New Variant From India, Cases Rising in Europe, Brazil's Worst Ever Health Crisis: COVID-19 Global Weekly Highlights

Medscape, Univadis, & MediQuality Staff

March 26, 2021

These are the global coronavirus stories you need to know about this week.

On Monday, AstraZeneca announced interim results of its phase 3 United States study showing 79% overall efficacy of its vaccine against symptomatic COVID-19. But by Tuesday, officials at the US National Institute of Allergy and Infectious Diseases had issued a statement calling into question the completeness of the company's data and the data and safety monitoring board criticised the company for "cherry picking" favourable findings rather than reporting the most recent numbers. On Thursday, the company revised the efficacy figure to 76%.

Meanwhile, researchers reported that Americans gained nearly 2 pounds per month during COVID-19 shelter-in-place orders in 2020, exacerbating the country's significant obesity problem. 

The European Medicines Agency (EMA) will convene an ad hoc expert group to provide "additional input" into the assessment of thromboembolic events occurring in European Union (EU) residents who have received AstraZeneca's COVID-19 vaccine.

Meanwhile, the EU has told AstraZeneca to "catch up" on vaccine deliveries in Europe before exporting doses to other countries.

Brazil is going through the worst period of its health crisis. Cases are rising and deaths reached a new high of 3158 in 24 hours. The health system is experiencing long waiting times for intensive care beds, and problems with intubation, drugs, respirators, and oxygen. In the state of São Paulo, 115 cities are at risk of running out of oxygen cylinders. The country has seen 298,843 deaths and 12,136,615 diagnoses since February 2020. Deaths stand at 13.3 per million inhabitants. Vaccination rates remains slow with 6% of the population having a first dose, and 2% a second dose as of Tuesday.  

In Germany, after gradually lifting some lockdown restrictions, the number of COVID-19 patients in intensive care units is on the rise again with more than 3000 occupied beds, as high as the peak of the first wave in spring 2020. On Wednesday, the number of new infections reported within 7 days per 100,000 inhabitants was at 108.1 nationwide. 

The UK marked one year since the first lockdown with a day of reflection. In the last 12 months the number of people who have died in the UK within 28 days of a positive test has risen from 938 to 126,172, including an estimated 247 frontline health and care workers. Saturday saw nearly 100,000 COVID-19 vaccine doses delivered in a single hour, or 27 a second, with a record 844,285 UK vaccinations in one day. Deaths and hospitalisations continue to fall but new cases remain at around 5000 a day.

Spain restarted use of the AstraZeneca vaccine on Wednesday, and has extended the age limit to 65 years. There are concerns people won’t trust it but the Minister of Health said the vaccine is "safe and effective" and made it clear that if someone refuses the AZ vaccine they will not be vaccinated. Only 4.6% of the population has been fully vaccinated. This week Spain registered the greatest increase in COVID-19 cases within the last 10 days. Travel restrictions will remain in place over Easter.

In Portugal, the incidence of the UK variant (B.1.1.7) is increasing and already comprises 70% of positive cases and is expected to reach 90%. There are currently 712 hospitalised COVID-19 patients and 155 in ICU beds, the lowest since October. The current incidence rate is 81.3 cases per 100,000 population. However, between March 14 and 20, more than 30 municipalities saw an increase greater than or equal to 30 new cases per 100,000 inhabitants, according to the Público newspaper. On Monday, the Portuguese health authorities decided to resume rollout of the AstraZeneca vaccine.

France is facing a resurgence of COVID-19 and lockdown restriction measures have been extended to new regions. President Macron announced several measures aimed at accelerating vaccination , including extending vaccination to people over 70 without comorbidities. New vaccination mega-centres will open next week. The national drug and product safety agency (ANSM) provided an inventory of thromboembolic events reported in France with the three available vaccines.

The epidemic in Italy is worsening. According to the latest government report from the Ministry of Health, the national incidence rate is above the threshold of 250 cases a week per 100,000 population for the seventh consecutive week.

The number of people hospitalised with COVID-19 is rising significantly (28,438 as of Wednesday), as well as those in intensive care (3588), and those quarantined at home (540,740). The average rate of positive swabs is 5.8% at a national level. The vaccination campaign is slowing down due to a lack of supplies. Across the country, eight million people have been vaccinated with more than 1.6 million people over 80 receiving at least one dose.

Phase 2/3 of the ReiThera vaccine trial based on gorilla adenovirus has begun in Italy, and the Spallanzani Institute will set up a trial to verify the efficacy of the Russian vaccine Sputnik V, especially against variants of concern. 

Ukraine has reported a record daily number of COVID-related deaths, while Bulgaria registered the highest daily rate of infections since the start of the pandemic. 

Cuba's drug regulatory authority approved a second COVID-19 vaccine candidate (Soberana) for late-stage clinical trials as the country races to secure a homegrown jab to quell its worst outbreak since the start of the pandemic and to sell abroad.

The country is one of a handful in the region that has not started vaccinating against COVID-19, as it is counting on its own vaccine candidates.

India has seen a surge of COVID-19 cases. On Wednesday, the country recorded 53,476 daily cases, the highest since October. A new 'double mutant variant' of SARS-CoV-2 with E484Q and L452R mutations has been detected in samples from the western state of Maharashtra.

More than half of Israel's 9.3 million population has now been fully vaccinated against COVID-19, the country's health minister said. 

Japan ended its state of emergency in Tokyo and its surrounding areas which began in early January. Despite restrictions being lifted, Tokyo's Governor, Yuriko Koike has warned people not to let down their guard to help avoid a resurgence of infections.

Authorities in Hong Kong and Macao temporarily suspended use of the Pfizer/BioNTech vaccine on Wednesday after being informed by distributor Fosun Pharma about defective lids in one of the batches. Fosun Pharma and BioNTech are investigating the issue and have clarified that there is no reason to believe the product is unsafe. 

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.


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