New Delta Variant Restrictions, Vaccine Booster Trial, Olympic Village Cases: COVID-19 Global Weekly Highlights

Medscape, Univadis, & MediQuality Staff

July 22, 2021

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

In the UK, Prime Minister Boris Johnson spent what he'd previously called 'freedom day' in self-isolation after his Health Secretary tested positive for COVID-19 at the weekend. COVID-19 legal restrictions in England were lifted on Monday and the use of face coverings became recommended rather than mandatory in most cases but are still needed in healthcare settings. UK cases continue to rise and the rate per 100,000 population was 472.3 on Wednesday. The UK will be vaccinating a limited number of 12 to 15-year olds, including clinically vulnerable children and those with vulnerable family members.

The Delta variant now accounts for 80% of cases in France and Government spokesperson, Gabriel Attal, spoke of a "virus that infects at lightning speed". Public Health France announced 18,181 new COVID-19 cases on Tuesday. This figure is up 161% on the previous week. On July 20, the incidence rate nationally was 84 cases per 100,000 inhabitants but in seven departments, the indicator is above 150/100,000.

Vaccination has reached record numbers with the health ministry saying: "We vaccinate twice as fast as Germany and Italy." As of July 20, 56.6% of the population had received a first dose and 46.4% were fully vaccinated. The National Medicines and Health Products Safety Agency (ANSM) said the Pfizer/BioNTech vaccine does not increase the risk of serious cardiovascular events in people aged 75 and over.

In Portugal, hospitalisations rose again over the last 6 days. The Delta variant is the dominant strain in all regions making up 88.6% of cases. The Directorate General of Health described the current epidemic as high intensity and a growing trend, widespread throughout the country and affecting all ages. The 14-day incidence was 403 cases per 100,000 population in mainland Portugal.

In Germany, attention is currently focused on the flood-affected states of North Rhine-Westphalia and Rhineland-Palatinate. The risk of COVID-19 infections increased as people may become infected during relief efforts or in emergency shelters. A special vaccination bus and rapid testing facilities were sent to the Rhineland-Palatinate area. The 7-day incidence has been rising steadily for more than 2 weeks and on Wednesday it was 11.4 per 100,000 population.

In Switzerland, around three-quarters of infections are probably due to the Delta variant. Health officials said the level of 1000 new infections per day could be exceeded this week or next. The vaccination programme has been continuing with 44.8% of the population now fully vaccinated 

As of July 19, 52% of the vaccine-eligible population in Austria was fully vaccinated, and 65% had received at least one dose. The most recent 7-day incidence was 25.4  per 100,000 population.

The fifth wave is hitting hard in Spain with an incidence at 14 days of slightly above 600 cases per 100,000 population. Of the new infections, 83.1% were in unvaccinated people. Some regions are considering reimposing restrictions, such as curfews or mandatory use of face masks outdoors. More than 62% of the Spanish population already has one dose of the vaccine, and 51.3% are fully vaccinated.

The latest stage of the pandemic is confirmed in almost all Italian regions. The incidence nationwide, between July 4-11, is 14 new cases per 100,000 population. The effectiveness of the complete course of vaccine is, so far, 88% against  infection, 94.6% against hospital admissions, 97.3% against the need for intensive care, and 95.8% against the risk of COVID-19 death. More than 45% of the population is fully vaccinated. To encourage vaccination uptake, the Government may require the EU Green pass to enter bars, restaurants, transport, and other public places.

Nearly 80% of people in Canada have received a first dose of COVID-19 vaccine and more than 50% are fully vaccinated. On Monday, the Canadian government announced that fully vaccinated US citizens will be able to enter the country from August 9 without quarantine. The reopening of borders for other foreign travellers is due in September.

The Delta variant has quickly dominated COVID-19 transmission in the US, it now accounts for an estimated 83% of infections.  Cases are up about 70% compared to the previous weekly average.  Hospitalisations and deaths have begun to trend upward as well.  The increases are hitting less vaccinated states harder than those with better coverage.  Local outbreaks are once again straining the healthcare system in some areas.  Despite this, some experts believe that the worst is over for the US since about 80% of people over the age of 65 are now vaccinated. There are still concerns the Delta variant will pose a danger to children who go back to school in a few weeks' time.  Some states have passed laws that prevent schools from requiring masks, and children under age 12 remain ineligible for the vaccine.

In Mexico, the undersecretary of health announced that COVID hospital occupancy has doubled and the patients admitted are mainly people under 50 and unvaccinated. So far, 17.24% of the population is fully vaccinated. The Delta variant accounts for about 60% of new cases in Mexico City. The US Government said it would keep the border with Mexico closed to non-essential land travel for another month.

Pan American Health Organisation (PAHO) Director Carissa Etienne said that South American countries with higher vaccination rates, such as Uruguay, Chile, and Argentina are reporting a sharp decline in cases. In Latin America and the Caribbean as a whole, only 15% of the population is fully vaccinated, while some countries, such as Honduras, have not yet reached 1%. COVID-19 infections are increasing in most Central American and Caribbean countries. Numerous cases are reported in Guatemala and both cases and deaths from COVID-19 are increasing in Cuba.

In Haiti, vaccination of health workers and the elderly has begun after receiving a donation of 500,000 Moderna vaccines from the US government through the COVAX scheme.

At least 110 cases of infection caused by the Delta variant were confirmed by the Ministry of Health in Brazil by Monday. However, there's only limited genetic sequencing available, so the true number is likely to be higher. A third booster dose is being debated. However, many experts say that the priority is to advance vaccination by age. As of Tuesday, around 42.51% of the Brazilian population received a first vaccine dose, while 16.22% were fully vaccinated. The rate of vaccination remains slow and is being affected by vaccine availability. On Monday, the National Health Surveillance Agency approved studies of a third dose of the Oxford/AstraZeneca vaccine. The trial will include 10,000 volunteers who participated in the initial study of the vaccine carried out in the country. The third dose is expected to be given 11 to 13 months after the second dose.

South Australia has become the third Australian state to go into lockdown after Victoria and parts of New South Wales. Nearly half of the country's 25 million population is now under lockdown. Prime Minister Scott Morrison is facing heavy criticism for the slow vaccination rollout in the country, as only 14% of the population is vaccinated.

The surge of infections continues in Tokyo, Japan with 1387 cases reported on July 20. Over 70 cases of COVID-19 linked with the Olympic Games were reported ahead of the opening ceremony, including at least three athletes at the Olympic village. Toshiro Muto, head of the Tokyo 2020 organising committee has not ruled out cancelling the games if the situation worsens. He stated that the committee would closely track infection numbers and hold "discussions" if required. 

A new report from the Washington-based Centre for Global Development suggests that India's COVID-19 actual death toll could be as much as 10 times higher than reported. On July 21, India reported a sharp spike in daily deaths after the state of Maharashtra corrected its fatality count and added another 3509 previously unreported deaths. According to the country’s fourth national serosurvey carried out in June-July 2021, antibodies against COVID-19 were detected in 67% of the population.

In response to the continuing surge of COVID-19 infections, Indonesia has extended its COVID-19 restrictions to July 25. President Joko Widodo stated that the curbs could be eased gradually next week if there is a drop in daily cases. Indonesia's 7-day average death toll was 1080, just behind Brazil's 1200.

The World Health Organisation said Africa recorded a 43% week-on-week rise in COVID-19 deaths last week. Hospital admissions were increasing rapidly and there are shortages of oxygen and intensive care beds.

Around 80% of the 301 personnel aboard a South Korean anti-piracy patrol ship in the Gulf of Aden has tested positive for COVID-19. None of the crew members were vaccinated as the ship had left for its mission in February, before the vaccination program was rolled-out in the country for military personnel.

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

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