The number of new cases per week has remained stable at 2 million for the past three weeks (Figure 1),with the cumulative total of over 34.8 million cases. Over 1 million deaths have now been reported globally, of which the majority were reported in the Region of the Americas (55%), followed by Europe(23%). In the past week, the regions of the Americas, South-East Asia, and Europe account for 91% of new cases. Five countries (namely India, the United States of America, Brazil, Argentina and France)reported 60% of new global cases this past week, while Israel registered the highest incidence (3717 new cases per 1 million population). Globally, the highest percentage of cases have been reported in the25-39 age group, with approximately 50% of cases in the 25-64 age group. However, the percentage of deaths increases with age, and approximately 75% of deaths are in those aged 65 years and above.
Although globally the number of new cases was similar to the number of cases in the previous week, there is considerable variation on a country- by-country basis. In several countries, the number of new cases is rising again, and in many (most notably within the European Region) the second wave is exceeding previous peaks; this can be partly attributed to enhancements in surveillance capacities overtime. In other countries we have seen a gradual decline in new cases from earlier peaks in August, for example in Brazil, Colombia and Peru. In India and the Philippines, the number of new cases appear to have stabilized, but they are still reporting high numbers. There are also examples of countries that have consistently shown an increasing incidence as their first wave continues; these include Indonesia, Iraq, and Myanmar, although Indonesia is reporting a slight drop this week. South Africa and Australia are examples of countries that have successfully managed to reduce the number of new cases and have seen large reductions from earlier peaks.
South Africa and Ethiopia continue to report the highest numbers of new cases in Africa, followed by Mozambique, Uganda, and Nigeria. Africa has seen a continuous decline in case incidence since mid-July; however, this trend is now slowing (Figure 3). For the first week since early August, the number of new deaths has risen – led by South Africa with a 29% increase in deaths in the past week. South Africa also has the second- highest mortality rate in the Region – 11 461 deaths per 1 million population. The provinces of Gauteng and the Western Cape have reported the most cases and deaths to date; however, these regions, as well as the country itself, have maintained sustained declines in the daily incidence since the end of July. Despite this, weekly case numbers have continued to rise in less populated provinces. The country moved to Alert Level 1 as of 21 September (the least strigent of the five alert levels applied by the South African Goverment), with all sectors of the economy now open with strict adherence to public health protocols. A WHO surge team of experts, including infectious disease specialists and epidemiologists, is currently in South Africa, and is continuing to work with the National Department of Health. New weekly cases have risen in Angola from 400 in the week of 7 September to 698 cases in the past week, a 74% increase, although the number of new cases has declined by 10% from the past week. Angola recently upgraded their self-reported transmission classification from ‘clusters of cases’ to ‘community transmission’. Luanda province remains the epicentre with around 90% of all cases. A total of 16 out of the 18 provinces have reported confirmed cases. WHO has trained around 90 community health mobilizers now operating across Luanda.
A similar incidence of new cases was reported across the Region over the past week (Figure 4) in comparison to previous week. The United States of America, Brazil, Argentina, Colombia, Mexico and Peru registered the highest number of weekly new cases. The United States of America continues to record approximately 300 000 new cases per week (894 new cases per 1 million population). Declines observed over July and August have stagnated in recent weeks, with several states reporting sharp rises in case numbers – most notably in Midwest states. Canada is also showing a large increase in new cases and new deaths compared with last week, at 43% and 208%respectively. Likewise, Argentina continues to report an increase in cases and deaths, with cumulative deaths exceeding 20 000 last week after a backlog of over 3000 reported deaths from Buenos Aires. Since peaking at just over 300 000 new weekly cases in the week of 27 July, new cases in Brazil have fallen to 190 000 new cases in the past week (898 new cases per 1 million population). Weekly new cases have also fallen in Colombia and Peru. In the Region of the Americas, as in other Regions, older persons are far more likely to experience severe disease following infection. Brazil reported that 76% of COVID-19 related deaths during February to September 2020 were in adults aged 60 years and older. In Peru, people over the age of 70 years had the highest COVID-19 mortality rates during March-May 2020 and estimates from Canada show that more than 80% of COVID-19 deaths have occurred in long-term-care facilities. WHO has published guidance on Preventing and managing COVID-19 across long-term care services with an annex providing a comprehensive set of actions for policymakers, national and local decision-makers and other actors.
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