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Update on Global Pandemic for Week Ending April 18

Number of Cases Worldwide

As of April 18, the worldwide statistics for COVID-19 pandemic as reported by Worldometer were:

- Total reported cases: 2,287,323. This is 526,739 more than the total reported on April 11 of 1,760,584.

- Total active cases: 1,544,017. This is 286,462 more than the number reported on April 11 of 1,257,555.

- Closed cases: 743,306. This is 233,509 more than the number reported on April 11 of 509,797.

- Deaths: 157,468. This is 55,983 more deaths than on April 11, when the toll was 101,485.

- Recovered: 585,838. This is 190,434 more recoveries than on April 11, when the number was 395,404.

There were 86,496 new cases from April 16 to 17. This compares to the one-day increase in cases from April 9 to 10 of 94,625.

The disease was present in 210 countries and territories, as was the case the week prior. Of these, 79 had less than 100 cases, as compared to April 11, when there were 83 countries with less than 100 cases.

The five countries with the highest number of cases on April 18 are noted below, accompanied by the number of cases and deaths per million population, which permit a more direct comparison between countries, as well as figures from the previous week on April 11:

USA: 715,105 (613,375 active; 63,841 recovered; 37,889 deaths)
- 2,160 cases per million; 114 deaths per million
- April 11: 521,714 (473,070 active; 28,580 recovered; 20,064 deaths) and 1,519 cases per million population; 57 deaths per million population

Spain: 191,726 (96,886 active; 74,797 recovered; 20,043 deaths)
- 4,101 cases per million; 429 deaths per million
- April 11: 158,273 (86,524 active; 55,668 recovered; 16,801 deaths) and 3,385 cases per million; 344 deaths per million

Italy: 175,925 (107,771 active; 44,927 recovered; 23,227 deaths)
- 2,910 cases per million; 384 deaths per million
- April 11: 147,577 (98,273 active; 30,455 recovered; 18,849 deaths) and 3,605 cases per million; 302 deaths per million

France: 147,969 (94,868 active; 34,420 recovered; 18,681 deaths)
- 2,267 cases per million; 286 deaths per million
- April 11: 124,869 (86,740 active; 24,932 recovered; 13,197 deaths) and 1,913 cases per million; 202 deaths per million

Germany: 142,569 (52,764 active; 85,400 recovered; 4,405 deaths)
- 1,702 cases per million; 53 deaths per million
- April 11: 122,171 (65,522 active; 53,913 recovered; 2,736 deaths) and 1,458 cases per million; 33 deaths per million

The U.S. remains far and away the country with the highest number of cases since achieving this dubious distinction about three weeks ago. Europe, as a whole has about half the worldwide reported cases with about 1,029,214 and overall remains the worst hit region.

Cases in Top Five Countries by Region

In Europe on April 18, the country with the fifth highest number of reported cases after the four listed above, is the UK:

UK: 114,217 (98,409 active; recovered NA; 15,464 deaths)
- 1,682 cases per million; 228 deaths per million
- April 11: 73,758 (64,465 active; 344 recovered; 8,958 deaths)
- 1,086 cases per million; 132 deaths per million

Beyond the countries with the highest number of reported cases, other statistics that show the rate of infection and death relative to population show that Belgium, a country of 11.46 million people which, as of April 18, reports 3,208 cases per million and 475 deaths per million, is also relatively hard hit. Switzerland, with 8.65 million people, is also among the European countries with the highest infection and death rates.

This week Austria became one of the first European countries to relax its coronavirus measures. News agencies report that with the number of new infections stabilizing, thousands of shops nationwide reopened their doors on April 14 following a one-month lockdown. Small businesses, as well as hardware and gardening stores, are allowed to reopen "but all shoppers are required to wear masks and maintain social distance." Shopping centres, larger stores and hairdressers are set to reopen from May 1, while restaurants and hotels could resume progressively from mid-May, Chancellor Sebastian Kurz said. Austria's modified lockdown is in place until the end of April. The number of active cases in Austria peaked on April 3 with 9,334 and as of April 17 the total number of reported cases is 14,595.

In Spain, where the number of active cases is said to have  nearly plateaued, Prime Minister Pedro Sanchez on April 13 allowed some workers to return to work, with police and the Red Cross handing out face masks at train stations to commuters, news agencies report. Only a few commuters were seen using Madrid's usually busy public transport, news agencies report. "Some workers in factories and the construction industry were permitted to resume work as the Spanish government looked to restart manufacturing," they report. Retail shops and services are still required to remain closed and white-collar workers still have to work from home. "Experts warned that many companies don't have access to enough health equipment to protect employees." Shops, bars and public spaces are scheduled to stay closed until at least April 26.

In Italy, the government is said to have decided to ease restrictions -- while still requiring the same social-distancing and sanitary measures -- after it saw a decline in the number of day-to-day infections, which reached 6,557 cases on March 21 and is now at just under 3,000. The country officially is under a nationwide lockdown until May 4 but news agencies report that bookshops, stationery stores and shops selling baby clothes were allowed to reopen on a trial basis on April 14. Some regional leaders, however, have opted to keep bookstores and stationery shops closed, including the hard-hit northern regions of Lombardy and Piemonte.

In France, where the rate of daily infections has yet to peak, President Emmanuel Macron announced on April 13 that the country's lockdown would be extended until May 11, saying that "There is new hope but nothing is won at the moment [...] the epidemic is not under control." From May 11, daycares, schools, colleges and lycées will be "progressively opened" as a priority, he said. However, restaurants, cafes, hotels, museums and cultural sites must stay closed and large festivals and events may only be allowed after mid-July.

In Scandinavia, Denmark reopened daycare centres and schools for children from first to fifth grades on April 15. The number of active cases in Denmark peaked on April 10 at 3,799. The rate of new daily cases has been under 200 since April 10, down from a high of 390 on April 7.

In contrast, on April 16, Britain extended its lockdown period another three weeks until May 7. People must stay at home unless they are shopping for basic necessities, or meeting medical needs. They are allowed to exercise in public once a day, and can travel to work if they are unable to work from home.

The European Commission called on EU countries to coordinate coronavirus exit plans to avoid flareups. German Foreign Minister Heiko Maas suggested that a single smartphone app can be used across the European Union to assist member states coordinate when and how to ease coronavirus lockdown rules and ensure safer measures across the bloc.

"It's important we don't end up with a patchwork of 27 coronavirus apps and 27 data protection regimes, but coordinate as best as possible," Maas said in an interview on April 14 with Germany's Funke media group. He said such an app would help ease travel and border closures across the EU and also safeguard personal privacy.

In Eurasia on April 17:

Turkey: 78,546 (68,146 active; 8,631 recovered; 1,769 deaths)
- 931 cases per million; 21 deaths per million
- April 10: 42,282 (39,232 active; 2,142 recovered; 908 deaths) and 501 cases per million; 11 deaths per million

Russia: 32,008 (29,145 active; 2,590 recovered; 273 deaths)
- 219 cases per million; 2 deaths per million
- April 10: 11,917 (11,028 active; 795 recovered; 94 deaths) and 82 cases per million; 0.6 deaths per million

Kazakhstan: 1,546 (1,182 active; 258 recovered; 5 deaths)
- 82 cases per million; 0.9 deaths per million
- April 10: 764 (697 active; 60 recovered; 7 deaths) and 43 cases per million; 0.5 deaths per million

Azerbajian: 1,340 (1,064 active; 174 recovered; 66 deaths)
- 132 cases per million; 1 death per million
- April 10: 991 (822 active; 159 recovered; 10 deaths) and 98 cases per million; 1 death per million

Armenia: 1,201 (780 active; 402 recovered; 19 deaths)
- 405 cases per million; 6 deaths per million
- April 10: 937 (776 active; 149 recovered; 12 deaths) and 316 cases per million; 4 deaths per million

The number of cases in Turkey has risen considerably in the last week, with a total number of reported cases nearing that of Iran and China, two countries with among the highest number of cases. On April 16, Turkey reported 4,801 cases in the previous 24 hours, the second highest in the world, surpassed only by the U.S. with 5,603 in that same period.

Sinan Adiyaman, head of the Turkish Medical Association (TBB), warned that, in contrast to the Turkish Ministry of Health's claims that the infection rate is stabilizing, the scale of the outbreak remained unclear because diagnostic tests only had 55-60 per cent accuracy rates and many patients had died with COVID-19 symptoms, but had been excluded from the death toll.

"We receive information based on our members' observations from across the country that the figures for cases and deaths are far higher," Adiyaman said.

The World Health Organization (WHO) said on April 14 that outbreaks were growing in Britain and Turkey.

"In fact, the WHO prediction is more accurate for Turkey. Because it is too early to say that we have taken control yet, even though health care professionals are working devotedly," Adiyaman said.

In West Asia on April 17:

Iran: 79,494 (20,472 active; 54,064 recovered; 4,958 deaths)
- 946 cases per million; 59 deaths per million
- April 10: 68,192 (28,495 active; 35,465 recovered; 4,232 deaths) and 812 cases per million; 50 deaths per million

Israel: 12,982 (9,705 active; 3,126 recovered; 151 deaths)
- 1,500 cases per million; 17 deaths per million
- April 10: 9,968 (8,871 active; 1,011 recovered; 86 deaths) and 1,166 cases per million; 11 deaths per million

Saudi Arabia: 7,142 (6,006 active; 1,049 recovered; 87 deaths)
- 205 cases per million; 2 deaths per million
- April 10: 3,287 (1,663 active; 351 recovered; 25 deaths) and 105 cases per million; 1 death per million

UAE: 5,825 (4,695 active; 1,095 recovered; 35 deaths)
- 589 cases per million; 4 deaths per million
- April 10: 2,659 (2,408 active; 239 recovered; 12 deaths) and 302 cases per million; 1 death per million

Qatar: 4,663 cases (4,192 active; 464 recovered; 7 deaths)
- 1,619 cases per million; 2 deaths per million
- April 10: 2,376 (2,164 active; 206 recovered; 6 deaths) and 872 cases per million; 2 deaths per million

In South Asia on April 17:

India: 13,385 (11,606 active; 1,777 recovered; 452 deaths)
- 10 cases per million; 0.3 deaths per million
- April 10: 6,725 (5,879 active; 620 recovered; 226 deaths) and 5 cases per million; 0.2 cases per million

Pakistan: 7,025 (5,125 active; 1,765 recovered; 135 deaths)
- 32 cases per million; 0.6 deaths per million
- April 10: 6,495 (5,702 active; 727 recovered; 66 deaths) and 29 cases per million; 0.3 deaths per million

Bangladesh: 1,838 (1,705 active; 58 recovered; 75 deaths)
- 11 cases per million; 0.5 deaths per million
- April 10: 424 (364 active; 33 recovered; 27 deaths) and 3 cases per million; 0.2 deaths per million

Afghanistan: 906 (777 active; 99 recovered; 30 deaths)
- 23 cases per million; 0.8 deaths per million
- April 10: 521 (474 active; 32 recovered; 15 deaths) and 13 cases per million; 0.4 deaths per million

Sri Lanka: 244 (160 active; 77; 7 deaths)
- 11 cases per million; 0.3 deaths per million
- April 10: 190 (129 active; 54 recovered; 7 deaths) and 9 cases per million; 01. deaths per million

In Southeast Asia on April 17:

Indonesia: 5,923 (4,796 active; 607 recovered; 520 deaths)
- 22 cases per million; 2 deaths per million
- April 10: 3,293 (2,761 active; 252 recovered; 280 deaths) and 13 cases per million; 1 death per million

Philippines: 5,878 (5,004 active; 487 recovered; 387 deaths)
- 54 cases per million; 4 deaths per million
- April 17: 4,076 (3,749 active; 124 recovered; 203 deaths) and 38 cases per million; 2 deaths per million

Malaysia: 5,251 (2,198 active; 2,967 recovered; 86 deaths)
- 162 cases per million; 3 deaths per million
- April 10: 4,346 (2,446 active; 1,830 recovered; 70 deaths) and 134 cases per million; 2 deaths per million

Singapore: 5,050 (4,331 active; 708 recovered; 11 deaths)
- 863 cases per million; 2 deaths per million
- April 10: 2,108 (1,444 active; 492 recovered; 7 deaths) and 360 cases per million; 1 death per million

Thailand: 2,700 (964 active; 1,689 recovered; 47 deaths)
- 39 cases per million; 0.7 deaths per million
- April 17: 2,473 (1,427 active; 1,013 recovered; 33 deaths) and 35 cases per million; 0.5 deaths per million

Indonesia experienced a relatively sharp increase in COVID-19 infections, surpassing the Philippines and Malaysia in the past week to now have the most cases in the region. Reuters reported that on April 17 "an Indonesian official said the number of cases could reach 106,000 by July and follows criticism that a low rate of testing has hidden the extent of the spread of the virus.

"Indonesia has accelerated testing and Achmad Yurianto, a health ministry official, said on [April 17] 42,000 tests had been performed, up about three-fold in two weeks.

"'Transmission is still occurring. This has become a national disaster,' Yurianto told a televised broadcast [...]"

NPR reports that "Indonesia, which is the world's fourth most populous country, did not confirm its first cases until March 2. Since then, cases have grown exponentially and on a daily basis, spreading to all 34 provinces across an archipelago of some 17,000 islands. Still, the first lockdown orders weren't issued until over a month later, and the restrictions only applied to the Jakarta capital region and its population of some 30 million.

"This week, President Joko Widodo expanded the restrictions to some other parts of the country. He also advised the public to stay home during the Muslim holy month of Ramadan, which starts later in April. [... An] estimated 19.5 million people traveled for the Eid al-Fitr holiday marking the end of Ramadan last year, according to Bloomberg News."

Singapore, which at the beginning of the pandemic was being lauded as a model country for containment of the outbreak, has seen a rapid increase in cases since April 10. It recorded an all-time high number of new cases on April 16 with 728, whereas the daily rate of new cases had been under 100 until April 4. The vast majority of new cases are amongst foreign workers who live in cramped and substandard living conditions. In data posted by Singapore's Ministry of Manpower in 2019, there were 1,399,600 foreign workers in the country, almost 25 per cent out of a total population of 5.7 million.

On March 22, the group Transient Workers Count Too warned that employers' practices were leaving foreign workers vulnerable to infection. The group stated:

"With COVID-19 now expected to be a danger for many more months, preparedness for various scenarios is key. One possibility is that a cluster breaks out at a foreign worker dormitory.

[...]

"Currently, foreign workers are housed 12 to 20 men per room in double-decker beds. They are transported to work on the back of lorries sitting shoulder to shoulder. Neither of these conditions conforms with social distancing.

"The risk of a new cluster among this group remains undeniable."

The group also reported that some employers impose large fines if workers do not show up for work, while others refuse to grant time off for more than one or two days for medical reasons.

The Guardian reported on April 17 that "Nine dormitories, the biggest of which holds 24,000 men, have been declared isolation units by officials, while all other buildings accommodating the city-state's 300,000 [construction] workers have been placed under effective lockdown. The restrictions, an attempt to reduce further transmission, have left the dormitories even more crowded than usual as only essential workers are permitted to leave."

Regarding living conditions, the Guardian reports that "While migrants were being served food so that they did not use shared kitchens, the quality of meals was poor and lacking in nutrition. In some cases 100 men were sharing five toilets and five showers."

Mohan Dutta, a professor at Massey University in New Zealand, who has interviewed 45 migrant workers in Singapore since the outbreak began, said many feared an outbreak was inevitable due to the conditions. "Participants told me that even up until Monday [April 13] they don't have access to soap and adequate cleaning supplies," he said.

In East Asia on April 17:

China: 82,692 (116 active; 77,944 recovered; 4,632 deaths)
- 57 cases per million; 3 deaths per million
- April 10: 81,907 (1,160 active; 77,370 recovered; 3,335 deaths) and 57 cases per million; 2 deaths per million

South Korea: 10,635 (2,576 active; 7,829 recovered; 230 deaths)
- 207 cases per million; 4 deaths per million
- April 10: 10,450 (3,125 active; 7,117 recovered; 208 deaths) and 204 cases per million; 4 deaths per million

Japan: 9,231 (8,106 active; 935 recovered; 190 deaths)
- 73 cases per million; 2 deaths per million
- April 10: 5,530 (4,746 active; 685 recovered; 99 deaths) and 44 cases per million; 0.8 deaths per million

Taiwan: 395 (223 active; 166 recovered; 6 deaths)
- 17 cases per million; 0.3 deaths per million
- April 10: 382 (285 active; 91 recovered; 6 deaths) and 16 cases per million; 0.3 deaths per million

China's Hubei Province on April 17 issued a "Notice on the Correction of the Number of New Coronary Pneumonia Cases Diagnosed and the Number of Diagnosed Deaths in Wuhan" in which it reported 1,290 additional deaths that had not been previously counted and reported, bringing the total number of deaths in Wuhan from 2,579 to 3,869, an increase of 50%, as the result of a revision by the Wuhan New Coronary Pneumonia Epidemic Prevention and Control. As part of this revision, 325 additional cases in Wuhan were also added. Separately, China's National Health Commission (NHC) reported 26 new cases (and no deaths) in its daily report.

Japan is the exception to the overall trend of very limited numbers of new cases in East Asia. The number of cases in Japan nearly doubled in the past week, while Prime Minister Shinzo Abe declared a nationwide state of emergency on April 16 until at least May 6, upgraded from April 8, when a state of emergency was declared in six out of 47 prefectures. Yasutoshi Nishimura, the minister in charge of Japan's emergency measures, said expanding the state of emergency to the whole country was "necessary" before the Golden Week holidays that start in late April. These are four national holidays that fall within the space of seven days, the last of which is on May 6.

On April 17, the government announced that it will offer a cash payment of 100,000 yen (U.S.$930) to every resident. Finance Minister Taro Aso said the government hoped to start payments in May.

Deutsche Welle reported on April 15 that "Nine of Japan's 47 prefectures are close to filling all the emergency hospital beds set aside for coronavirus cases, according to national broadcaster NHK, including Tokyo, Osaka, Hyogo and Fukuoka [...].

"The city government of Osaka on [April 14] issued a plea for residents to donate waterproof coats to hospitals as health workers are running out of protective clothing, an indication that the coronavirus is spreading faster than anticipated and provoking further criticism of the central government's response. [...] Osaka Mayor Ichiro Matsui said doctors and nurses at a number of hospitals are forced to wear trash bags when they treat patients. The city has requested donations of unused raincoats and asked local manufacturers of similar clothing to step up production and sell equipment to the city at fair market rates."

In North America on April 18:

USA: 715,105 (613,375 active; 63,841 recovered; 37,889 deaths)
- 2,160 cases per million; 114 deaths per million
- April 11: 521,714 (473,070 active; 28,580 recovered; 20,064 deaths) and 1,519 cases per million population; 57 deaths per million population

Canada: 32,412 (20,523 active; 10,543 recovered; 1,346 deaths)
- 859 cases per million; 36 deaths per million
- April 11: 22,148 (15,566 active; 6,013 recovered; 569 deaths) and 587 cases per million; 15 deaths per million

Mexico: 6,875 (4,204 active; 2,125 recovered; 546 deaths)
- 53 cases per million; 4 deaths per million
- April 11: 3,441 (2,614 active; 633 recovered; 194 deaths) and 27 cases per million; 2 deaths per million

Despite the terrible levels of infection and deaths in the U.S., widespread layoffs in the medical system are taking place, due to the private profit motive on which the system is based. The New York Times reported on April 3, "As hospitals across the country brace for an onslaught of coronavirus patients, doctors, nurses and other health care workers -- even in emerging hot spots -- are being furloughed, reassigned or told they must take pay cuts.

"The job cuts, which stretch from Massachusetts to Nevada, are a new and possibly urgent problem for a business-oriented health care system whose hospitals must earn revenue even in a national crisis. Hospitals large and small have canceled many elective services -- often under state government orders -- as they prepare for the virus, sending revenues plummeting.

"That has left trained health care workers sidelined, even in areas around Detroit and Washington, where infection rates are climbing, and even as hard-hit hospitals are pleading for help.

[...]

"[T]he Department of Veterans Affairs is scrambling to hire health care workers for its government-run hospitals, especially in hard-hit New Orleans and Detroit, where many staff members have fallen ill. The department moved to get a federal waiver to hire retired medical workers to beef up staff levels.

"But even as some hospitals are straining to handle the influx of coronavirus patients, empty hospital beds elsewhere carry their own burden.

[...]

"Governors in dozens of states have delivered executive orders or guidelines directing hospitals to stop non-urgent procedures and surgeries to various degrees. Last month, the United States surgeon general, Dr. Jerome M. Adams, also implored hospitals to halt elective procedures.

"That has left many health systems struggling to survive."

USA Today reported on April 2 that "By June, an estimated 60,000 family practices will close or significantly scale back, and 800,000 of their employees will be laid off, furloughed or have their hours reduced as they see a decline in business during the coronavirus pandemic, according to a HealthLandscape and American Academy of Family Physicians report released [April 2].

"That represents 43 per cent of the nearly 1.9 million people employed at family medicine offices, including receptionists, medical assistants, nurses, physicians, billing staff and janitors.

"The figure doesn't include reductions at hospitals and specialty clinics that also feel the pinch."

The Washington Post reported on April 9 that "Remaining front-line workers face longer hours, and some have seen their pay cut and benefits reduced.

"For hospitals already in bad financial shape before the outbreak, the loss of income has raised doubts about their ability to keep treating patients.

[...]

"These experiences reflect the losses across the entire health-care system given the cancellation of nonessential procedures, analysts said. A typical hospital system with 1,000 beds and the ability to perform outpatient surgeries is predicted to lose around $140 million -- half its operating revenue -- over a three-month period, the Advisory Board, a consulting firm, reported this week.

"Further complicating problems has been the need to finance the purchase of additional equipment to protect staff and prepare for coronavirus patients.

"Facilities have spent large sums to create negative air pressure rooms, so infected patients can be effectively isolated from those who have not contracted the virus. Many have also set up drive-through clinics and tent facilities, further depleting their coffers, the [Inspector General of the Department of Health and Human Services] found [in an April 3 report].

[...]

"As part of the stimulus package enacted last month, the federal government has allocated $100 billion to hospitals and some other health providers to help offset lost income, pay for the construction of temporary facilities and retrofits and to buy equipment and supplies.

"But health-care executives and analysts doubt that will be sufficient. That $100 billion pot is about equal to total hospital industry revenue per month, according to the Advisory Board. Hospitals expect to be treating COVID-19 patients for several months to come."

In Central America and the Caribbean: on April 17:

Panama: 4,016 (3,809 active; 98 recovered; 109 deaths)
- 931 cases per million; 25 deaths per million
April 10: 2,752 (2,670 active; 16 recovered; 66 deaths) and 638 cases per million; 15 deaths per million

Dominican Republic: 3,755 (3,344 active; 215 recovered; 196 deaths)
- 346 cases per million; 18 deaths per million
- April 10: 2,620 (2,396 active; 98 recovered; 126 deaths) and 242 cases per million; 12 deaths per million

Cuba: 862 (664 active; 171 recovered; 27 deaths)
- 76 cases per million; 2 deaths per million
April 10: 565 (498 active; 51 recovered; 15 deaths) and 50 cases per million; 1 death per million

Costa Rica: 642 (564 active; 74 recovered; 4 deaths)
- 126 cases per million; 0.8 deaths per million
- April 10: 539 (506 active; 30 recovered; 3 deaths) and 106 cases per million; 0.6 deaths per million

Honduras: 442 (391 active; 10 recovered; 41 deaths)
- 45 cases per million; 4 deaths per million
- April 10: 382 (352 active; 7 recovered; 23 deaths) and 39 cases per million; 2 deaths per million

Cuba now has 21 medical brigades, comprised of some 1,200 people, assisting the local efforts of 20 countries in Europe, Africa, the Middle East and Latin America and the Caribbean fight the pandemic.  At the same time the U.S. blockade continues to impact Cuba's capacity to look after the well-being of its people. The Director General of Latin America and the Caribbean of the Cuban Ministry of Foreign Relations, Eugenio Martínez Enríquez, reported in his official Twitter account that the U.S. company Vyaire Medical Inc. bought IMT Medical and Acutronic, the supplier of ventilators to Cuba, and announced the suspension of ties with Cuba, because "the corporate guideline we have today is to suspend all commercial relations with Medicuba."

The Vice President of Medicuba Luis Silva reported that Cuba tried to acquire medicine and supplies with 60 firms in the U.S. of which only two replied, including Bayer, with which an agreement was signed that could not be executed, due to the prohibition issued by the U.S. Treasury Department, with the justification that, supposedly, its licence to do so had expired.

On April 1, Cuba's Ambassador to China, Carlos Miguel Pereira, denounced that the blockade had prevented the Chinese company Alibaba from bringing humanitarian aid to Cuba to fight COVID-19. On March 22, Jack Ma, founder of Alibaba and the foundation that bears his name, announced that 2 million masks, 400,000 rapid diagnostic kits and 104 respirators would be sent, in addition to equipment such as gloves and protective suits, to 24 countries in Latin America, including Cuba. However, as Ambassador Pereira noted, the U.S. transport company declined to fulfill its contract at the last minute using the argument that the regulations that comprise the economic, commercial and financial blockade imposed against the destination country, prevented it from doing so.

Cubans have not forgotten that in 1981, a major epidemic of dengue hemorrhagic fever hit Cuba, which it attributed to U.S. biological warfare, that killed 158 people, 101 of them children. The impossibility of acquiring fumigation equipment from the United States on time caused a greater delay in controlling the disease, resulting in a significant increase in the number of cases and deaths.

The fact that the blockade continues to endanger Cuban lives, especially during a global pandemic, underscores the criminal and genocidal nature of the U.S. blockade and the urgency that it be brought to an end immediately.

To that end, the Caribbean Community (CARICOM) nations were convened by Barbados for an emergency videoconference meeting on April 15 where they called for U.S. sanctions on Venezuela and Cuba to be lifted, saying "All countries must be part of the global effort to combat COVID-19." CARICOM also condemned the U.S. decision to suspend its funding of the WHO: "It is unfortunate that the resources of the WHO are under threat, in days that demand unity in leading the fight against the pandemic."

The health situation, food security and protection of the elderly from disease in the region were also addressed. In general, "the region has responded quite well to the pandemic," the Caribbean Public Health Agency Executive Director Dr. Joy St. John said at the meeting. According to Dr. St. John, the early implementation of measures in the region helped to contain the virus. But a more coordinated approach is needed to address the next phase of the pandemic.

CARICOM will consider a proposed protocol on the reopening of borders. Once the decision is taken, all Member States will at the same time adhere to this proposal. The countries also agreed that the inter-regional transport of people and goods by air and sea will also be scrutinized, making particular reference to the operations of regional air carriers.

In South America on April 17:

Brazil: 30,891 (14,913 active; 14,026 recovered; 1,954 deaths)
- 145 cases per million; 9 deaths per million
- April 10: 18,397 (17,250 active; 173 recovered; 974 deaths) and 87 cases per million; 5 deaths per million

Peru: 12,491 (6,097 active; 6,120 recovered; 274 deaths)
- 379 cases per million; 8 deaths per million
- April 10: 5,897 (4,159 active; 1,569 recovered; 169 deaths) and 179 cases per million; 5 deaths per million

Chile: 8,807 (5,403 active; 3,299 recovered; 105 deaths)
- 461 cases per million; 5 deaths per million
- April 10: 6,501 (4,865 active; 1,571 recovered; 65 deaths) and 340 cases per million; 3 deaths per million

Ecuador: 8,225 (6,984 active; 838 recovered; 403 deaths)
- 466 cases per million; 23 deaths per million
- April 10: 7,161 (4,354 active; 339 recovered; 272 deaths) and 406 cases per million; 17 deaths per million

Colombia: 3,233 (2,539 active; 550 recovered; 144 deaths)
- 64 cases per million; 3 deaths per million
- April 10: 2,223 (1,980 active; 174 recovered; 69 deaths) and 44 cases per million; 1 death per million

There has been a sharp increase in the number of cases in Peru in the past week, giving it the second highest number of cases in the region in the past week, displacing Ecuador, where despite a relatively small increase in the number of cases in the past week, the number of active cases and deaths continues to rise. Ecuador has by far the highest rate of deaths per million in the region at 23. This number reflects official reports that for weeks have been widely believed to be a gross underestimate, given the collapse of the hospital and undertaking/funeral services in the hard-hit port city of Guayaquil in Guayas province, with bodies remaining for days in the homes where people have died.

It was reported this week that in the province of Guayas there were over 5,000 deaths that could be related to COVID-19, given that in the first two weeks of April government figures showed there were 6,700 people who died in the province, far more than the average 1,000 deaths that usually occur during that period of time.  

In refuting the official figures that continue to be reported, the mayor of Guayaquil, Cynthia Viteri has said that patients continue to die without ever having been tested, and that there is no space, time or resources to be able to do further tests and know whether or not they died of coronavirus. She also indicated that in March there were 1,500 more deaths in the city than in the same period during 2019.

Another alarming fact is that more than 70 doctors are reported to have succumbed to the virus in Guayas.

Under the government of Lenin Moreno Ecuador's health care system has been subjected to draconian funding cuts and privatization, with the country's 2019 health care budget being reduced by 36 per cent compared to 2018. In addition the program that received the largest "investment" in the sector was one dedicated to a restructuring of health care by getting rid of public employees in the system. This privatization initiative exceeded investments in badly needed infrastructure and equipment maintenance, contributing to the catastrophe being witnessed today.

As if this were not enough, the Moreno government saw fit to pay U.S.$324 million on the country's external debt in the midst of the pandemic rather than investing in its debilitated health care system to save lives.

The underreporting of cases and deaths is not unique to Ecuador, but characterizes other countries in the region with neo-liberal governments, many of them brought to power in foreign-backed coups of one type or another to dismantle existing public services as in the case of Brazil and Bolivia, or kept in power with foreign backing to shore up traditional privatized systems of health care, education and others through corruption and force, as in Chile and Colombia.

In many of these countries doctors and nurses have been holding public protests over the lack of even basic PPE and other desperately needed resources to be able to treat their patients. In an open letter, the Colombian Medical Federation, the Colombian Association of Scientific Societies, the Colombian Medical College and the Federation of Medical Unions said they would no longer work with Health Minister Fernando Ruiz over his mishandling of the crisis, and urged state governors to ignore President Ivan Duque's plan to lift the quarantine prematurely. They also have said they will not obey the government's labour decree forcing doctors and nurses to work without any measures in place to protect them, saying they would abide by the oath they took when they graduated, but that nobody could force them to commit suicide.  

Adding to the region's problems, the Pan-American Health Organization reports there have been over a million cases of dengue fever, a mosquito-borne disease that is sometimes lethal, throughout the Americas. Most of the cases are in Brazil and Paraguay, far surpassing the number reported for the same period last year. Other countries affected include Bolivia and Colombia. 

In Venezuela, President Nicolás Maduro stated on April 15 that his administration aims to carry out 10 million tests for COVID-19, "with the help of the World Health Organization, the Pan American Health Organization, China, Russia, Iran, and Cuba." He added that Venezuela has carried out 250,123 tests so far and has the interim goal of performing one million tests.

On April 14, Communication Minister Jorge Rodriguez reported that Venezuela has conducted the most screening for COVID-19 in Latin America, figures which are verified by Johns Hopkins University.

As of April 17, Venezuela has 204 cases (84 active; 111 recovered; 9 deaths), with a rate of 7 cases per million and 0.3 deaths per million.

In Africa on April 17:

Egypt: 2,673 (1,881 active; 596 recovered; 196 deaths)
- 26 cases per million; 2 deaths per million
- April 10: 1,699 (1,233 active; 348 recovered; 118 deaths) and 17 cases per million; 1 death per million

South Africa: 2,605 (1,654 active; 903 recovered; 48 deaths)
- 44 cases per million; 0.8 deaths per million
- April 10: 2,003 (1,569 active; 410 recovered; 24 deaths) and 34 cases per million; 0.4 deaths per million

Morocco: 2,528 (2,122 active; 273 recovered; 133 deaths)
- 68 cases per million; 4 deaths per million
- April 10: 1,448 (1,168 active; 109 recovered; 97 deaths) and 39 cases per million; 3 deaths per million

Algeria: 2,268 (1,137 active; 783 recovered; 133 deaths)
- 52 cases per million; 8 deaths per million
- April l0: 1,761 (1,100 active; 405 recovered; 256 deaths) and 40 cases per million; 6 deaths per million

Cameroon: 996 (810 active; 164 recovered; 22 deaths)
- 38 cases per million; 0.8 deaths per million
- April 10: 820 (710 active; 54 recovered; 12 deaths) and 31 cases per million; 2 deaths per million

As of April 17, there are 19,398 cases in Africa, roughly double the number of cases a week earlier. Egypt has overtaken South Africa with the highest number of cases in the past week,

On April 13, the African Union informed that "As part of the efforts to strengthen Africa's response and preparedness in combating the COVID-19 pandemic, the African Union Commission through the Africa Centres for Disease Control and Prevention (Africa CDC) and the United Nations Development Programme (UNDP) have jointly designed a program to support on-going efforts in Africa.

"The joint program aims to coordinate COVID-19 response to recovery efforts along with Member States, Regional Economic Communities and Regional Mechanisms (RECs/RMs) as well as Civil Society Organisations (CSOs) and Faith-based Organizations (FBOs) to ensure coordinated cooperation and communication and to adopt a holistic approach. The four joint interventions areas are:

- Regional coordination and building of synergies;
- Socio-economic, health, governance and political impact assessments;
- Capacity building and knowledge sharing;
- Risk communication strategies and sensitization campaigns;

"These areas are aligned with both the Africa CDC's mandate and the continental strategy on COVID-19 preparedness and response as well as the UNDP's regional approach on response to recovery.

"Specific focus on surveillance; laboratory; counter-measures guidance; health care preparedness; risk communications and social engagement; supply-chain management continues to be led by the Africa CDC."

Africa CDC on April 14 informed that "The first United Nations 'solidarity flight' left Addis Ababa, Ethiopia, today from where it will transport vital medical cargo to all countries in Africa, where supplies are desperately needed to contain the spread of COVID-19.

"The WHO cargo was transported by the United Nations World Food Programme (WFP), and includes face shields, gloves, goggles, gowns, masks, medical aprons, and thermometers, as well as ventilators.

"The cargo also includes a large quantity of medical supplies donated by the Ethiopian Prime Minister Abiy Ahmed and Jack Ma Foundation Initiative to reverse COVID-19 in Africa. The African Union, through the Africa Centres for Disease Control and Prevention (Africa CDC) is providing technical support and coordination for the distribution of the supplies."

WHO Director-General Dr. Tedros noted that "The Solidarity Flight is part of a larger effort to ship lifesaving medical supplies to 95 countries."

The WHO cargo includes one million face masks, as well as personal protective equipment, which will be enough to protect health workers while treating more than 30,000 patients across the continent.

The WHO Africa region reports that countries' experience dealing with Ebola and Influenza is being brought to bear on the COVID-19 pandemic. It gives the example of Tanzania, and states, "Tanzania is tapping into the skills of health workers already knowledgeable in infectious disease control, established influenza sentinel surveillance system and repurposing facilities to tackle the new virus.

"When the tenth Ebola outbreak erupted in the Democratic Republic of the Congo in 2018, Tanzania trained 2,400 health workers. Training sessions initially planned for Ebola were reviewed to include COVID-19. More than 300 of them have now been retrained to join the frontline ranks of the country's COVID-19 battle.

"In regions that had been identified as being at high risk of Ebola, rapid response teams were formed and trained, and authorities identified isolation areas at specific health facilities in each district and health workers trained to manage those units and handle suspected cases. The health workers and the resources are now proving critical in COVID-19 response.

"In addition, structures such as isolation units in district health facilities set up for Ebola preparedness are now being turned into COVID-19 units. All the country's 26 regions have been instructed to designate isolation areas for potential COVID-19 infection, while health worker training in patient triage for Ebola readiness now counts among the assets in curbing the spread of the new coronavirus.

[...]

"WHO Tanzania is working with the Ministries of Health in mainland Tanzania and in Zanzibar to build the capacity of health workers on clinical care, improving infection prevention, laboratory testing and other prevention measures. A total of 182 facilities have been designated to be able to isolate and treat COVID-19 in all district councils. The government has also identified 26 regional referral facilities to be capacitated to provide critical care. Most of the referral facilities already have staff trained in advanced care for Ebola, which included critical care.

[...]

"The government has also intensified public health education, working with WHO, UNICEF, religious leaders and telecommunications firms to provide facts and debunk rumours about COVID-19."

In Oceania on April 17:

Australia: 6,523 (2,639 active; 3,819 recovered; 65 deaths)
- 256 cases per million; 3 deaths per million
- April 10: 6,328 (3,043 active; 3,141 recovered; 54 deaths) and 245 cases per million; 2 deaths per million

New Zealand: 1,409 (582 active; 816 recovered; 11 deaths)
- 292 cases per million; 2 deaths per million
- April 10: 1,239 (921 active; 317 recovered; 1 death) and 266 cases per million; 0.4 deaths per million

Guam: 135 (5 deaths)
- April 10: 128 (4 deaths)

French Polynesia: 55
- 196 per million
- April 10: 51 and 182 per million

New Caledonia: 18 (4 active; 14 recovered)
- April 10: 18 (17 active; 1 recovered)

(With files from Worldometers, WHO, teleSUR, Granma, Prensa Latina, Reuters, NPR, USA Today, Washington Post, New York Times, Guardian, Ahval, Deutsche Welle, Africa CDC, Prensa Latina, Colombia Reports, Brasil de Fato)

Supplement  


This article was published in

Volume 50 Number 13 - April 18, 2020

Article Link:
For Your Information: Update on Global Pandemic for Week Ending April 18


    

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