Coronavirus World Map: 896,450 Confirmed Cases; 201 Countries; 45,526 Deaths

Note: There is now a newer Novel Coronavirus (COVID-19) Situation Report 74.

WHO Novel Coronavirus (COVID-19) Situation Report 73

• No new countries/territories/areas reported cases of COVID-19 in the past 24 hours.
• WHO has released a Medical Product Alert that warns consumers, healthcare professionals, and health authorities against a growing number of falsified medical products that claim to prevent, detect, treat or cure COVID-19. Find more here.
• WHO is working with Iraq to increase surveillance and response capacities. WHO has printed hundreds of thousands of prevention and transmission control messages, taken mobile health teams to the streets, and delivered urgent consignments of personal protective equipment (PPE) and laboratory test kits. More information can be found here.
• WHO has been working with governments and partners around the world, across many areas of activity: conducting needs assessments, providing hand sanitizers and masks for health professionals, providing training on the clinical management of patients with COVID-19, collaborating with local media outlets and conducting awareness raising activities, delivering test kits, conducting simulation exercises, and shipping personal protective equipment through WHO logistical hubs. As an example, WHO EURO has released a photo story of WHO’s activities in Kyrgyzstan, available here.
• Our understanding of the transmission of COVID-19 virus continues to improve with the evolution of the outbreak. For more, see ‘Subject in Focus’ below.

Risk Assessment

Global Level: Very High

Coronavirus Situation in Numbers

Globally

• 896,450 confirmed cases (72,839 new)
• 45,526 deaths (4,924 new)

Western Pacific Region

• 107,626 confirmed cases (1,204 new)
• 3,723 deaths (22 new)

European Region

• 503,006 confirmed cases (38,809 new)
• 33,604 deaths (3,515 new)

South-East Asia

• 5,324 confirmed cases (149 new)
• 216 deaths (21 new)

Eastern Mediterranean Region

• 58,168 confirmed cases (3,887 new)
• 3,280 deaths (165 new)

Regions of the Americas

• 216,912 confirmed cases (28,161 new)
• 4,565 deaths (1,165 new)

African Region

• 4,702 confirmed cases (629 new)
• 127 deaths (36 new)

Subject in Focus: The routes of transmission from COVID-19 patients

As the COVID-19 outbreak continues to evolve, we are learning more about this new virus every day. Here we summarize what has been reported about transmission of the COVID-19 virus, and provide a brief overview of available evidence on transmission from symptomatic, pre-symptomatic, and asymptomatic people infected with COVID-19.

Symptomatic transmission

By way of definition, a symptomatic COVID-19 case is a case who has developed signs and symptoms compatible with COVID-19 virus infection. Symptomatic transmission refers to transmission from a person while they are experiencing symptoms.

Data from published epidemiology and virologic studies provide evidence that COVID-19 is primarily transmitted from symptomatic people to others who are in close contact through respiratory droplets, by direct contact with infected persons, or by contact with contaminated objects and surfaces.^1-7 This is supported by detailed experiences shared by technical partners via WHO global expert networks, and reports and presentations by Ministries of Health.

Data from clinical and virologic studies that have collected repeated biological samples from confirmed patients provide evidence that shedding of the COVID-19 virus is highest in upper respiratory tract (nose and throat) early in the course of the disease.^8-11 That is, within the first 3 days from onset of symptoms.^10-11 Preliminary data suggests that people may be more contagious around the time of symptom onset as compared to later on in the disease.

Pre-symptomatic transmission

The incubation period for COVID-19, which is the time between exposure to the virus(becoming infected) and symptom onset, is on average 5-6 days, however can be up to 14 days. During this period, also known as the “pre-symptomatic” period, some infected persons can be contagious. Therefore, transmission from a pre-symptomatic case can occur before symptom onset.

In a small number of case reports and studies, pre-symptomatic transmission has been documented through contact tracing efforts and enhanced investigation of clusters of confirmed cases.^12-17 This is supported by data suggesting that some people can test positive for COVID-19 from 1-3 days before they develop symptoms.^6,16 Thus, it is possible that people infected with COVID-19 could transmit the virus before significant symptoms develop. It is important to recognize that pre-symptomatic transmission still requires the virus to be spread via infectious droplets or through touching contaminated surfaces.

Asymptomatic transmission

An asymptomatic laboratory-confirmed case is a person infected with COVID-19 who does not develop symptoms. Asymptomatic transmission refers to transmission of the virus from a person, who does not develop symptoms.

There are few reports of laboratory-confirmed cases who are truly asymptomatic, and to date, there has been no documented asymptomatic transmission. This does not exclude the possibility that it may occur. Asymptomatic cases have been reported as part of contact tracing efforts in some countries.

WHO regularly monitors all emerging evidence about this critical topic and will provide an update as more information becomes available.

Selected references

1. Liu J, Liao X, Qian S et al. Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China, 2020. Emerg Infect Dis 2020 DOI: 10.3201/eid2606.200239
2. Chan J, Yuan S, Kok K et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020 DOI: 10.1016/S0140-6736(20)30154-9
3. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; DOI: 10.1056/NEJMoa2001316
4. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506.
5. Burke RM, Midgley CM, Dratch A, Fenstersheib M, Haupt T, Holshue M,et al. Active monitoring of persons exposed to patients with confirmed COVID-19 —United States, January–February 2020. MMWR Morb Mortal Wkly Rep. 2020 DOI: 10.15585/mmwr.mm6909e1
6. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 16-24 February 2020 [Internet]. Geneva: World Health Organization; 2020 Available from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
7. Ong SW, Tan YK, Chia PY, Lee TH, Ng OT, Wong MS, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020 Mar 4 [Epub ahead of print].
8. Wang W, Xu Y, Ruqin G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA 2020 DOI: 10.1001/jama.2020.3786
9. Lauer SA, Grantz KH, Bi Q et al. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann Intern Med 2020 DOI: 10.7326/M20-0504
10. Liu Y, Yan LM, Wan L et al. Viral dynamics in mild and severe cases of CVOID-19. Lancet Infect Dis DOI: 10.1016/S1473-3099(20)30232-2
11. Wolfel R, Corman V, Guggemos W et al Virological assessment of hospitalized cases of coronavirus disease 2019. DOI: 10.1101/2020.03.05.20030502
12. Yu P, Zhu J, Zhang Z, Han Y. A familial cluster of infection associated with the 2019 novel coronavirus indicating possible person-to-person transmission during the incubation period. J Infect 2020 DOI: 10.1093/jiaa077
13. Huang R, Xia J, Chen Y, Shan C, Wu C. A family cluster of SARS-CoV-2 infection involving 11 patients in Nanjing, China Lancet Infect Dis 2020 DOI: 10.1016/ S1473-3099(20)30147-X
14. Pan X, Chen D, Xia Y et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis 2020 DOI: 10.1016/S1473-3099(20)30114-6
15. Tong Z-D, Tang A, Li K-F, Li P, Wang H-L, Yi J-P, et al. Potential presymptomatic transmission of SARS-CoV-2, Zhejiang Province, China, 2020. Emerg Infect Dis. 2020 DOI: 10.3201/eid2605.200198
16. Wei WE, Li Z, Chiew CJ, Yong SE, et al. Presymptomatic Transmission of SARS-CoV-2 —Singapore, January 23–March 16, 2020. MMWR, 1 April 2020/69.17.
17. Kimball A, Hatfield KM, Arons M, James A, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility —King County, Washington, March 2020. MMWR, 3 April 2020, 69(13);377–381

Countries, territories or areas with reported laboratory-confirmed COVID-19 cases and deaths, April 2, 2020

Country/Territory/Area	Confirmed Cases
United States of America	187302
Italy	110574
Spain	102136
China	82724
Germany	73522
France	56261
Iran	47593
United Kingdom	29478
Switzerland	17070
Turkey	15679
Belgium	13964
Netherlands	13614
Austria	10711
Republic of Korea	9976
Canada	9005
Portugal	8251
Brazil	5717
Israel	5591
Australia	4976
Sweden	4947
Norway	4665
Czechia	3589
Ireland	3447
Denmark	3107
Chile	3031
Malaysia	2908
Russian Federation	2777
Poland	2554
Romania	2460
Ecuador	2372
Japan	2384
Luxembourg	2319
Philippines	2311
Pakistan	2291
Thailand	1771
Saudi Arabia	1720
Indonesia	1677
India	1636
Finland	1446
South Africa	1380
Greece	1375
Peru	1323
Dominican Republic	1284
Iceland	1220
Mexico	1215
Panama	1181
Serbia	1060
Argentina	1054
Singapore	1000
Croatia	963
Colombia	906
Algeria	847
Slovenia	841
Qatar	835
United Arab Emirates	814
Ukraine	804
Egypt	779
Estonia	779
Iraq	728
New Zealand	723
International (Diamond Princess Cruise Ship)	712
Morocco	676
Lithuania	581
Armenia	571
Bahrain	569
Hungary	525
Lebanon	479
Bosnia and Herzegovina	464
Latvia	446
Republic of Moldova	423
Tunisia	423
Bulgaria	422
Slovakia	400
Andorra	396
Kazakhstan	386
Azerbaijan	359
North Macedonia	354
Costa Rica	347
Uruguay	338
Cyprus	320
Kuwait	317
Puerto Rico	286
Réunion	281
Jordan	278
Albania	277
Burkina Faso	261
San Marino	236
Afghanistan	235
Oman	231
Vietnam	218
Cuba	212
Ghana	195
Belarus	192
Côte d’Ivoire	190
Senegal	190
Uzbekistan	190
Malta	188
Faroe Islands	173
Honduras	172
Mauritius	154
Sri Lanka	143
Venezuela	143
Cameroon	139
Nigeria	139
Palestinian Territory	134
Brunei Darussalam	131
Martinique	128
Guadeloupe	125
Kosovo	125
Democratic Republic of the Congo	123
Georgia	121
Montenegro	120
Mayotte	116
Bolivia	115
Kyrgyzstan	115
Cambodia	109
Trinidad and Tobago	89
Rwanda	82
Jersey	81
Kenya	81
Guernsey	78
Gibraltar	69
Guam	77
Niger	74
Liechtenstein	72
Paraguay	69
Isle of Man	65
Aruba	55
Bangladesh	54
Madagascar	53
French Guiana	51
Uganda	44
Guatemala	39
Jamaica	38
French Polynesia	37
Monaco	37
Togo	36
Zambia	36
Djibouti	34
Barbados	33
Bermuda	32
El Salvador	32
Guinea	30
United States Virgin Islands	30
Mali	28
Ethiopia	26
Congo	22
Saint Martin	21
United Republic of Tanzania	20
Guyana	19
Maldives	18
Haiti	16
New Caledonia	16
Myanmar	15
Bahamas	15
Eritrea	15
Cayman Islands	14
Equatorial Guinea	14
Mongolia	14
Benin	13
Saint Lucia	13
Curaçao	11
Dominica	11
Namibia	11
Greenland	10
Lao People’s Democratic Republic	10
Libya	10
Mozambique	10
Seychelles	10
Syrian Arab Republic	10
Eswatini	9
Grenada	9
Guinea-Bissau	9
Angola	8
Central African Republic	8
Saint Kitts and Nevis	8
Suriname	8
Zimbabwe	8
Antigua and Barbuda	7
Chad	7
Gabon	7
Sudan	7
Holy See	6
Liberia	6
Northern Mariana Islands	6
Saint Barthelemy	6
Sint Maarten	6
Cabo Verde	5
Fiji	5
Mauritania	5
Montserrat	5
Nepal	5
Nicaragua	5
Somalia	5
Turks and Caicos	5
Bhutan	4
Belize	3
Botswana	3
British Virgin Islands	3
Gambia	3
Anguilla	2
Burundi	2
Sierra Leone	2
Papua New Guinea	1
Saint Vincent and the Grenadines	1
Timor-Leste	1
Total	896450

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).