WORLDWIDE HEALTH ALERT - COVID-19 UPDATE

Updated on 22 April 2020


The Situation: As of Wednesday, 22 April, there are 2,593,129 confirmed COVID-19 cases worldwide – just over 170,600 more cases than Monday. This data includes 179,725 deaths and 696,948 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. 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


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

  • Spain’s daily death rate remains stable with 435 deaths reported on Wednesday. Tuesday there were 430. Monday 399 were reported.

  • Poland’s case total passed the 10,000 mark with presidential elections coming up on 10 May.

  • Sweden, which never locked down, keeping public life as unrestricted as possible allowing some exposure to the virus with the aim of building immunity amongst the general public, expects to reach “herd immunity”. Sweden’s chief epidemiologist says that the tactic appears to be working and that Stockholm could reach “herd immunity” in a matter of weeks.

  • Ukraine extends lockdown through 11 May.

  • Germany reports 2,237 new cases. Cancels Oktoberfest.

  • Italy reports a record increase in number of people recovered. Now almost 49,000 total.

Eurasia

  • Russian spokesman calls coronavirus a “huge challenge” for the country. Reports 5,236 new cases Wednesday, pushing total to just shy of 58,000, while death toll remains low at only 513.

  • Turkey posts 4,611 new cases and 119 deaths in one day. Total number of cases reaches 95,591 pushing the country past Iran and China’s reported totals.


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 extends its partial lockdown measures for another 4 weeks. The country reported over 1,000 new cases for the 3rdday in a row and continues as the country in SE Asia with the highest number of cases with over 10,000. Foreign workers living in cramped dormitories have made up the majority of new cases.

  • India halts antibody testing (ordered the test from China) due to unreliable results.

  • Taiwan saw an uptick in cases since Saturday after 3 days of reporting 0 cases last week. The 28th case among navy sailors who’d recently returned from a goodwill mission to Palau. 700 sailors were on that trip.

  • 33 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 bans Ramadan travel.

  • China reports 30 new cases on 21 April, 23 of which were imported and 0 deaths for 7th consecutive day.

o Beijing recloses city’s gyms over past weekend over concerns of a resurgence of the virus.

o Municipal authorities in Beijing disclosed that a Chinese man that had returned from studies in Florida tested positive for the virus after completing the required 14-day isolation period for returning to Beijing and testing negative three times. Three of his family members have contracted the virus and a major business and residential district has been listed as the “highest-risk region” in the country.

Middle East

  • Iraq to scale back 24-hour curfews for Ramadan with new curfew times from 7pm-6am Sunday through Thursday. Total bans will remain in place on Fridays and Saturdays. Social distancing and bans on gatherings of more than 3 people

  • Pakistan reports its highest daily death toll with 17.

  • Saudi Arabia plans to ease curfew hours for Ramadan allowing more time to shop for essentials within boundaries of their neighborhoods.

  • 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

  • Mexico cases jump by over 700 in one day. Total stands at 9,501 with 857 deaths.


Canada

  • Total number of cases pushes past 37,300.

  • 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 825,306 confirmed cases, 45,075 total deaths and 75,673 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. 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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