Global COVID markers decline, but hot spots remain in two regions

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Though COVID-19 cases and deaths continued to decline over the past 4 weeks, the World Health Organization (WHO) is tracking rises in two of its regions, South East Asia and the Eastern Mediterranean. In its weekly update today, it also noted rises in individual countries in other parts of the world.

WHO plans transition to sustained COVID management

At a WHO media briefing yesterday, Director-General Tedros Adhanom Ghebreyesus, PhD, said though the WHO is encouraged by the sustained drop in deaths, which have dropped 95% since the beginning of the year. However, he warned that some countries are seeing rises, and over the past 4 weeks, about 14,000 people died from their infections.

He also raised concerns about the large numbers of people with long COVID, estimated to affect 1 in 10 infected people, pointing for a substantial need for longer-term care.

Tedros said though officials look forward to the end of the public health emergency phase, it's clear that the virus is here to stay, and the emergence of XBB.1.16 is a reminder that the virus is still changing and is capable of causing illness and deaths.

Next week, the WHO will publish its latest strategy guide, which will help countries transition from the emergency response to longer sustained management of COVID-19, Tedros said.

Hot spots and variant shifts

Overall, cases declined 23% and deaths dropped 36% compared to the previous 28 days. The WHO repeated its caveat that the numbers are underestimates due to reduced testing and delays in reporting.

In the South East Asia region, cases over the last 4 weeks were up sharply, mainly led by rises in India and, to a lesser extent, Indonesia and Thailand. Deaths in the region also rose, mainly due to increases in India and Indonesia.

In the Eastern Mediterranean region, which includes much of the Middle East, Saudi Arabia, Qatar, and Iran, reported modest rises over the past 4 weeks, with deaths also on the rise, especially from Iran.

Elsewhere, cases were up sharply in Vietnam, which is included in the WHO's Western Pacific region.

The WHO's latest report also shows a shift in Omicron subvariant proportions. Focusing on the two variants of interest, the proportion of XBB.1.5 declined from 49.1% to 45.4% between early March and the first week of April. Meanwhile, for XBB.1.16, the proportion since early March has increased from 1.3% to 4.3%.

XBB.1.16, responsible for fueling India's spike, has now been detected in 37 countries. The WHO recently added it as the second variant of interest and released a preliminary risk assessment, which it said may become dominant in some countries due to its growth advantage and immune escape properties. However, so far, there's no evidence that infections are more severe.

In related developments, the European Centre for Disease Prevention and Control (ECDC) today in its weekly COVID snapshot said activity is decreasing or stable across most of the region, with death rates stable. Of five countries with adequate sequencing, the proportion of XBB.1.5 is 57.3%, with other XBB subvariants at 26.2%.

The latest update from the United Kingdom's Health Security Agency (HSA) said that hospital admission rates declined for all age groups, but the highest levels are still in people over age 75.

Mary Ramsay, MD, the HSA's immunization head, said the virus has not gone away and that officials continue to see thousands of cases every week. "So topping up your protection is particularly important for groups who are more vulnerable."

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