Updates on the emerging novel coronavirus pandemic from the Johns Hopkins Center for Health Security.
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Brazil
reported 45,403 new cases, currently #2 globally in daily confirmed COVID-19 cases. This week, newly reported daily incidence of cases has increased slightly, however daily incidence remains fairly stable suggesting a potential plateau in cases. Brazil remains #2 globally in terms of
daily incidence
, following only the US.
Mexico
reported 7,051 new cases and is ranked #5 in terms of daily incidence, however, Mexico and Russia remain closely tied for daily incidence. Broadly, the Central and South American regions are still major COVID-19 hotspots. Including Brazil and Mexico, the region represents 6 of the top 13 countries globally in terms of daily incidence, including
Colombia
(#7),
Argentina
(#8),
Peru
(#9), and
Chile
(#13).
India
reported its highest
daily incidence
to date, with 32,695 new cases. India remains #3 globally in terms of
daily incidence
.
Pakistan
continues to report decreasing incidence since its peak in mid-June, and its total active cases continue to decline, with currently 70,787 active cases and 2,085 new cases in the past 24 hours.
Bangladesh
continues to report decreased daily incidence as well, reporting 3,034 new cases. Bangladesh is now #10 globally in terms of daily incidence. Notably, Bangladesh’s test positivity remains slightly above 20% and the number of
daily tests performed
has decreased steadily since early July. This could indicate that Bangladesh's decreased incidence could be driven more by reduced testing than slowing transmission.
Overall, the Eastern Mediterranean Region remains a global hotspot, representing 5 of the top 10 countries in terms of per capita incidence:
Bahrain
(#1),
Oman
(#2),
Qatar
(#8),
Kuwait
(#7), and Saudi Arabia (#13).
Australia
has been experiencing an increase in new cases since the end of June. The Ministry of Health reported 315 new cases bringing the total to 11,325 cases as of July 17, primarily due to an outbreak in the southeastern region of the country.
The
US CDC
reported 3.48 million total cases (67,404 new) and 136,938 deaths (947 new). Thirty nine states are reporting increasing incidence of confirmed cases, with the largest outbreaks occurring in
Texas
and
Florida
. Both of those states reported a record number of new deaths with
110
and
156
new deaths respectively. Cases in the US have increased by 206% since June 9, up from 20,338 new cases per day to 62,324 yesterday (
7-day average
).
RWANDA RESPONSE
Rwanda has emerged as a leader in controlling the pandemic. In addition to
fast implementation of strict lockdowns
, Rwanda also has a
robust testing
and contact tracing program. Testing is widely and freely available, with testing sites being set up along high foot-traffic areas. Rwandan health authorities say that they have converted their widespread HIV testing capabilities for use in COVID-19 testing. They also conduct pooled testing in order to process samples more quickly and return faster results. Police, college students, and healthcare workers have been recruited as contact tracers. In the
Rusizi district
, a hotspot in the country, people were largely compliant with the strict lockdowns and suspension of travel to and from the area. As a result, within-district mobility has begun to resume while travel in and out of the district is still banned. The combination of these measures in addition to mobility restrictions has allowed some
places of worship
to begin reopening under certain conditions this week. Despite these successes, the United Nations Population Fund (UNFPA) stated that COVID-19 and its associated control measures could undo hard-earned gains against
gender-based violence
. In order to maintain momentum, UNFPA held a series of virtual seminars on June 30th targeting Rwandan youth to engage them in these issues.
VACCINE UPDATE
As
vaccine candidates
across the world continue to advance through clinical trials, certain candidates have already started to be used in select populations in some places outside a clinical trial framework. China has started vaccinating military service members with a vaccine candidate developed by Cansino Biologics, which is also undergoing clinical trials in Canada. Two products made by the Chinese-government affiliated company Sinopharm have been offered to employees of a state-owned oil company. The use of these experimental vaccines, none of which have completed the clinical trial process raises ethical and safety concerns.
Meanwhile, news media have
reported
that intelligence officials have accused hackers of allegedly attempting to steal vaccine research from American, British, and Canadian organizations. According to Britain’s National Cyber Security Center, hackers tied to Russia have used malware and phishing emails to trick people into submitting security credentials and provide access to confidential information about vaccines in development. Russian officials have denied involvement in any attack. Intelligence officials from the three governments have warned that it is important for organizations to immediately address vulnerabilities identified by software companies to protect themselves from attacks. The news comes at a time of rising concern and questions about government transparency in the race to develop a vaccine.
The US government, and in particular Operation Warp Speed, has received criticism about lack of transparency in selecting
candidates
to financially support, both from
members of Congress
and from members of the media and
scientific community
. Wide ranges in funding allocated to different pharmaceutical companies, several of which have little experience successfully producing licensed vaccines, have prompted
concerns
about conflicts of interest.
MANDATORY WORKPLACE REGULATIONS
Virginia has reportedly become the
first state
in the country to mandate coronavirus-related workplace safety measures. The measure, called an “emergency temporary standard” will compel companies to comply with safety measures or face up to $130,000 in fines. The measures include mandates focused on protective gear, disinfection and sanitation, and physical distancing, among other features. The move also protects employees who voice safety concerns to their employers. The measure is expected to last at least 6 months and comes amid measures by a growing number of US states to mandate face coverings in public.
Mandates
to wear masks have been enacted in a range of both Democratic and Republican-led states, despite early partisanship associated with mask wearing. However, the
governor of Georgia
has gone in the opposite direction, banning local governments in the state from requiring masks to be worn. While the governor’s spokesperson stated that the governor supports mask wearing, he received criticism from Atlanta Mayor Keisha Lance Bottoms, who herself has tested positive for COVID-19 and has enforced mask mandates in Atlanta.
NATIONAL ACADEMIES REPORT ON SCHOOL REOPENING
A new report from the
National Academies of Medicine, Science, and Engineering
discusses the risks and benefits of schools reopening for in-person learning amidst the COVID-19 pandemic. The report outlines that for schools and districts that decide to physically reopen, they should prioritize doing so for students K-5 and those with special needs because they stand to benefit the most in terms of learning and psychosocial development. Recommendations for reopening are paired with mitigation measures necessary to reduce the risk of COVID-19 transmission to students and their families, teachers, and staff. The report also emphasizes how the pandemic is reinforcing inequalities that exist across school systems and communities in the US, and it urges school districts to account for equity when deciding how and when to reopen. The report recommends that decisions should be made with sensitivity to local resources and an awareness that communities most heavily impacted by COVID-19 are those often with resourced school districts. Ultimately the decision to resume in person learning is local and each district will need to determine the best course of action in consultation with parents, members of the community, teachers, and staff.
HEALTHCARE WORKER INFECTIONS IN KENYA
An outbreak of COVID-19 in
Pumwani Maternity Hospital
in Kenya has resulted in 41 healthcare workers becoming infected. As the largest referral maternity hospital in the country performs between
50-100 deliveries
daily. This latest incidence of healthcare worker infections brings the national total to 450 confirmed cases among healthcare workers as reported by the
Ministry of Health
on Wednesday July 15. This represents approximately 4.1% of the total confirmed cases in Kenya and thus far there have been 4 deaths among healthcare workers from COVID-19. Nationally there is a
shortage of N95 masks
necessary for protecting healthcare workers against infection, requiring 24 hour use of the same mask while providing care. Unions representing a range of healthcare disciplines are emphasizing a need for additional personal protective equipment (PPE) to ensure the safety of healthcare workers. In addition to lack of adequate supply of PPE, some facilities have reported that PPE supplies are not at an appropriate quality to effectively protect. In response to the recent surge in infections at Pumwani Maternity Hospital, the Ministry of Health is conducting wide-scale testing of healthcare workers, and reduced care provided to only those most complex deliveries which cannot be performed in other facilities.
LATIN AMERICA SURPASSES
US The total number of COVID-19 deaths in Latin America and the Caribbean has surpassed those in the US and Canada. Latin America and the Caribbean is now reporting over
146,515 cumulative deaths
, while the US and Canada are reporting over 144,451 cumulative deaths. Public health experts have been concerned with the severity of the outbreak in the region and the potential for outsized impacts from COVID-19. With large divides between wealthy and impoverished communities, an ongoing migrant worker crisis, social and political unrest, large numbers of historically marginalized indigenous populations, and an aging population and infrastructure, the Latin American region has a
number of vulnerabilities
to lasting damage from COVID-19.
The outbreak in the region is thought to have started
among wealthier
people returning from international travel, but quickly moved to
overpopulated urban centers
and working class persons. In particular,
migrant workers and informal workers
are at higher risk of contracting COVID-19 and potentially contributing to its spread. Many heads of state have struggled with the balance between controlling the pandemic in their territories and reopening their economies. Brazilian President Jair Bolsonaro was among the most insistent political leaders in his calls to reopen the Brazilian economy. Brazil now has the
second highest case count
in the world at 2,012,151 cases, behind the United States at 3,592,316 cases.
While the working class of the region has already been heavily impacted by the pandemic, the political class is also beginning to be affected. At least
three heads of state
have tested positive for COVID-19 with many other politicians also testing positive. Brazilian President Jair Bolsonaro, Bolivian Interim President Jeanine Añez, and Honduran President Juan Orlando Hernandez have all tested positive in recent weeks.
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