'Plan B', Booster Doses, Mask Mandates: COVID-19 Global Weekly Highlights

Medscape, Univadis, & MediQuality Staff

October 21, 2021

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

A group representing the UK's NHS leadership urged ministers to enact England's COVID-19 'Plan B' now amid rising cases. UK coronavirus cases have reached their highest daily level since early March, and cases are at their highest level for almost 3 months. UK COVID-19 cases could go as high as 100,000 a day, England's Health Secretary Sajid Javid told a Downing Street briefing. However, he said the NHS wasn't yet under high enough pressure for restrictions. The British Medical Association said that was "willfully negligent". The weekly case rate has risen from 367 cases per 100,000 population at the start of October to its current level of 463 per 100,000. That compared with far lower rates in neighbouring countries, including Spain (24 per 100,000), France (48), and Germany (80).

In France, the spread of the virus continues to accelerate slowly with 5934 new cases reported on October 19 and a reproduction rate below 1 but up for the third week in a row. The Government is therefore looking to speed up the administration of booster doses with the Pfizer vaccine. The flu vaccination campaign was brought forward by a few days in order to encourage COVID-19 flu booster co-vaccination for the most vulnerable people. So far, 34% of eligible people, including over-65s and healthcare professionals, have received a third dose. So far, 73.6% of the total population is fully vaccinated.

The Robert Koch Institute (RKI) says there are 80.4 new infections per 100,000 population per week in Germany. Last month the figure was 71.0. There were 17,015 new infections a day reported this week.

The number of COVID-19 patients admitted to hospital per 100,000 population within 7 days was 2.13. This is the main parameter for possible tightening of COVID-19 restrictions.

In Germany, 4,174,400 people are recovered from COVID-19. COVID-related deaths rose to 94,808. So far, 65.9% of the total population are fully vaccinated, and 68.9% have received at least one vaccine dose.

Health Minister Jens Spahn spoke in favour of ending the "epidemic situation" on November 25. This was welcomed by physician and hospital groups but criticised by the German Society for Immunology and the Patient Protection Foundation.

In Austria, 780,269 COVID-19 infections have been recorded to date, with 11,196 COVID-19-related deaths as of October 20. This corresponds to an infection rate of 8.63% and a death rate of 1.43%. Within the last week, 180.7 new infections per 100,000 population were reported in Austria (7-day incidence). To date, 61.32% of the population is fully vaccinated.

In Switzerland, new daily infections are currently increasing. According to the head of the Crisis Management and International Cooperation Section at the Federal Office of Public Health (BAG), incidences are highly dispersed. They range from 70 to 530 cases per 100,000 inhabitants. Young people between 10 and 19-years-old in particular are affected. Hospitalisations are declining slightly, with 90% of hospitalisations being among unvaccinated people.

In Belgium, 73% of the population is fully vaccinated. Daily infections averaged 2438 between 6 and 12 October, up 28% compared to the previous week. An average of 60 daily hospital admissions were recorded.

About two thirds of people hospitalised with COVID-19 are unvaccinated, while the other third are vaccinated people generally over the age of 75. The current testing strategy, where people need to see a doctor when they have COVID-19 symptoms, will be reviewed as it is not possible for GPs to spend half their time doing PCR tests.

In Portugal, in the last 4 days, the incidence per 100,000 inhabitants increased from 83.2 in the country and on the continent to 84.3 and 84.7, respectively. Two weeks ago Portugal was the first country in the world to reach 85% of its population vaccinated.

In Spain after 2 days of slight increases, the incidence of new infections has fallen again and stands at 41.9 cases per 100,000 population, with 1889 new infections on Wednesday compared to 4492 on Monday. Children under 12 years of age, the only population group that has not received the vaccine yet, continues with a rate of more than 50 cases per 100,000. The latest report shows that the rate of ICU beds occupied by COVID-19 patients is 4.76% and hospital beds stands at 1.51%.

So far, 78.2% of the population is fully vaccinated.

In Italy the incidence of SARS-CoV-2 infection dropped to 29 cases per 100,000.

Occupancy of medical and intensive care wards continues to decline.

Vaccinations have increased after COVID passports became mandatory last Friday.

Last week, there were nearly 817,000 new COVID-19 infections and more than 18,000 COVID-19 related deaths reported in the Americas.

Cases, deaths, and hospitalisations continue to fall in the US after the summer Delta surge, but hotspots remain in states in the upper Midwest and Mountain West, where dropping temperatures are sending people indoors.  Dr Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, warned that even though numbers were heading in the right direction, it was no time to drop our guard.  The US was moving forward on a plan to provide booster doses of the three authorised and approved vaccines and was preparing to begin vaccinating children as young as 5 by early November, pending approvals from the nation’s drug regulators.  The US also unveiled a plan to allow vaccinated travellers to enter the country.

In Mexico, the cumulative incidence rate of cases is 2917.4 per 100,000 population. Seventy-seven percent of the population over 18 years of age has received at least one dose of COVID-19 vaccine. On October 18 vaccination against COVID-19 began for children and adolescents between 12 to 17 years with some comorbidities.

So far, 41% of people across Latin America and the Caribbean have been fully vaccinated.

In South America, Bolivia and Venezuela are reporting a rise in new infections.

In the Caribbean, the Dominican Republic and Barbados are reporting jumps of more than 40% in new cases over the last week. Puerto Rico, Trinidad and Tobago, and Martinique are also reporting a rise in new infections.

The Pan American Health Organisation Director, Dr Carissa Etienne, announced that the PAHO is working together with the US CDC "to implement a new PCR based multiplex protocol that would allow countries to simultaneously detect COVID-19 and influenza from the same sample”.

Since the beginning of the pandemic, 603,324 people have died from COVID-19 in Brazil. On Monday, relatives of victims gave evidence to a parliamentary inquiry commission that is investigating the Government's management of the pandemic. "I turned my grief into my fight. The Government's work should have been more serious", said Katia Castilho dos Santos, who lost both her parents. Her 71-year-old mother was treated with drugs that were not effective against the disease, such as hydroxychloroquine.

After being heard, taxi driver Marcio Antônio do Nascimento e Silva, who lost his son and last year rebelled against the disrespect for those killed by the disease during a demonstration on Copacabana beach, in Rio de Janeiro, said he could finally start mourning. That is what millions of Brazilian families expect when the commission's final report is voted on. The voting was extended for a week because of disputes over the proposal to indict Brazil’s president for genocide.

As of Tuesday, 49.22% of the population are fully vaccinated.
In a bulletin released on October 15 specialists from the COVID-19 Fiocruz Observatory, from Oswaldo Cruz Foundation said controlling the pandemic will need additional measures, including vaccination passports and the use of masks.

South Korea will ease its stringent restrictions on social gatherings this week, as the country gets ready to adopt its 'living with COVID-19' strategy. 

The first set of travellers arrived in Singapore via flights from Amsterdam and London on October 20 under the expanded quarantine-free programme. 

China will offer COVID-19 booster vaccinations for residents in Beijing, as the city prepares to host the Winter Olympics in February. The country has administered a total of 2.236 billion doses to date. 

Indonesia and Malaysia are likely to start a travel corridor between the two countries soon.

The lockdown in Auckland, New Zealand has been extended by 2 weeks to curb the spread of the Delta variant of SARS-CoV-2. 

Thousands of children in Sydney, Australia returned to schools on October 18 after attending online classes from home for several months. Mask mandates in offices have been removed and large gatherings are now allowed, both indoors and outdoors. Melbourne is likely to lift its stay-at-home orders this week. 

Africa is currently reporting a million new infections about every 60 days and has reported more than 8,515,000 since the pandemic began.

The average number of new infections reported each day in the Republic of the Congo has risen by more than 68 over the last 3 weeks, 20% of its previous peak. Egypt is reporting its highest number of new infections since June.

Regarding vaccination only nine African countries met the target of vaccinating 10% of their populations by the end of September. Only 4% of the population of the continent is already vaccinated.

Morocco has a vaccination rate of approximately 118 doses per 100 people, registering one of the highest numbers of inoculations. In South Africa, the most affected country on the continent, the vaccination rate has reached 33.14 per 100 population. As of October 16, 2021, Seychelles was the African country with the highest vaccination rate. There, around 150 doses were administered per 100 individuals. 

The Government of Saudi Arabia has removed social distancing measures and allowed maximum capacity attendance at the Grand Mosque, Mecca for the first time since the COVID-19 pandemic began. However, visitors need to be fully vaccinated against COVID-19 and must wear masks at all times on mosque grounds. 

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

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