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A week of grim global COVID-19 milestones — except in Africa

The past week saw the United States hit more than 12m COVID-19 infections, with a quarter of a million dead, while Europe was caught in a second wave that has new cases growing five-fold and deaths up four-and-a-half-fold to 5,000 per day. Africa’s total infections have now passed 2m, but it has had comparatively far fewer deaths – 48,000 – and African infections and deaths make up only 4% of the global total.

Meanwhile, there is growing evidence that an early mutation made the pandemic harder to stop.

The number of coronavirus cases in the United States continues to grow. As of Tuesday morning, at least 12,492,100 people had tested positive for the virus, according to The New York Times database, and at least 257,600 patients with the virus had died.

“After case numbers fell steadily in April and May, cases in the US are growing again at about the same rapid pace as when infections were exploding in New York City in late March. But the hotspots are now mainly spread across the southern and western parts of the country,” the newspaper reported.

More than 15 million people in Europe have been infected with coronavirus, making it the worst hit region in the world, reported Voice of America correspondent Mariama Diallo on 21 November 2020. Authorities hope new lockdowns will get the situation under control.

At the weekend, Natasha Frost of The New York Times wrote that the second coronavirus wave in Europe “appears to have crested in recent days, but not before setting records that prompted another series of shutdowns”.

“The rate of new cases reported across the continent quintupled between September and November to about 300,000 a day, before declining a bit. Deaths have shot up from about 700 a day to almost 5,000, and a clear pattern of receding has yet to emerge. Hospitalisation numbers have begun to flatten, but at a level that is nearly as high as the spring peak.”

 

Europe faces 'six tough months' of pandemic, WHO says

A tough six months lies ahead for Europe, which is again the epicentre of the coronavirus pandemic, the World Health Organization has warned, reported the BBC on 20 November.

Hans Kluge, WHO Europe director, said the continent had recorded more than 29,000 new COVID-19 deaths last week.

However, he said new cases were declining as lockdowns curb infections. Most European countries reintroduced tight restrictions to stem the spread of the disease as a second wave of the pandemic gathered pace in October.

So far, Europe has seen 15,738,179 confirmed infections and 354,154 deaths attributed to the coronavirus, with only the Americas reporting higher region-wide figures.

A large portion of those infections and deaths have been registered in the United Kingdom, Russia, France, Spain, Italy and Germany. In Europe, the UK has the highest death toll at 53,870, while France has the highest number of cases at 2,115,717.

According to the BBC, Kluge said Europe accounted for 28% of global cases and 26% of deaths. He expressed particular concern over the situation in Switzerland and France, where intensive care units are at 95% capacity.

"Europe is once again the epicentre of the pandemic, together with the United States," Kluge told a news conference in Copenhagen, adding that latest figures showed there was "one person dying every 17 seconds".

"There is light at the end of the tunnel but it will be a tough six months," he said, referring to the development of vaccines.

Vaccine hopes

At a virtual EU summit last Thursday, European Commission President Ursula von der Leyen said the bloc could approve two vaccines by year's end. Four vaccines – Oxford, Pfizer-BioNTech, Sputnik and Moderna – have reported good preliminary data.

Von der Leyen said the European Medicines Agency could give "conditional marketing authorisation" for the Moderna and Pfizer-BioNTech vaccines "as early as the second half of December if all proceeds now without any problem".

Kluge said recent progress on vaccines was promising, but did not yet represent "a silver bullet" because "we know the supply will be limited particularly in the beginning". In the meantime, social distancing and wearing a mask remained the best ways to mitigate the spread of the virus, he said.

What's happening in individual countries?

France is in its second national lockdown, with people only allowed to leave home to go to work or school, buy essential goods, seek medical help or exercise for one hour a day, the BBC report continues. Anyone going outside must carry a written statement justifying their journey.

French Health Minister Olivier Veran said that while it was too soon to lift restrictions, the virus was not circulating as widely as before the latest measures were introduced. He told a news conference that anxiety and uncertainty caused by the pandemic was affecting the mental health of the population but that "we must not reduce our efforts".

In Italy, where COVID-related deaths have already more than doubled in November compared with October, Prime Minister Giuseppe Conte warned that Christmas would look very different this year. "Big parties, kisses and hugs will not be possible, this would mean an abrupt rise in the [infection] curve in January."

In the UK, another 22,915 daily cased of COVID were recorded last Thursday, according to the BBC, and there were 501 further deaths within 28 days of a positive test, the government's dashboard shows.

Russia is also recording more than 20,000 new cases each day. Authorities in the capital Moscow have opened five field hospitals to help cope, including one in an ice rink, the BBC concludes.

 

Africa hits two million cases

Last Thursday 19 November, AP reported that Africa had surpassed two million confirmed coronavirus cases. Africa Centres for Disease Control and Prevention (CDC) Director John Nkengasong warned that “we are inevitably edging toward a second wave” of infections.

The Africa CDC said the 54-nation continent had seen more than 48,000 deaths from COVID-19. Its infections and deaths make up less than 4% of the global total.

Cara Anna wrote for AP that nearly 20 African countries have seen a more than 20% increase in cases over the past four weeks, according to WHO. This time the surge is driven not by South Africa, but by North African nations as temperatures fall there, according to AP.

Several African countries have confirmed virus cases in the six figures. South Africa leads with more than 750,000, while Morocco has more than 300,000, Egypt more than 110,000 and Ethiopia more than 100,000. Kenya has had a fresh surge in cases.

Africa has conducted 20 million coronavirus tests since the pandemic began, but shortages mean the true number of infections is unknown, AP reported.

Africa’s 1.3 billion people are being warned against “prevention fatigue” as countries loosen pandemic restrictions to ease economic suffering. “If we relent, then all the sacrifices we put into efforts over the past 10 months will be wiped away,” Nkengasong told reporters, expressing concern that many countries are not enforcing public health measures.

While the world takes hope from promising COVID-19 vaccines, Africa worries that it will suffer as richer countries buy up supplies, the AP story continued. Also, Nkengasong warned, it would be “extremely challenging” to deploy temperature-sensitive vaccines – and the price of any COVID-19 vaccine will also influence its fair distribution.

More optimistic is positive attitudes in Africa towards any COVID-19 vaccine. According to the AP article, early data from a vaccine perception survey in 11 countries showed that 81% of respondents would accept a vaccine: “So that’s very, very encouraging news.”

 

Light at the end of the tunnel

On Monday 23 November, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that with the latest positive news from vaccine trials, “the light at the end of this long, dark tunnel is growing brighter. There is now real hope that vaccines – in combination with other tried and tested public health measures – will help to end the pandemic.”

The urgency with which vaccines have been developed must be matched by the same urgency to distribute them fairly, he told a media briefing. “No vaccines in history have been developed as rapidly as these. The scientific community has set a new standard for vaccine development. Now the international community must set a new standard for access.”

In April, WHO created the Access to COVID-19 Tools Accelerator. “The ACT Accelerator has supported the fastest, most coordinated and successful global effort in history to develop vaccines, diagnostics and therapeutics,” said Ghebreyesus.

More than 50 diagnostic tests are being evaluated and new rapid antigen diagnostics are being made available for low- and middle-income countries. Dexamethasone treatments are being rolled out, and new medicines including monoclonal antibodies are being tested.

But a “fundamental change in funding and approach” is needed to realise the promise of the ACT Accelerator”. US$4.3 billion is required immediately to support mass procurement and delivery of vaccines, tests and treatments; US$23.8 billion more will be needed next year.

“This isn’t charity, it’s the fastest and smartest way to end the pandemic and drive the global economic recovery, he told reporters.

 

Growing evidence that early mutation exacerbated the pandemic

On 24 November, The New York Times revealed growing evidence that an early mutation made the pandemic harder to stop.

“As the coronavirus swept across the world, it picked up random alterations to its genetic sequence. Like meaningless typos in a script, most of those mutations made no difference in how the virus behaved,” wrote James Glanz, Benedict Carey and Hannah Beech.

“But one mutation near the beginning of the pandemic did make a difference, multiple new findings suggest, helping the virus spread more easily from person to person and making the pandemic harder to stop.”

The mutation, known as 614G, was first spotted in eastern China in January and then spread quickly throughout Europe and New York City. Within months, the variant took over much of the world, displacing other variants, The New York Times reported.

There has been fierce debate among scientists about whether the variant evolved the ability to infect people more efficiently, of whether the variant had “simply been lucky”.

“But a host of new research – including close genetic analysis of outbreaks and lab work with hamsters and human lung tissue – has supported the view that the mutated virus did in fact have a distinct advantage, infecting people more easily than the original variant detected in Wuhan, China.”

 

[link url="https://www.nytimes.com/2020/11/22/briefing/europe-covid-uk-trump-israel.html"]The New York Times – Europe, Covid-19, Trump: Your Monday Briefing[/link]

 

[link url="https://www.bbc.com/news/world-europe-55008447"]BBC News story – Coronavirus: Europe faces 'six tough months' of pandemic, WHO says[/link]

 

[link url="https://apnews.com/article/pandemics-africa-health-coronavirus-pandemic-kenya-2aa6091466b9eb670c5ce51778cb05b5?"]AP story – African continent hits 2 million confirmed coronavirus cases[/link]

 

[link url="https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—23november-2020"]WHO Director-General's opening remarks at the media briefing on COVID-19 -on 23 November 2020[/link]

 

[link url="https://www.nytimes.com/2020/11/24/world/covid-mutation.html"]The New York Times story – Evidence Builds That an Early Mutation Made the Pandemic Harder to Stop[/link]

 

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