The U.S. has become the epicentre of the COVID-19 pandemic at Dadhaleh Institute

The U.S. has become the epicentre of the COVID-19 pandemic

The U.S. has become the epicentre of the COVID-19 pandemic, accounting for the highest number of cases worldwide (104,126), which represents an 18% increase between 27 and 28 March. Canada has also [... ]a few seconds.

The U.S. has become the epicentre of the COVID-19 pandemic, accounting for the highest number of cases worldwide (104,126), which represents an 18% increase between 27 and 28 March. Canada has also experienced a 15% increase over the last day, totalling 4,757 cases. The increase in case numbers in South and Central American countries are also noteworthy; Brazil is reporting more than 3,400 cases, and Ecuador and Chile are reporting more than 1,600 cases each.

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Europe needs testing capacity and mitigation strategies

The European CDC warned that with current testing capacity and if nations do not enact mitigation strategies, Europe could see by the middle of April a scenario similar to what China experienced [... ]a few seconds.

The European CDC warned that with current testing capacity and if nations do not enact mitigation strategies, Europe could see by the middle of April a scenario similar to what China experienced in Hubei province at the beginning of the outbreak. Spain and Germany are leading the increase in number of confirmed cases, accounting for 12% and 13.5% of newly confirmed cases globally on March 28, totalling 65,719 and 50,871 respectively. While Germany has maintained a relatively low CFR (0.75%), the death toll in Spain (5,138) now exceeding China. The decreasing trend in Italy earlier this week did not continue, as the total number of confirmed cases surpassed 86,498 with an alarming CFR of 10.56%.

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Growing numbers of cases and deaths in Iran

The number of cases and deaths in Iran keep growing with total number of cases increasing to 32,332 and the death toll is 2,926. More than half of all Iranian government employees [... ]a few seconds.

The number of cases and deaths in Iran keep growing with total number of cases increasing to 32,332 and the death toll is 2,926. More than half of all Iranian government employees are staying home as part of measures to contain the outbreak. The government has not imposed any travel ban or lockdowns. The significant translocation of the population for the Persian New Year holidays is of concern as it may lead to continued intra-country/provincial exportations of the virus.

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Overnight changes in Asian-Pacific countries

Several Asian-Pacific countries have seen overnight changes or escalating reports: Thailand, Hong Kong, India, Philippines, Indonesia, New Zealand, and Singapore. South Korea has slowly decreased daily new case counts to around 100-150 [... ]a few seconds.

Several Asian-Pacific countries have seen overnight changes or escalating reports: Thailand, Hong Kong, India, Philippines, Indonesia, New Zealand, and Singapore. South Korea has slowly decreased daily new case counts to around 100-150 since March 12, although they have reported an increase in imported cases.

related to AsiaSouth KoreaThailandIndiaPhilippinesIndonesiaNew ZealandSingapore

China's numbers remain high even as local transmission interrupted

While China has virtually interrupted local transmission, it remains the third leading country with 81,340 confirmed cases and 3,292 reported deaths. Imported cases are on the rise and there are small numbers [... ]a few seconds.

While China has virtually interrupted local transmission, it remains the third leading country with 81,340 confirmed cases and 3,292 reported deaths. Imported cases are on the rise and there are small numbers of locally acquired cases periodically being reported. Authorities have indicated that China will end its lockdown of most of Hubei province while Wuhan will remain under lockdown for another ten days.

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Africa may have window of opportunity to contain the disease

At least 46 countries across Africa have reported COVID-19 cases, recording more than 4,136 confirmed cases and 128 deaths. Five countries are experiencing local transmission: South Africa, Algeria, Burkina Faso, Senegal, and [... ]a few seconds.

At least 46 countries across Africa have reported COVID-19 cases, recording more than 4,136 confirmed cases and 128 deaths. Five countries are experiencing local transmission: South Africa, Algeria, Burkina Faso, Senegal, and Cameroon. All but six countries in the region have reported local infections in contacts of imported cases. The WHO said many of the cases are still linked to travel and that the region still has a window of opportunity to contain the disease. South Africa reported more than a quarter of the continent's cases (1,187), with Northern African countries Egypt (576), Algeria 155 new cases, bringing its total case number to 709. Algeria (302 cases) and Burkina Faso (146 cases) are the other 2 worst-hit countries in the region.

related to AfricaSouth AfricaEgyptAlgeriaBurkina FasoSenegalCameroon

Accelerating access to rapid diagnostic testing

Health Canada expedites access to diagnostic lab test kits (March 18) FDA fast-tracks approval for rapid (45 min) diagnostic test (March 20) [... ]a few seconds.

Health Canada expedites access to diagnostic lab test kits (March 18) FDA fast-tracks approval for rapid (45 min) diagnostic test (March 20)

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Anticipated Drug Shortages

COVID-19: Predicting Healthcare Resource Needs in Ontario (March 23) Critical inhaler medication shortage looms as coronavirus cases soar (March 23) Drug Shortage Concerns Are Top of Mind Amid COVID-19 Outbreak (March 20) [... ]a few seconds.

COVID-19: Predicting Healthcare Resource Needs in Ontario (March 23)
Critical inhaler medication shortage looms as coronavirus cases soar (March 23)
Drug Shortage Concerns Are Top of Mind Amid COVID-19 Outbreak (March 20)
Real-World Shortages Not Addressed in New COVID-19 Guidance (March 20)

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Global rise is exponential

The pandemic continues to grow exponentially. As of March 25, It took only 6 days for the global case number to double from 200,000 to over 400,000 (and 2 days from 300,000 [... ]a few seconds.

The pandemic continues to grow exponentially. As of March 25, It took only 6 days for the global case number to double from 200,000 to over 400,000 (and 2 days from 300,000 to 400,000). At least 650,567 cases and 30,299 deaths have been reported in 199 countries as of March 28 at 2:30pm EST. Europe and the U.S. account for almost two thirds of all cases globally. There is growing alarm, however, as case reports are increasing in many low- and middle-income countries.

Select Case Fatality Rates (for countries with at least 50 deaths)

Worldwide: 4.7% Italy: 10.6% Spain: 7.9% Iran: 7.1% China: 4.1% France: 6.1% US: 1.6% South Korea: 1.5% Canada: 1.2% Germany: 0.7%

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Research: The effect of control strategies to reduce...

Lancet: The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study (Prem et al. 2020) Findings Projections show that physical distancing [... ]less than a minute.

Lancet: The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study (Prem et al. 2020)

Findings

Projections show that physical distancing measures were most effective if the staggered return to work was at the beginning of April; this reduced the median number of infections by more than 92% and 24% in mid-2020 and end-2020, respectively. There are benefits to sustaining these measures through April in order to delay and reduce the height of the peak, median epidemic size, and providing health-care systems more time to expand and respond.

Interpretation

Premature and sudden lifting of interventions could lead to an earlier secondary peak, which could be flattened by relaxing the interventions gradually.

Research: Evidence of initial success for China exiting...

Imperial College London: Evidence of initial success for China exiting COVID-19 social distancing policy after achieving containment (Ainslie et al. 2020) Findings Estimated transmissibility from reported cases and compare those with daily [... ]less than a minute.

Imperial College London: Evidence of initial success for China exiting COVID-19 social distancing policy after achieving containment (Ainslie et al. 2020)

Findings

Estimated transmissibility from reported cases and compare those with daily data on within-city movement as a proxy for economic activity in order to determine the public health and socio-economic impact of imposing and relaxing social distancing measures by China to control COVID-19. The results suggest that after very intense social distancing which resulted in containment, China has successfully exited their stringent social distancing policy to some degree.

Interpretation

China is at a more advanced stage of the pandemic globally. While the results do not preclude future epidemics in China, the policies implemented to reduce the spread of COVID-19 and the exiting strategies that followed can inform decision making processes for countries once containment is achieved.

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Research: Identifying Locations with Possible Undetected...

CDC (Early Release): Identifying Locations with Possible Undetected Imported Severe Acute Respiratory Syndrome Coronavirus 2 Cases by Using Importation Predictions (De Salazar et al. 2020) Findings The aim was to identify locations [... ]less than a minute.

CDC (Early Release): Identifying Locations with Possible Undetected Imported Severe Acute Respiratory Syndrome Coronavirus 2 Cases by Using Importation Predictions (De Salazar et al. 2020)

Findings

The aim was to identify locations with likely undetected or under-detected imported cases of COVID-19. The results suggest that locations above the 95% PI of imported-and-reported cases could have higher case-detection capacity. Locations below the 95% PI might have undetected cases because of expected imported-and-reported case counts under high surveillance. Under-detection of cases could increase the international spread of the outbreak because the transmission chain could be lost, reducing opportunities to deploy case-based control strategies.

Interpretation

They recommend rapid strengthening of outbreak surveillance and control efforts in locations below the 95% PI lower bound to curb potential local transmission. Early detection of cases and implantation of appropriate control measures can reduce the risk for self-sustained transmission in all locations.

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Notable research papers

JAMA: Preparation for Possible Sustained Transmission of 2019 Novel Coronavirus. Lessons from previous epidemics (Swerdlow and Finelli, 2020) Lancet: COVID-19 in children: the link in the transmission chain (Kelvin & Halperin, 2020) [... ]a few seconds.

JAMA: Preparation for Possible Sustained Transmission of 2019 Novel Coronavirus. Lessons from previous epidemics (Swerdlow and Finelli, 2020)
Lancet: COVID-19 in children: the link in the transmission chain (Kelvin & Halperin, 2020)
Lancet: The Italian health system and the COVID-19 challenge (Armocida et al, 2020)
Cell: COVID-19 infection: the perspectives on immune responses (Shi et al, 2020)

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Research: Maternal, Fetal and Neonatal Outcomes

Lancet: Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study (March 24) [... ]a few seconds.

Lancet: Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study (March 24)

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Research: Surface stability and possible fomite transmission

CDC: Public Health Responses to COVID-19 Outbreaks on Cruise Ships (March 23) NEJM: Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 (March 17) [... ]a few seconds.

CDC: Public Health Responses to COVID-19 Outbreaks on Cruise Ships (March 23) NEJM: Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 (March 17)