A summary of WHO COVID-19 developments 22.03.2020

Image Credit: Pixabay, user name: geralt

Over the past week the global pandemic of Coronavirus (COVID-19) has broadened and deepened, particularly amongst Western economies. Each day, the pandemic seems to reach a new and tragic milestone as well as creating unprecedented challenges for governments, their healthcare systems and economies. At the same time, some successes provide hope that even the most severe situations can be turned around. For example, on Thursday 19th March, Wuhan (the Chinese province where COVID-19 was first identified) reported no new cases for the first time since the outbreak started in December. Furthermore, clinical trials for the first vaccines have begun, enabled by China sharing it’s knowledge on the genetic sequence of the COVID-19 virus. The pandemic continues to evolve quickly and fluidly. Below is a summary of some key developments and information published by the WHO this week.

Firstly, starting with the latest numbers. On Friday 20th March, the global number of COVID-19 reported cases surpassed 250,000. This represents approximately a +90% increase in new infections relative to the same point last week. As of 23:59 (CET) 21st March, China has 81,498 reported cases in a population of 1.4 billion people. In the rest of the world, there are 210,644 reported cases, in a population of 6.3 billion. This has resulted in a total of 12,784 deaths or 4.4% of the reported case count. Europe continues to be the current epicentre of the pandemic as the region has reported more cases and deaths than the rest of the world combined, including China.

Note that the apparent decrease in number of cases may be due to a reporting bias during the weekend.
WHO, Situation Dashboard, COVID-19 cases by reported location, 21st March 2020

The global mortality rate is trending upward and the WHO is reporting large differences in the mortality rate between regions. During the press briefing on Friday 20th March, WHO Scientific Technical Lead Dr Maria van Kerkhove shared some comments on this. She noted that there are a combination of factors around why we are seeing differences in mortality amongst countries and that we have to be careful about making comparisons at this stage. The primary reason behind these differences appears to be due to the population demographics that the virus is affecting and infecting. For example, we may expect a higher mortality rate from an older and ageing population. That said, the number of deaths over the number of cases is only a snapshot and we don’t know the extent of infection in the population, therefore, this is an incomplete snapshot. There are also people still in a severe condition, some of whom will recover and some of whom will die so we don’t have precise numbers yet.

The market for personal protective equipment (PPE) has effectively “collapsed” and the WHO is working to ensure a pandemic supply chain network. The current market dynamics have been creating extreme difficulties in ensuring health workers have access to the equipment they need to do their jobs safely and effectively. With the support of the Chinese Government, the WHO has identified some producers in China who have agreed to supply the WHO so that it can refill it’s inventory and ship PPE to the regions and populations who need it the most. The WHO is aiming is to build a pipeline to ensure continuity of supply. The challenge is as much about manufacture as well as distribution. The WHO is finding that it has become increasingly difficult to move supplies around, whether it’s PPE or human expertise. During the press briefing on Friday 20th March, Executive Director Dr Michael Ryan commented “We have issues with flights, we have issues with getting access to where we are going”“I think as we speak over 100,000 merchant seamen are currently sitting in ports all over the world and can’t either come into the country they’re in or move on on the ships they’re on so we have some serious issues within the supply chain”.

The shortfall in supply of PPE is unknown as the future demand is unknown at this point. One figure from the WHO estimates that there are in excess of 26 million healthcare workers who may have to at some point engage in the provision of healthcare to people who potentially have COVID-19. That’s a huge number of healthcare workers to protect. These healthcare workers will have to change PPE every time they do a shift, creating unpredicted demand for certain types of PPE.

The WHO has distributed approximately 1.5 million COVID-19 lab tests globally and it anticipates that it may require between 80x to 100x more tests to meet demand. When discussing COVID-19 testing during the press briefing on Friday 20th March, Executive Director Dr Michael Ryan commented that the WHO may need to scale up it’s COVID testing by approximately 80 to 100 times from current levels. This estimate is a more pessimistic scenario although that’s what the WHO is aiming to achieve by working with partners and the private sector in order to scale up production so that it has access to the tests needed.

The WHO is calling for “physical distancing”, rather than “social distancing”. Keeping a physical distance between people is important to prevent the virus from transmitting to one another. This is an “absolutely essential pubic health measure amongst a wider package of measures” in order to reduce transmission. That said, the WHO is now using the phrase “physical distancing” instead of “social distancing”, highlighting the need for people to remain connected to family and loved ones in order to maintain their mental health and wellbeing during a highly stressful period. Given where technology is right now, we can keep connected in many ways without actually physically being in the same room or physically being in the same space.