Geneva: The regions reporting the highest weekly COVID-19 case incidence per 100 000 population continue to be the European Region (260.2 new cases per 100 000 population) and the Region of the Americas (73.6 new cases per 100 000 population); these regions also reported the highest weekly incidence in deaths, of 3.2 and 1.3 per 100 000 population, respectively.
The European Region reported an 11% increase in new weekly cases, while the other regions reported a decrease or incidence similar to the previous week.
Globally, the numbers of weekly COVID-19 cases and deaths have increased for more than a month. During the week of 15-21 November 2021, nearly 3.6 million confirmed new cases and over 51 000 deaths were reported, reflecting a 6% increase for cases and deaths as compared to the previous week.
In the European Region, Russia led with 8709 new deaths; 6.0 new deaths per 100 000; similar to the previous week’s figures), Ukraine (4567 new deaths; 10.4 new deaths per 100 000; similar to the previous week’s figures).
Following a steady decrease since mid-September 2021, the Region of the Americas reported a 19% increase in the incidence of deaths this week, with over 13 000 new deaths. Twenty-one percent (12/56) of the countries reported an increase of over 10%, with Ecuador reporting the largest proportionate increase (100%), followed by Mexico (50%) and Bahamas (50%). The highest numbers were reported from the United States of America (8906 new deaths; 2.7 new deaths per 100 000; a 20% increase), Brazil (1879 new deaths; <1 new death per 100 000; a 31% increase), and Mexico (1015 new deaths; <1 new death per 100 000; a 50% increase).
The highest numbers of new cases were reported from the United States of America (558 538 new cases; similar to the previous week’s figures), Germany (333 473 new cases; a 31% increase), the United Kingdom (281 063 new cases; an 11% increase), the Russian Federation (260 484 new cases; similar to the previous week’s figures) and Turkey (163 835 new cases; a 9% decrease).
The largest proportionate decrease was reported from the South-East Asia Region (11%), followed by the Eastern Mediterranean Region (9%). While the Western Pacific Region and the Region of the Americas reported relatively stable case incidence, they both reported large increases in new weekly deaths, 29% and 19% respectively. In contrast, the African and the South-East Asia regions reported a 30% and 19% decrease in new weekly deaths.
India reported 2132 new deaths; (<1 new death per 100 000; a 22% decrease), during the week.
The cumulative number of confirmed cases reported globally is now over 256 million and the cumulative number of deaths is more than 5.1 million.
The current global epidemiology of SARS-CoV-2 is characterized by a predominance of the Delta variant, with the
prevalence of other variants continuing to decline among genomic sequences submitted to publicly available
datasets or detections reported to WHO. Delta has outcompeted other variants, including other
VOCs, in most countries.
Of 845 087 sequences uploaded to GISAID with specimens collected in the last 60 days 1, 842 992 (99.8%) were Delta, 519 (0.1%) Gamma, 212 (<0.1%) Alpha, 16 (<0.1%) Beta, and 0.1% comprised other circulating variants (including Variants of Interest – Mu and Lambda).
Meanwhile, since the beginning of 2021, countries have gradually reopened their borders for international travel: at least 74 countries accept incoming travelers who present either proof of COVID-19 vaccination, a negative PCR test within a given timeframe, or proof of previous SARS-CoV-2 infection. Additionally, 121 countries require proof of a negative PCR or a rapid antigen test before departure regardless of the vaccination status, while 93 countries perform testing upon arrival and 131 countries require isolation or quarantine of some or all travelers. The cost of these measures is generally charged to the traveler, which is counter to the recommendations issued by the World Health Organization (WHO) Director-General following the ninth meeting of the IHR Emergency Committee on October 26, 2021, given that this may be economically restrictive for many.
While at least 53 countries have recently reduced the duration of quarantine or testing requirements for vaccinated
travelers, 22 countries require vaccination for entry, with limited exceptions for nationals or travelers with proof of
previous SARS-CoV-2 infection. Vaccination-based entry requirements do not align with Article 42 of the IHR (2005), which advises that measures must be applied in a non-discriminatory manner, as nearly half of the global population have yet to receive one dose of vaccine.
Currently, at least 85 countries are performing regular risk assessments to inform the public health measures taken
for international travel, frequently updating and publishing a list of countries at higher risk to which they apply more
restrictive quarantine and additional testing measures. Twenty-nine countries still have entry bans for travelers
arriving from certain countries affected by SARS-CoV-2 variants of concern despite the dominance of the Delta
variant globally.
In the meantime, WHO stated today that with support of the Strategic Advisory Group of Experts (SAGE) on Immunization and its COVID-19 Vaccines Working Group, it is reviewing the emerging evidence on the need for and timing of vaccinating children and adolescents with the currently available COVID-19 vaccines which have received Emergency Use Listing (EUL).
Although the majority of COVID-19 vaccines are only approved for use in adults aged 18 years and above, an increasing number of vaccines are now also being authorized for use in children. Some countries have given emergency use authorization for mRNA vaccines for use in the adolescent age group (aged 12-17 years): BNT162b2 developed by Pfizer, and mRNA 1273 developed by Moderna. In November 2021, one stringent regulatory authority approved the mRNA vaccine BNT162b2 for the use in children aged 5-11. Trials in children as young as age 3 years were completed for two inactivated vaccines (Sinovac-CoronaVac and BBIBP-CorV) and these products were approved by Chinese authorities for the age indication of 3-17 years; although these vaccine products have received EUL for adults, they have not yet received WHO EUL for children. Covaxin, an adjuvanted inactivated vaccine developed by Bharat, was approved in India for the age indication of 12-17 years; but not yet received WHO EUL for this age indication. The Indian regulatory authorities have given approval to ZycovD, a novel DNA vaccine, for ages 12-17 years; however, this vaccine has not yet received WHO EUL. Several COVID-19 vaccines are undergoing trials in younger age groups (including as young as 6 months of age), but results have not yet been published.
WHO though reiterated that the greatest burden of disease in terms of severe disease and deaths remains among older persons and those with comorbidities, the evidence of which led to the WHO Prioritization Roadmap which identifies high priority-use groups according to vaccine supplies available to countries.
– global bihari bureau
