Coronavirus World Map: 2,314,621 Confirmed Cases; 207 Countries; 157,847 Deaths

Note: There is now a newer Novel Coronavirus (COVID-19) Situation Report 92.

WHO Novel Coronavirus (COVID-19) Situation Report 91

• No new country/territory/area reported cases of COVID-19 in the past 24 hours.
• The urgent need for a COVID-19 vaccine underscores the pivotal role immunizations play in protecting lives and economies. Dr. Hans Henri P. Kluge, WHO Regional Director for Europe, marking the European Immunization Week 2020, stressed ‘we must not, especially now, let down our guard on immunizations’. WHO and UNICEF have released a joint statement to mark European Immunization Week 2020, which is available here.
• WHO has published a brief on the use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Concerns have been raised that NSAIDs may be associated with an increased risk of adverse effects. However, as explained in the brief, at present there is no evidence of severe adverse effects. The brief is available here.
• WHO has recently published an updated strategy to help guide the public health response to COVID-19 which is available here, and is one of the topics for today’s ‘Subject in Focus’ below.
• An update on Emergency Medical Teams, the Global Health Cluster, the Global Outbreak Alert and Response Network, and Risk Communications and Community Engagement is also provided in today’s ‘Subject in Focus’ below.

Risk Assessment

Global Level: Very High

Coronavirus Situation in Numbers

Globally

• 2,314,621 confirmed cases (72,846 new)
• 157,847 deaths (5,296 new)

European Region

• 1,149,071 confirmed cases (26,882 new)
• 103,586 deaths (2,648 new)

Regions of the Americas

• 858,631 confirmed cases (36,771 new)
• 40,615 deaths (2,357 new)

Western Pacific Region

• 132,438 confirmed cases (1,326 new)
• 5,648 deaths (27 new)

Eastern Mediterranean Region

• 129,433 confirmed cases (4,742 new)
• 6,048 deaths (140 new)

South-East Asia

• 29,576 confirmed cases (2,257 new)
• 1,275 deaths (90 new)

African Region

• 14,760 confirmed cases (868 new)
• 662 deaths (34 new)

Subject in Focus

1. Updated strategy to help guide public health response to COVID-19

WHO published the first Strategic Response and Preparedness Plan on February 3, 2020. Since then, we have learned a huge amount about COVID-19, and how best to slow and stop it spreading through communities around the world. WHO has been rapidly translating this new knowledge into guidance for national governments, health workers, and everyone else involved in the global response to COVID-19. On April 14, WHO published a strategy update reflecting what we have learned to inform the next iteration of the Strategic Preparedness and Response Plan (SPRP) due in the coming weeks.

The update is intended to help guide the public health response to COVID-19 at national and subnational level. The update emphasizes the need to tailor the response to COVID-19 carefully to local contexts, however, there are some important lessons that can be applied in a broad range of situations.

One important lesson is that the faster and the more effective we are at finding all suspected cases of COVID-19, testing, isolating and treating the confirmed cases and tracing their contacts, then the harder we make it for the virus to spread. This in turn makes it easier for health systems to cope, deliver quality care, and save lives.

This principle applies in all contexts, but it can sometimes be a challenge to put into practice even in settings with ample resources. Together with the whole UN system, WHO has worked and is continuing to work closely with all partners and national governments to ensure that all populations, but especially the most vulnerable populations, including those in humanitarian settings, benefit from a coordinated and effective response. Alongside the SPRP, that applies to all countries, the COVID-19 Global Humanitarian Response Plan (issued on March 25, 2020), sets out the most urgent health and humanitarian actions required to prepare and respond to COVID-19 in the most fragile contexts.

The update also sets out key criteria and considerations for countries that are considering lifting some of the widespread restrictions on movement, often termed “lockdowns,” that have been used to suppress the spread of COVID-19 through communities. By ensuring these criteria are met, it should be possible for countries to sustain a steady state of low-level or no transition at the same time as resuming some social and economic activities. However, without careful planning, and in the absence of scaled up public health and clinical care capacities, the premature lifting of physical distancing measures is likely to lead to an uncontrolled resurgence in COVID-19 transmission and an amplified second wave of cases.

Finally, the update sets out the shift required in the international system to support countries to plan, finance and implement their response to COVID-19. The world has never faced this scale of challenge before. COVID-19 is a truly global crisis, and the only way to overcome it is together, in global solidarity.

2. Partner Coordination

Emergency Medical Teams (EMT)

• Over a hundred EMTsand focal points worldwide are working closely with the EMT Secretariat, and are continuously engaging in monitoring, guiding, and facilitating national and international COVID-19 response operations. A weekly Global Coordination Call is held, providing the network with updates on current operations, technical guidance, and sharing of current experiences and practices from various EMT responses to COVID-19.
• As of April 19, international EMTs have deployed to fifteen countries. Thirty-two EMTs are responding nationally to support and reinforce the local health systems in all Regions.
• The EMT Secretariat met with the Regional Group for the European Region on April 17. Following discussions, there was an agreement for the Secretariat to provide regular updates and present the types of support needed globally in order to raise awareness and facilitate deployments of available EMTs.
• Recently, Chinese EMTs were deployed to Ethiopia and Burkina Faso, and UK EMT to Zambia. Additional deployments of Chinese EMTs are under discussion to Algeria, Democratic Republic of the Congo and Zimbabwe. Requests from Botswana, São Tomé and Príncipe, and Yemen are also being processed.
• The following guidance and recommendations have been finalized: technical guidance on COVID-19 community facilities and treatment centers; recommendations on pre-hospital emergency medical services; and recommendations for medical surge capacity and deployments of EMTs. A modularized just-in-time training package on COVID-19 for the EMT workforce is currently being finalized.

Global Health Cluster (GHC)

• All 29 countries with IASC activated Health Clusters/Sectors are reporting confirmed COVID-19 cases. The 900 national and international health cluster partners are urgently responding to COVID-19 specific needs whilst maintaining essential health services for 65 million people affected by humanitarian crises.
• The GHC is collaborating with other clusters to inform adaptive approaches to implement key public health actions in complex setting (e.g. isolation in camp-like settings with Shelter and Camp Coordination and Camp Management Clusters).
• Updating of the Global Humanitarian Response Plan (GHRP) has been launched at country and global level, involving partner consultation, and consideration of including additional countries.
• A GHC COVID-19 Task Team is being established to (i) Identify & promote minimum standards for humanitarian settings; (ii) support multi-sectoral action; and (iii) intensify advocacy to address unmet needs/ operational barriers. The Task Team will build upon and strengthen existing global partner initiatives with strong field driven engagement to capture operational practice and lessons.

Global Outbreak Alert and Response Network (GOARN)

WHO continues to facilitate direct and remote technical assistance to countries through GOARN regional and global network of networks to support health operation. UNICEF, IFRC, US CDC, and OCHA are embedded in the global COVID-19 incident management team in Geneva; and are supporting all pillars of response. Work is ongoing to launch public information hub on GOARN Knowledge Platform for COVID-19 to share resources from partners and other stakeholders.

GOARN activities include:

• Operational coordination;
• Collaboration on training and capacity building, including Field Epidemiology Training Programmes, regional and global networks, and alumni networks;
• Roll out and implementation of Go.Data; and
• Response research(including support to COVID-19 Research Innovation and Research Roadmap working groups).

Risk Communications and Community Engagement (RCCE)

IFRC, UNICEF, and WHO with GOARN support are strengthening coordination and collaboration among key stakeholders at the global and regional levels in risk communications and community engagement (RCCE). As the COVID-19 pandemic develops into a global humanitarian crisis, there is increasing coordination with IASC Results Group 2 on Accountability and Inclusion and its humanitarian partners to join and align efforts in regard to country operations, solutions and tools for stronger community engagement and accountability approaches on the ground.

• The RCCE global strategy has been completed, and is a ‘live’ document that will be revised and enhanced following the Strategic Preparedness Response Planrevision and Global Humanitarian Response Plan.
• Strengthened coordination of partners with a focus on needs of migrants and vulnerable populations, community engagement in remote populations and addressing reports of stigma and xenophobia.
• Work is ongoing to a launch public information hub for COVID-19 on GOARN Knowledge Platform to share RCCE resources from partners and other stakeholders,and enable access to RCCE information.
• A rapid consultation on social, cultural, behavioral perspectives in the COVID-19 response was undertaken. Briefs were completed on information, misinformation, disinformation and on compliance with physical distancing measures for COVID-19 and implications for RCCE in Eastern and Southern Africa (April 2020). A GOARN RCCE Data Collection Tools Repository was developed for rapid access to tools for COVID-19 RCCE data collection. Africa and Asia RCCE coordination groups are triangulating community insights with the intent to inform RCCE priorities and strategies within these regions.
• A joint “live” guidance has been developed on “Community Engagement and COVID-19 Movement Restrictions: Tips for Engaging People in Low-Resource Settings Remotely and In-Person.”
• Guidance and webinars on engagement with faith-based organizations and religious leaders are underway this week ahead of Ramadan. A community action guide with tips for individuals and communities to take simple actions to support and protect people around them during the epidemic is available here.

Countries, territories or areas with reported laboratory-confirmed COVID-19 cases and deaths, April 20, 2020

Recommendations and Advice for the Public

If you are not in an area where COVID-19 is spreading or have not traveled from an area where COVID-19 is spreading or have not been in contact with an infected patient, your risk of infection is low. It is understandable that you may feel anxious about the outbreak. Get the facts from reliable sources to help you accurately determine your risks so that you can take reasonable precautions (see Frequently Asked Questions). Seek guidance from WHO, your healthcare provider, your national public health authority or your employer for accurate information on COVID-19 and whether COVID-19 is circulating where you live. It is important to be informed of the situation and take appropriate measures to protect yourself and your family (see Protection measures for everyone).

If you are in an area where there are cases of COVID-19 you need to take the risk of infection seriously. Follow the advice of WHO and guidance issued by national and local health authorities. For most people, COVID-19 infection will cause mild illness however, it can make some people very ill and, in some people, it can be fatal. Older people, and those with pre-existing medical conditions (such as cardiovascular disease, chronic respiratory disease or diabetes) are at risk for severe disease (See Protection measures for persons who are in or have recently visited (past 14 days) areas where COVID-19 is spreading).

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