WORLDWIDE HEALTH ALERT - COVID-19 UPDATE

Updated on 27 April 2020


The Situation: As of Monday, 27 April, there are 2,992,970 confirmed COVID-19 cases worldwide – almost 257,000 more cases than Friday. This data includes 207,518 deaths and 876,043 recoveries. A total of 185 countries are reporting confirmed cases. CDC adds six symptoms to Covid-19 list: chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. Countries around the world beginning to ease lockdowns as daily infections and deaths slow while some are continuing to maintain and/or increase restrictions. 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

  • Belgium admits only 127 new patients to hospitals on Sunday due to coronavirus in lowest number since 18 March, beginning of lockdown.

  • Spain reports 331 new deaths in 24 hours, a rise in this number from the lows reported just recently. Began easing some restrictions on Sunday, allowing children out to play for first time in six weeks.

  • U.K.’s Boris Johnson returned to work to tackle how to lift lockdown, asking for patience in the process.

  • Germany makes masks mandatory on public transport as country begins to loosen lockdown measures.

  • Norway’s primary schools reopen to youngest students with a 15 max per class.

  • Italy to begin easing lockdown (strictest and longest in Europe) on 4 May allowing people to move around their regions and bars and restaurants to open up take out and delivery services. Factories and construction sites to resume work with physical distancing and other health protocols.

  • Sweden expected to reach “herd immunity” in Stockholm as soon as next month. Amid warnings from WHO that there is no evidence that those who have recovered from Covid-19 have immunity or if they do how long that immunity lasts.

o Sweden is reporting 18,926 total cases and 2,274 deaths

o Neighboring countries Denmark and Norway did impose lockdowns and are reporting 8,896 cases and 427 deaths for Denmark; 7,527 cases and 202 deaths for Norway


Eurasia

  • Russia’s total number of cases surpasses China’s with 87,147 and 794 deaths. Cases have doubled in an 8-day period. Government expects cases numbers to plateau around mid-May.


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 reported 931 new cases on Sunday, only 15 of which were permanent residents. Saturday it had 618. Total climbs to 14,423 with 12 deaths.

  • India reports positive results from social distancing. Orders testing kits from China be returned to suppliers due to unreliable results.

  • Japan bans travelers from 14 more countries, including Russia and Saudi Arabia, joining U.S., all of Europe and China – 87 in total.

  • South Korea recently reporting that 222 Covid-19 patients have tested positive again after being told they were clear. Health authorities are researching to determine if these are cases of reinfection or it testing failed to recognize virus still present.

  • China reports 3 new cases – 2 returned from overseas, other is in Heilongjiang province bordering Russia.

o Chinese police arrest three with links to archiving online censored articles concerning the coronavirus outbreak.


Middle East

  • Iran to reopen mosques in areas of country that have been consistently free of coronavirus infections.

  • Pakistan extends flight ban on all international flights through 15 May.

  • Afghanistan releasing 60% of its 36,000 prisoners to alleviate overcrowded prisons as outbreak spreads. Officials saying they have capacity for 18,000. Reporting 1,703 cases of coronavirus, but testing is extremelylimited.

  • 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

  • 217 Cuban doctors arrive in South Africa to help fight Covid-19. South Africa has the highest number of cases in Africa with 4,546 and 87 deaths.

  • 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.


Oceania

  • New Zealand to move to Phase 3 Monday with parliament and courts reopening and about 400,000 people to return to work, still under very stringent conditions. Only one new case was reported on Monday.

  • Australia – the government’s COVIDSafe tracing app was downloaded by 1.3 million after just being launched Sunday. Health Minister Greg Hunt says the app is necessary to help “disease experts find people who might have been exposed.”

South/Central America

  • Ecuador being hit hard, with the 2nd highest cases in South America to Brazil though it’s only the 8thlargest in population number. 70% of the cases are being reported in coastal Guayas province, includes Guayaquil. An estimate from the mayor’s office puts death toll from the outbreak at over 7,000 in Guayaquil alone during March and April. Only officially reporting “confirmed” and suspected deaths at 1,366.

o The Los Angeles Times reported: Official data from Ecuador’s civil registry department — which maintains records of births and deaths nationwide — confirm that the Guayaquil area has experienced an extreme surge in mortality. In Guayas province, 13,162 deaths were recorded between March 1 and April 22, 2020 compared to 3,771 deaths for all of March and April 2019, and 3,459 deaths during the same period in 2018.

o Guayaquil sits at sea level about 152 miles south of the equator – hot, humid and tropical in climate –the virus seems undeterred by the conditions.

  • 24 March: At least 44 attacks against medical workers have been reported in Mexico since mid-March. Mexico is reporting 11,633 confirmed cases and 1,069 deaths.

Canada

  • 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 967,585 confirmed cases, 54,931 total deaths and 107,060 recovered.

  • 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. 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 24 April for comparison. New countries to reach the top 25 and data are in red. New numbers are in red and 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. · Chills sometimes with repeated shaking

· Headache

* 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

  • Chills sometimes with repeated shaking

  • Headache

  • Muscle aches or pain

  • 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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