Global COVID-19 total tops 200,000; WHO unveils massive treatment study

IV drips
IV drips

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With outbreaks gaining steam in many countries, the global COVID-19 total passed 200,000 reported cases today, and the World Health Organization (WHO) announced a large international clinical trial to test five treatment regimens.

As cases surged in Italy, France, Spain, and Germany, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said more than 80% of the world's cases are in two regions: the Western Pacific and Europe. He said many countries are feeling overwhelmed. "We hear you. We know the tremendous difficulties you face and the enormous burden you’re under. We understand the heart-wrenching choices you are having to make."

The global total today is 214,894 from 156 countries, 8,732 of them fatal, according to the Johns Hopkins online dashboard.

Tedros urged countries that with sporadic cases or clusters to isolate, test, and treat every suspected case and trace every contact. "This is the best hope of preventing widespread community transmission."

International trial seeks robust treatment data

Regarding the trial, Tedros said multiple small trials using different methods may not yield strong evidence needed to reveal which ones can save lives. So he said the WHO has organized a large international study—called the SOLIDARITY trial—to get more robust data.

He said the simplified study design allows even overloaded hospitals to participate. So far, countries that have agreed to participate include Argentina, Bahrain, Canada, France, Iran, Norway, South Africa, Spain, Switzerland, and Thailand.

Ana Maria Henao, MD, unit head of the WHO's research and development blueprint, said the study has five arms that include: the country's standard of care; remdesivir (a new antiviral); lopinavir and ritonavir (an HIV combination drug); lopinavir, ritonavir, and interferon; and chloroquine (a malaria drug).

She said the streamlined randomized trial can be adjusted based on countries' availability of the drugs and can be adjusted to include other arms.

European outbreaks intensify

Italy today reported 4,207 more cases, along with 475 more deaths, boosting its respective totals to 35,713 and 2,978, according to the health ministry's latest update.

The country's fatality rate is estimated at 11%, higher than the 1% to 2% reported in neighboring countries. At today's media briefing, Mike Ryan, MD, who heads the WHO's health emergencies program, said Italy's higher level may be due to multiple factors, including that it is further along in its outbreak with outcomes known after lengthy hospitalizations for many severely ill patients.

He also said the higher level could related to Italy's older population or the fact that hospitals in the most affected regions are struggling to provide the standard of care, which he said also played a role in Hubei provinces higher death rate compared with the rest of China.

Three other European countries today reported more than 1,000 new cases, including Spain (1,390), France (1,404), and Germany (1,042). Their respective totals are now 13,716, 9,134, and 8,198. Also, the United Kingdom's total climbed to 2,626 confirmed infections, and the UK's prime minister announced that schools would close on Mar 20 until further notice.

In a televised message to Germany today, Chancellor Angela Merkel said the country's COVID-19 outbreak is its biggest challenge since World War II.

Yesterday, Montenegro reported its first detections, in two women who had traveled abroad, meaning all European countries have now reported cases, Anadolu Agency reported.

Iran and Africa developments

Iran, the world's third hardest-hit country, today reported 1,192 new cases, plus 147 more deaths, raising its respective totals to 17,391 and 533, according to the health ministry.

In Africa, Nigeria reported 5 more cases, bringing its total to 8, the Nigeria Centre for Disease Control said. All patients had traveled from the United States or the United Kingdom.

The Africa CDC said the African region now has 529 cases, 13 of them fatal, in 31 countries. Tedros said the total for sub-Saharan Africa, the region reporting the fewest cases, is 233, including 4 deaths.

Australia, Colombia declare emergencies

Meanwhile, virus activity is slowly but steadily ramping up in other parts of the world. Australian Prime Minister Scott Morrison today declared a "human biosecurity emergency" and urged citizens to avoid traveling out of the country, Reuters reported.

The health emergency gives the government extra powers to order lockdowns, curfews, and quarantines. In another new measure, the country banned nonessential indoor gatherings of 100 or more people.

Australia has reported about 500 cases, 6 of them fatal, but health officials are worried about rising numbers.

Colombia's president yesterday declared a state of emergency and ordered older people to stay in their homes starting Mar 20 and extending until May 31, according to a separate Reuters report. People age 70 and older can leave their homes only for food, medications, medical care, and banking.

The country has reported 75 cases so far, most of them linked to Europe or United States travel.

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