Changes in Restrictions, Mandatory Vaccination: Global COVID-19 Weekly Highlights

Medscape, Univadis, & MediQuality Staff

January 20, 2022

In the UK, the biggest news of the week is that it looks as if Omicron numbers are finally going down, meaning that the wave has now peaked. Hospital numbers, which were doubling every 9 days 2 weeks ago, have now stabilised. Due to this, the Government is ending Plan B, and returning to Plan A, which means that mandatory certifications will end and people can stop working from home. Mask wearing will also no longer be mandated. Last Thursday, January 13, the number of days that someone who tested positive was reduced from 7 days to 5 days, following two positive lateral flow tests. This is despite studies showing that people might be still infectious after 5 days. Staffing of hospitals continues to be an issue, especially as mandatory vaccinations are coming into effect at the end of March, meaning healthcare workers will have to start their first dose by February 3 in order to keep their jobs. The NHS is planning to terminate those that refuse to vaccinate, unless they have an exemption, without redundancy pay.

In related news, there are studies that show that pregnancy complications are worse for COVID-infected mothers who are unvaccinated and that the risk of infection is greater if stressed. The Government was also censured when the High Court ruled that the ʹhigh priority laneʹ the Government set up for PPE equipment at the start of the pandemic was unlawful. Rules allowing contracts to be awarded without competition were relaxed to speed the process.

As of January 17, 90.7% of the UK population over 12 have had a first dose of the COVID-19 vaccine, with 83.4% having had a second dose, and 63.6% a booster. The daily rate of infections is 94,432, with 673,987 over the last 7 days - a reduction of 38.9%, according to data from January 18. The UK Health Security Agency is reporting 1,892 patients admitted to hospital daily on January 14, and 15,217 over the last 7 days down by 2.9% compared to the previous week. As for testing, the daily rate of positive tests is 1,363,401, or 9,382,684 over the last 7 days - down 22.5% from the previous week, as of January 17. There are 438 deaths reported daily, as of January 18, with a 7-day total of 1904 - up 14.7% from the previous week.

In France, the average number of COVID-19 cases over 7 days is at its highest (309,433), the incidence rate of the disease remains high (3063/100,000), as well as the rate of positive tests (23.9%) but experts believe that the 5th wave has probably peaked.

Regarding vaccination, government spokesman Gabriel Attal believes that the new vaccination pass will be able to come into effect by the end of the week. The previous pass, the Health Pass, the Economic Analysis Council say that its introduction helped to prevent an estimated 32,065 hospitalisations and 3979 deaths in France. As of January 18, 32,421,168 people have had a booster dose. Deliveries of Novavax's vaccine, proposed as an alternative for those who refuse mRNA vaccines, have been delayed to late February (delayed from early February).

Half of all people living in Belgium have now received a COVID-19 booster dose, as new cases continue to rapidly increase due to the Omicron variant. As of Sunday, 5.87 million people have received a booster dose of a COVID-19 vaccine, representing 63% of over-18s and 51% of the entire population. However, there is no longer a need to fear an upcoming tidal wave of infections, according to virologist Steven Van Gucht. "We can be hopeful about the future. The infections are not rising as quickly as we feared."

With a delay to other EU countries, the COVID-19 case numbers in Germany are also reaching previously unknown heights. On Wednesday, the Robert Koch Institute (RKI) reported that for the first time since the beginning of the COVID-19 pandemic, more than 100,000 infections were submitted within one day: Specifically, the health offices had reported 112,323 cases in 24 hours. That is about 32,000 more than on Wednesday a week ago. The 7-day incidence also reached a high of 584.4. The previous day, the nationwide incidence had been 553.2 (previous week: 407.5; previous month: 315.4).

Despite the increase in cases, the number of patients in intensive care units has fallen from around 5000 in the first half of December to 2664 on Tuesday, according to the German Intensive Care Association (DIVI). The number of reported COVID-19 deaths has also declined in recent days. 

Currently, comparatively few elderly people are becoming infected. According to the RKI, the 7-day incidence among people aged 80 and older was recently around 115 - a slight increase from previous weeks. Among 5- to 14-year-olds, the incidence is now about 10 times higher than among the elderly and has more than doubled within a week.  

By March 15, employees in institutions such as doctors' surgeries and clinics have to submit proof of vaccination or convalescence. However until now there are no signs yet of more dismissals as a result of the impending compulsory vaccination. The vaccination rate in hospitals nationwide is very high at more than 90%, they say.

In Austria, a new record value is emerging, even if the available figures have not yet been adjusted: The Epidemiological Reporting System (EMS) showed 31,070 new infections within 24 hours on Wednesday morning. The 7-day incidence is given as 1288 (as of January 18).

Austria's government presented the draft law on compulsory vaccination on Sunday. It will apply to everyone over the age of 18 from the beginning of February, with high penalties after an introductory phase, which will end in mid-March. Pregnant women and people who have recovered for a maximum of 180 days are exempt.

In Switzerland according to Virginie Masserey, head of the infection control section at the Federal Office of Public Health (FOPH), the number of COVID-19 cases is stabilising at a very high level. In recent days, only a "very slow increase" has been observed. She pointed out that there is currently a high number of unreported new infections. The number of new infections in Switzerland is currently 29,151 and the 7-day incidence is 2203.2.

A reported 6,032,187 COVID-19 first vaccinations have been carried out so far (as of January 16), which amounts to 69.21% of the population; 67.53% are fully vaccinated. Soon, 12- to 15-year-olds will also be vaccinated.

In Portugal, a report from the Ordem dos Médicos and Instituto Superior Técnico predicts that the peak of the fifth wave of COVID-19 in Portugal should occur between January 20-24, during which time the number of new infections may reach 50,000 cases daily. It is estimated that around 400,000 people will be in isolation on January 30, on the day that the country holds its early elections for Parliament.

On Monday, Portugal recorded 46 deaths from COVID-19 and 43,729 infections, according to the epidemiological bulletin of the Directorate-General for Health (DGS) reported on January 18. In addition, according to the DGS, this was the highest number of fatalities since there were 58 deaths from COVID-19 on February 25, 2021.

Mathematician Carlos Antunes, from the Faculty of Sciences of the University of Lisbon, told Público newspaper, "we already have 30 deaths a day, in average terms, which is a relatively high mortality and above the 'red line' that would be the 20 deaths per million inhabitants in the last 14 days". For the mathematician, there is a probability of reaching 40 deaths a day. "Usually hospitalsations and deaths have a delay in relation to the peak of the incidence, which will now occur," considered Antunes.

On the January 18, the national incidence was 4300.6 cases per 100,000 inhabitants. On the mainland, the rate was 4155.9 cases per 100,000 inhabitants. The national and continental transmission rate was 1.13.

Until the January 15, about 8.8 million people were fully vaccinated in Portugal. In addition, the country has already administered more than 4 million booster doses. The third dose was given to 90% of people aged 80 and over; 92% of people aged 70-79 years and 81% of people aged 60-69 years, according to the latest vaccination bulletin from the Directorate-General for Health.

The president of the Spanish government announced last week a surveillance plan for COVID-19 as an endemic disease. This will mean the end of the daily count of cases and massive testing. Some experts are against this measure and consider it to be too soon. The incidence has fallen for the first time since last November (around 3000 per 100.00), which seems to indicate that the country has already reached the peak of the sixth wave.

The Director of the Pan American Health Organization (PAHO), Carissa F. Etienne, announced that during the past week the Americas region reported nearly 7.2 million new COVID-19 infections and more than 15,000 COVID-related deaths. Also, more than 60% of people in Latin America and the Caribbean have been fully vaccinated against COVID-19. The organization plans to vaccinate at least 70% of the population by mid-2022.

Across the Latin America and Caribbean region, new cases and hospitalisations have increased in the past week. In Panama, Costa Rica, and Honduras cases have doubled. While in Martinique and St. Martin, cases have increased by 600% and 135%, respectively.

The vaccination of children aged 5-11 officially started vaccinating throughout Brazil on Monday (January 17), exactly one year after the start of vaccination in the country. More than 79% of the Brazilian population are in favour of immunising children, while 17% reject the vaccination of this age group, according to a survey released on Sunday by the Datafolha Research Institute, belonging to Grupo Folha, which publishes one of the largest newspapers in the country. The rate of people against it is higher among the age group 35-44 (22%), those who completed high school (21%), and the richest in the country (28%).

Another survey by the Datafolha Institute, released on January 15, revealed that the volume of Brazilians who claim to have contracted the novel coronavirus is twice the official records. According to the study, 1 in 4 Brazilians aged 16 or over says they have been diagnosed with COVID-19 since the beginning of the pandemic, which represents about 42 million infected people. Approximately 25% of respondents said they had been tested to confirm SARS-CoV-2 infection. According to data collected from the states by a consortium of press vehicles that monitors the pandemic, the registered cases reach another 22.8 million.

Another survey released on January 18 by the Datafolha Institute shows that 81% of the Brazilians are in favour of presenting proof of vaccination against COVID-19 when entering closed places, such as offices, bars, restaurants, and concert halls. Only 18% are against charging for the "vaccination passport".

Brazil is facing the worst moment of contagion since the beginning of the pandemic. The moving average of cases reached 77,200 daily cases. Compared to the previous 14 days, this is an increase of 662%. In total, the country has 23,083 officially registered cases of the new coronavirus and 621,261 deaths from the disease, according to data from the consortium of vehicles that monitor the pandemic. The effects of a cyber attack on the Ministry of Health's systems still impact official data.

Until Sunday, 68.25% of the population have been fully vaccinated (146,615,093). A reported 75.43% have had a first dose (162,045,04 people). The booster dose was given to 33,853,750 people, which corresponds to 15.76% of the population. 

In Africa the cases decreased last week (190,000, 27% less) and so did the number of deaths (2000, a decrease of 4%). Morocco still has closed borders. In South Africa, only 8 weeks after researchers first identified the new Omicron variant, the country's wave of infections has fallen as sharply as it climbed. Nevertheless, vaccinations remain low. Just around 10% of Africa’s population has been fully vaccinated. Vaccine supplies to the continent have improved recently, and WHO is stepping up its support to countries to effectively deliver doses to the wider population.

Australia reported a record number of 74 daily COVID-19 deaths on January 18. Of these, 36 were reported in the state of New South Wales. The previous daily record was 59 deaths reported on September 4, 2020.

China has reported its first case of Omicron in the capital Beijing, less than 3 weeks before the start of the Winter Olympics. Restrictions have been also implemented in the city of Zhuhai after discovery of seven Omicron cases. 

Japan is set to impose tougher restrictions on dining and gathering in 13 regions of the country, including Tokyo from January 21 to February 13. The country reported a record number of 32,087 daily COVID-19 cases on January 19.

Hong Kong is set to cull 2000 hamsters, after several rodents at a pet store imported from the Netherlands were found be infected with COVID-19. The city will also restrict the sale of hamsters and the import of small mammals.

India reported 282,970 cases on January 19, the highest daily count in more than 8 months. The overall peak level of infections could be weeks away; however, the country's largest cities, Mumbai and Delhi have reportedly reached their peak and cases are now on the decline.

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

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