Global COVID-19 total nears 6.5 million as WHO lifts pause on drug trial

World Health Organization (WHO) advisors today allowed the hydroxychloroquine arm of a large multi-country treatment trial to resume, following a temporary pause to allow after its safety monitoring group to review the data.

As the global total approached 6.5 million cases, the agency said it is worried about accelerating epidemics, especially in Central and South America.

The global total today climbed to 6,445,457, and at least 382,451 people have died from their infections, according to the Johns Hopkins online dashboard.

WHO review found no safety alarms

After a recent observational study in The Lancet reported that COVID-19 patients treated with hydroxychloroquine and chloroquine had a higher risk of death and serious heart rhythm complications, a WHO review board overseeing large multi-country randomized controlled trials of four different treatments announced a pause on the hydroxychloroquine arm of the study so that its safety monitoring group could look for any problems.

At a media briefing today, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said that, based on mortality data, members saw no reason to modify the trial protocol and added that the group will notify principal investigators that the hydroxycholoroquine part of the trial can resume.

"The Data Safety and Monitoring Committee will continue to closely monitor the safety of all therapeutics being tested in the Solidarity Trial," Tedros said, adding that, so far, the SOLIDARITY trial has recruited more than 3,500 patients in 35 countries.

The controversial drug has been touted as a treatment by the leaders of some countries, such as the United States and Brazil, despite scant evidence of its effectiveness. A group of more than 100 scientists recently signed a letter to The Lancet regarding their concerns about the data in the large observational trial that recently raised safety concerns.

(See today's CIDRAP News story, "Controversy over data in hydroxychloroquine COVID-19 study grows.")

Huge global daily totals in Latin America

Over the past 5 days, the WHO has received reports of 100,000 cases a day, and countries in the Americas account for most of the cases, Tedros said.  "For several weeks, the number of cases reported each day in the Americas has been more than the rest of the world put together," he said, noting that the WHO is especially worried about Central and South American countries such as Brazil and Peru that are experiencing accelerating outbreaks.

Mike Ryan, MD, who leads the WHO's health emergencies program, emphasized that not all epidemics in Latin America are at the same stage. For example, he noted that many Caribbean countries have done a superb job in keeping their cases low.

He added that concerns are Haiti's growing outbreak, because of its vulnerable population. The country today reported 281 cases, for a total of 2,507, of which 48 have been fatal. Once intense transmission it established, it's tough to root the virus out, Ryan said.

The Eastern Mediterranean region, Southeast Asia, and Africa are also reporting increased COVID-19 activity, but with smaller numbers, Tedros said. In Europe, however, cases continue to decline, and yesterday the region reported its fewest cases since Mar 22, he said.

China denies charges of slow data sharing

When asked about an Associated Press (AP) investigation yesterday that revealed WHO frustrations with China's slow information sharing in the crucial first month of SARS-CoV-2 spread, WHO officials had little response. Ryan said the WHO has worked to support and share information equally with all of its member states and has engaged them in "frank and forthright conversations with governments at all levels."

Meanwhile, China today dismissed the claims in the AP report as untrue, Reuters reported. The country's foreign ministry spokesman Zhao Lijan made the comments today at a daily briefing in Beijing.

In other global developments:

  • An Indian health official said the country is still weeks away from its peak, Reuters The country today noted 9,614 new cases, for a total of 216,805. India has started easing some of its restrictions and faces a new challenge, with Cyclone Nisarga today hitting the coast of Maharashtra state, which is home to Mumbai, one of the country's main hot spots.

  • Mexico's health minister said yesterday that the country appears to have reached its peak, Reuters Yesterday it reported 3,891 cases, a record high.

  • The International Council of Nurses said today that more than 600 nurses have died from COVID-19 and that more than 230,000 healthcare workers have contracted the virus. It estimated that 7% of the world's cases are among health workers and that about 450,000 of the global total could reflect healthcare worker infections. The group called on governments to collect more accurate data on the disease's burden on healthcare professionals and to do more to protect them against the virus.

  • Sweden's chief epidemiologist, Anders Tegnell, PhD, was quoted on Swedish radio today as saying the country should have done more to control the virus, Reuters Sweden took a more relaxed approach to ordering restrictions and has faced criticism and has reported much higher case numbers than its Nordic neighbors.

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