Countries face diverse challenges as pandemic total nears 20 million

As the global COVID-19 case number grows within striking distance of 20 million cases today and with virus levels rising in many countries that had previously curbed their outbreaks, the head of the World Health Organization (WHO) today urged nations to use all the tools they have to continue reopening safely.

The pandemic total today is at 19,952,057 cases, and 732,689 people have died from their infections, according to the Johns Hopkins online dashboard.

Large outbreaks in big countries

Large outbreaks in some of the world's most populous countries such as India, the United States, and Brazil are fueling much of recent surge.

India's daily COVID-19 death total yesterday crossed the 1,000 mark for the first time, with 1,007 fatal cases, the Times of India reported. The country, which has the world's third-highest total, also reported 63,851 new cases.

The country also reported an outbreak at one of the world's biggest Hindu temples, which is located in the southern part of the country, Reuters reported. Since the temple reopened on June 11, 743 employees have been infected, three fatally.

Meanwhile, Brazil's cases topped 3 million in recent days, with about 23,000 reported yesterday. Global health officials have said the virus is now spreading from major cities into more rural and remote locations where health access and systems are weaker.

ECDC weighs in on Europe's case rises

The European Center for Disease Prevention and Control (ECDC) said today in its latest risk assessment that many European countries are reporting increased case numbers, partly due to wider testing in mild and asymptomatic cases, though there is also a true resurgence as many countries relax physical distancing measures.

It added that reimposing or reinforcing targeted measures that mitigate the number of cases, along with related hospitalizations and deaths, may be advisable. It also noted that comprehensive testing is useful for rapidly detecting increased cases and identifying those at high risk.

Though cases are increasing overall, the level is still below the region's first peak that occurred on Apr 9. Over the past 2 weeks, most of the new cases have been reported in Spain, Romania, France, the United Kingdom, and Germany.

Rises in hospitalizations and intensive care unit (ICU) occupancy have been reported from a handful of countries, including Bulgaria, Croatia, Czechia, Luxembourg, Romania, and Slovenia. The region's overall death rate has been stable for about the past 2 weeks.

Multiple outbreaks in work settings have occurred at slaughterhouses, meat processing plants, construction sites, and mines, and clusters have been found in healthcare settings, food packaging and processing plants, factories, and offices.

WHO Director-general urges countries to turn outbreaks around

At a World Health Organization (WHO) media briefing today, Director-General Tedros Adhanom Ghebreyesus, PhD, said this week the pandemic total will top 20 million cases and 750,000 deaths. "Behind these statistics is a great deal of pain and suffering," he said.

He emphasized that it's never too late to turn outbreaks around, provided leaders take action and the public embraces new measures. He praised countries in the Mekong region, as well as New Zealand and Rwanda for their early virus suppression efforts, and he lauded countries such as the United Kingdom and France that have taken strong and precise measures to address emerging clusters and flare-ups.

"Now is the time to do it all, invest in the basics of public health and we can save both lives and livelihoods," Tedros said. "In the countries that have done this successfully, they are using a risk-based approach to reopen segments of societies, including schools."

Australia and Vietnam updates

In Australia, which has been battling a spike in cases in Victoria state in and around Melbourne, virus activity shows signs of a possible peak, though it reported 19 deaths today, a daily record high and all from Victoria, Reuters reported.

As for cases, the country reported 337 today, the lowest number since July 29. The drop comes more than a month into a lockdown in Melbourne, with its population of 5 million people.

Vietnam, which experienced a recent flare-up centered in Danang that spread to other parts of the country, reported 31 new cases yesterday, all linked to Danang. So far, 355 infections—including 11 deaths—have been linked to the recent outbreak, with illnesses reported from 15 locations in the country.

In other developments:

  • Mexico, which has the world's sixth highest case count and the world's third highest death total, is facing the challenge of citizens' pervasive fear of hospitals, the New York Times reported. Health officials said patients often wait too long to seek medical care and that thousands are dying outside of hospitals, which increases the risk of transmission and hides the true impact of the disease.
  • In two recent developments regarding the scientific evaluation of mask use, the Netherlands' National Institute for Public Health and Environment (RIVM) announced they would hold off on issuing a mandatory mask rule, given that there is no hard evidence that they reduce the spread of the virus. It said there is ongoing research and that experts will continuously review all existing research. Officials said nonmedical masks can be considered when distancing isn't possible, such as during public transport, but that mask use could provide a false sense of security or lead to lax attention to other mitigation measures. Also, a July 23 report from authors at the Center for Evidence-Based Medicine said despite two decades of pandemic preparedness, there is still considerable uncertainty about the value of wearing masks. They warned about inferring causation based on regional geographic observations. And they also noted that there are nine registered mask trials that are recruiting participants, though with the small number and lateness in the pandemic cycle they are unlikely to yield clear answers for decision-makers.

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