Malawi 3 664 107 99 5 Community transmission 0 Congo 3 159 121 54 3 Community transmission 0 Zimbabwe 2 512 78 34 0 Clusters of cases 0 Mali 2 510 7 123 0 Community transmission 0 Equatorial Guinea 2 350 0 41 0 Community transmission 10 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Cabo Verde 2 307 49 22 0 Clusters of cases 0 South Sudan 2 305 43 46 1 Community transmission 0 Eswatini 2 207 65 32 4 Community transmission 0 Guinea-Bissau 1 954 0 26 0 Community transmission 6 Rwanda 1 823 71 5 0 Clusters of cases 0 Sierra Leone 1 783 15 66 0 Community transmission 0 Namibia 1 774 87 8 1 Clusters of cases 0 Benin 1 770 76 35 1 Community transmission 0 Mozambique 1 669 53 11 0 Community transmission 0 Liberia 1 162 27 72 1 Community transmission 0 Niger 1 132 8 69 0 Community transmission 0 Uganda 1 115 12 2 1 Clusters of cases 0 Burkina Faso 1 086 5 53 0 Community transmission 0 Angola 932 16 40 1 Clusters of cases 0 Chad 915 0 75 0 Community transmission 3 Togo 868 15 18 1 Community transmission 0 Sao Tome and Principe 863 1 14 0 Clusters of cases 0 Botswana 686 0 1 0 Clusters of cases 2 United Republic of Tanzania 509 0 21 0 Community transmission 80 Lesotho 505 59 12 1 Clusters of cases 0 Burundi 361 16 1 0 Clusters of cases 0 Comoros 354 14 7 0 Community transmission 0 Mauritius 344 0 10 0 Sporadic cases 2 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Gambia 277 61 6 0 Sporadic cases 0 Eritrea 263 0 0 0 Sporadic cases 1 Seychelles 107 0 0 0 Sporadic cases 4 Territoriesii Mayotte 2 873 0 38 0 Clusters of cases 2 Réunion 657 0 3 0 Clusters of cases 1 Americas United States of America 4 148 011 63 968 145 727 929 Community transmission 0 Brazil 2 394 513 51 147 86 449 1 211 Community transmission 0 Mexico 385 036 6 751 43 374 729 Community transmission 0 Peru 379 884 3 923 18 030 187 Community transmission 0 Chile 345 790 2 198 9 112 92 Community transmission 0 Colombia 240 795 7 254 8 269 294 Community transmission 0 Argentina 158 321 4 801 2 913 66 Community transmission 0 Canada 113 556 350 8 885 4 Community transmission 0 Ecuador 80 694 658 5 515 8 Community transmission 0 Bolivia (Plurinational State of) 68 281 1 825 2 535 62 Community transmission 0 Dominican Republic 62 908 2 012 1 063 8 Community transmission 0 Panama 58 864 871 1 275 25 Community transmission 0 Guatemala 45 053 561 1 734 35 Community transmission 0 Honduras 38 438 879 1 098 37 Community transmission 0 Venezuela (Bolivarian Republic of) 14 929 666 138 4 Community transmission 0 El Salvador 14 630 409 400 10 Community transmission 0 Costa Rica 14 600 931 98 11 Community transmission 0 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Haiti 7 297 37 157 1 Community transmission 0 Paraguay 4 328 104 40 2 Community transmission 0 Nicaragua 3 004 0 108 0 Community transmission 5 Cuba 2 495 17 87 0 Clusters of cases 0 Suriname 1 381 76 23 0 Clusters of cases 0 Uruguay 1 174 8 34 0 Clusters of cases 0 Jamaica 837 6 10 0 Clusters of cases 0 Guyana 360 8 20 0 Clusters of cases 0 Bahamas 326 10 11 0 Clusters of cases 0 Trinidad and Tobago 147 0 8 0 Sporadic cases 1 Barbados 108 0 7 0 Clusters of cases 1 Antigua and Barbuda 82 0 3 0 Clusters of cases 1 Saint Vincent and the Grenadines 52 0 0 0 Sporadic cases 3 Belize 48 0 2 0 Sporadic cases 1 Saint Lucia 24 0 0 0 Sporadic cases 3 Grenada 23 0 0 0 Clusters of cases 61 Dominica 18 0 0 0 Clusters of cases 44 Saint Kitts and Nevis 17 0 0 0 No cases 16 Territoriesii Puerto Rico 15 143 603 201 0 Community transmission 0 French Guiana 7 332 0 41 0 Community transmission 1 United States Virgin Islands 361 9 7 0 Clusters of cases 0 Martinique 269 0 15 0 Clusters of cases 2 Cayman Islands 203 0 1 0 Sporadic cases 12 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Guadeloupe 203 0 14 0 Clusters of cases 2 Bermuda 154 1 9 0 Sporadic cases 0 Aruba 117 0 3 0 Sporadic cases 4 Turks and Caicos Islands 97 5 2 0 Clusters of cases 0 Sint Maarten 94 0 15 0 Sporadic cases 2 Saint Martin 49 0 3 0 Sporadic cases 1 Curaçao 29 0 1 0 Sporadic cases 2 Falkland Islands (Malvinas) 13 0 0 0 No cases 92 Montserrat 13 1 1 0 No cases 0 Bonaire, Sint Eustatius and Saba 11 0 0 0 Sporadic cases 3 British Virgin Islands 8 0 1 0 No cases 72 Saint Barthélemy 7 0 0 0 No cases 1 Saint Pierre and Miquelon 4 0 0 0 Sporadic cases 10 Anguilla 3 0 0 0 No cases 114 Eastern Mediterranean Iran (Islamic Republic of) 291 172 2 333 15 700 216 Community transmission 0 Pakistan 274 289 1 176 5 842 20 Clusters of cases 0 Saudi Arabia 266 941 1 968 2 733 30 Clusters of cases 0 Iraq 110 032 2 459 4 362 78 Community transmission 0 Qatar 109 305 269 165 1 Community transmission 0 Egypt 92 062 479 4 606 48 Clusters of cases 0 Oman 76 005 1 147 384 13 Community transmission 0 Kuwait 63 773 464 433 4 Clusters of cases 0 United Arab Emirates 58 913 351 344 1 Community transmission 0 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Bahrain 39 131 384 141 4 Clusters of cases 0 Afghanistan 36 263 106 1 269 10 Clusters of cases 0 Morocco 20 278 633 313 8 Clusters of cases 0 Sudan 11 424 39 720 3 Community transmission 0 Djibouti 5 050 11 58 0 Clusters of cases 0 Lebanon 3 750 168 51 4 Clusters of cases 0 Somalia 3 178 0 93 0 Sporadic cases 1 Libya 2 669 122 60 2 Clusters of cases 0 Yemen 1 685 7 480 5 Community transmission 0 Tunisia 1 452 9 50 0 Sporadic cases 0 Jordan 1 168 - 142 11 0 Clusters of cases 0 Syrian Arab Republic 650 23 38 2 Community transmission 0 Territoriesii occupied Palestinian territory 13 125 330 79 1 Clusters of cases 0 Europe Russian Federation 818 120 5 635 13 354 85 Clusters of cases 0 The United Kingdom 299 430 745 45 752 14 Community transmission 0 Spain 272 421 0 28 432 0 Clusters of cases 2 Italy 246 118 254 35 107 5 Clusters of cases 0 Turkey 226 100 927 5 613 17 Community transmission 0 Germany 205 609 340 9 118 0 Clusters of cases 0 France 169 222 0 30 078 0 Clusters of cases 2 Kazakhstan 83 122 1 402 585 0 Clusters of cases 0 Sweden 78 997 0 5 697 0 Community transmission 2 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Belarus 66 846 0 524 0 Community transmission 2 Belgium 65 933 0 9 821 0 Community transmission 1 Ukraine 65 656 807 1 616 11 Community transmission 0 Israel 61 339 1 199 463 9 Community transmission 0 Netherlands 52 946 214 6 140 0 Community transmission 0 Portugal 50 164 209 1 717 1 Clusters of cases 0 Romania 44 798 1 120 2 187 22 Community transmission 0 Poland 43 065 443 1 671 7 Community transmission 0 Armenia 37 390 73 711 6 Community transmission 0 Switzerland 34 325 110 1 700 1 Community transmission 0 Kyrgyzstan 33 296 483 1 301 24 Clusters of cases 0 Azerbaijan 30 050 417 417 9 Clusters of cases 0 Ireland 25 881 12 1 764 0 Clusters of cases 0 Serbia 23 730 467 534 8 Community transmission 0 Republic of Moldova 23 034 206 740 7 Community transmission 0 Uzbekistan 20 820 594 117 5 Clusters of cases 0 Austria 20 486 137 712 0 Community transmission 0 Czechia 15 324 112 371 3 Clusters of cases 0 Denmark 13 438 0 613 0 Community transmission 2 Bulgaria 10 427 115 340 2 Clusters of cases 0 Bosnia and Herzegovina 10 332 263 285 2 Community transmission 0 North Macedonia 10 086 152 460 0 Clusters of cases 0 Norway 9 085 0 255 0 Clusters of cases 2 Finland 7 393 5 329 0 Clusters of cases 0 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Tajikistan 7 192 42 59 0 Pending 0 Luxembourg 6 272 83 112 0 Community transmission 0 Croatia 4 857 65 136 3 Clusters of cases 0 Albania 4 763 126 138 4 Clusters of cases 0 Hungary 4 448 13 596 0 Community transmission 0 Greece 4 193 27 202 1 Clusters of cases 0 Montenegro 2 851 282 43 3 Clusters of cases 0 Slovakia 2 179 38 28 0 Clusters of cases 0 Slovenia 2 082 16 115 0 Clusters of cases 0 Estonia 2 034 1 69 0 Clusters of cases 0 Lithuania 2 008 7 80 0 Community transmission 0 Iceland 1 847 4 10 0 Community transmission 0 Latvia 1 219 13 31 0 Clusters of cases 0 Georgia 1 137 6 16 0 Sporadic cases 0 Cyprus 1 057 4 19 0 Clusters of cases 0 Andorra 904 7 52 0 Community transmission 0 San Marino 716 0 42 0 Community transmission 17 Malta 700 14 9 0 Sporadic cases 0 Monaco 99 0 1 0 Sporadic cases 50 Liechtenstein 87 0 1 0 Sporadic cases 7 Holy See 12 0 0 0 Sporadic cases 81 Territoriesii Kosovo[1] 7 094 220 167 8 Community transmission 0 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Isle of Man 336 0 24 0 No cases 66 Jersey 332 0 31 0 Community transmission 1 Guernsey 252 0 13 0 Community transmission 85 Faroe Islands 191 0 0 0 Sporadic cases 7 Gibraltar 185 0 0 0 Clusters of cases 1 Greenland 13 0 0 0 No cases 59 South-East Asia India 1 435 453 49 931 32 771 708 Clusters of cases 0 Bangladesh 223 453 2 275 2 928 54 Community transmission 0 Indonesia 98 778 1 492 4 781 67 Community transmission 0 Nepal 18 613 130 45 0 Clusters of cases 0 Maldives 3 302 50 15 0 Clusters of cases 0 Thailand 3 295 4 58 0 Clusters of cases 0 Sri Lanka 2 782 12 11 0 Clusters of cases 0 Myanmar 350 1 6 0 Clusters of cases 0 Bhutan 95 2 0 0 Sporadic cases 0 Timor-Leste 24 0 0 0 No cases 94 Western Pacific China 87 028 189 4 659 0 Clusters of cases 0 Philippines 80 448 2 036 1 932 35 Community transmission 0 Singapore 50 369 481 27 0 Clusters of cases 0 Japan 29 989 607 996 0 Clusters of cases 0 Australia 14 403 453 155 10 Clusters of cases 0 Reporting Country/Territory/Area Total confirmed* cases Total confirmed* new cases Total deaths Total new deaths Transmission classificationi Days since last reported case Republic of Korea 14 175 25 299 1 Clusters of cases 0 Malaysia 8 897 13 124 1 Clusters of cases 0 New Zealand 1 206 0 22 0 Clusters of cases 3 Viet Nam 420 2 0 0 Clusters of cases 0 Mongolia 288 0 0 0 Sporadic cases 2 Cambodia 225 0 0 0 Sporadic cases 1 Brunei Darussalam 141 0 3 0 No cases 80 Papua New Guinea 62 23 0 0 Sporadic cases 0 Fiji 27 0 0 0 Sporadic cases 6 Lao People's Democratic Republic 20 0 0 0 Sporadic cases 2 Territoriesii Guam 329 0 5 0 Clusters of cases 3 French Polynesia 62 0 0 0 Sporadic cases 29 Northern Mariana Islands (Commonwealth of the) 40 1 2 0 Pending 0 New Caledonia 22 0 0 0 Sporadic cases 12 Subtotal for all regions 16 113 708 254 274 646 628 5 490 Other† 741 0 13 0 Not applicable - Grand total 16 114 449 254 274 646 641 5 490 **See Annex 1 for data, table and figure notes. Technical guidance and other resources – To view all technical guidance documents regarding COVID-19, please go to this webpage. – Updates from WHO regional offices – WHO AFRO – WHO PAHO – WHO EMRO – WHO SEARO – WHO EURO – WHO WPRO – Research and Development – Online courses on COVID-19 and in additional national languages – The Strategic Preparedness and Response Plan (SPRP) outlining the support the international community can provide to all countries to prepare and respond to the virus – WHO Coronavirus Disease (COVID-19) Dashboard – Weekly COVID-19 Operations Updates Recommendations and advice for the public – Protect yourself – Questions and answers – Travel advice – EPI-WIN: tailored information for individuals, organizations and communities Case definitions WHO periodically updates the Global Surveillance for human infection with coronavirus disease (COVID-19) document which includes surveillance definitions. Definition of COVID-19 death A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g. trauma). There should be no period of complete recovery between the illness and death. Further guidance for certification and classification (coding) of COVID-19 as cause of death is available here and here. Annex 1: Data, table and figure notes Caution must be taken when interpreting all data presented. Differences are to be expected between information products published by WHO, national public health authorities, and other sources using different inclusion criteria and different data cut-off times. While steps are taken to ensure accuracy and reliability, all data are subject to continuous verification and change. Case detection, definitions, testing strategies, reporting practice, and lag times differ between countries/territories/areas. These factors, amongst others, influence the counts presented, with variable underestimation of true case and death counts, and variable delays to reflecting these data at global level. The designations employed, and the presentation of these materials do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Countries, territories and areas are arranged under the administering WHO region. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. [1] All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999). In the map, number of cases of Serbia and Kosovo (UNSCR 1244, 1999) have been aggregated for visualization purposes. *A small number of countries/territories/areas report combined probable and laboratory-confirmed cases; efforts are underway to identify these for notation in the data table.†Other: includes cases reported from international conveyances. Due to the recent trend of countries conducting data reconciliation exercises which remove large numbers of cases or deaths from their total counts, WHO will now display such data as negative numbers in the “new cases” / “new deaths” columns as appropriate. This will aid readers in identifying when such adjustments occur. When additional details become available that allow the subtractions to be suitably apportioned to previous days, graphics will be updated accordingly. Prior situation reports will not be edited; see covid19.who.int for the most up-to-date data. Additional table notes i Transmission classification is based on a process of country/territory/area self-reporting. Classifications are reviewed on a weekly basis and may be revised as new information becomes available. Differing degrees of transmission may be present within countries/territories/areas; classification is based on the highest category reported within a country/territory/area. Categories: • No cases: with no confirmed cases; • Sporadic cases: with one or more cases, imported or locally detected; • Clusters of cases: experiencing cases, clustered in time, geographic location and/or by common exposures; • Community transmission: experiencing larger outbreaks of local transmission defined through an assessment of factors including, but not limited to: large numbers of cases not linkable to transmission chains; large numbers of cases from sentinel lab surveillance; and/or multiple unrelated clusters in several areas of the country/territory/area; • Pending: transmission classification has not been reported to WHO. ii “Territories” include territories, areas, overseas dependencies and other jurisdictions of similar status. Country, territory, or area-specific notes, updates and errata • Update 27 July 2020, Montenegro: Counts adjusted retrospectively by national authorities: case and death counts adjusted between 19 March to 1 April, on 9 May, and from 14 June to 26 July . • Update 27 July 2020, Belgium: Counts adjusted retrospectively by national authorities: case and death counts adjusted between 9 May to 25 July . • Update 27 July 2020, USA: Counts adjusted retrospectively by national authorities: case count adjusted for 26 July (added 74,235 cases and 1,135 deaths instead of 0 new cases and 0 new deaths).