WORLDWIDE HEALTH ALERT - COVID-19 UPDATE

Updated on 20 April 2020


The Situation:

As of Monday, 20 April, there are 2,422,525 confirmed COVID-19 cases worldwide – just over 234,000 more cases than Friday. This data includes 166,235 deaths and 635,895 recoveries. A total of 185 countries are reporting confirmed cases.

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. 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


Europe

  • European CDC says there are over 1 million cases in continental Europe and the U.K. as of 19 April and death toll is over 100,000. Spain has the highest number of confirmed cases.

  • Denmark, Germany & the Czech Republic to reopen some shops

  • Poland began loosening some restrictions – opening parks and forests – on Monday. Also reported a daily high of new cases on Sunday with 545. Government says it will re-tighten restrictions if numbers begin to spike.

  • Norway claims it has coronavirus under control and reopens preschools.

  • Germany reports 2nd day decline in new cases with 1,775 and 110 new deaths.

  • U.K. to start testing effects of plasma from Covid-19 survivors to see if it helps a Covid-19 patient’s speed of recovery and chances of survival. Waiting for approvals to move forward with study.

  • Spain case total climbs past 200,000 as death toll rose to almost 21,000. Records lowest daily death toll in a month on Monday.


Eurasia

· Russia reports 4,268 new cases on Monday, a drop from the 6,060 reported on Sunday. Total number of cases over 47,121. 44 deaths in past 24 hours.

Asia

  • 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 daily record number of new cases with 1,425 with vast majority of those among migrant workers living in dormitories. Total number of cases at 8,014.

  • Malaysia only reports 36 new cases Monday and no new deaths in lowest daily total since imposing movement restrictions a month ago. Total number of cases at 5,425 with 89 deaths.

  • Indonesia reports 185 new cases, totaling just over 6,700. 8 new deaths take toll to 590. Over 49,700 tests have been performed.

  • South Korea reported only 13 new cases Monday keeping daily totals below 20 for 3rd day.

  • Bangladesh tightens restrictions after a funeral for a popular cleric attracts tens of thousands of attendees from seven villages.

  • India’s countrywide lockdown – one of the strictest globally – through 3 May is putting strain on small and medium-sized enterprises, which account for about 30% of the country’s economic activity and supports some 111 million jobs.

  • China reports no deaths for 2nd consecutive day. 12 new cases, 8 of which were imported, and 49 asymptomatic cases.

o As China returns to “normal life” people report that “it all feels a little off”.

o Increase in reports of discrimination against foreigners in China

o Number reported as “recovered” in Wuhan dropped over the weekend as 100s were discovered to have been wrongly listed as cured/discharged over past 3 months. Went from 47,300 down to 46,359.


Middle East

  • Iran reports 91 deaths over past 24 hours pushing toll to 5,209. Remains hardest-hit country in Middle East.

  • Pakistan to move towards “smart lockdowns” targeting areas of outbreak and away from the nationwide lockdown they’re currently under. Concerns over economic implications with a countrywide style lockdown driving the decision. Case total went over 8,000 Sunday with 176 reported 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


Oceania

  • Australia reopens some beaches in Gold Coast and Sydney as Queensland reports no new cases Monday and New South Wales only 6.

  • New Zealand to move from a Level 4 Lockdown to a Level 3 next Monday for two weeks.


Africa

  • 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

  • Brazil’s president Bolsonaro showed public support for about 600 people who’d gathered in front of the army’s headquarter in the capital of Brasilia on Sunday. Group was defending military rule and protesting against stay-at-home orders. Brazil added about 9,000 new cases over the weekend.


Canada

· 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 760,245 confirmed cases, 40,690 total deaths and 71,003 recovered.

  • “Operation Gridlock” and other protests erupt across the country demanding that businesses be allowed to reopen.

  • On April 16, 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 17 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.

* 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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