WORLDWIDE HEALTH ALERT - COVID-19 UPDATE

Updated on 24 April 2020


The Situation: As of Friday, 24 April, there are 2,735,979 confirmed COVID-19 cases worldwide – just over 141,000 more cases than Wednesday. This data includes 192,125 deaths and 752,148 recoveries. A total of 185 countries are reporting confirmed cases. Vaccine trials are under way in the U.S., Europe and China, but will take 12-18 months to be fully developed and released to the public


Researchers suggest social distancing measures might be necessary into 2022 without an effective treatment or vaccine. Globally, countries – and in the U.S. state governors – begin to outline plans to restart their economies. Public health officials around the world say the only way to keep the death toll from growing quickly is to extend lockdowns.

Below is an example of the virus’ progression from inception to reported numbers:


The U.N. Secretary General: “the pandemic is the world’s biggest challenge since World War II” as a U.N. report estimates that 25 million jobs could be lost worldwide. Experts are saying the number of cases and deaths worldwide are “seriously under-counted” due to mild cases that are missed, lack of testing and governments underplaying the pandemic’s impact.

U.N. World Food Programme warns that global hunger could double and the number of people facing acute food insecurity could hit 265 million in the wake of the pandemic.

Europe

  • WHO said Thursday, that half of all deaths across Europe were in nursing homes.

  • Spain records 367 new deaths, lowest daily number in over a month.

  • Poland extends school closures until 24 May.


Eurasia

  • Russia’s defense ministry is building 16 new hospitals across the country to meet needs of the outbreak. Expected to be ready by mid-May. Russia has almost 70,000 confirmed cases and 615 deaths.

Asia

  • 20 April: Experts worry that Southeast Asia could become next hotspot as it has seen a quick rise in numbers over the past couple weeks. Over 28,000 cases across the region as of Sunday with Indonesia, Philippines, Malaysia and Singapore accounting for 87.9% of those cases. Low testing rates in Indonesia and Philippines have raised concerns that tens of thousands are going undetected.

  • Singapore reports 897 new cases –largely among migrants living in dormitories. Now has 4th highest infection rate in Asia behind China, India and Japan.

  • India sees highest single-day case jump on Thursday since 19 April with 1,680 as state of Maharashtra saw a surge in cases with 778 of those cases.

o PM Modi states that the biggest lesson from the pandemic is that the country must be self-sufficient in meeting its own needs and that it cannot afford to have to look outward to handle a future crisis of this magnitude. India has been importing PPE, medical supplies and ventilators from China.

  • 91 crew members test positive on an Italian cruise ship docked in Japan for repairs. Ship has no passengers, only 623 crew members on board.

  • Indonesia has 436 new cases in a single-day record jump and pushing total over 8,200. Death toll adds 42 more.

o Hundreds gather in ultra-conservative Aceh province mosque for prayers at beginning of Ramadan despite Covid-19 concerns.

  • Malaysia reports 88 new cases for 8th consecutive day of double-digit numbers. One new death brings total to 96.

  • Hong Kong reports no new cases or deaths.

  • Philippines infection total pushes past 7,000 with 211 new infections and also 15 more deaths.

o Government extends lockdown in Manila until 15 May, while planning to ease restrictions on lower-risk areas. International and domestic flights will remain suspended until mid-May as well.

  • South Korea reports no new deaths for first time in a month and only six new cases.

  • Japan sees highest daily death toll Thursday with 29. Total stands at 341 total, including 13 from the Diamond Princess cruise ship.

  • China reports no new deaths for 9th consecutive day on Friday. Six new cases, 2 of which imported.

Middle East

  • Iran’s death toll rises by 93 to 5,574. Total number of cases reaches 88,194 with 3,121 of those in critical condition.

  • Pakistan’s numbers continue to climb as government starts using its Inter-Services Intelligence (ISI) service – originally used against terrorism – for tracking and tracing people who have been in contact with positive Covid-19 cases.

  • Qatar reports 761 new cases in highest daily increase yet. Over 8,500 cases and 10 deaths.

  • 3 March: WHO’s regional director for the eastern Mediterranean calls for countries in the region to “be more aggressive” in testing and tracing efforts

Africa

  • Djibouti now reporting the highest prevalence of cases in Africa as the population has not been complying with social distancing measures imposed by the authorities. 985 cases - and 2 deaths – are a 7-fold increase in cases in just 2 weeks and a prevalence of 98.6 cases per 100,000 people.

  • 17 April: WHO Africa – a tentative projection shows that cases in Africa could hit as many as 10 million in 3-6 months.

  • 10 March: The WHO says some African countries could peak in next couple weeks, observing that numbers have doubled over past 4 days with concerns over lack of testing.

  • More than half of Africa’s 54 countries have implemented lockdowns, travel ban, curfews or other restrictive measures in efforts to stem the spread of coronavirus. Leaders warn that the continent faces economic collapse if financial assistance isn’t provided to the millions that are out of work.

  • There has been an increase in reports of police and military abuses of civilians. A 13-year-old boy was shot and killed in the Mathare area of northeastern Nairobi, Kenya earlier this week. Other reports coming from Uganda and other countries as well.

South/Central America

  • Venezuela protests turned deadly after a protester was shot dead in a southern city. People took to the streets in provincial cities protesting the rising prices of food and essentials. Venezuela is currently reporting 311 confirmed cases and 10 deaths.

  • At least 44 attacks against medical workers have been reported in Mexico since mid-March, from being struck to having scalding liquid thrown on them to being discriminated against by neighbors and threatened with violence if they didn’t leave their neighborhoods. Mexico is reporting 11,633 confirmed cases and 1,069 deaths.


Canada

  • Total number of cases pushes past 43,000. Canada’s public health authority reporting that some one million N95 respirators from China have failed to meet with federal Covid-19 standards and cannot be used in hospitals.

  • 20 April: Canada says border restrictions with U.S. will remain in place for some time as both countries battle the virus.


U.S.

  • U.S. cases rose to 869,172 confirmed cases, 49,963 total deaths and 80,934 recovered. U.S. recorded highest daily death toll with 3,332 deaths in 24 hours.

  • 21 April: U.S. CDC director Dr. Robert Redfield, warns a second wave of coronavirus during next fall/winter’s flu season could be deadly and states should start preparing now.

  • On April 16, US President Trump’s guidelines for moving out of stay-at-home restrictions suggests that states start reopening businesses, restaurants and others by 1 May or earlier as governors deem appropriate for their state.

  • On April 14, President Trump announced a temporary halt in funding to the World Health Organization until a review can be conducted on the WHO’s initial handling of COVID-19 in China.

  • Federal stay-at-home measures and social distancing guidelines were extended through 30 April.

  • Dr. Fauci says it would “not be surprising” to see 100,000 deaths in U.S. from the coronavirus. Compared to the 2017-2018 flu season, which killed 60,000 in the U.S., stating that this virus is “clearly worse”. High end projections put number of U.S. deaths at around 200,000.


Please note changes to the following chart: Numbers in ( ) reflect ranking of country in the previous report on 22 April for comparison. New countries to reach the top 25 and data are inred. New numbers are inredand numbers from last report are in black.

Other significant factors for consideration:

  • Experts estimated the actual number of cases could be much higher than what is being officially recorded and reported. If that is true, the mortality rate could be much lower.

  • Men were also disproportionately affected during MERS and SARS outbreaks.

  • Women, in general, have a stronger immune response than men.

  • China accounts for nearly a third of the world’s smokers with more than half of the men smoking compared to just over 2% of China’s women smoking.


Travel Effects:

  • Many countries have urged citizens to reconsider travel or avoid nonessential travel to China and avoid all travel to Hubei.

  • Airlines around the world suspended services to all or some of China and other hot spots around the globe.

  • Several countries banned foreigners who recently traveled to China and/or are Chinese passport holders and increased health screening measure at ports of entry

  • Specialized quarantines based on needs per country.

  • Travel Ban on Europe – to take affect Friday, March 13 at midnight, no travel from Schengen Area countries.

o From DHS: These countries, known as the Schengen Area, include: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland. This does not apply to legal permanent residents, (generally) immediate family members of U.S. citizens, and other individuals who are identified in the proclamation. LINK

o The Department of State advises U.S. citizens to avoid all international travel due to the global impact of COVID-19.

* In countries where commercial departure options remain available, U.S. citizens who live in the United States should arrange for immediate return to the United States, unless they are prepared to remain abroad for an indefinite period.

* U.S. citizens who live abroad should avoid all international travel. Many countries are experiencing COVID-19 outbreaks and implementing travel restrictions and mandatory quarantines, closing borders, and prohibiting non-citizens from entry with little advance notice.

* Airlines have cancelled many international flights and several cruise operators have suspended operations or cancelled trips. If you choose to travel internationally, your travel plans may be severely disrupted, and you may be forced to remain outside of the United States for an indefinite timeframe.

o On March 14, the Department of State authorized the departure of U.S. personnel and family members from any diplomatic or consular post in the world who have determined they are at higher risk of a poor outcome if exposed to COVID-19 or who have requested departure based on a commensurate justification. These departures may limit the ability of U.S. Embassies and consulates to provide services to U.S. citizens.

  • Department of State – Information for Travelers - LINK

o Includes advise for U.S. citizens that are currently abroad with specific information for those in China, Europe and on cruise ships.

o Covid-19 virus related emergency numbers:

* From U.S. or Canada: 1-888-407-4747

* From Overseas: +1 202-501-4444

* Enroll in STEP - LINK

  • Current CDC Travel Alerts for Covid-19:

o Level 3 – Avoid all nonessential travel – Global COVID-19 Pandemic Notice – Widespread Ongoing Transmission - LINK

o See LINK for all current travel alerts by country


Symptoms to Watch Out For:

Officials say the respiratory disease, is capable of spreading through human-to-human contact, droplets carried through sneezing and coughing, and germs left on inanimate objects. The virus might spread during the incubation period – which is believed to be from 1 to 14 days. Be on the lookout for the following symptoms:

  • High fever

  • Difficulty breathing or shortness of breath

  • Cough (usually dry) and/or sore throat

  • Fatigue

  • Muscle aches

  • Diarrhea, nausea, and/or vomiting

  • Loss of smell and/or taste (uncommon)

  • Confusion, stroke-like symptoms, and/or seizures (rare)

  • Pneumonia (secondary infection)

Mitigating Measures to Apply:

  • Monitor local authorities for updates

  • Avoid travel to or through China (including layovers) and specifically through Wuhan and Hubei province, Northern Italy, South Korea, certain areas in the United States and other notable hotspots where transmission is high or on the rise across the globe.

  • Avoid non-essential travel to areas where the infection is known or spreading rapidly

  • Travelers who return from infected areas should self-quarantine

  • Practice social distancing at the workplace and in public spaces

  • Consider work from home arrangements for employees in locations where the virus is spreading or if employees must transit through those areas

  • Employees who feel ill or who have flu-like, respiratory or other symptoms should consider self-quarantine and or stay at home instead of attending office or other functions

  • Weigh the risks of conducting large scale gatherings where the virus is located and the potential for attendees to transit through higher risk areas

  • Large scale gatherings should be avoided

  • Avoid contact with animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat)

  • Wash hands frequently with soap and water; use an alcohol-based hand sanitizer if soap and water isn’t available

  • Older travelers and those with underlying health issues may be at higher risk and should speak to their healthcare provider before travel

  • Avoid exposure to those presenting the above symptoms

  • Avoid populated areas and gatherings if you feel ill (if at all possible)

  • Allow extra time for temperature screening at airports worldwide

  • Enroll in a Safe Traveler Program to receive warnings from your preferred embassy

  • Seek medical care immediately if you experience symptoms and have recently traveled to the infected areas; notify your healthcare provider of your recent travel

  • Confirm travel schedule is not impacted by the coronavirus (including quarantines, which may be individually-imposed, visit/visa restrictions, entry/exit requirements and restrictions, etc.)

  • Ensure the validity of all visas prior to travel as this could be subject to restrictions and changes


Affected Travelers and others:

All travelers have the potential for exposure


DISCLAIMER and Hold Harmless

Disclaimer: LSDS™ gathers information from multiple sources and offers insight and perspective to travelers. Sources cannot be validated for accuracy in every instance. Travelers assume all risk associated with their travel and are responsible for the decisions associated with travel and for their own safety. Users of this reference document agree, to hold harmless LSDS™ (LLC) its employees and clients associated with any risk or injury incurred during travel.

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