1.
YALE -TULANE - SACRED HEART - ESF-8 SPECIAL GLOBAL REPORT
CORONAVIRUS (COVID-19)
AS OF 27 APRIL 2020
1200 HRS EDT
NEWS SOURCES
• NEW YORK TIMES COVID-
19 COVERAGE
• REUTERS
• CNN
ASSOCIATION
• AMERICAN HOSPITAL
ASSOCIATION
• NRHA
SITUATION - GLOBAL
PORTALS, BLOGS, AND RESOURCES
• YALE NEWHAVEN HEALTH –
COVID-19
• YALE MEDICINE
• YALE NEWS _COVID 19
• JOHN HOPKINSUNIVERSITY
COVID-19GLOBALCASES(CSSE)
• COVID-19SURVEILLANCE
DASHBOARD
• CIDRAP
• H5N1
• VIROLOGY DOWN UNDER BLOG
• WORLDOMETER
• 1POINT3ACRES
• CORONAVIRUS POTAL
• OUR WORLD IN DATA
• Evaluate
• McKinseyand Company
• WORLD EconomicForum
BACKGROUND
WHO
• WHO –COVID-19
• ECHO
• PAHO
AFRO
• EMRO
• WESTERN PACIFIC
OCHA
• RELIEFWEB
ECDC
• EUROPEAN CENTRE FOR
DISEASE PREVENTIONAND
CONTROL
CCDC
• CHINACENTER FOR
DISEASE CONTROLAND
PREVENTION
ACDC
• AFRICA CENTER FOR
DISEASE CONTOL
INTERNATIONAL JOUNALS AND ONLINE LIBRARIES
• BMJ
• CAMBRIDGE UNIVERSITY PRESS
• COCHRANE
• ELSEVIER
• JAMA NETWORK
• THE LANCET 2019-NCOV RESOURCE
CENTRE
• NEW ENGLAND JOURNAL OF MEDICINE
• OXFORD UNIVERSITY PRESS
• WILEY
EUROPE
AMERICAS
EASTERN MEDITERRANEAN
AFRICA
DISTRIBUTION
SOUTH-EAST ASIA
WESTERN PACIFIC
US FEDERAL GOVERMENT
HHS
• COVID-19
CDC
• CDC – COVID-19
NIH
• COVID-19
FEMA
• FEMA
HEALTHCARE INNOVATIONS
Yale-Tulane-Sacred Heart
Planning and Response Network
RISK ASSESSMENT
RISK TO GENERAL
POPULATION
RISK TO ELDERLY
POPULATION
RISK TO HEATHCARE
SYSTEM CAPACITY
MODERATE VERY HIGH HIGH
GLOBAL
CONFIRMED CASES DEATHS RECOVERED
2,989,090 207,431 875,054
There are now nearly 3 million confirmed cases
of coronavirus worldwide, It is highly likely that
the number of positives cases is much higher
than this since the virus can be asymptomatic,
causing no noticeable illness in some people
while in others it can cause serious illness and
death. It is also likely that he virous has been
circulating in the western countries much longer
than first reported.
JHU CSSE COVID-19 DASHBOARD AS OF 4/27/2020 0831 HRS EDT
RESEARCH

2.
BACKGROUND
BACKGROUND:
At the end of December 2019, Chinese public health authorities reported several
cases of acute respiratory syndrome in Wuhan City, Hubei province, China. Chinese
scientists soon identified a novel coronavirus as the main causative agent. The
disease is now referred to as coronavirus disease 2019 (COVID-19), and the
causative virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-
2).
It is a new strain of coronavirus that has not been previously identified in humans.
The initial outbreak in Wuhan spread rapidly, affecting other parts of China.
The International Health Regulations (IHR) (2005) Emergency Committee on the
outbreak of COVID-19 was first convened on 22‒23 January 2020, and subsequently
reconvened on 30 January 2020.
PUBLIC HEALTH EMERGENCY OF INTERNATIONAL CONCERN (PHEIC)
The WHO Director General declared the COVID-19 outbreak to be a public health
emergency of international concern (PHEIC) on 30 January 2020.
The Emergency Committee provided recommendations to WHO, to China, to all
countries and to the global community, on measures to control the outbreak.
PANDEMIC
11 March 2020. WHO declared COVID-19 a pandemic because of the “alarming
levels of spread and severity, and by the alarming levels of inaction”. At that time,
there were large outbreaks of the virus in Italy, South Korea, and the United States.
25 March 2020, more than 150 countries worldwide were affected
from people returning from affected areas. Transmission events were also reported
from hospitals, with COVID-19 cases identified among healthcare workers and
patients [13]. During the following week, several European countries reported cases
of COVID-19 in travelers from the affected areas in Italy, as well as cases without
epidemiological links to Italy, China or other countries with ongoing.
26 March 2020 the United States overtakes China and Italy with the highest number
of confirmed cases in the world.
8 March 2020 - Italy issued a decree to install strict public health measures including
social distancing starting first in the most affected regions and on 11 March 2020,
extending these measures at national level. Following Italy, Spain, France and many
other European countries installed similar public health measures.
22 February 2020 - Italian authorities reported clusters of cases in Lombardy and
additional cases from two other regions, Piedmont and Veneto. Over the following
days, cases were reported from several other regions. Transmission appears to have
occurred locally, in contrast to first-generation transmission limited testing capacity
had crippled response to the disease. The declaration came after a 13-fold rise in the
number of cases outside China in the two weeks prior to the declaration.
6 February 2020: First death in US. Autopsies on the bodies of two people who
died at home on Feb. 6 and Feb. 17 showed they were positive for the virus, a
California county announced 21 April. Previously, the first U.S. death had been
thought to occur Feb. 29 outside Seattle. The autopsy findings revealed that the
virus may have been spreading in U.S. communities earlier than previously
known. The two people died during a time when very limited testing was
available only through the CDC, and the agency's testing criteria restricted
testing to only individuals with a known travel history and who sought medical
care for specific symptoms.
24 January 2020 - French health officials confirmed the first three cases in
Europe.

3.
RISK ASSESSMENT
RISK TO GENERAL
POPULATION
RISK TO ELDERLY
POPULATION
RISK TO HEATHCARE SYSTEM
CAPACITY
MODERATE VERY HIGH VERY HIGH
SITUATION - GLOBAL
AFFECTED COUNTRIES/AREAS /TERRITORIES WITH CASES : 213
CURRENT EPI CENTER OF THE VIRUS: EUROPE (1,343,086)
COUNTRY WITH MOST CASES: UNITED STATES (784,272)
As of 26 April 2020, the ongoing pandemic of the coronavirus (COVID-19) has
spread to six continents, infecting 2.9 million people, and killed over 200
thousand though the actual death toll is almost certainly higher.
Governments have employed various forms of social distancing in an attempt to
slow that rate of infection so that hospital systems would not be overwhelmed
by demands. A body of preliminary research suggests that social distancing and
lockdowns have worked to flatten the curve and, at a minimum, greatly slowed
down the spread of the disease.
Countries now are putting together the pieces for the next phase of their
response after either gradually lifting stringent lockdown measures or
announcing plans to do so.
The World Health Organization on Friday, 24 April 2020, warned against relying
on antibody tests for policy decisions as leaders consider how to reopen their
economies and reintegrate society. While countries like Italy have even floated
the idea of “immunity passports” for people who test positive, W.H.O. officials
noted that it is not known to what extent people carrying antibodies are immune
to the virus. (The W.H.O. on Saturday backed off an earlier assertion that people
with antibodies may not be immune at all.) But widespread testing has started
nonetheless, and important decisions are likely to flow from the results. (NYT)
GLOBAL
CONFIRMED CASES DEATHS CFR RECOVERED
2,989,090 207,431 6.93% 875,054
https://who.sprinklr.com/
World leaders pledged on Friday, 24 April 2020 , to accelerate work on tests,
drugs and vaccines against COVID-19 and to share them around the globe.
French President Emmanuel Macron, German Chancellor Angela Merkel and
South African President Cyril Ramaphosa were among those who joined a
video conference to launch what the WHO had billed as a "landmark
collaboration" to fight the pandemic.
The aim is to speed development of safe and effective drugs, tests and
vaccines to prevent, diagnose and treat COVID-19, the lung disease caused
be the novel coronavirus - and ensure equal access to treatments for rich and
poor.
Several big countries did not participate, including the United States, China,
India, and Russia.
A spokesman for the U.S. mission in Geneva had earlier told Reuters that the
United States would not be involved. "Although the United States was not in
attendance at the meeting in question, there should be no doubt about our
continuing determination to lead on global health matters, including the
current COVID crisis," he said by email. (Reuters)
JHU CSSE COVID-19 DASHBOARD AS OF 4/27/2020 0831 HRS EDT

4.
SITUATION - GLOBAL
The five countries reporting the most cases are: United States, Brazil
,Canada , Ecuador, Peru, (PAHO COVID-19 PORTAL)
United States - The number of confirmed coronavirus cases in the U.S. is closing
in on 1 million. In New York, the epicenter of the U.S. outbreak, the daily death
toll fell below 400 for the first time in weeks. COVID-19 cases are now growing
in areas such as the Midwest and South. Based on county-level data Grand
Forks, North Dakota; Sioux City, Iowa; Waterloo, Iowa; Columbus, Ohio; Green
Bay, Wisconsin; Amarillo, Texas; Lincoln, Nebraska; Des Moines, Iowa; Wichita,
Kansas; and Chattanooga, Tennessee are locations where the virus is
accelerating. (CIDRAP)
Ecuador - Ecuador is seeing one of the world's worst coronavirus outbreaks,
with possibly thousands dead. There has been a surge of infections in the
province that includes Ecuador’s business capital, Guayaquil, where residents are
thought to have brought the virus home after visiting Spain. In Guayaquil,
fatalities during the first two weeks of April were eight times higher than usual,
the data indicates. Within weeks of the first case being identified in Guayaquil,
hospitals were overflowing and burial systems collapsed under overwhelming
demand, leaving dead bodies to pile in the streets and pushing families to bury
loved ones in coffins made of cardboard. (NYT)
Brazil - Brazil's COVID-19 caseload reached 61,888, with the death toll hitting
4,205, the Health Ministry said Sunday,26 April 2020. According to the daily
report from the ministry, in the past 24 hours, 3,379 people tested positive for
COVID-19, up 5.8 percent, and 189 patients died, up 4.7 percent.
The southeast state of Sao Paulo, the nation's worst-hit area, reported 20,715
infections with 1,700 deaths, followed by the state of Rio de Janeiro, which
reported 7,111 infections with 645 deaths. Medical officials in Rio de Janeiro and
at least four other major cities have warned that their hospital systems are on
the verge of collapse, or already too overwhelmed to take any more patients.
Health experts expect the number of infections in the country of 211 million
people will be much higher than what has been reported because of insufficient,
delayed testing. Meanwhile, President Jair Bolsonaro has shown no sign of
wavering from his insistence that COVID-19 is a relatively minor disease and that
broad social-distancing measures are not needed to stop it.
AMERICAS
EUROPE
Italy - Italian Prime Minister Giuseppe Conte announced Sunday 26 Athat the
country's funeral ban will be lifted on May 4
Italy's Civil Protection agency reported 260 new deaths in the past 24 hours on
Sunday -- the country's lowest daily number of deaths since mid-March.
There have been 26,644 COVID-19 deaths in Italy, according to the Civil
Protection agency. The country has the second-highest number of deaths in the
world, after the United States.
Spain had 288 deaths in one day, the Spanish Health Ministry reported on
Sunday. That is the country's lowest one-day death toll reported in 37 days. The
total number of deaths from COVID-19 in Spain is 23,190, according to the
health ministry -- the third-highest number globally.
On Sunday, children in Spain were allowed outside for the first time since the
country's lockdown began more than 40 days ago. Children under the age of 14
can now leave their homes for an hour each day.

5.
SITUATION - GLOBAL
AFRICA
Kenya - Demoted a top scientist in charge of overseeing the country’s
coronavirus testing, raising concerns and prompting criticism about the timing of
the government’s directive. Dr. Joel Lutomiah, the deputy director for the Center
for Virus Research at the Kenya Medical Research Institute, was dismissed from
the role after test results were delayed, according to local news reports.
Scientists at the institute, however, said that he was fired for standing up to
government officials and demanding more funding during this crucial period.
South Africa - Overall, the number of cases continues to grow, but South Africa,
which was initially hit hard by the virus, has seen degrees of success in its
efforts. On Thursday, April 23, President Ramaphosa announced a “phased
easing” of the lockdown. From 1 May, some businesses will be allowed to re-
open, including some retail services, hot food delivery, mining and
manufacturing. From midnight 1 May, all South Africans have to wear a face
mask in public as the country moves from level five of the national lockdown to
level four. A curfew, starting at 8pm and ending at 5am, will also be in place
from 1 M say. People will now be able to exercise outside of curfew hours (from
5am to 8pm). Details of what this means will be announced next week — but
gyms will not be open. Public transport will operate during these curfew times,
but under strict health protocols and a 70% maximum capacity
India - The death toll due to COVID-19 continued to rise on Sunday, 26 April 2020
with the country registering a total of 826 fatalities and 26,917 cases, according to
the Union Health Ministry. While the death toll rose by 46, the number of cases
spiked by 1,975 since Saturday evening. The number of active cases stood at
20,177, while 5,913 people have recovered and one patient has migrated, the
Ministry said. The total number of cases includes 111 foreign nationals, while 312
cases are being assigned to States for contact tracing.
SOUTH EAST ASIA
WESTERN PACIFIC
South Korean - Health officials are investigating several possible explanations
for a small but growing number of recovered coronavirus patients who later test
positive for the virus again. Although re-infection would be the most
concerning scenario because of its implications for developing immunity in a
population, both the KCDC and many experts say this is unlikely. Instead, the
KCDC says it is leaning toward some kind of relapse or “re-activation” in the
virus. A relapse could mean that parts of the virus go into some kind of dormant
state for a time, or that some patients may have certain conditions or weak
immunity that makes them susceptible to the virus reviving in their system. As
of 26 April 2020, 263 people have re-tested positive. Viral culture tests on these
cases are on going.
Iran - Health authorities have registered 1,153 new cases of the COVID-19
illness since midday Saturday, bringing the total number of confirmed cases to
90,481. Sixty additional fatalities were recorded, with the overall death toll
reaching 5,710 It is the country's lowest number of officially declared deaths
since March 10.
Under pressure from religious institutions, Iran’s government on Sunday
announced it would reopen some 127 religious sites, including shrines and
mosques, in about a week at locations around the country, which has endured
one of the world’s worst coronavirus outbreaks. (NYT)
EASTERN MEDITERRANEAN
Saudi Arabia - eased curfews on Sunday, 26 April 2020, across the country
but kept 24-hour lockdowns in place in the city of Mecca and neighborhoods
previously put in isolation to curb the spread of the new coronavirus.
Pakistan - The number of confirmed COVID-19 cases in Pakistan has risen to
12,723 as of 26 April 2020. Increase of 783 new cases in the last 24 hours.
The most affected province due to COVID-19 virus is Punjab 5,378, followed
by Sindh 4,232. Minister for Health Dr Zafar Mirza on Saturday said 79% of the
coronavirus cases in the country now were locally transmitted. (Reliefweb)

6.
Distribution of COVID-19 cases worldwide, as of 27April 2020
https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases
Distribution of COVID-19 deaths, worldwide, as of 27 April 2020

7.
AMERICAS
NORTH AMERICA
CONFIRMED CASES DEATHS CFR RECOVERED
1,027,607 58,895 5.73% 132,225
RISK ASSESSMENT
RISK TO GENERAL
POPULATION
RISK TO ELDERLY
POPULATION
RISK TO HEATHCARE SYSTEM
CAPACITY
MODERATE VERY HIGH HIGH UNITED STATES
• 965,933 cases, 54,877 deaths, 107,045 recovered (JHU)
• Different parts of the country are seeing different levels of COVID-19 activity.
The United States nationally is in the acceleration phase of the
pandemic. The duration and severity of each pandemic phase can vary
depending on the characteristics of the virus and the public health response.
(CDC)
• The greatest number of cases have been recorded in New York, New Jersey,
Massachusetts, Illinois, California, Pennsylvania, Michigan, Florida,
Louisiana, and Connecticut.
• The curve is beginning to flatten (peak deaths were 10 days ago) but as some
states begin to reopen non-essential businesses, the rate of transmission
could ramp up again (CNN) (IHME)
MEXICO
• 14,677 cases, 1,351 deaths,8,354 recovered (JHU)
• Dozens of medical workers have been physically attacked, as rumors spread
they are responsible for spreading the virus through Mexico. (CNN) IMSS has
recorded at least 21 attacks on staff in 12 states, but many more have been
reported through social media. Apart from aggression, health care
workers face a beleaguered hospital system that lacked equipment and staff
even before the virus spread. Hospital staff in various cities, including
Tijuana, have denounced shortages of protective gear and personnel.
• U.S. and Mexico have extended restrictions on nonessential border
crossings for an additional 30 days (NPR).
Coronavirus-COVID-19 AS OF 27 APR 2020 0933 HRS EDT
North America has the most cases and deaths of any continent. Governments
across the region are struggling in their response.
CANADA
• 47,1666 cases, 2,663 deaths, 17,408 recovered (JHU)
• Canada, like most parts of the world, has been struggling to supply PPE. The
government announced this week they received 1 million unusable KN95
masks from China and that they had two planes going to China to obtain
PPE come back empty.
• Plans to eventually restart the Canadian economy do not rely on certain
immunity levels being achieved in the population. (Reuters).
• Ontario and Quebec account for the majority of the countries cases. 80% of
deaths in Quebec have been in nursing homes (NP)
• Prime Minister Justin Trudeau announced an additional C1.1 billion ($782
million) to bolster vaccine research, clinical trials and national testing.
(Reuters)

8.
AMERICAS
SOUTH AMERICA AND CARIBBEAN
CONFIRMED CASES DEATHS CFR RECOVERED
146,884 6,634 4.60% (South America)
3.95% (Caribbean)
50,082
RISK ASSESSMENT
RISK TO GENERAL POPULATION RISK TO ELDERLY POPULATION RISK TO HEATHCARE SYSTEM
CAPACITY
MODERATE VERY HIGH HIGH
The coronavirus landed in South America on February 26, when Brazil confirmed a
case in São Paulo. Despite the array of actions taken to contain COVID-19’s spread,
the number of cases in South and Central America exceeded 100,000 on 20 APR (DW
News)(JHU Dashboard). Cases will continue to intensify over the coming weeks
(ASCOA). Brazil, Peru and Ecuador currently have the most cases. (JHU Dashboard).
BRAZIL
• 63,100 cases, 4,286 deaths, 30,152 recovered (CORONAVIRUS-COVID-19 )
• Medical officials in Rio de Janeiro and at least four other major cities have warned
that their hospital systems are on the verge of collapse, or already too
overwhelmed to take any more patients
• In Manaus, the biggest city in the Amazon, officials said a cemetery has been
forced to dig mass graves because there have been so many deaths. Workers
have been burying 100 corpses a day — triple the pre-virus average of burials.
Despite this, President Jair Bolsonaro has shown no sign of wavering from his
insistence that COVID-19 is a relatively minor disease and that broad social-
distancing measures are not needed to stop it.
• On Saturday, the city of Rio plans to open its first field hospital, with 200 beds,
half reserved for intensive care. Another hospital erected beside the historic
Maracana football stadium will offer 400 beds starting next month.
(SOURCE: AP)
ECUADOR
• 22,719 cases, 576 deaths, 1,366 recovered (CORONAVIRUS-COVID-19 )
• Ecuador’s government has acknowledged the official death count is far short
of reality. The death toll in Ecuador during the outbreak is estimated to be 15
times higher than the official number of Covid-19 deaths (576) reported by
the government, according to an analysis of mortality data by The New York
Times. 7,600 more people have died in Ecuador from March 1 to April 15 this
year compared to years past.
• Dead bodies are lying at home and in the streets of Ecuador’s largest city
Guayaquil, a city so hard-hit by coronavirus that overfilled hospitals are
turning away even very ill patients and funeral homes are unavailable for
burial.
• Ecuador has taken a very active response; including strict curfews,
mandatory masks, cancelled public transport and driving only allowed once
per week in the capital. Despite its active coronavirus response, Ecuador is
unlikely to cope well if the epidemic spreads quickly from Guayaquil into the
rest of the country.
• Ecuador has a quarter as many ventilators per person as the United States.
Testing in the country is scarce and has largely been outsourced to private
corporations, making it prohibitively expensive.
PERU
• 27,517 cases, 728 deaths, 8,088 deaths (CORONAVIRUS-COVID-19 )
• Peru has the second highest number of cases in South America after Brazil,
despite a tough lockdown aimed at halting the spread of the coronavirus.
• Peru’s hospitals are straining to deal with a rapid rise in the number of
COVID-19 infections, with bodies being kept in hallways, masks being
repeatedly reused, and protests breaking out amongst medical workers
concerned over their safety.
• The health ministry says it expects patient numbers to peak within days or in
the following week.
(US NEWS AND WORLD REPORT) (Reuters)
CORONAVIRUS-COVID-19 AS OF 26 APRIL 2020, 2338 HRS EDT

9.
AFFECTED COUNTRIES/TERRITORIES: 53/7
• 51% of the cases reported in week 16/2020 were from United Kingdom,
Turkey, Spain and Russian Federation
• Reported case counts are increasing in the eastern part of the Region,
particularly in Russia, Serbia, Ukraine and Kazakhstan
• 69% of the deaths reported in week 16/2020 were from United Kingdom,
France, Italy and Spain
• The proportion of reported cases that died has increased since week 9 (2.2%)
and is now 11%. This is likely due to a range of factors including a shift to
testing more severe cases and increased incidence in older age groups
• 16% of all reported infections with information available was in a health care
worker
• 82% of ICU admissions were in persons aged 50-79 years of age, with 74% of all
ICU admissions in men
• 95% of deaths were in persons aged 60 years and older and 63% of all deaths
were in men. 95% of deaths with information available had at least one
underlying condition, with cardiovascular disease the leading comorbidity (70%)
EUROPE
RISK ASSESSMENT
RISK TO GENERAL
POPULATION
RISK TO ELDERLY POPULATION RISK TO HEATHCARE SYSTEM
CAPACITY
MODERATE VERY HIGH HIGH
http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/weekly-surveillance-report
EUROPE
CONFIRMED CASES DEATHS CFR RECOVERED
1,360,672 124,560 9.10 436,503
WHO EUROPEAN REGION DATA AS OF: 27 APRIL 2020, 1000 (CET)

10.
EUROPE
ITALY
• 175,925 cases, 23,227 deaths, 44,927 recovered (JHU)
After enduring the longest lockdown in Europe and one of the world’s most deadly
coronavirus outbreaks, Italians heard the details on Sunday of Prime Minister
Giuseppe Conte’s plan to ease restrictions and reopen their economy starting on
May 4.
• While gatherings and parties remain banned, and travel remains closely
regulated, with special auto-certification forms required for movement, visiting of
relatives will be allowed to people within Italian regions on 4 May.
• Schools will remain closed for the rest of the academic year.
• A fixed price for individual masks at 50 cents to prevent price gouging
• Manufacturing and construction sectors will be allowed to operate as long as
workers observed social distancing and wore masks.
• Funerals will once again will be permitted but they would be limited to 15 people,
preferably in an outdoor setting. (NYT)
UNITED KINGDOM
• 154,037 cases, 20,797 deaths, 781 recovered (JHU)
Johnson, who spent days in intensive care in hospital after he was infected with the virus,
said the country was coming 'to the end of the first phase of this conflict’.
'We must also recognize the risk of a second spike, the risk of losing control of that virus and
letting the reproduction rate go back over one because that would mean not only a new
wave of death and disease but also an economic disaster,” he said. (NYT)
Prime Minister Boris Johnson thanked Britons
for abiding by the lockdown as he returned to
work on Monday, 27 April, 2020, after
recovering from a serious Covid-19 infection,
saying Britain was turning the tide against the
coronavirus spread.
“Everyday I know that this virus brings new
sadness and mourning to households across
the land and it is still true that this is the
biggest single challenge this country has faced
since the war,” Johnson said outside his
Downing Street office.
http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/weekly-surveillance-report

11.
• 155,193 cases, 5,750 deaths, 114,500 recovered (Robert Koch-Institute:
COVID-19-Dashboard)
• Germany is aiming to sample the entire population for antibodies in coming
months. In Munich, residents of 3,000 households chosen at random are being
asked to allow monthly blood tests for Covid-19 antibodies for a year. It’s an
ambitious study whose central aim is to understand how many people — even
those with no symptoms — have already had the virus, a key variable to make
decisions about public life in a pandemic.
• Face masks become mandatory for those using public transport and in most shops
across Germany on Monday, 27 April as the country gradually reopens despite
worries that the loosening of measures could be too much too soon.
• Guidelines agreed to by federal and state governments allow states to make the
final decision regarding store and school openings as well as the rules on masks,
leading to a hodgepodge of policies across the country.
FRANCE
GERMANY
• 124,856 cases, 22,856 deaths, 44,903 recovered (Sant’e Publique)
• France saw COVID-19 deaths rose by 242 to 22,856 as of Sunday, the lowest
daily increase this week, bringing relief to the health system of the country
which is planning to lift the lockdown on May 11, data from the Health Ministry
showed.
• The numbers of COVID-19 victims in intensive care also dropped, but only
slightly, to 4,682
• But officials said they were worried by an increase in critically ill patients
suffering from other conditions. More than 7,553 people were in intensive care
units in France on Sunday - 50 per cent more than the country's total capacity
before the epidemic struck.
• Overall, 28,217 people are being treated in hospital for the virus.
• The total of positive cases now stands at 124,575, up by 461 in the last 24 hours,
while 44,903 patients have recovered and returned home.
• With the country's health system still under strain, Prime Minister Edouard
Philippe will set out his strategy for ending the lockdown before parliament on
Tuesday.
TURKEY
• 110,130 cases, 2,805 deaths, 29,140 recovered(Turkey’s General Directorate of
Public Health)
• The health ministry has announced 99 new deaths from COVID-19, the lowest in
nearly two weeks bringing the total to 2,805. 3,558 people were released from
hospitals in the past 24 hours, bringing the number of recovered patients 29,140.
The Health Minister reported that the downward trend continues in patients
needing intensive care has continued. Currently 1776 patients are in intensive
care. Turkey ranks seventh in the world for the number of confirmed infections,
110,130. (TIME)
EUROPE
RUSSIA
• 87,147 cases, 794 deaths, 7,346 recovered (https://covid19.rosminzdrav.ru/)
• Russia confirmed 6,198 new coronavirus infections Monday, bringing the
country’s official number of cases to 87,147. Russia has now surpassed China to
become the world's ninth most-affected country amid the pandemic.
• Moscow authorities will not ease the city's self-isolation orders during the May
holidays which include Labor Day and Victory Day, the mayor's office said.
• Meanwhile, the head of Russia’s consumer health watchdog argued self-
isolation should be extended by at least another two weeks, until the middle of
May.
• At least 874 Russian troops tested positive for Covid-19 between March and April
26, 19 of whom are in critical or serious condition, the Defense Ministry said.

12.
CONSIDERATIONS FOR GRADUAL EASING OF COVID-19 MEASURES
Member States of the WHO European Region are at varying phases of the COVID-
19 pandemic. Regardless of the phase, governments and public health authorities
must begin to envision, and plan for, the subsequent stages of their response
strategy, with the ultimate aim of reaching and maintaining a state of low-level or
no transmission..
WHO/Europe has published key considerations for the gradual easing of the
lockdown restrictions introduced by many countries in response to the spread of
COVID-19 across the European Region.
The transition out of lockdown is set to be a complex and uncertain phase.
Challenges and circumstances vary from country to country and there is no one-
size-fits-all approach. It is vital that countries clearly communicate this to the
public to build trust and ensure that people observe restrictions specific to their
situation.
“Strengthening and Adjusting Public Health Measures throughout the COVID-19
Transition Phases” aims to support countries by providing key considerations for
the slow easing of restrictions and transitioning to a ‘new normal’.
While everyone wishes the return of economic activity, it’s important to be clear
that this will be a gradual process, requiring strict monitoring and a possible
reintroduction of measures should there be a new increase in cases.”
WHO/EUROPE
SOURCE: http://www.euro.who.int/en/health-topics/health-
emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-
technical-guidance/coronavirus-disease-covid-19-outbreak-technical-
guidance-europe/strengthening-and-adjusting-public-health-measures-
throughout-the-covid-19-transition-phases.-policy-considerations-for-
the-who-european-region,-24-april-2020

13.
KEY POINTS:
• The pathobiology of coronavirus infection involves SARS-CoV-2 binding to the host receptor
angiotensin-converting enzyme 2 (ACE2) to mediate entry into cells;
• ACE2, which is expressed in the lungs, heart and vessels, is a key member of the renin
angiotensin system (RAS) important in the pathophysiology of CVD;
• CVD associated with COVID-19, likely involves dysregulation of the RAS/ACE2 system due
to SARS-CoV-2 infection and due to comorbidities, such as hypertension;
• CVD may be a primary phenomenon in COVID-19, but may be secondary to acute lung injury,
which leads to increased cardiac workload, potentially problematic in patients with pre
existing HF;
• Cytokine release storm, originating from imbalance of T cell activation with dysregulated
release of interleukin (IL)-6, IL-17 and other cytokines, may contribute to CVD in COVID-19. IL-6
targeting is being tested therapeutically;
• Immune system activation along with immunometabolism alterations may result in plaque
instability, contributing to development of acute coronary events.
PATHOPHYSIOLOGY - MECHANISM OF DISEASE IN RELATION
WITH THE CARDIOVASCULAR SYSTEM
EUROPEAN SOCIETY OF CARDIOLOGIST GUIDANCE FOR THE DIAGNOSIS AND
MANAGEMENT OF CV DISEASE DURING THE COVID-19 PANDEMIC
https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance
Leading experts treating COVID-19 patients provide advice on managing
cardiovascular disease during the pandemic. The European Society of
Cardiology (ESC) guidance is published online.
The novel coronavirus not only causes viral pneumonia but also has major
implications for the cardiovascular system.
Heart and stroke patients are more likely to have severe cases of COVID-
19, as are people with other risk factors, including advanced age, diabetes,
hypertension and obesity.
In addition, COVID-19 patients may develop heart damage, which raises
their chance of dying.
This detailed document provides healthcare professionals the best available
knowledge, based on practical experience, on how to diagnose and manage
cardiovascular conditions in COVID-19 patients, treat the coronavirus
infection, and organize and priorities care. It will be updated as more
evidence is gathered.

14.
EASTERN MEDITERRANEAN
AFFECTED COUNTRIES/TERRITORIES: 22
RISK ASSESSMENT
RISK TO GENERAL
POPULATION
RISK TO ELDERLY
POPULATION
RISK TO HEATHCARE SYSTEM
CAPACITY
MODERATE HIGH HIGH
The five countries reporting the most cases are: Iran, Saudi Arabia, Pakistan, Qatar,
United Arab Emirates (EMR Portal)
With Ramadan having started on 24 April 2020, the WHO Regional Office for the
Eastern Mediterranean has developed a guiding document on safe Ramadan practices
in the context of COVID-19.
The entire polio networks in Pakistan, Afghanistan and Somalia are fully engaged in
the COVID-19 response.
WHO’s Regional Office for the Eastern Mediterranean has issued a warning that any
suspension of immunization services or hesitancy to use them during the COVID-19
pandemic will result in resurgence of diseases that have largely been controlled. The
Eastern Mediterranean Region includes half of all people affected by humanitarian
emergencies globally, and any suspension or underutilization of immunization
services may exacerbate their suffering.
IRAN
• 91,472 confirmed cases, 5,806 deaths, 70,933 recovered (JHU)
• On 18 April 2020, Iranian authorities began lifting business and travel restraints,
causing a 6% surge in the number of people seeking hospital treatment for COVID-
19 symptoms in Tehran alone by midweek.
• Health Ministry spokesman Kianush Jahanpur on April 26 urged Iranians to respect
health and physical-distancing measures, despite a slowing in the COVID-19 death
toll. Rohani reportedly warned on April 26 that Iranians can expect major
disturbances to continue throughout the year as a result of the pandemic.
SAUDI ARABIA
• On 25 April 2020, Saudi Arabia confirmed on Saturday 1,197 new coronavirus
cases, taking the total number of COVID-19 cases in the Kingdom to 16,299.
• Saudi King Salman Bin Abdul Aziz has ordered the partial lifting of a curfew
imposed due to the new coronavirus across the country while keeping a 24-hour
lockdown in the holy city of Mecca . The partial lifting of the restriction started
Sunday from 9am until 5pm and will continue until May 14, the agency added.
• Saudi Arabia signs SR 955 million deal with China to provide 9 million COVID-19
tests. The contract includes 500 experts, specialists, and technicians to conduct
the tests, he construction of six large-scale laboratories in a number of areas in
Saudi Arabia, including a mobile laboratory with a capacity of 10,000 tests daily.
PAKISTAN
• 13,328, confirmed cases, 281 deaths, 3,929 recovered (JHU)
• The federal Minister for Planning and Development, Asad Umar, announced that
the government has extended the lockdown for another 15 days till 9 May 2020.
• The federal government, in collaboration with the Pakistani diaspora working in
the health sector, launched the Yaran-i-Watan program to aid in providing an
adequate national emergency response.
QATAR
• 11,244, confirmed cases, 10 deaths, 1,066 recovered (JHU)
• The number of positive cases in Qatar jumped by 761 in a 24-hour period, marking
the Gulf country's highest daily increase. The total number of cases reported in the
country stands at 11,244, with 10 deaths. Most of the new cases registered are
due to expatriate workers working in different occupations who have been in
contact with previously discovered cases, as well as recording new cases of COVID-
19 among groups of workers from outside the industrial area who were identified
through testing by the Ministry of Public Health. (The Peninsula)
UNITED ARAB EMIRATES
• 10,349 confirmed cases, 76 deaths, 1,760 recovered (JHU)
• The Sheikh Khalifa Medical City in Abu Dhabi constructed a new hospital to treat
COVID-19 patients in only 48 hours with 127 new beds and staffed with 85 nurses
and 20 doctors. This is just another field hospital that has already been opened
across the Emirates to boost the fight against COVID-19 and ease the pressure on
the country's healthcare system.
• As of 24 April 2020, Dubai residents are allowed to move freely between 6am and
10pm without a permit for essential journeys and can spend up to 2 hours a day
exercising outside.
SOUTH AMERICA
CONFIRMED CASES DEATHS CFR RECOVERED
167,995 7,087 4.22% 86,540
WHO EMR Portal DATA AS OF: 26 APRIL 2020,1300
SOURCES: REGIONAL WHO OFFICE EAST MEDITERRANEAN

15.
AFRICA
AFFECTED COUNTRIES/TERRITORIES: 45
Nearly all African countries are reporting cases. There have been more than
30,000 confirmed cases in and over 1,000 deaths reported across all member
States with the exception of Comoros and Lesotho.
Since April 15, there has been a 43% increase in the number of COVID-19
cases and a 38% increase in the number of COVID-19 deaths reported in the
WHO African Region. In the last week, an increasing trend in the weekly case
incidence was observed in Algeria, Cote d’Ivoire, Ghana, Guinea and South
Africa, while a decreasing trend occurred in Cameroon.
The most affected countries in the African Region are:
• South Africa (4,220 cases / 79 deaths)
• Algeria (3,127 cases / 415 deaths)
• Cameroon (1,489 cases / 53 deaths)
• Ghana (1,150 cases / 10 deaths )
• Nigeria 1,182 cases / 32 deaths)
• Cote d’Ivoire (1,150 cases / 14 deaths)
• Guinea (996 cases / 32 deaths)
These countries account for 66% of the
cases reported in the region
Number of confirmed COVID-19 cases in the WHO African Region by
country, 25 February – 21 April 2020 (n = 15,394)
RISK ASSESSMENT
RISK TO GENERAL
POPULATION
RISK TO ELDERLY POPULATION RISK TO HEATHCARE SYSTEM
CAPACITY
MODERATE HIGH HIGH
The African Union Commission and the Africa Centres for Disease Control and
Prevention ave launched a new initiative, the Partnership to Accelerate COVID-
19 Testing (PACT): Trace, Test & Track. The goal of the continental strategy is to
prevent severe illness and death from COVID-19 infection in African Union
Member States and minimize social disruption and the economic consequences
of COVID-19.
WHO is providing remote support to affected countries on the use of electronic
data tools, so national health authorities can better understand the outbreak in
their countries. Reponse has included providing thousands of COVID-19 testing
kits to countries, training dozens of health workers and strengthening
surveillance in communities, coordinating regional surveillance efforts,
epidemiology, modelling, diagnostics, clinical care and treatment, and other
ways to identify, manage the disease and limit widespread transmission.
AFRICA
CONFIRMED CASES DEATHS CFR RECOVERED
20,652 861 4.55% 7,154
Source: WHO Situation Report
Source: WHO Situation Report
WHO Africa Portal DATA AS OF: 27 APRIL 2020, 0100

16.
The four countries reporting the most cases are: India, Indonesia, Bangladesh and
Thailand. These four countries are just beginning to see sustained transmission and
represent the majority of the confirmed cases in the region.
INDIA
• 28,380 confirmed cases, 886 deaths, 6,523 recovered (JHU)
• Prime Minister Modi ordered a total lock down of the country on March 24 and
has extended the shutdown until 3 May 2020.
• Even before the pandemic, India was suffering a shortage of hospital beds.
• According to OECD, India has 0.5 hospital beds available for every 1,000 people.
Most of these are clustered in urban areas, and availability differs hugely
between states. In the eastern state of Bihar, for example, there are 0.11 beds
per 1,000 people, while West Bengal has 2.5 beds per 1,000 people.
• After India’s health ministry repeatedly blamed an Islamic seminary for
spreading the coronavirus — a spree of anti-Muslim attacks has broken out
across the country.(NYT)
• India’s central bank Governor Shaktikanta Das underlined the need for fiscal
measures to support the economy, saying a slippage in budget gap target
was unavoidable amid the coronavirus crisis.(Bloomberg)
INDONESIA
• 9,096 confirmed cases, 765 deaths, 1,151 recovered (JHU)
• The Health Ministry announced 214 new confirmed COVID-19 cases on
Monday, bringing the total number of infections nationwide to 9,096.
Speaking at a press conference on Monday, the ministry’s disease control
and prevention director general, Achmad Yurianto, added that 22 more
people had died of the disease, bringing the death toll to 765.
SOUTH EAST ASIA REGION
CONFIRMED CASES DEATHS CFR RECOVERED
46,798 1,853 4.9% 5458
AFFECTED COUNTRIES/TERRITORIES: 10
THAILAND
• 2,931 confirmed cases, 52 deaths, 2,609 recovered(JHU)
• Thailand said it plans to extend its state of emergency to May 31 to cement
progress in reducing infections. The emergency, which was due to expire at the
end of April, is set to be extended by another month.
BANGLADESH
• 5,416 confirmed cases ,145 deaths. 122 recovered (JHU)
• Cases in Bangladesh are doubling every 2.5 days, making the country’s
caseload one of the fastest-rising in the world.
• Concerns continue to grow in Bangladesh over the country's limited
coronavirus testing capacity, 26,604 samples out of a population of 160
million people have been tested
• At least 251 doctors had tested positive for coronavirus
• Bangladesh is also grappling with a severe shortage of (PPE) for its health
workers.
JHU CSSE COVID-19 DASHBOARD AS OF 4/19/2020, 12:38:31 AM
• The capital city recorded 70 new confirmed cases, bringing the total tally
to 3,869. Meanwhile, West Java reported 39 new cases, West Sumatra
19, Central Java 17 and Banten 12. The virus has spread to all of the
country's 34 provinces.
RISK ASSESSMENT
RISK TO GENERAL
POPULATION
RISK TO ELDERLY POPULATION RISK TO HEATHCARE SYSTEM
CAPACITY
MODERATE HIGH HIGH
SOUTH-EAST ASIA

17.
WESTERN PACIFIC
AFFECTED COUNTRIES/TERRITORIES: 22
RISK ASSESSMENT
RISK TO GENERAL POPULATION RISK TO ELDERLY POPULATION
MODERATE HIGH HIGH
The five countries repotting the most cases are: China, Japan, Singapore,
Republic of Korea, Philippines
CHINA
• 83,912 confirmed cases, 4,637 deaths,78, 306 recovered (JHU)
• China has reported their caseload shift from sustained community
transmission to ongoing imported cases, requiring continued high-level
alertness to detect, contain, and prevent a large second wave.
• The city of Wuhan, the initial epicenter of the coronavirus pandemic, no
longer has any Covid-19 patients in hospital after the last 12 were
discharged on 26 April 2020.
• Sinovac Biotech has developed a successful vaccine which has protected
monkeys from the virus . Phase I clinical trials in Jiangsu province, north
of Shanghai with 144 volunteers on 16 April. (Science)
JAPAN
• 13,441 confirmed cases and 372 deaths and 1,809 recovered. (JHU)
• Japan has witnessed a rise in cases across the entire country – new
COVID-19 infections hit 585 in single day.
• Japan's Prime Minister Shinzo Abe declared a nationwide state of
emergency, expanding the one put in place less than two weeks ago that
covered Tokyo and six other prefectures.
https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200417-sitrep-88-covid-
191b6cccd94f8b4f219377bff55719a6ed.pdf?sfvrsn=ebe78315_6
WESTERN PACIFIC REGION
CONFIRMED CASES DEATHS CFR RECOVERED
144,833 5,971 4.12%%
RISK TO HEATHCARE SYSTEM CAPACITY
SOUTH KOREA
• 10,738 confirmed cases and 243 deaths and 8,764 recovered. (JHU)
• South Korea has a case fatality rate (CFR) of 1.4%, well below the world average.
• Seoul has extended its social distancing policy until May 5.
• Widespread testing, intensive contact tracing and tracking apps have enabled
South Korea to limit the spread of the virus with social distancing rather than
lockdowns.
• South Korean health officials are investigating several possible explanations for a
small but growing number of recovered coronavirus patients who later test
positive for the virus again
PHILIPPINES
• 7,777 confirmed cases and 511 deaths and 932 recovered. (JHU)
• Coronavirus infections in the Philippines continued its steady rise on Saturday,
hitting 7,294 since the first Covid-19 case was reported on Jan. 30.
The Department of Health said 792 patients have recovered, while 494 have died
from the disease.
• The number of health workers who tested positive for Covid-19 (coronavirus) in
the Philippines has climbed to 1,101, a senior Philippine health official said on
Sunday morning (April 26). Health Undersecretary Maria Rosario Vergeire said in a
virtual media briefing that among the infected medical workers are 434 doctors,
400 nurses, 55 nursing assistant, 32 medical technologist, and 21 radiologic
technologists. 26 health workers have died from the disease, including 20 doctors
and 6 nurses.
AUSTRALIA
• 6,714 confirmed cases, 83 deaths, 5,541 recovered (JHU)
• Currently, Australia does not have widespread community transmission of COVID-
19.
• The Australian Government today launched voluntary coronavirus app, COVIDSafe
on April 25 The app, based on source code from Singapore’s Tracetogether
software, maintains a log of Bluetooth connections a person’s phone makes with
the phones of those they have come into contact with, making it easier for health
authorities to trace potential Covid-19 carriers in the case of a positive diagnosis.
• The Prime Minister has activated the Emergency Response Plan for Novel
Coronavirus (COVID-19).
• To find out how the Australian Government is managing COVID-19, go
to Government response to the outbreak.
WESTERN PACIFIC REGION COVID-19 PORTAL 1100 HRS 27 April 2020 (GMT+8)

18.
WESTERN PACIFIC - SINGAPORE
• 14,423 confirmed cases and 12 deaths and 1,060 recovered. (JHU)
• The number of COVID-19 cases in Singapore crossed the 13,000 mark on Sunday (26 Apr), after another 931
cases were confirmed as of noon. A total of 886 of 26 Aril 2020 cases were work permit holders residing in
dormitories, MOH said in an update on Sunday night. Another 25 were work permit holders living outside of
dormitories. (CNA)
• Testing in the worker dormitories, where the outbreak has surged in recent weeks, has already accelerated
and is one of the reasons Singapore’s case numbers have shot up, sometimes by more than 1,000 cases a day.
There are 1,311 confirmed cases still in hospital. Most are stable or improving, and 22 are in critical condition
in the intensive care unit. Twelve people in Singapore have died due to COVID-19
• Meanwhile, 11,241 cases are currently isolated and cared for at community facilities. These are cases that
have mild symptoms or are clinically well but still test positive for COVID-19.
• Although there is push to open community isolation centers, existing ones are currently at a choke point as
new facilities are built.
Singapore’s Outbreak Serves as a Cautionary Tale for Neglecting Marginalized Communities During A
Pandemic.
In recent weeks, as the coronavirus has ripped through migrant worker’s facilities, their unsanitary and overcrowded
conditions have quickly become the subject of international attention. Singapore, recently lauded for its gold-standard
approach to testing and tracing, now demonstrates both the dangers of neglecting marginalized communities, and the
vulnerability of nations to a second wave of infections. (The Guardian)
Little attention was paid to migrant workers who, despite the pandemic, continued to live in close quarters, and spent hours
a day travelling on the back of crowded lorries to get to and from construction sites. Activists say they raised concerns about
the risks posed by the virus to migrant workers as early as February. In March, the campaign group Transient Workers Count
Too (TWC2) said the risk of an outbreak among this community was “undeniable”.
When clusters began to emerge, the government moved 7,000 workers, mostly people who do essential jobs such as
working on power plants, out of the buildings. About 293,000 remain housed in such facilities. Authorities say they will
prioritize relocating older people. Cleaning services have been increased to improve hygiene, officials say, and meals are
also being delivered to prevent workers needing to use communal kitchens.

19.
RESEARCH
Treatment of cardiovascular disease during the Covid-19 pandemic
New research has shown that although those with CVD are at risk,
cardiac injury can occur in those with confirmed Covid-19 and no
previous cardiovascular (CV) risk. This will increase the use of and the
demand for various CV treatments as patients are treated
symptomatically and potentially longer-term if the myocardium effects
are long-lasting. SOURCE: ESC Guidance for the Diagnosis and
Management of CV Disease during the COVID-19 Pandemic
BCG vaccination may induce heterologous immunity and protect against
Covid-19
Preliminary reports from epidemiological studies suggest that countries with
universal BCG vaccination programs have been impacted less by Covid-19,
leading researchers to theorize that BCG vaccination may offer some level of
heterologous immunity against Covid-19. Currently there are several studies
around the world examining if this vaccine is able to offer a level of innate
immunity against Covid-19. The results of all the trials could provide essential
data in determining whether the BCG vaccine provides a level of immunity or
protection against Covid-19. A positive correlation could prove to be key in
combating Covid-19, as the BCG vaccine has a well-documented safety profile.
Furthermore, the vaccine already has well-established production routes that
would enable quick delivery to all those who require it.
China’s initial coronavirus outbreak in Wuhan spread twice as fast as once
thought.
Epidemiologists had previously estimated that each person with Covid-19, the
disease caused by the virus, infected two to three people on average, based
on early cases in the city of Wuhan. But researchers in the United States have
said that the chaos in Wuhan as infections there rose at the start of the year
may have produced incomplete data and a distorted picture. The new
estimation by Los Alamos National Laboratory in New Mexico show that the
doubling time early in the epidemic in Wuhan was 2.3–3.3 days. Assuming a
serial interval of 6–9 days, we calculated a median R0 value of 5.7 (95% CI 3.8–
8.9). The study shows that further show that active surveillance, contact
tracing, quarantine, and early strong social distancing efforts are needed to
stop transmission of the virus. SOURCE: EID Journal early release
Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients
than nasopharyngeal swabs
A person’s saliva accurately reveals whether they are infected with SARS-
CoV-2, a finding that could make tests for the virus safer and more widely
available. Anne Wyllie at the Yale School of Public Health in New Haven,
Connecticut, and her colleagues collected both saliva and throat samples
from people hospitalized with COVID-19 (A. Wyllie et al. Preprint at
medRxiv, http://doi.org/ggssqf, 2020). The team’s testing did not detect the
virus in some patients’ throat-swab samples — but did detect it in the same
patients’ saliva samples. Saliva testing also showed that two health-care
workers who felt fine and had negative throat tests were actually infected.
Intensive testing finds a small town’s many silent infections
On 21 February, the town of Vo’ reported Italy’s first COVID-19 death, leading
authorities to ban movement in the town and end public services and
commercial activities there for two weeks. Andrea Crisanti at Imperial College
London and his colleagues swabbed almost every resident of Vo’ for viral RNA at
the beginning and end of the lockdown.
The team found that some 43% of the people infected with SARS-CoV-2 in the
town reported no fever or other symptoms (E. Lavezzo et al. Preprint at
medRxiv http://doi.org/ggsmcj; 2020). The researchers observed no statistically
significant difference in potential infectiousness between those who reported
symptoms and those who did not.
Asymptomatic and pre-symptomatic individuals have a key role in COVID-19
transmission, which makes it difficult to control the disease without strict social
distancing, the authors say.

20.
HEALTHCARE INNOVATIONS TO FIGHT COVID-19
SOURCE : https://www.av.co/covid-diagnostics
@vasudevbailey
@zoeguttendorfZ

21.
SOURCE : https://www.av.co/covid-diagnostics
@vasudevbailey
@zoeguttendorfZ
HEALTHCARE INNOVATIONS TO FIGHT COVID-19

22.
SOURCE : https://www.av.co/covid-diagnostics @vasudevbailey
@zoeguttendorf
HEALTHCARE INNOVATIONS TO FIGHT COVID-19