COVID-19 UPDATE – 18 MARCH

COVID-19 UPDATE 18 March

COVID-19 UPDATE – 18 MARCH

COVID-19 UPDATE – 18 MARCH

Executive Summary A little under a year ago, on 11 March 2020, the World Health Organisation (WHO) declared a global pandemic following the emergence of COVID-19. Since first appearing in Wuhan, China, the virus has now infected some 121 million people and killed more than 2.6 million globally. Aside from the obvious public health crisis, coronavirus-related restrictions and national lockdowns continue to cause serious damage to economies as well as increasing political instability and social unrest globally. Even now, over a year into the pandemic, many countries are still suffering high daily rates in the multiple thousands and remain under stringent lockdown restrictions. However, life in some countries like China and in South East Asia and Oceania, for example, have returned to relative normality. Many countries are now beginning to see their programs reach younger ages, with the UK and US seeing a drop in fatalities from their programmes. As these efforts continue, we are set to see death rates drop and an increasing number of countries relax their restrictions to allow a

Global share of confirmed COVID-19 cases

3% 0%

16% 22%

29% 30%

Asia Europe North America South America Africa Oceania

resumption of commercial and social activities, as well as a resumption of some normality.

Current Statistics (Numbers Vary Between Sources) Total Cases 121,804,092 Total Cases per 1 million 15,626 Confirmed Active Cases 20,913,714 (Has decreased in past two weeks) Current Serious/Critical Cases 88,871 (Has decreased in past two weeks) Total Confirmed Recoveries 98,198,453 Total Confirmed Deaths 2,691,925 Country Specific Information (Selected Countries) Countries Confirmed Doses Number of Doses Administered per 100 Total number of cases per 1 million United States 113.04 million 33.8 91,145 India 37.14 million 2.7 8,257 China 64.98 million 4.5 63 (sixty-three) United Kingdom 27.03 million 39.8 62,733 Brazil 12.68 million 6 54,770 Turkey 12.14 million 14.4 34,485 Germany 9.85 million 11.8 31,090 Israel 9.56 million 110.5 89,608 Russia 7.82 million 5.4 30,268 Chile 7.78 million 40.7 47,067 France 7.55 million 11.1 63,427 Italy 7.20 million 11.9 54,336 United Arab Emirates 6.83 million 69 43,345

Asia and Oceania scheme allows businesses to purchase for their staff in order to avoid a lengthy wait for publicly offered jabs. While the scheme will no doubt Asia's worst-affected nations see an increase in the pace of , some health experts have warned of the risk of inequality and that it does not fit in with the wider public health strategy. India 11,156,748 In India, Maharashtra, Kerala, Punjab, Karnataka, Gujarat, Tamil Nadu and Madhya Pradesh are currently reporting an increase in cases. On Sunday, Indonesia 1,353,834 14 March, the Union Health Ministry confirmed that these states accounted for approximately 89 per cent of nationwide new cases. On the other hand, Pakistan 583,916 states that include Rajasthan, Jharkhand, Puducherry and Lakshadwee are witnessing a decrease in the daily new . Philippines 582,215 Since the beginning of its vaccination campaign on 16 January, the nation has vaccinated more than 10.5 million people in what officials have called Bangladesh 547,930 the “world’s biggest vaccination drive”. The help that the nation will receive 0 5,000,000 10,000,000 15,000,000 from the United States will boost its vaccine manufacturing production and On 12 March, President Joe Biden announced that the United States along help it achieve the designated vaccination target. with Japan, India and Australia will partner to provide 1 billion doses of Meanwhile, a new variant of the disease has been discovered in Japan. The Johnson & Johnson’s vaccine to nations across South East Asia, which is new strain of the disease was discovered after a man who travelled from the currently experiencing a vaccination shortage. Whilst the US and Japan will Philippines tested positive after undergoing the compulsory quarantine at the help India, Australia will assist with the distribution of the vaccine across airport. This mutation, N501Y, is reportedly different from others previously South East Asia. The announcement followed the Quad Summit, a virtual found in the United Kingdom (B117), Brazil (P1) and South Africa (B1351), meeting between the heads of state of the Australia, India, Japan and the however, it poses a similar threat as it is more contagious than the original United States. version. Overall, the country is experiencing a surge in infections. Osaka Johnson & Johnson’s COVID-19 vaccine has been recently granted prefecture has reported the highest number of new cases over the past two emergency authorization by the World Health Organization (WHO). The weeks. Authorities are considering increased preventative measures ahead vaccine is now available for distribution through the global initiative Covax, of the delayed 2020 Summer Olympics that are scheduled to be held in July which aims at ensuring that low-income countries have equitable access to and August in Tokyo; this includes decreasing venues capacities by 50 per the vaccine. cent. Discussions are still ongoing and Japan’s organising committee will reportedly announce over the coming months what precautions will be Following the Indonesian government’s approval of a controversial private adopted. vaccination scheme last month, the nation is expecting a delivery of some 20 million doses by the end of the second quarter. The private vaccination The vaccination campaign continues in Australia where more than 160,000 people have had at least the initial dose. With a target of 4 million

administered jabs by April, this figure is below what authorities hoped to achieve. Prime Minister Scott Morrison recently blamed the vaccination delays on issues in the international supply chain. Authorities remain hopeful that a large percentage of the population will receive both doses by October this year and if the international production of the vaccine is stepped up, this can be brought forward. In recent news, Prime Minister Scott Morrison announced that an additional $1.1 billion will be allocated to the COVID-19 response. The Australian government is also working with Singapore to establish a travel bubble between the two nations. Meanwhile, a similar attempt with neighbouring New Zealand has stalled. Over the past weekend, in New Zealand, Auckland emerged from a two- week lockdown sparked by a community transmitted case detected in Papatotoe in February. After all cases from the cluster recovered, Auckland is now on Alert Level 1 with the rest of the nation. The vaccine rollout is underway and most recently, COVID-19 Response Minister Chris Hipkins announced that at least two million people in the most at-risk groups will be vaccinated over the upcoming three months. New Zealand’s economy contracted in the final quarter of 2020, raising the prospect the nation could be heading towards a technical recession. Overall economic activity dropped by one per cent compared to Q3 while GDP remains 0.9 per cent under December 2019’s figure. The disappointing figures have been blamed on COVID-19 restrictions, which severely affected the country’s important tourism sector, among others.

Europe shots, a break with EU strategy. Several Central European countries are currently experiencing a renewed Similarly, cases in Poland are also increasing and the country recorded surge of COVID-19 infections, including the Czech Republic, Hungary and 17,260 new cases on 10 March, the greatest number since late November Poland, among others. In the Czech Republic, the number of patients being 2020. A spokesperson speaking on behalf of the country’s health ministry treated in intensive care reached a new peak in the past week. Moreover, suggested “increased looseness” among Poles towards coronavirus last week the nation had the highest new cases per million rate of all restrictions was to blame for the latest rise in cases. The country is now European countries, with over 15,000 per million. officially facing its third wave of COVID-19, and as a result, the Polish National Health Fund, which is the national public healthcare system, has In Hungary, the numbers of daily infections are rising and in recent days have once again recommended that hospitals begin to suspend or delay routine surpassed December’s highest daily caseload, which marked the nation’s procedures to concentrate on the pandemic. previous peak of infections. As well as the rising number of infections, Hungary also has one of the regions highest death rates with surgeon New data from Eurostat also shows that Poland recorded the highest excess general Cecilia Muller previously describing the situation as “very serious”. death rates in the entirety of the EU. The Polish excess death rate in 2020 was 20.5% above its historical base line average. Whilst, Poland has Hungary is, however, beginning to vaccinate at a faster rate than most other officially only recorded 28,500 COVID-19 deaths in 2020 this high rate of EU countries, being only behind Malta in the EU and the UK in the wider excess deaths shows that a large proportion of COVID-19 deaths in the Europe. This has been helped by a strategy that has not only sought jabs country went unrecorded in the official statistics. It also points to the fact that from within the EU, but also the acquisition of Russian and Chinese made a large number of people in the country likely perished as an indirect result of the pandemic as Polish hospitals, like many in the world, cut back on other surgeries and operations in 2020 to focus almost purely on treating COVID- 19 patients. In the past weeks, there has been concern over the Oxford-AstraZeneca vaccine after several deaths caused by blood clots occurred in recently vaccinated individuals. This has resulted in a number of countries suspending the vaccines use. Germany, Italy, France, Spain and the Netherlands became the latest countries to pause the rollout of the jab on Monday. Norway, Denmark and Bulgaria suspended their programmes last week. Some of those nations have only suspended the use of certain batches of the vaccine, while Denmark, Norway and Iceland took the more extreme step to pause the entire rollout of the vaccine pending investigations. The decision came as the World Health Organisation (WHO) urged nations not to pause their AstraZeneca programs. They added that there were no signs that the jab was causing the highlighted issues. At the EU level¸ the European Medical Agency (EMA) is of the opinion that the benefit of the AstraZeneca vaccine in preventing COVID-19 outweighs the risk of side effects. British Prime Minister Boris Johnson also added that Britain’s

medicines regulator saw “no reason to discontinue” use of the vaccine, with Downing Street asserting that the jab was deemed by regulators to be both Europe's worst-affected nations “safe and effective”.

In the UK, the country’s National Health Service (NHS) has warned of a Russia 4,418,436 “significant reduction in the weekly supply of vaccines” from April. As yet, it is unclear as to why this may be. While the UK and the EU are in disagreement over the export of vaccines, it is unclear whether this has UK 4,274,579 resulted in the shortage. France 4,146,609 The President of the European Commission, Ursula von der Leyen, has stated that Brussels is still waiting for vaccine exports from the UK. She warned that if vaccine supplies do not improve, then the EU “will reflect Italy 3,281,810 whether exports to countries who have higher vaccination rates than us are still proportionate”, which observers have interpreted to mean the UK. Spain 3,206,116 As of 17 March, more than 25 million adults have received the first dose from either the AstraZeneca, Moderna, or Pfizer vaccines that are currently 0 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 approved for use in the UK. The country’s Health Secretary, , has stated that the NHS is on course to have offered the vaccine to all adults over the age of 50 by 15 April. However, it remains to be seen whether the UK will be able to fulfil its objective of offering a first dose to all adults by the end of July due to the reported shortages.

Americas In Brazil the disease is showing no sign of slowing down. The nation has surpassed India and it currently holds the second highest number of deaths Cases continue to surge in parts of the continent including Brazil, Panama in the world after the United States. and Guatemala. On the other hand, some nations such as the United States., Mexico and Canada are witnessing a drop in cases. According to official data, 15 state capitals are at more than 90 per cent intensive care unit (ICU) capacity. The recent surge of cases comes after On 12 March, in his first televised speech US President Joe Biden stated the illegal carnival celebrations. The worst affected hospitals are located in Porto nation is making great progress in the fight against the pandemic. He also Alegre and Campo Grande. Health experts in the country also suggest that set the July 4 Independence Day as a possible date for a return to some if the vaccination campaign is not scaled up, infection numbers are likely to normality. The president also announced that a premature relaxation of surge over the coming months. restrictions is a risky move. Although cases have been decreasing since mid- January, the curve has been levelling off recently. US share of Global Total The US vaccine rollout is also starting to show results. According to media analysis of official data, the number of deaths and hospital admissions are falling more quickly among older people than in the wider population. 25

US cases as a percentage of all confirmed global COVID-19 cases

Meanwhile, Brazil’s President Bolsonaro continues to downplay the severity of the situation, leaving state and local authorities to make decisions on whether to implement restrictions. Several states have adopted new restrictions including shutting down non-essential businesses. Supply issues are also affecting the vaccination drive in the nation, which started behind other countries in the region. Despite this, on 12 March the government announced it reached a deal to purchase 10 million doses of the Russian Sputnik V vaccine.

The ongoing COVID-19 pandemic in the country has also claimed the scalp of its third Minister of Health in the country since it began. Eduardo Pazuello, The Americas worst-affected nations whose appointment to the position of Health Minister occurred in May 2020 has been marred by an increasing death toll, oxygen shortages in the USA 30,294,798 Amazonian city of Manaus, and a slow roll out of the nation’s vaccination programme. His replacement, Marcelo Queiroga, is a well-respected Brazil 11,700,431 cardiologist doctor in the country, however he steps into the role as Brazil faces its “worst moment” in the pandemic. All but two Brazilian states now Colombia 2,314,154 have their intensive care capacity filled at 80% or above, while the southern state of Rio Grande do Sul has no intensive care capacity at all. Argentina 2,218,425 A sustained surge of the disease has also been reported in Argentina. Due to the rise in cases in the nation and in neighbouring regions, President Mexico 2,169,007 Alberto Fernández extended the state of emergency at least until the end of 2021. Alongside this, the country’s health authority has issued new travel 0 5,000,00010,000,00015,000,00020,000,00025,000,00030,000,00035,000,000 guidance, which restricts travel into the country further. Under the new rules, non-essential travel is barred, a negative PCR test must be presented which is no older than 72 hours, and on arrival into Argentina travellers must quarantine for ten days. These new rules have been brought into place after two flights to Buenos Aires from Cancun, arrived in the country carrying 44 and 55 travellers infected with COVID-19 respectively. The vaccination campaign is underway in every country in South America. Uruguay was the last nation to join the vaccination drive in March. Chile, which has been one of the hardest hit countries in the region, is not among the top countries who are performing an effective campaign. It is reported that more than 25 percent of its population has received at least one jab.

Early negotiations and a fast distribution were among the factors for Chile’s success.

Africa scale of daily infections the country had previously seen. This would then mean that over time the virus would naturally begin to slow in its spread. Africa's worst-affected nations Alongside this, South African scientists have discovered that the antibodies in the body which are released when fighting the South African variant, also known as 501Y.V2, is likely able to protect against multiple mutations of the South Africa 1,532,497 COVID-19 virus. These finds will provide hope that vaccines which are tweaked to provide added protection against 501Y.V2 will also be successful Morocco 490,088 against other variants meaning that any future vaccines may need to be tweaked less. Tunisia 243,439 In Rwanda, a number of COVID-19 emergency restrictions were eased on 16 March. The curfew was reduced by two hours, and now will run between Egypt 192,840 21:00 and 4:00 local time. Further to this, businesses in the country will now be allowed to remain open until 20:00. Alongside these changes to the Ethiopia 179,812 ongoing COVID-19 measures the country has also announced that it will be including all the refugees in the country in its ongoing vaccination drive, one 0 500,000 1,000,000 1,500,000 2,000,000 of the few countries to officially confirm this. As part of this they have already In South Africa, which has been one of the continents worst hit countries by inoculated around 500 refugees across a number of different camps in the the COVID-19 pandemic, the case load has begun to drop in recent weeks, country. Most of the refugees in the country have fled from the DRC. The and this is despite the country not enforcing a new lockdown, or even vaccination campaign in Rwanda is in its early stages currently and its commencing a large-scale vaccination campaign. Towards the end of targeted at high risk groups, and healthcare workers. January, the country was recording around 22,000 new daily cases, and at In Egypt, the country’s presidential health minister has announced that they the time of writing daily cases have dropped to around 1,000. are preparing the health system to be fully ready for an increase in COVID- Given that the country was home to the South African strain, which was seen 19 daily cases as the country enters Ramadan, which begins in the middle to be more viral that traditional COVID-19. Epidemiologists are now trying to of April. Last year, during Ramadan, Egypt enacted a number of temporary piece together why cases in the country have fallen, when by all other measures to try and help stem the impact of the period on COVID-19. These indicators, they should have continued to rise. Two of the working theories measures included a curfew which allowed families to gather for the Iftar are that whilst no new measures were enforced by the governments, and meal in the evening but meant they had to disperse shortly afterwards. It is many were actively removed, people continued to abide by habits shaped likely that Egypt will implement similar restrictions again in this year’s previously. As such, large scale mask wearing, and Ramadan. continued even in the absence of regulations dictating these actions. In Ethiopia, the government has recently launched its national COVID-19 Alongside this, there is the possibility that certain sections of South African vaccination campaign as the country is also experiencing a surge in daily society may have reached some levels of herd immunity due to the sheer infections. The country is the East African state hardest hit by COVID-19.

Alongside the launch of the vaccination drive, the government has also launched a new campaign to encourage social distancing and mask wearing in public, as it fears that the general population are not utilising these tools enough to supress the virus. Furthermore, in the Tigray region of Ethiopia, which was the scene of a recent armed conflict between the Federal government, and regional leaders, the government is to set up the necessary infrastructure to allow for community wide COVID-19 testing. It is believed that this is a necessary step in the region as the recent conflict there is likely to have allowed for large scale community transmission in the virus, as over 2.2 million people have been left displaced by fighting between the Tigray People's Liberation Front (TPLF) and the Ethiopian National Defense Forces. In Tanzania, the President, John Magufuli, has died with widespread speculation that the cause of his death was COVID-19. He is not the first African leader to have succumbed to COVID-19. In the course of the pandemic, the Prime Minister of Eswatini, Ambrose Dlamini, Burundi's President Pierre Nkurunziza, and a whole host of senior government ministers in Zimbabwe, South Africa, and Malawi have all died of COVID-19. The succumbing of the Tanzanian President to the disease is stark given that he has been one the foremost COVID-19 deniers on the Continent. For many month’s his government denied that Tanzania had registered any COVID-19 infections, and when they finally admitted they may have an epidemic the President stated that herbal remedies, steam inhalation, and prayer would cure those of the illness. The government had arrested a number of people for speculation as to the health of the President, in recent days, with rumours he was in hospital in Kenya being treated for COVID-19. It is unlikely that the death of President Magufuli will change how the Tanzanian government have reacted to the COVID-19 pandemic within the country. Indeed, officially his death has been recorded as death by heart complications.

Middle East A number of countries in the Middle East have continued to stop the spread of new COVID-19 strains from coming into the country. to make progress with vaccination campaigns and a number of countries are In the UAE, the government has announced that they have now vaccinated showing signs of continued and sustained returns to some form of normality. over 50 percent of the population. Health authorities in the country have also announced that a number of those who had received the Chinese developed In Saudi Arabia, which had one of the world’s strictest lockdowns in 2020, Sinopharm vaccine have had to be given a third doses of the vaccine, to help the Health Ministry recently announced that over 2 million people in the boost their immune systems response, with a number of medical country had now received their COVID-19 , and that in the next professionals in the UAE warning that a number of patients who have two weeks 80 percent of all vaccinations slots in the Kingdom had been received the Sinopharm vaccine are showing “low levels” of necessary booked. The Saudi Arabian vaccination programme allows people to easily antibodies, despite receiving the specified two doses. book a vaccination appointment through the Sehhaty Application health portal. Middle East's worst-affected nations Alongside this, the government has announced that they will be opening the Hajj 2021 to foreign Muslims, after the 2020 Hajj was restricted to those only already within Saudi Arabia. The ministers for the Hajj, and for Health have Turkey 2,930,554 also announced anyone who wishes to attend the 2021 Hajj must have been vaccinated and have a certificate of proof. The Hajj is a major source of soft Iran 1,771,115 power for Saudi Arabia, and also a main source of income for the Kingdom, and many businesses in the twin holy cities of Mecca and Medina, and so the fact that it is once again open to pilgrims from around the world will be Israel 824,178 seen as a large step towards normalcy in the country. Iraq In Iran, the government has announced that the country has begun human 774,015 trials of Fakhravac, its third domestically produced COVID-19 vaccine. Alongside this, the head of the Setad, which is in charge of another Jordan 504,915 vaccination effort in Iran, Barekat, has announced that Barekat is 90 percent effective and that its mass production has begun ready to begin dispensation 0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 to Iranians. In Israel and Palestine, there is increasing anger at the fact that the Meanwhile the joint Iranian-Cuban vaccine has had its first doses imported government is making the vaccination process mandatory, unless for into the country and the first 100,000 doses of this vaccine are to be legitimate medical reasons, and linking it to enhanced societal freedom. dispensed in the coming days. Further to this, as a recipient country of Hopes for herd immunity could be damaged should the numbers of vaccine vaccines under the WHO’s COVAX scheme, the country has managed to deniers be large enough. secure 16 million doses of COVID-19 vaccines. Iran began its mass Gaza, meanwhile, has received its second shipment of COVID-19 vaccines. vaccination campaign over two months ago, and the government is hoping This shipment has been provided as aid by the UAE and totals around that all of the nation’s population who are classed as “vulnerable” will have 38,700 doses of the Russian Sputnik V vaccine. The UAE has already sent been fully vaccinated before 20 March. a shipment of 20,000 doses of COVID-19 vaccines to the Gaza Strip. In the The Iranian Civil Aviation Authority has also announced that all flights West Bank meanwhile, authorities have imposed new COVID-19 restrictions between Iran and Iraq have been suspended for a week, as the country tries after the area has seen a sharp increase in new daily infection rates.