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European and World Stand: +33.4 million cases and a million dead

The new SARS-CoV-2 virus causes the disease known as Covid-19. There are 33.5 million registered cases in the world, over one million dead, and more than 23 million people have recovered to date (29 September 2020). The most affected country is the US (with more than 7.1 million cases and more than 205,000 deaths), followed by India (+6 million cases and +96,000 deaths), and Brazil (with +4.7 million cases and +142,000 deaths). Russia has over 1.1 million cases, Colombia (+25,000 deaths) and Peru (+32,000 deaths) over 800,000 cases. Spain has reported more than 748,000 cases and +31,000 deaths, being most affected EU Member State. Mexico and  Argentina over 700,000 cases, while South Africa is close to that figure.  

France, Iraq and the Philippines are over 500,000 cases. Chile, Iran, the UK,  are over 400,000 cases. Bangladesh, Saudi Arabia, Turkey, Italy, and Pakistan are over 300,0000 cases, while Germany and Indonesia are nearby. Over 200,000 cases are Israel and Ukraine. Over 100,000 are Canada, EcuadorBoliviaQatar, Romania, the Netherlands, BelgiumMorocco, Kazakhstan and Egypt, while the U. A. Emirates and Sweden are nearby. Poland, Belarus, Portugal, Switzerland and Moldova also have tens of thousands of cases. China, where the pandemic started in December 2019, has officially reported some more than 85,000 infected people.

On 8/12/2019 the first case of SARS-CoV-2 pneumonia was admitted to hospital in Wuhan (Hubei province, China). The virus was identified there on 7/1/2020, but the person-to-person transmission was only confirmed on 20 January. China closed Wuhan on 23/1/2020 when the virus had already gone around the world: some 25 countries identified and reported their first cases between 20-31 January, all in persons direct or indirectly related to this Chinese city. Dr Zhong Nanshan, the 2002-2003 “SARS hero” of Guandong province, explained that the most effective measure is “early detection and isolation”. Therefore, strong confinement was declared, and the result was very successful in controlling the spread of the virus to the rest of China and to the world. Since early December 2019 until late January 2020, thousands of people travelled between Wuhan and many other countries worldwide, some of them sick with light or no symptoms. A few of them ended up in hospitals where the virus was detected. But most of them did not need to go to the doctor but had the capacity to transmit the virus.

WHO discussed on 24 January about the declaration of an international emergency, but decided not to do so because there was not enough information on the clinic, transmission, and source of the outbreak. It also recommended implementing measures to limit risk, but without any restriction to the international movement of persons and trade. WHO finally declared the emergency on 30 January, but most of Europe and the US did nothing in the first three weeks of February. This virus hides and spreads better than any other in its species, therefore late reaction by health authorities seemed to be inevitable, and the effects have been devastating in some countries. In the US (with 330 million inhabitants) only 60 cases were identified during the whole February; 53 in Germany (83 million inhabitants); 38 in France (66 million), 16 in the UK (67 million ), and 32 in Spain (46 million).

International travel was cancelled worldwide, while business and economy became paralyzed, except for essential activities. 4.5 billion people in 180 countries had to confine themselves and social separation was widely established. In June 2020 most European countries started de-confinement, with different rhythms and without a common EU criterium, while the pandemic had crossed to the Americas, the most affected continent by now. In Asia, the pandemic seemed to be under control, and Africa was not strongly affected. However, there were concerns related to the weakness of African health systems (though holding a high experience in facing outbreaks).

AEBR has prepared tables with updated information on countries with more than 100,000 total cases or more than 200 cases per 100,000 inhabitants in Europe and in the World. In the end, a table with information from other European countries has also been included, particularly on border closing and deconfinement. We have kept on filling these tables with further desk research and info provided by our readers.

The EU made public on 30 June the countries which have access to the EU: Thailand, Algeria, Australia, Canada, South Korea, Japan, Georgia, Montenegro, New Zealand, Rwanda, Serbia, Tunis, Uruguay, Morocco, and China (the latter two, with reciprocity. Russia, the US, and Latin America (except Uruguay) are excluded.

See the table ‘most affected countries in Europe’ , where you can see updated information about those countries with more than 100,000 cases in total or 200 cases /100,000 inhabitants.

See also the table ‘less affected countries in Europe’.

At the end of June, the pandemic seemed to be stabilized in Western Europe, while it grew in the East (Russia, Turkey, Belarus, Ukraine). However, a second wave was growingly evident in some countries at the end of August, particularly in Spain, but also in some regions of Belgium, France, the Czech Republic and Romania. Spain is the EU Member State with the highest number of cases, while the UK is the European country with more deaths, followed by Italy, France and Spain.

The European Centres for Disease Prevention and Control (ECDC) publishes every week a map with 14-day COVID-19 case notification rate per 100,000 inh., per regions. This is the map published on 16 September 2020:

14-day COVID-19 case notification rate per 100 000, weeks 36-37

Some small countries have also registered a high incidence (cases/100,000 inh.). In Europe: Albania (426.53), Andorra (2,030.91), Armenia (1,597.48), Bosnia and Herzegovina (758.65), Channel Islands  (600.00), Faeroe Islands (884.54), Iceland (654.06), Isle of Man (403,19.62), Kosovo (687.31), Luxembourg (1,269.51), Liechtenstein (298.07), Moldavia (1,721.92), Monaco (496.38), Montenegro (1,269.31), North Macedonia (794.88 ), San Marino (2,140.32), and the Vatican (1,454.55).

In other continents: Aruba (3,195.39), Bahamas (833.42), Bahrein (4,109.68), Bermuda (278.26), British Virgin Islands (231.54), Cabo Verde (953.71), Cayman Islands (324.14), Costa Rica (1,274.38), Dominican Republic (1,013.44), Djibouti (563.45), Equatorial Guinea (382.13), El Salvador (429.12), Eswatini (461.63), French Polynesia (395.78), Gabon (410.33), Guam (1,214.33), Guatemala (493.70), Guyana (278.31), Honduras (742.04), Kuwait (2,403.35), Lebanon (413.16), Maldives (1,871.05), Namibia (420.38), Nepal (228.29), Oman (1,935.51), Palestine (781.03), Panama (2,528.45), Puerto Rico (1,216.44), São Tomé and Príncipe (430.27), Singapore (1,021.09), Sint Maarten (1,389.91), St. Martin (885.67), Surinam (817.55), Trinidad and Tobago (277.22), Turks and Caicos Islands (1,760.49), United Arab Emirates (881.70), and US Virgin Islands (1,157.23).

See the table most affected countries in other continents’

In North America, besides the US (the most affected country in the world), Canada registered half of its cases in retirement homes.

Latin America is the new epicentre of the pandemic. In the middle of the winter, Brazil (which seems out of control) has had several days a higher number of daily deaths than the US. The flexibility of restrictions has been criticized and it is considered it has not arrived at the peak. The pandemic spreads across ChilePeru, Colombia, Panama, Mexico, Argentine, Bolivia and Ecuador have a higher number of cases, exceeding the capacities of health systems.

In Asia, the outbreak started in Wuhan (province of Hubei) and China seems to have it under control, but there are now more imported cases than local transmission, leading to ban the entry of foreigners, except diplomatic staff. Local outbreaks in Beijing in June and in Xinjiang province. India could not avoid the spread of the virus despite confinement measures since 25 March. They de-escalate but COVID still grows at a very rapid rate during the Monsoon (+ 5.4 million cases, +86,000 deaths, and up to 90,000 new cases daily). Iran is the following most affected country (+422,000 cases and 24,000 deaths), particularly in the province of Teheran, with difficulties to import equipment due to international sanctions (US). In Western Asia, it growingly affects Saudi Arabia (+329,000 cases), as well as Qatar and the United Arab Emirates. Bangladesh, Pakistan and Iraq are over 300,000 cases; and the Philippines (+286,000 cases, with +5,000 in one day –3 August–). Indonesia and Singapore are also affected, and Central Asian Republics such as Kazakhstan (+100,000 cases) and Kyrgyzstan (+40,000) have also increased cases.

South Corea had a great incidence in February but contained the spread of the virus in mid-March and has become one of the best practices on early action based on technology efficiency. Japan detected first cases at Diamond Princess cruise ship and had to postpone the Olympic Games to 2021.

Africa is the last continent of spread, and it is not very much affected for the time being, but there is a worrying upward trend in countries with very weak health infrastructure. Current food crisis could also double. South Africa has already overcome more than 659,000 cases and +15,000 deaths. There is also a relevant spread in Egypt, MoroccoNigeria, EthiopiaGhana, Algeria, and Kenya. Other countries keep a low incidence, but the last country without cases (Lesotho) registered first positive on 12 May. On 10-11 May South Sudan registered first contagions in displaced camps, a major concern for humanitarian organisations due to overcrowding and lack of services. Several people were killed in Guinea on 12 May during protests against restrictions.

Social distance in these countries is hardly possible, and confinement should be handled with care because millions of people in the world need to go to work every day for their families to eat. They cannot stay long periods without assistance. The WHO estimates that 190,000 people could die and 44 million could get infected in the pandemic is not controlled in Africa. UN Economic Commission for Africa (UNECA) estimates that more than 300,000 Africans could die in a continent with 56% of the urban population living in deprived neighbourhoods or very poor houses, only 34% of households have basic facilities to wash hands.

In Oceania, Australia has registered more than 26,800 cases and 840 deaths, started de-confinement and it is reactivating its economy, though an outbreak has forced the confinement of Melbourne and has declared the state of disaster in the State of Victoria. New Zealand has little incidence (1,800 cases and 25 deaths) but keeps social restrictions and social distance. They declared the country coronavirus-free on 8 June, but they keep closed borders and do not discard new outbreaks. Auckland has been isolated until 21 August.

(Sources: Johns Hopkins Whiting School of Engineering, national authorities, EU institutions, The Eastern Institute, …)

(we keep on filling these tables with further desk research and info provided by our readers)

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