Published Date: 2021-02-12 21:02:47 Subject: PRO/AH/EDR> COVID-19 update (61): meat facility, S Korea, T lymphocytes, S Asia, WHO, globalArchive Number: 20210212.8187538

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Published Date: 2021-02-12 21:02:47

Subject: PRO/AH/EDR> COVID-19 update (61): meat facility, S Korea, T lymphocytes, S Asia, WHO, global Archive Number: 20210212.8187538

CORONAVIRUS DISEASE 2019 UPDATE (61): MEAT FACILITY, SOUTH KOREA CASE SURGE, T LYMPHOCYTES, REGIONAL, WHO, GLOBAL

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A ProMED-mail post http://www.promedmail.org ProMED-mail is a program of the

International Society for Infectious Diseases http://www.isid.org

In this update:

[1] Meat facility outbreak: comment [2] South Korea: surge in cases

[3] SARS-CoV-2 infection of T helper lymphocytes [4] From our regional networks: South Asia

[5] WHO: daily new cases reported (as of 11 Feb 2021)

[6] Global update: Worldometer accessed 11 Feb 2021 17:52 EST (GMT-5)

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[1] Meat facility outbreak: comment Date: Wed 10 Feb 2021

From: Alex I. Donaldson <[email protected]> [edited]

The outbreak of COVID-19 reported at Belmont Meats in North York, Toronto [Ontario, Canada] is yet another in a series of such incidents in meat plants. Between March and June 2020, outbreaks of COVID-19 were reported in meat plants extending from Europe to North America. In some instances, many hundreds of workers were affected, e.g., in the outbreaks at Sioux Falls, South Dakota, USA and at Tonnies, near Gutersloh, North Rhine-Westphalia, Germany.

Various reasons have been proposed for the outbreaks, including the crowded working conditions and environmental conditions suitable for the survival of COVID-19. Certain working practices, common to meat plants, and employed to maintain hygiene, could be contributory (1). Those practices include the frequent washing down and brushing of oors and surfaces. Those procedures are very effective methods for generating large quantities of droplets and aerosols, especially when high-pressure hosing is employed. If a surface is contaminated with COVID-19, perhaps unknowingly from an infected worker, then others in that environment will be at risk of inhaling an infectious aerosol.

A feature of cases during outbreaks in meat plants is that there is a sudden sharp spike in cases. This suggests the simultaneous infection of workers from the same source rather than person-to-person spread, which would be more protracted due to the incubation period of 5 to 14 days.

(2)

Measures which could be taken to reduce the risk of transmission within meat plants could include the following: (i) the vaccination of workers; (ii) the screening of workers to reduce the risk of infected workers entering the plant, e.g., by taking temperatures before entry; (iii) the cessation of procedures that are likely to produce aerosols (This could be done by sluicing down with water and using rubber squeegees instead of brushes and power hoses. The latter could be replaced by steam hoses.); and (iv) providing workers with higher-grade masks, i.e., those of FFP2/3 (EU standard) or N95/99 (US standard).

Reference

1. Donaldson AI. Aerosols in meat plants as possible cause of COVID-19 spread. Vet Rec. 2020; 187(1): 34-35. doi: 10.1136/vr.m2702

--

Communicated by:

Alex I. Donaldson

<[email protected]>

[ProMED thanks Dr. Donaldson for his insightful comments and reference to the potential transmission modes for COVID-19 spread in meat-processing facilities. Taylor et al. have estimated approximately 236 000 to 310 000 (6%-8% of all US cases) COVID-19 cases and 4300 to 5200 (3%-4% of all US deaths) deaths, respectively, to be associated with proximity to livestock plants (as of 21 Jul 2020), with the vast majority likely related to community spread outside these plants. The association was found primarily among large processing facilities and large meatpacking companies (see https://www.pnas.org/content/117/50/31706).

Most study results indicate a strong positive relationship between livestock-processing plants and local community transmission of COVID-19, suggesting that these plants may act as transmission vectors into the surrounding population and accelerate the spread of the virus beyond what would be predicted solely by population risk characteristics. Policy responses to the COVID-19 outbreak must strike a balance between maintaining essential supply chains and limiting the spread of the virus. - Mod.UBA]

******

[2] South Korea: surge in cases Date: Thu 11 Feb 2021 18:50 KST Source: Yonhap News Agency [edited]

https://en.yna.co.kr/view/AEN20210211000553315?section=news

South Korea's new [daily] coronavirus cases bounced back above 500 Thursday [11 Feb 2021], putting authorities on heightened alert over a potential surge in infections during the extended Lunar New Year holiday.

The country added 504 more COVID-19 cases in the past 24 hours, including 467 local infections, raising the total caseload to 82 434, the Korea Disease Control and Prevention Agency (KDCA) said.

It marks the biggest daily tally since 27 Jan 2021 when the gure was 559.

The Thursday tally also marks a jump from 444 cases registered on Wednesday [10 Feb 2021], 303 cases on Tuesday [9 Feb 2021] as well as Monday's [8 Feb 2021] 289 cases, which was the lowest daily tally since 23 Nov 2020.

Faced with a are-up in virus cases, the KDCA on 31 Jan 2021 extended Level 2.5 social distancing rules, the 2nd highest in a 5-tier scheme, in the greater Seoul area and Level 2 measures in other regions until 14 Feb 2021.

South Korea added 10 more deaths, raising the total to 1496. The fatality rate of COVID-19 here stood at 1.81%.

Since late last month [January 2021], the daily caseload has been moving in the 300-400 range due to continuing cluster infections from unauthorized religious education facilities in the central and southwestern regions.

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Daily infections have been slowing down since the 3rd wave of the pandemic peaked at an all-time high of 1241 daily cases on 25 Dec 2020.

But health authorities remain on heightened alert as the Lunar New Year holiday kicked off Thursday [11 Feb 2021] for a 4-day run through Sunday [14 Feb 2021]. Many Koreans travel across the country to visit their families and relatives during the traditional holiday.

To fend off a potential are-up during the holiday when travel and gatherings increase, authorities have kept in place tight social distancing requirements throughout the holiday, including a nationwide ban on gatherings of 5 or more people.

The government has also taken precautionary measures to discourage the Lunar New Year migration, permitting sales of only window seats on trains and withholding its annual exemption of toll fees on highways during the holiday.

Authorities plan to announce whether they will lower the current virus curbs, the 2nd highest in the 5-tier scheme, over the weekend, after gauging the trajectory of the pandemic during the holiday.

Health Minister Kwon Deok-cheol stressed South Korea is at a "critical juncture" in COVID-19 containment as nagging infection clusters, particularly in the capital area, are threatening to reverse the downward virus curve.

"The daily tally that has been on a steady downturn since peaking on 25 Dec [2020] (resurged to) surpass 500 after more than 400 cases were reported a day earlier. Clusters of infections have been ceaselessly continuing at churches, nursing homes, rms, saunas and restaurants," the minister said.

"It is feared that infections may grow further during the Lunar New Year holiday," he said, calling for extra caution to prevent virus proliferation.

A religious foundation known as Seungri and its af liated education institution in Bucheon, west of Seoul, reported 48 more con rmed cases to a total of 101, according to health authorities.

A private network of acquaintances in Seoul's Yongsan Ward, based on churches and social gatherings, reported a cluster of 46 new cases con rmed among them, bringing its caseload to 47.

Of the newly identi ed local infections, 177 cases were reported in Seoul and 181 cases in the surrounding Gyeonggi Province.

Incheon, 40 kilometers (about 25 mi) west of Seoul, reported 25 more cases. The 3 regions, representing around half of the nation's population, alone were responsible for 82% of the total infections reported Thursday [11 Feb 2021].

Outside the capital area, the biggest port city of Busan along the southern coast added 29 more cases.

Of the 37 imported cases, 14 were from the USA, 7 from Indonesia and 4 from Hungary, according to KDCA.

The number of seriously or critically ill COVID-19 patients reached 170, down 14 from a day earlier. The total number of people released from quarantine after making full recoveries was up 412 from the previous day to reach 72 638.

Separately, the country's COVID-19 response headquarters announced that its recent evaluation found that the locally developed COVID-19 treatment, CT-P59 by Celltrion, has an effect in treating the 6 existing types of COVID-19 and the more contagious form of the virus from Britain but has little effect on the variant from South Africa.

The evaluation result also found the imported treatment remdesivir to be effective in treating all types of COVID-19 including the variant from South Africa, it said.

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KDCA also announced that its vaccination experts' committee will hold a meeting later in the day to discuss the use of the AstraZeneca vaccine.

A day earlier, KDCA approved the use of the AstraZeneca vaccine for people aged 65 or higher, but skepticism still remains here as to whether it is safe for the aged to receive the vaccine.

Based on the result of the meeting, KDCA will x its vaccination plan for February and March [2021] and announce the details of the plan next Tuesday [16 Feb 2021], it said. South Korea is set to start vaccinating its population against COVID-19 on 26 Feb 2021.

Meanwhile, South Korea has extended the ban on passenger ights arriving from Britain, which has been in place since 23 Dec 2020, until 11 Feb 2021 to block the new virus variant that was rst identi ed in Britain.

All foreign entrants are required to present papers showing negative polymerase chain reaction (PCR) tests taken within 72 hours of their departure to the nation.

The pandemic, which started in China in late 2019, has killed nearly 2.4 million people worldwide and infected more than 107 million as of 1 Feb 2021, according to a tally from Johns Hopkins University.

--

Communicated by:

ProMED Rapporteur Kunihiko Iizuka

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[3] SARS-CoV-2 infection of T helper lymphocytes Date: Fri 5 Feb 2021

Source: MedRxiv [edited]

https://www.medrxiv.org/content/10.1101/2020.09.25.20200329v1; full text:

https://www.medrxiv.org/content/10.1101/2020.09.25.20200329v1.full.pdf

Citation: Davanzo GG, Codo AC, Brunetti NS, et al. SARS-CoV-2 uses CD4 to infect T helper lymphocytes. MedRxiv. Epub 28 Sep 2020. https://doi.org/10.1101/2020.09.25.20200329

Abstract ---

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of a major global outbreak of respiratory tract disease known as coronavirus disease-2019 (COVID-19). SARS-CoV-2 infects the lungs and may cause several immune-related complications such as lymphocytopenia and cytokine storm, which are associated with the severity of the disease and predict mortality. The mechanism by which SARS-CoV-2 infection may result in immune system dysfunction is not fully understood. Here we show that SARS-CoV-2 infects human CD4+ T helper cells, but not CD8+ T cells, and is present in blood and bronchoalveolar lavage T helper cells of severe COVID-19 patients. We demonstrated that SARS-CoV-2 spike glycoprotein (S) directly binds to the CD4 molecule, which in turn mediates the entry of SARS- CoV-2 in T helper cells in a mechanism that also requires ACE2 and TMPRSS2.

Once inside T helper cells, SARS-CoV-2 assembles viral factories, impairs cell function and may cause cell death. SARS-CoV-2 infected T helper cells express higher amounts of IL-10, which is associated with viral persistence and disease severity. Thus, CD4- mediated SARS-CoV-2 infection of T helper cells may explain the poor adaptive immune response of many COVID-19 patients.

--

Communicated by:

ProMED Rapporteur Kunihiko Iizuka

[Similar to other respiratory viral infections, adaptive immune responses, particularly of T cells, have a prominent role in SARS-CoV-2

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infection. In contradiction to the above report, "multiple studies have indicated heterogeneity in immune responses to SARS-CoV-2, including in CD8+ T cells, and emerging data identify potentially distinct patient immunotypes that might be related to disease features. Second, autopsy studies and scRNA-seq data from bronchoalveolar lavage uid suggest the importance of respiratory CD8+ T cell responses, and recent scRNA-seq data from the upper respiratory tract imply that interactions occur there between epithelial cells and cytotoxic T lymphocytes, in particular through an interferon-gamma (IFN-gamma) axis. Indeed, more robust clonal expansion of CD8+ T cells in peripheral blood or bronchoalveolar lavage uid may be associated with milder disease or recovery, although it is not clear whether this CD8+ T cell clonal expansion is the cause or consequence of the disease recovery." (Source:

https://www.nature.com/articles/s41577-020-0402-6).

There is evidence of functional impairment and increased expression of activation and/or exhaustion markers by CD4+ T cells in patients with COVID-19 (1). Case reports have suggested that CD8+ T cell activation might be greater than CD4+ T cell activation, as de ned by activation markers such as CD38 and HLA-DR (2). However, another study identi ed a subset of patients with higher levels of CD4+ T cell activation who possibly do worse clinically. One report has described a higher proportion of IFN-gamma-producing T helper 1 (TH1)-like cells in patients with moderate disease than in patients with severe disease (3). Moreover, CD4+ T cells speci c for the SARS-CoV-2 spike protein have been identi ed in acute infection (4).

References

1. Diao B, Wang C, Tan Y, et al. Reduction and functional exhaustion of T cells in patients with coronavirus disease 2019 (COVID-19).

Front Immunol. 2020; 11: 827. https://doi.org/10.3389/ mmu.2020.00827

2. Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71: 762-8. https://doi.org/10.1093/cid/ciaa248

3. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest.

2020; 130: 2620-9. https://www.jci.org/articles/view/137244

4. Weiskopf D, Schmitz KS, Raadsen MP, et al. Phenotype and kinetics of SARS-CoV-2-speci c T cells in COVID-19 patients with acute respiratory distress syndrome. Sci Immunol. 2020; 5: eabd2071. https://immunology.sciencemag.org/content/5/48/eabd2071 - Mod.UBA]

******

[4] From our regional networks: South Asia COVID-19 update (14): Nepal 20210212.8182398 COVID-19 update (15): South Asia 20210212.8186695 In this update:

[A] Bangladesh [B] India [C] Pakistan [D] Sri Lanka [E] Nepal

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[A] Bangladesh

Date: Fri 12 Feb 2021 02:14 AM BST Source: The Daily Star [edited]

https://www.thedailystar.net/backpage/news/daily-covid-infection-rate-falls-265pc-2043381

Bangladesh's daily coronavirus infection rate fell to 2.65% yesterday [11 Feb 2021]. The health authorities recorded 9 deaths from COVID-19 and 418 fresh cases in the last 24 hours until morning.

So far, Bangladesh has con rmed 539 571 coronavirus cases, including 8248 fatalities. The mortality rate stood at 1.53%, according to a handout from the Directorate General of Health Services. Until morning, 485 971 patients (90.07%) have recovered.

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Bangladesh reported its 1st coronavirus cases on 8 Mar 2020 and the 1st death on 18 Mar 2020. So far, 3 808 017 samples, including 15 776 in the past 24 hours, have been tested. The overall infection rate is 14.17%.

The government launched a countrywide COVID-19 vaccination drive on 7 Feb 2021. Doses of Oxford-AstraZeneca vaccine that Bangladesh brought from India's Serum Institute have been sent to hospitals across the country to make the inoculation drive a success.

--

Communicated by:

ProMED-SoAs

<[email protected]>

[Mass vaccination against COVID-19 in Bangladesh started on 7 Feb 2021 after vaccinating 567 people as part of piloting on 27 and 28 Jan 2021. The disease occurrence is slowing down steadily, with case positivity of above 2% but below 3% over the last 7 days. - Mod.PKB

Maps of Bangladesh: http://tinyurl.com/bw2fuve and http://healthmap.org/promed/p/153]

---- [B] India

Date: Thu 11 Feb 2021 21:33 IST Source: Hindustan Times [edited]

https://www.hindustantimes.com/india-news/india-should-be-very-very-proud-who-s-praise-amid-falling-covid-19-cases- 101613056206080.html

The Union ministry of health and family welfare data showed on Thursday [11 Feb 2021] that there were 12 923 new cases of COVID- 19 in the last 24 hours, taking the cumulative count of people infected with the virus in the country to 10 871 294.

India on Thursday [11 Feb 2021] earned a pat on the back from the World Health Organization (WHO) for its efforts to contain the spread of the coronavirus disease (COVID-19) as the global body said the number of infections in the country has been on the decline.

"Over 3 months now, cases of COVID-19 in India have been consistently going down.... Considering the magnitude of the

population...it's something the Government of India should be very, very proud of," Roderico Ofrin, WHO's India representative, was quoted as saying by ANI [Asian News International].

"Bringing that diligence, discipline, and vigour into their response to the vaccination campaign, we have seen it's been so successful.

Around 6 million were vaccinated in 22 days. It's the fastest as we see rates of vaccination happening," Ofrin added.

According to the Union ministry of health and family welfare on Thursday [11 Feb 2021] morning, India reported 12 923 new cases of COVID-19 in the last 24 hours, taking the cumulative count of people infected with the virus in the country to 10 871 294. There are 142 562 active cases and 10 573 372 recoveries as India's death toll stood at 155 360 with 108 deaths in the last 24 hours. The country is witnessing a sustained decline in the number of COVID-19 cases reported daily since the reported peak in mid-September 2020, the government has said. India has also vaccinated more than 7 million people since the programme began on 16 Jan 2021, in the world's largest vaccination drive against COVID-19.

Ofrin also added a word of praise for Gujarat. "Hats off to Gujarat government for taking the review amid pandemic for information and better evidence to tweak their responses, which they have, especially during the 2nd wave that happened," he said.

This is not the 1st time that the global health body has praised India. On 6 Feb 2021, it had said that the country has shown great progress in signi cantly driving down the number of COVID-19 cases. "This shows us that if we can do these simple public health solutions, we can beat the virus.... With vaccines being added, we would even expect more and better outcomes," WHO's director-

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general Tedros Adhanom Ghebreyesus had said.

Last month [January 2021], Ghebreyesus had thanked India and Prime Minister Narendra Modi for their continued support to the global COVID-19 response as the country supplied vaccines, being manufactured in the country, to neighbouring countries, including Bhutan, Maldives, Nepal, Myanmar, and Bangladesh, as well as other nations. "Thank you, India and Prime Minister Narendra Modi for your continued support to [the] global COVID-19 response. Only if we act together, including sharing of knowledge, we can stop this virus and save lives and livelihoods," Tedros had said.

[Byline: Meenakshi Ray]

--

Communicated by:

ProMED-SoAs

<[email protected]>

[The updated information on the distribution of active cases, cured/discharged/migrated cases, deaths, and total con rmed cases attributed to COVID-19 in India by states and union territories can be seen at https://www.mohfw.gov.in/, by clicking COVID-19 Statewise Status. - Mod.PKB

Maps of India: http://www.mapso ndia.com/maps/india/india-political-map.htm and http://healthmap.org/promed/p/142]

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[C] Pakistan

Date: Fri 12 Feb 2021 Source: The Dawn [edited]

https://www.dawn.com/news/1606853/govt-aims-to-vaccinate-30m-people-against-covid-19-by-september-pti

The government is aiming to achieve herd immunity by vaccinating 70 million people against COVID-19 by the end of the current year [2021]. About 30 million people will be vaccinated by September [2021].

This was stated by representatives of Pakistan Tehreek-i-Insaf (PTI) about the ruling party's policy on vaccination and management of the impact of COVID-19 on education and economy at a session organised by the Pakistan Institute of Legislative Development and Transparency (Pildat) at a local hotel on Thursday [11 Feb 2021].

Party's central joint secretary Mussadiq Ghumman, parliamentary secretary national health services Dr. Nausheen Hamid, and others attended the session.

According to the draft policy of the party on coronavirus vaccination, the government aims to achieve herd immunity by vaccinating 70% of the population in 2021. Approximately 100 million Pakistanis are eligible to receive the coronavirus vaccine as per global guidelines. The government already has secured enough doses to vaccinate 30 million people by September [2021] -- almost 50% of the target.

According to the draft policy, the vaccine would be administered free of cost at public health facilities. Criteria have been de ned for frontline healthcare workers after consultation with provincial stakeholders, and a Resource Management System (RMS) has been set up so they could be registered through healthcare facilities.

During school closures, the federal government was able to offer digital learning content through "TeleSchool". The content on TeleSchool was provided free of cost by major Edtech partners, including Sabaq Foundation, Taleemabad, The Citizens Foundation, Punjab IT Board, Allama Iqbal Open University, and Knowledge Platform. The policy stated that the government had built national consensus and coordination through the platform of Inter-provincial Education Ministers' Conference and took decisions after

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consultations.

The policy also stated that to mitigate the adverse effects on the economy, Prime Minister Imran Khan announced on [24 Mar 2021] a scal stimulus package to support the economy and protect the weak segments of the population.

Other measures to manage the impact of COVID-19 on economy included maintaining low interest rate to stimulate GDP growth and employment, cash transfer to poor women through Kafaalat programme, and launching of a poverty alleviation programme via microloans.

Four people lost their lives to COVID-19 in the twin cities [Islamabad and Rawalpindi] while 123 people were diagnosed with the disease on Thursday [11 Feb 2021]. Around 25 patients were discharged from hospitals in Rawalpindi.

The positivity rate in the capital stood at 1.9% while 4747 tests were conducted during the last 24 hours.

The deceased were identi ed as [ZN], 82, a resident of Gulistan Colony. She was taken to Fauji Foundation Hospital on 1 Feb 2021 where she died. [ZR], 58, a resident of Morgah, was admitted to Holy Family Hospital on 10 Feb 2021 where he passed away.

Both the patients who died in Islamabad were males aged between 40 and 79 years. Their addresses are still not known.

In Rawalpindi District, there are 210 active patients out of whom 61 are in hospitals and 153 isolated in their homes. A total of 440 patients are waiting for the results of their coronavirus serology.

Out of the newly detected patients in the district, 26 belong to Rawalpindi city and cantonment areas, including 7 from cantonment, 15 from Potohar Town, and 4 from Rawal Town. Two patients came from Gujar Khan and one from Taxila. Two patients came from Chakwal and 2 from Islamabad.

As many as 61 patients are admitted in Rawalpindi hospitals, including 10 in Benazir Bhutto Hospital, 21 in Fauji Foundation Hospital, 13 in Holy Family Hospital, 15 in Rawalpindi Institute of Urology, and 2 in Hearts International Hospital. Nine patients are on ventilators, including 25 on oxygen support, and 27 are stable.

Commissioner retired Capt. Mohammad Mehmood told Dawn that the number of patients had slightly increased in the last 2 days, but the number of critical patients had reduced in hospitals. He said 32 people tested positive in Rawalpindi and 7 in Jhelum. Meanwhile, 16 cases in the capital were reported in the age-group of 30-39, followed by 15 in 50-59, 13 each 10-19, 20-19, 40-49, 10 in 0-19, 5 each in 60-69, 70-79, and one in 80 and above, of cials said, adding 11 cases were reported from Loi Bher, 8 from Tarlai, 6 each from F-11, G-11, Bhara Kahu, F-7, 5 each from G-6, G-7, 4 from G-13, 3 each from I-10, G-8, Alipur, 2 each from Khana, E-11, F-8, G-9, F-6, Sihala, and one each from G-10, Kurri, F-10, I-9, Model Town, Chak Shahzad, H-13, Kural, I-11, E-16, and G-12.

[Byline: Ikram Junaidi, Aamir Yasin, and Munawer Azeem]

--

Communicated by:

ProMED-SoAs

<[email protected]>

[As indicated in the news report above, to develop herd immunity against COVID-19, Pakistan is aiming at vaccinating around 70 million people by the end of 2021, although vaccination has not started yet in the country.

The trends of daily con rmed COVID-19 cases and deaths attributed to the disease in Pakistan can be seen at https://covid19.who.int/region/emro/country/pk. - Mod.PKB

Maps of Pakistan: http://www.mapsofworld.com/pakistan/pakistan-political-map.html and http://healthmap.org/promed/p/140]

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[D] Sri Lanka

Date: Thu 11 Feb 2021 21:55 IST Source: The Daily Mirror [edited]

http://www.dailymirror.lk/breaking_news/Daily-COVID-cases-exceed-900-for-third-consecutive-day/108-205602

The total number of COVID-19 cases in the country exceeded the 900 mark for the 3rd consecutive day.

Accordingly, a total of 939 COVID-19 patients were reported across the country today [11 Feb 2021] and the total number of COVID- 19 cases in the country now stands at 73 116.

--

Communicated by:

ProMED-SoAs

<[email protected]>

[The South Asian COVID-19 situation, according to data from Worldometer (https://www.worldometers.info/coronavirus/) as of 12 Feb 2021 at 05:22 GMT:

Country: Total cases / Total deaths / Deaths per million population India: 10 880 413 / 155 484 / 112

Pakistan: 560 363 / 12 218 / 55 Bangladesh: 539 531 / 8248 / 50 Nepal: 272 430 / 2052 / 70 Sri Lanka: 73 116 / 379 /18 Afghanistan: 55 445 / 2424 /61 Maldives: 17 387 / 56 /102 Bhutan: 861 / 1 / 1

In South Asia, India, Bangladesh, Nepal, and Sri Lanka have already started vaccination rollout against COVID-19, using the vaccine

"Covishield" produced by the Serum Institute of India (https://thehimalayantimes.com/nepal/nepal-covid-19-vaccine-roll-out-pm-oli- to-inaugurate-drive-in-nepal-at-10). The vaccine was originally developed by Oxford-AstraZeneca. India has also supplied this vaccine to Bhutan and Maldives.

Pakistan has not started vaccination yet but is aiming at vaccinating around 70 million people at the end of this year (2021).

Starting vaccination from 16 Jan 2021, more than 7 million people in India have been vaccinated with the 1st dose of the vaccine, as of 12 Feb 2021 (https://www.livemint.com/news/india/india-goes-past-7-million-vaccine-doses-gives-states-deadlines-to-speed-up- 11613028076641.html). As of 10 Feb 2021, a total of 337 769 people have been vaccinated against COVID-19 in Bangladesh (https://dghs.gov.bd/images/docs/Press%20Release/Press-release-of-11-02-2021.pdf; in Bengali).

Over the last 7 days, 8521, 828, and 6001 cases were detected in Pakistan, Nepal, and Sri Lanka, respectively, suggesting a decline of daily new cases in Pakistan and Nepal, but an increasing trend again in Sri Lanka compared with the data from the previous week.

The daily case positivity against the total number of samples tested in Bangladesh is decreasing slowly, and it was above 2% but below 3% over the last 7 days. The total number of daily COVID-19 cases in India is also dropping but very slowly, as the average daily positive cases over the last 7 days was 10 983 compared with 11 795, recorded in the preceding 7 days.

To compare the situation in South Asian countries above with previous disease data, ProMED readers are referred to the archives

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below:

- 5 Feb 2021 at 07:26 GMT: 20210205.8167512 - 29 Jan 2021 at 05:59 GMT: 20210129.8146910 - 22 Jan 2021 at 06:45 GMT: 20210122.8126152 - 15 Jan 2021 at 06:39 GMT: 20210115.8105278 - 8 Jan 2021 at 05:52 GMT: 20210108.8083556 - 1 Jan 2021 at 06:23 GMT: 20210101.8062937 - 25 Dec 2020 at 06:24 GMT: 20201226.8045837 - 18 Dec 2020 at 05:52 GMT: 20201220.8027646 - 11 Dec 2020 at 06:47 GMT: 20201213.8010169 - 4 Dec 2020 at 06:44 GMT: 20201205.7992003 - 27 Nov 2020 at 07:04 GMT: 20201127.7975379 - 20 Nov 2020 at 05:55 GMT: 20201120.7958257 - 6 Nov 2020 at 06:28 GMT: 20201106.7920767 - 30 Oct 2020 at 02:48 GMT: 20201101.7902222 - 23 Oct 2020 at 05:55 GMT: 20201025.7884337 - 16 Oct 2020 at 06:23 GMT: 20201017.7866149 - 9 Oct 2020 at 05:30 GMT: 20201011.7847842 - 2 Oct 2020 at 06:09 GMT: 20201002.7830222 - 25 Sep 2020 at 06:03 GMT: 20200925.7811558 - 18 Sep 2020 at 04:55 GMT: 20200918.7791805 - 11 Sep 2020 at 06:28 GMT: 20200911.7768020 - 4 Sep 2020 at 05:46 GMT: 20200904.7745644 - 28 Aug 2020 at 06:25 GMT: 20200830.7724555 - 21 Aug 2020 at 06:33 GMT: 20200822.7701213 - 14 Aug 2020 at 02:38 GMT: 20200815.7676465 - 7 Aug 2020 at 03:02 GMT: 20200809.7653320 - 31 Jul 2020 at 12:08 GMT: 20200731.7630191 - 24 Jul 2020 at 05:14 GMT: 20200724.7606708 - 17 Jul 2020 at 05:16 GMT: 20200717.7583563 - 10 Jul 2020 at 08:35 GMT: 20200710.7559716 - 3 Jul 2020 at 05:42 GMT: 20200703.7535367 - 26 Jun 2020 at 06:11 GMT: 20200627.7511829 - 19 Jun 2020 at 06:47 GMT: 20200620.7486580 - 12 Jun 2020 at 06:49 GMT: 20200613.7460702 - 5 Jun 2020 at 07:04 GMT: 20200606.7429525 - 29 May 2020 at 07:07 GMT: 20200529.7392910 - 22 May 2020 at 06:18 GMT: 20200522.7364852 - 15 May 2020 at 06:24 GMT: 20200515.7338409 - 8 May 2020 at 06:20 GMT: 20200508.7312471 - 1 May 2020 at 8:36 GMT: 20200501.7287142 - 24 Apr 2020 at 14:53 GMT: 20200426.7262474 - 17 Apr 2020 at 12:13 GMT: 20200418.7234555 - 10 Apr 2020 at 8:06 GMT: 20200410.7207231

The lowest number of con rmed cases recorded so far is from Bhutan, 861, with one death. - Mod.PKB]

---- [E] Nepal

Date: Wed 10 Feb 2021 21:04 NPT Source: The Himalayan Times [edited]

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https://thehimalayantimes.com/covid-19/nepal-covid-19-update-134-new-cases-118-recoveries-and-no-fatalities-recorded-on- wednesday

Nepal's Health Ministry shared the latest updates on coronavirus contagion from across the country.

To date [10 Feb 2021], 2 104 626 tests through the polymerase chain reaction (PCR) method have been carried out wherein 4309 tests were performed in the last 24 hours.

At present, there are 88 people under quarantine in various facilities across the country. The number of active cases in Nepal is 1753.

A total of 134 new cases of the coronavirus infection were registered today [10 Feb 2021] taking the national tally to 272 349.

As many as 118 persons earlier diagnosed with the disease have tested negative in the last 24 hours. With the recent addition, the national COVID-19 recovery tally has now reached 268 549.

Meanwhile, no fatalities were con rmed by the Ministry today [10 Feb 2021], with which the country's COVID-19 death toll remains at 2047.

As of today [10 Feb 2021], the country has witnessed 272 349 cases of coronavirus infection while 268 549 people have recovered from the disease. Meanwhile, 2047 COVID-19 fatalities have been con rmed.

--

Communicated by:

ProMED-SoAs

<[email protected]>

[Information on Nepal's COVID-19 cases can be found on the government portal at https://covid19.mohp.gov.np/.

Technical guidance and information, education, and communication materials from the Ministry of Health and Population, Nepal, can be found at https://heoc.mohp.gov.np/update-on-novel-corona-virus-covid-19/. - Mod.GS]

--

Communicated by:

ProMED

<[email protected]>

******

[5] WHO: daily new cases reported (as of 11 Feb 2021) Date: Thu 11 Feb 2021

Source: WHO [abridged, edited]

https://covid19.who.int/table

*Daily case reports as of 11 Feb 2021 19:11 CET

Surveillance ---

WHO region (no. countries/territories):

Total con rmed cases (new cases in last 24 hours) / Total deaths (new deaths in last 24 hours) ---

(12)

Western Paci c Region (19): 1 509 522 (7139) / 26 613 (251) European Region (61): 36 132 951 (160 815) / 800 491 (4689) South East Asia Region (10): 13 122 278 (23 538) / 201 506 (315) Eastern Mediterranean Region (22): 5 924 791 (25 957) / 138 459 (382) Region of the Americas (54): 47 606 632 (185 832) / 1 112 708 (6747) African Region (49): 2 694 171 (10 577) / 67 225 (403)

Cases on an international conveyance (Diamond Princess): 745 (0) / 13 (0)

Con rmed cases (new cases in last 24 hours) / Total deaths (new deaths in last 24 hours) Grand total: 106 991 090 (413 858) / 2 347 015 (12 787)

--

Communicated by:

ProMED

<[email protected]>

[The number of countries and territories reporting con rmed cases of COVID-19 to WHO remains 219.

Data by country, area, or territory for 11 Feb 2021 can be accessed at https://promedmail.org/wp-content/uploads/world- pdf/2021%20WHO%20Daily%20Tables%20Feb11_1613147869.pdf.

- The Americas region reported 44.9% of daily case numbers and 52.7% of the daily deaths reported in the past 24 hours and maintained its position as the most severely affected region, having reported more than 47.60 million cases. The USA remains the most heavily affected country, and reported just over 90 000 cases, followed by Brazil and Mexico (reporting more than 10 000 cases in the past 24 hours); 6 additional countries reported more than 1000 cases in the past 24 hours (Columbia, Argentina, Peru, Chile, Bolivia, and Canada), and an additional 7 countries (Panama, Guatemala, Paraguay, Uruguay, Dominican Republic, Venezuela, and Cuba) reported more than 500 but fewer than 1000 cases.

- The European region reported 38.8% of daily case numbers and 36.6% of the daily deaths reported in the past 24 hours, and total cumulative cases reported exceed 36.13 million. Countries not reporting cases include Belgium and Kazakhstan, among others.

France is the most heavily affected, followed by Russia, the UK, Italy, and Germany reporting more than 10 000 cases in the last 24 hours. Another 20 countries reported more than 1000 cases, and an additional 6 countries reported more than 500 but fewer than 1000 cases.

- The Eastern Mediterranean region reported 6.2% of daily case numbers and 2.9% of the deaths reported in the past 24 hours, having reported a cumulative total of more than 5.92 million cases. Iran maintains its dominance, reporting just over 7500 cases, followed by UAE, Lebanon, Iraq, Jordan, Pakistan, and Tunisia. Kuwait, Bahrain, Morocco, Palestinian Authority, and Egypt reported more than 500 but fewer than 1000 cases.

- The African region reported 2.5% of daily case numbers and 3.1% of the deaths reported in the past 24 hours, having reported a cumulative total of more than 2.69 million cases. South Africa maintains its dominance, with over 3100 cases, followed by Nigeria.

Ethiopia, Mozambique, and Zambia reported more than 500 but fewer than 1000 cases. Ghana, Botswana, and Congo, among others, did not report any newly con rmed cases in the preceding 24 hours.

- The Western Paci c region reported 1.7% of daily case numbers and 1.9% of the deaths reported in the past 24 hours, having reported a cumulative total of more than 1.50 million cases. Malaysia reported the highest number of cases over the last 24 hours (over 3200 cases), followed by Japan, Philippines, South Korea, and China.

- The South East Asia region reported 5.6% of the daily newly reported cases and 2.4% of reported deaths in the past 24 hours, having reported a cumulative total of more than 13.12 million cases. India was dominant with over 12 000 cases, followed by Indonesia having reported over 8000 cases, Sri Lanka, Bangladesh, Thailand, Nepal, and Maldives.

(13)

On the Overview tab at the WHO source URL, the epidemic curve of con rmed COVID-19 cases by WHO region, 30 Dec 2019 through 11 Feb 2021, is an excellent visual representation of the pandemic. - Mod.UBA]

******

[6] Global update: Worldometer accessed 11 Feb 2021 17:52 EST (GMT-5) Date: Thu 11 Feb 2021

Source: Worldometer [edited]

https://www.worldometers.info/coronavirus/#countries

[For those who wish to see the detailed global data, a snapshot of the Worldometer table at the time we accessed it is available at https://promedmail.org/wp-content/uploads/world-pdf/2021%20WORLDDATA%20FEB11_1613148313.pdf.

A 7-day series of cumulative data reported by countries, territories, and reporting entities can be found at https://promedmail.org/wp- content/uploads/world-pdf/2021%20FEB11WORLD7_1613148411.pdf. - Mod.UBA]

Total number of reported deaths: 2 377 285 Total number of worldwide cases: 108 282 208

Number of newly con rmed cases in the past 24 hours: 443 622

--

Communicated by:

ProMED

<[email protected]>

[In the past 24 hours, the USA (103 481), Brazil (53 993), and France (21 063) have reported the highest numbers of cases. A global total of 13 749 deaths were reported in the past 24 hours (late 10 Feb 2021 to late 11 Feb 2021).

Countries reporting more than 10 000 newly con rmed cases in the past 24 hours (8 countries) include the USA, Brazil, France, Spain (17 853), Russia (15 038), Italy (15 146), the UK (13 494), and Mexico (11 138). A total of 52 countries reported more than 1000 cases in the past 24 hours; 27 of the 52 countries are from the European region, 11 are from the Americas region, 6 are from the Eastern Mediterranean region, 2 are from the South East Asia region, 3 are from the Western Paci c region, and 3 are from the African region.

Comparing the 7-day averages of daily con rmed cases from the past 7 days and those from 8-14 days ago, case counts have decreased by 14.5%, while daily reported deaths have decreased by 8.1%. Similar comparative 7-day averages in the USA show an 8.9% decrease in daily reported cases and a 14.1% decrease in reported deaths.

Impression: The global daily reported cases were over 400 000 newly con rmed infections in the past 24 hours with over 108.1 million cumulative reported cases and over 2.37 million reported deaths. Countries in the European and the Americas regions are still showing the largest increases in daily new case counts, even in the face of overall decreasing reports. The Eastern Mediterranean countries have been demonstrating decreasing case counts while the Western Paci c and African countries are increasing in reported cases. - Mod.UBA]

Published Date: 2021-02-12 21:02:47 Subject: PRO/AH/EDR> COVID-19 update (61): meat facility, S Korea, T lymphocytes, S Asia, WHO, globalArchive Number: 20210212.8187538

Published Date: 2021-02-12 21:02:47

Subject: PRO/AH/EDR> COVID-19 update (61): meat facility, S Korea, T lymphocytes, S Asia, WHO, global Archive Number: 20210212.8187538

See Also