New Rules for Unvaccinated People, Clinical Trial of Novel Vaccine, Lifting Restrictions: COVID-19 Global Weekly Highlights

Medscape, Univadis, & MediQuality Staff

September 23, 2021

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

More than 160,000 UK deaths have now been recorded with COVID-19 mentioned on the death certificate. The number for deaths within 28 days of a positive test is lower at 135,252. As of Monday (September 20), new positive cases were down 12% over 7 days at a rate of 303.3 per 100,000 population. Hospitalisations were down 4.8%, and deaths were up 0.4%. The rollout of COVID-19 vaccinations to 12 to 15-year-olds has begun, as well as booster vaccinations for healthcare staff, over-50s, and other priority groups.

A clinical trial of a novel COVID-19 vaccine that could boost the immune response generated by existing COVID vaccines and help combat variants of the SARS-CoV-2 virus was launched in the UK this week. US pharmaceutical company, Gritstone, has partnered with the National Institute for Health Research Manchester Clinical Research Facility to evaluate effectiveness of the vaccine, called GRT-R910.

On Wednesday, 10,454 new positive tests were reported in Germany. This brings the 7-day incidence down to 65 (Tuesday: 68.5). In 15 of the 16 states, at least 60% of residents have received at least a first dose of vaccine. Only the state of Saxony is still below this threshold at 57.1%. Nationwide, 67.3% of all residents have now received at least one dose as of Tuesday, with 63.3% of the total population now fully vaccinated.

The federal and state health ministers decided on Wednesday that non-vaccinated people will no longer receive compensation for loss of earnings due to ordered COVID-19 quarantine from November at the latest. Only people for whom there is a vaccination recommendation and who can also be vaccinated are affected. 

The head of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen, has called for all COVID-19 restrictions to be lifted at the end of October. However, the proposal has met with opposition: the Marburger Bund doctors' association, for example, believes the demand is wrong. The step would be highly risky at the present time and a gamble with health. Implementation would be particularly dangerous for non-vaccinated people. 
 

Meanwhile, German Health Minister Jens Spahn expects herd immunity against the virus to begin next spring. According to Spahn, if no new virus variant appears against which vaccination does not protect, the pandemic will be over and a return to normality will be possible.

In France, pandemic indicators continue to improve. As of Tuesday, 7851 new cases were detected and 503 patients were hospitalised. Overall, 8594 patients are hospitalised for COVID-19, including 1744 in intensive care.

On Wednesday the government decided to lift certain health rules including ending the requirement to wear masks in primary schools from October 4 in areas where the incidence rate is less than 50 per 100,000 population.

The number of COVID-19 vaccine doses has reached the target of 50 million set by the government, at 74.3% of the total population.

In terms of research, an AP-HP study shows that patients infected during the first wave maintain a stable memory response for up to 12 months (memory B cells), and develop, after a dose of vaccine, excellent serological and cellular memory capable of recognising and neutralising the Beta and Delta variants of SARS-CoV-2.

In Austria, 63.5% of the population had been vaccinated against COVID-19 with at least one dose by the beginning of the week (September 21). 60% have complete vaccination protection. The 7-day incidence was 150 on September 21, slightly lower than the previous week.

To encourage more people to be vaccinated, Austria's capital, Vienna, is increasing pressure on the unvaccinated with new COVID-19 rules. From October 1, only vaccinated people and those recovered from COVID-19 will be allowed to attend events with more than 500 people.  According to this rule, a negative test result will no longer be sufficient for attendance. 

As of Wednesday, the 7-day incidence in Switzerland is 140 per 100,000 population, with coverage rates of 61% for first dose vaccine and 53% for the second dose. However, despite further declines in infection rates, the fourth wave is not yet considered broken and the Federal Office of Public Health expects the situation to worsen in the autumn. In addition, the vaccination rate is rising too slowly to dispense with COVID-19 measures. 

The epidemiological situation in Italy is improving, with 54 cases per 100,000 population, just above the epidemic threshold. The burden on hospitals also slightly decreased during the last week. Italy has vaccinated 75.64% of its population above 12-years-old. A third dose of vaccine is now available for immunosuppressed patients. A booster dose is suggested to vulnerable patients vaccinated more than 6 month ago, mostly over-80s.

To overcome vaccine resistance, especially as autumn is beginning and schools reopened, the Government has extended the need of the Green Pass for workplaces, public and private, and for parents to enter their children’s school, starting from October 15. Those who are not vaccinated can have a 48-hour Green Pass with antigenic tests paid for at their own expense.

In Portugal, more than 81.5% of the population were fully vaccinated against COVID-19, making the country the most vaccinated in the world, according to the portal Our World in Data, from the University of Oxford. More than 87% have received at least one dose of vaccine.

Currently, the Delta variant is responsible for 99.7% of new infections. The number of cases, deaths, and hospitalisations for COVID-19 has stabilised, which has allowed the progressive lifting of restrictions. The national incidence is 149.1 cases per 100,000 population.

In Spain the incidence of new COVID-19 cases continues to drop. The latest report from the Ministry of Health has 2450 new infections, the lowest number since July 2020, and 82 deaths. So far, 76.1% of the population is already fully vaccinated, and 79.0% have at least one dose. Young people between 12 and 19-years-old are about to reach 70% coverage for full vaccination.

The Ministry of Health has extended administration of the third dose to: people with solid organ transplants, hematopoietic stem cell transplant recipients, people under treatment with anti-CD20 drugs, those with certain immunosuppressive treatments, and residents in older age people homes. A decision on the possibility of injecting a second dose to those vaccinated with the Jannsen vaccine is pending.

During the 59th meeting of the Directing Council of the Pan American Health Organisation (PAHO), it was reported that the course of the COVID-19 pandemic in the Americas remains "highly uncertain". According to the report Update on COVID-19 in the Region of the Americas: the Region of the Americas had reported 39% of the cases and 47% of the deaths that have been reported worldwide due to COVID-19. Argentina, Brazil, Colombia, and the United States of America were among the 10 countries that reported the highest number of cumulative cases worldwide. Brazil, Colombia, the US, Mexico, and Peru were among the 10 countries with the highest number of cumulative deaths worldwide.

In Mexico, as of September 21, there has been a 23% decrease in the number of estimated cases of COVID-19, compared to the previous week. 70% of the population over 18 years of age has received at least one dose of a COVID-19 vaccine. The Undersecretary of Prevention and Health Promotion said that the next age group contemplated in the vaccination plan would be adolescents over 16 years of age; however, there is still no date for their immunisation.

On Monday (September 20), the moving average of deaths in Brazil in the last 7 days was 557 – above the 500 mark for the 7th day in a row. Compared to the average of 14 days ago, the variation was +6%, after 22 consecutive days of decline. On Sunday (19), the Brazilian President landed in New York to take part in the UN General Assembly without being vaccinated against COVID-19. He is the only one of the G20 leaders who has not been vaccinated.

On Wednesday (September 15), the Ministry of Health published a note going back on previous guidance to vaccinate adolescents from 12 to 17-years-old without comorbidities. However, at least 13 states of the 27 in the country decided to maintain immunisation of this group.

By September 21, Brazil had 38% of its population fully immunised and 66% of the population having taken at least the first dose of a COVID-19 vaccine. The country has had 591,034 coronavirus deaths.

On Wednesday, the US FDA granted emergency use authorisation (EUA) for a third dose of the Pfizer COVID-19 vaccine for those over the age of 65, and groups at higher risk of infection. The US also plans to donate an additional 500 million COVID-19 vaccine doses to countries around the world, according to Reuters.

Protests against lockdown and mandatory vaccinations are being held in Melbourne, Australia. As some demonstrators turned violent, authorities had to use pepper spray, rubber ball grenades, and foam baton rounds to disperse the crowds. The police arrested more than 200 people on the third consecutive day of protests on September 22. The city has been under lockdown for 7 weeks now.

New Zealand eased the COVID-19 restrictions a little in Auckland on September 20. The city moved from a level 4 lockdown, the highest level, to level 3. Residents are now allowed to get takeaways and expand their household bubbles to include isolated individuals.

After 2 months of lockdown, authorities in Vietnam relaxed some restrictions in the capital Hanoi on September 21, allowing government offices, markets, essential services, and takeaway restaurants to remain open. Schools and public transport will remain shut, and public events and gatherings are still banned. Vietnam gave approval to Cuba's Abdala vaccine on September 18, making it the eighth COVID-19 vaccine approved for use in the country.

India conducted a massive COVD-19 vaccination drive on September 17, administering 25 million vaccine doses on the occasion of Prime Minister Narendra Modi's 71st birthday. Following approval of the indigenous COVID-19 vaccine ZyCoV-D, India is likely to start vaccinations for children aged 12 and above from October. The manufacturer Zydus Cadila will produce 10 million doses a month starting in October. India is likely to resume exports of COVID-19 vaccines later this year.

Authorities in China have said that 71% of the country's 1.4 billion population has received both doses of a COVID-19 vaccine.

Cambodia has announced that children ages 6- to 11-years will receive COVID-19 vaccines in order to facilitate their safe return to schools, which have remained closed for several months. Around 72% of the country's 17 million population has received at least one dose of China's Sinovac and Sinopharm COVID-19 vaccines.

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

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