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World is Entering a ‘New and Dangerous Phase’ of the Pandemic, WHO

During its Monday media briefing, the WHO Director General outlined four types of COVID-19 outbreaks occurring globally, [ ... ]

During its Monday media briefing, the WHO Director General outlined four types of COVID-19 outbreaks occurring globally, including countries that [1] responded rapidly and avoided large outbreaks, [2] brought large outbreaks under control, [3] overcame their first peak and are struggling with new peaks, and [4] are currently in the intense transmission phase. The last category presents the biggest immediate risk and includes ten countries that account for almost 80% of new infections, with half of these in the U.S. and Brazil alone. The rate of new infections in the U.S. does not appear to be slowing despite an increase in testing, with total cases expected to surpass 4 million this week. With over 2 million confirmed cases, the outbreak in Brazil continues to be a major concern, particularly in light of irregularities in official government figures. This led to a stand-off last month between Brazilian President Bolsonaro– who has been criticized for downplaying the pandemic despite testing positive for the virus last week – and the Supreme Court, which prompted one Justice to demand the government immediately “re-establish the daily dissemination of epidemiological data on the COVID-19 pandemic.”
The Red Cross Red Crescent has warned that South Asia is quickly becoming the next epicentre of the pandemic, with rapidly rising cases across India, Pakistan, Bangladesh and Afghanistan. With the second highest number of daily new cases and over 1.1 million confirmed infections, the outbreak in India is rapidly escalating. This includes the Delhi metropolitan area that is home to 25 million people and accounts for almost half of all cases in the country. The latest projection from MIT, still under peer review, warns that India could have the largest number of cases in the next six months, with modelling scenarios estimating up to 287,000 cases per day in the absence of stronger public health measures.
Across Africa, the number of COVID-19 infections surpassed 750,000 this week, as the over 15,000 mortalities over the past five months have now exceeded the total number of lives lost to the West African Ebola outbreak between 2014 and 2016. At least 22 African countries have seen the number of Coronavirus cases double in the last month, with at least 35 countries experiencing community transmission. With the largest number of cases on the continent, South Africa recently re-imposed a ban on the sale of alcohol to reduce avoidable injuries and the burden on hospitals, while tightening curfews and mask requirements. Fragile health systems in many countries on the continent are increasingly overwhelmed, according to the WHO Director for Africa, who called on governments and the international community to scale up public health measures such as testing, contact tracing and case isolation. There is particular fear of outbreaks among vulnerable populations such as humanitarian response locations, marginalized communities as well as elderly populations, who are on average ten times more at risk of death, although they only account for 20% of COVID-19 infections in Africa.
Countries that previously succeeded in containing the virus are meanwhile reporting resurgence in cases, such as Hong Kong where a third wave of outbreaks prompted renewed lockdowns and physical distancing measures. A paper in the BMJ shows how COVID-19 related mortalities in Mexico have also tripled since the country began to relax lockdowns in early June despite warnings by experts and local health officials questioning official figures by the government. The cost of a subsequent lockdown in OECD countries alone has been estimated at US$1.1 trillion in additional output losses this year, which would increase five-fold if an outbreak were to occur in early 2021.

An alarming new report by the ILO estimates that nearly half of the global workforce, more than 1.6 billion people, could lose their livelihoods due to COVID-19 related reductions in global trade and increased lockdown control measures. The report projects that lost income could total US$3.4 trillion this year, as the equivalent of 200 million full-time jobs have or will disappear since the start of the pandemic. The staggering figures include many informal workers that may lack worker benefits or social protection, and push upwards of 500 million people into poverty. The UN High Commissioner for Human Rights issued a Guidance for countries to adopt strategies that protection homeless people, as the Special Rapporteur on Extreme Poverty and Human Rights raised the likelihood that extreme poverty will increase for the first time in 20 years that is threatening 40 to 60 million people globally.

With incomes virtually stopping overnight in some countries, the UN Global Network Against Food Crisis warns that as many as 265 million people around the world may suffer from food insecurity and possible starvation. This includes the half a billion smallholder farmers that produce almost 80% of food consumed in Asia and Sub-Saharan Africa. Some countries have turned to cash payments to support the poor, including Pakistan where the government announced US$900 million in emergency funds for over 80 million people. Many countries such as Bangladesh are confronted by increasing public protests due to lockdowns. In Malawi, the High Court set aside plans for a COVID-19 lockdown pending a review within seven days, as protestors against the lockdown carried placards declaring that it would be better to contract the virus than die of hunger because they are unable to work. The WHO has also expressed concern of community spread in West Africa, as multiple countries have issued targeted lockdowns and curfews in major cities in addition to restrictions on inter-urban travel, stopping short of nationwide lockdowns.

With a looming recession and ballooning debt obligations in many developing countries, the IMF urged donor countries to support economic stimulus packages to address the immediate and long-term hunger impact. UN OCHA also states that about 700 million people (10% of the world’s population) are most vulnerable and concentrated in about 30 to 40 countries which already receive humanitarian assistance and will see a big drop in incomes as the virus spreads and governments impose restrictive measures and lock downs. They estimate that US$90 billion would be needed to provide income support, protect against starvation, and support a systematic health response for the world’s most vulnerable people. This represents 1% of the approximately US$8 trillion stimulus packages that the IMF states G20 countries have put in place to safeguard their own economies. The World Bank’s Pandemic Emergency Financing Facility will meanwhile provide a modest $200 million in pandemic bonds to 64 low- and middle-income countries to finance COVID-19 related medical and personal protective equipment, medicines and support for frontline health workers.

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Earlier today, China increased the number of COVID-related deaths in Wuhan by 50%, raising the country’s toll by 1,300 to 4,632. While the government claims this reflects updated hospital counts as well as those who died at home, the revision in the reported figures partially validates accusations of under-reporting, including by intelligence agencies. The broader challenge is that most models of the pandemic are based on prior figures from China and may need to be revised to reflect these significant adjustments.

In China, a cluster of cases linked to the Nigerian community in Guangzhou has also sparked alleged discrimination towards Africans by locals and virus prevention officials.

Asian-Pacific countries are beginning to experience second waves of infections, including Singapore which is reporting the highest case rate in the region (500 cases per million people). Despite these spikes, the “suppress and lift” strategy of aggressive testing, isolation, and contact tracing by countries such as Singapore and Hong Kong remains a model response and has helped prevent exponential spread.

In Iran, the number of reported cases and deaths approach 80,000 and 5,000, respectively. Fearing a protracted economic crisis, some “low-risk” businesses were allowed to open, prompting concerns of a second wave of infections. The government has asked for economic support and sanction relief from the IMF, which the U.S. has thus far blocked despite international pressure to sideline geopolitical tensions to allow countries to respond to the pandemic.

With 13,835 confirmed cases, India has become the third Asian country to surpass the 10,000 mark. Like in Pakistan (7,025) and Bangladesh (1,838), the true outbreak size is expected to be significantly higher in India due to varying testing and counting strategies. In India, the government has extended the nation-wide lockdown until May 3, while food shortages and a mass exodus from major urban areas has raised concern about local transmission in rural parts of the country. There are positive reports that some states like Kerala have managed to bend the curve by adopting “aggressive testing, contact tracing, and cooked meals.”

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During its Monday media briefing, the WHO Director General outlined four types of COVID-19 outbreaks occurring globally, including countries that [1] responded rapidly and avoided large outbreaks, [2] brought large outbreaks under control, [3] overcame their first peak and are struggling with new peaks, and [4] are currently in the intense transmission phase. The last category presents the biggest immediate risk and includes ten countries that account for almost 80% of new infections, with half of these in the U.S. and Brazil alone. The rate of new infections in the U.S. does not appear to be slowing despite an increase in testing, with total cases expected to surpass 4 million this week. With over 2 million confirmed cases, the outbreak in Brazil continues to be a major concern, particularly in light of irregularities in official government figures. This led to a stand-off last month between Brazilian President Bolsonaro– who has been criticized for downplaying the pandemic despite testing positive for the virus last week – and the Supreme Court, which prompted one Justice to demand the government immediately “re-establish the daily dissemination of epidemiological data on the COVID-19 pandemic.”
The Red Cross Red Crescent has warned that South Asia is quickly becoming the next epicentre of the pandemic, with rapidly rising cases across India, Pakistan, Bangladesh and Afghanistan. With the second highest number of daily new cases and over 1.1 million confirmed infections, the outbreak in India is rapidly escalating. This includes the Delhi metropolitan area that is home to 25 million people and accounts for almost half of all cases in the country. The latest projection from MIT, still under peer review, warns that India could have the largest number of cases in the next six months, with modelling scenarios estimating up to 287,000 cases per day in the absence of stronger public health measures.
Across Africa, the number of COVID-19 infections surpassed 750,000 this week, as the over 15,000 mortalities over the past five months have now exceeded the total number of lives lost to the West African Ebola outbreak between 2014 and 2016. At least 22 African countries have seen the number of Coronavirus cases double in the last month, with at least 35 countries experiencing community transmission. With the largest number of cases on the continent, South Africa recently re-imposed a ban on the sale of alcohol to reduce avoidable injuries and the burden on hospitals, while tightening curfews and mask requirements. Fragile health systems in many countries on the continent are increasingly overwhelmed, according to the WHO Director for Africa, who called on governments and the international community to scale up public health measures such as testing, contact tracing and case isolation. There is particular fear of outbreaks among vulnerable populations such as humanitarian response locations, marginalized communities as well as elderly populations, who are on average ten times more at risk of death, although they only account for 20% of COVID-19 infections in Africa.
Countries that previously succeeded in containing the virus are meanwhile reporting resurgence in cases, such as Hong Kong where a third wave of outbreaks prompted renewed lockdowns and physical distancing measures. A paper in the BMJ shows how COVID-19 related mortalities in Mexico have also tripled since the country began to relax lockdowns in early June despite warnings by experts and local health officials questioning official figures by the government. The cost of a subsequent lockdown in OECD countries alone has been estimated at US$1.1 trillion in additional output losses this year, which would increase five-fold if an outbreak were to occur in early 2021.

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