Image Credit: Pixabay, user name: geralt
This past week has been particularly alarming since the spread of Coronavirus (COVID-19) began on the 31st December 2019. The number of new infections has been accelerating and the global mortality rate edging in the wrong direction. The WHO’s decision to declare the outbreak as a global pandemic, along with regional shutdowns of non-essential services and travel restrictions, has intensified fear amongst the general population within Europe, which has now become the epicentre of the pandemic. Below is a factual summary of some of the key developments and information published by the WHO over the past week.
On Wednesday 11th March, the WHO declared COVID-19 as a global pandemic as data showed that the global situation was deteriorating. Up until this point, the WHO had maintained that COVID-19 was a series of regional epidemics and a public health emergency of international concern. It had refrained from categorising COVID-19 as a global pandemic as there was evidence that the virus was being contained within certain geographies and that it was still possible to avoid the virus from reaching every country. During a media briefing on 28th February, the WHO stated that it would declare a global pandemic if it thought that every person at a global level is likely to come into contact with COVID-19.
The WHO Director-General commented: “WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction. We have therefore made the assessment that COVID-19 can be characterised as a pandemic.”
Media briefing, 11th March, transcript of opening statement / Periscope recording
On Saturday 14th March, the global number of COVID-19 reported cases surpassed 150,000. As of 10am (CET) 15th March, China has 81,048 reported cases in a population of 1.4 billion people. In the rest of the world, there are 72,469 reported cases, in a population of 6.3 billion. This has resulted in a total of 5,735 deaths or 3.7% of the reported case count. Time-series data continues to show falling numbers of new cases from China. From 26th February onward, there have been more new cases of COVID-19 reported from countries outside of China than from China.
On Friday 13th March, the WHO Director General commented that Europe has now become the epicentre of the pandemic. Europe now has more reported cases and deaths than the rest of the world combined, excluding China.
As of Saturday 14th March, a total of 143 territories have reported COVID-19 cases. Within the previous week, the following territories reported their first COVID-19 cases:
- Monday 9th March: (5 new) Brunei Darussalam, Mongolia, Cyprus, Guernsey, Panama.
- Tuesday 10th March: (4 new) Bolivia, Jamaica, Burkina Faso, Republic of the Congo.
- Wednesday 11th March: (4 new) French Polynesia, Turkey, Honduras and Côte d’Ivoire.
- Thursday 12th March: (5 new) Jersey, Réunion, Saint Vincent/Grenadines, Cuba, Guyana.
- Friday 13th March: (13 new) unreported
- Saturday 14th March: (9 new) African Region [7], European Region [1], Region of Americas [1]
On the Friday 13th March, WHO announced the launch of a Solidarity Response Fund to raise money to support the work of the WHO and it’s partners to respond to the COVID-19 pandemic. The fund expects to raise money from a wide range of donors including private individuals and corporations. Read the press release.
On Thursday 12th March, a delegation of WHO and health experts concluded it’s mission to Iran. The WHO initiated this delegation following large increases in COVID-19 cases within Iran as well as a higher mortality rate within the country, which is currently approximately 4.3% of confirmed cases. After five days of extensive meetings and field visits the WHO concludes that the measures in place to tackle the virus are moving in the right direction, although a lot more still needs to be achieved. Read the press release.
Comparisons have continued to be made between COVID-19 and influenza, SARS and MERS. The WHO reiterated that COVID-19 is a unique virus with unique characteristics. The influenza virus and COVID-19 are similar in that they both cause respiratory disease and they are both transmitted by contact, droplets and fomites, hence similar public health measures are important to prevent infection. A few of the key differences relate to the speed of transmission, reproductive number and severity of the viruses. Firstly, Influenza can spread faster than COVID-19 although the reason remains unknown. It is thought that the transmission of Influenza occurring pre-symptomatic (transmission of the virus before the appearance of symptoms) is behind a higher speed of transmission. There is very limited evidence that COVID-19 is transmitting pre-symptomatically. Secondly, the reproductive number (the number of secondary infections generated from one infected individual) is understood to be between 2 and 2.5 for COVID-19 virus, higher than for influenza. So while COVID-19 may transmit slower than Influenza, it may eventually infect more people. These estimates remain highly contextual and time-specific, making direct comparisons difficult. Thirdly, the frequency of severe cases as well as mortality from COVID-19 appears to be higher than seasonal Influenza. For COVID-19, the current data suggests that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation. While the true mortality of COVID-19 will take some time to fully understand, the data so far indicates that the crude mortality ratio is between 3-4%. For seasonal influenza, mortality is usually below 0.1%. Finally, antivirals and vaccines are available for influenza whereas no vaccine currently exists for COVID.
More than 20 vaccines for COVID-19 are under development, globally. Several of these vaccinations are at the clinical trial stage and the WHO expects to receive the results of these trials within a few weeks. Despite this progress, the WHO’s stance is that containment, public education and encouraging calm decisive action rather than fear, remain the top priorities in order to prevent further transmission.
On Friday 6th March, the WHO published an R&D roadmap which distills the research priorities identified during its convention of more than 400 scientists. All ideas have been distilled into a core group of priorities in 9 key areas, including, the natural history of the virus, epidemiology, vaccines, diagnostics, therapeutics, clinical management, ethical considerations, social sciences and more. The R&D roadmap focuses on research that can save lives now, as well as longer-term research priorities for vaccines and therapeutics.
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