Calls for Vaccination, Cases Rising in Europe and America, and the COVID Passport: COVID-19 Global Weekly Highlights

Medscape, Univadis, & MediQuality Staff

November 25, 2021

In the UK, a report has found that the government was not "fully prepared" for the "wide-ranging impacts" that COVID-19 had on society, the economy, and essential public services. Detailed plans on shielding, job support schemes, and school disruption were found to be lacking. Additionally, "previous simulation exercises" – that would have helped with COVID-19 preparations – were "not fully implemented", according to the National Audit Office (NAO). Besides this, the British Medical Association (BMA) has called for a wide-ranging appraisal of racial bias throughout the health system after the Government ordered a review to investigate whether medical devices were equally effective regardless of a patient’s ethnicity. On Friday, November 19, it was announced that people who have had a COVID-19 vaccine booster or a third dose will now be able to demonstrate their updated vaccine status through the NHS COVID Pass. The European Medicines Agency (EMA) has started reviewing data on a new COVID-19 vaccine, Nuvaxovid (also known as NVX-CoV2373), with the effectiveness and safety of the vaccine being evaluated under an accelerated timeline, and a decision could be issued within weeks.

COVID-19 cases have increased to around 42,500 per day, at a rate of 427.6 per 100,000 population. The number of deaths have decreased by 5.5% and there has been a 9.5% reduction in hospital admissions. So far, 80.3% of over-12s are fully vaccinated and 27.2% have received a third vaccine dose or booster.

In France, the fifth wave of the pandemic "started off with a bang," said Gabriel Attal, government spokesman. Evidence, if needed, that the fifth wave is in full force, was seen in the fact that Prime Minister Jean Castex was diagnosed positive for SARS-CoV-2 on Monday, November 22, after one of his daughters tested positive earlier that day. The Minister of National Education Jean-Michel Blanquer told the National Assembly on Tuesday that 6000 classes were cancelled in France, an increase of 2000 compared to 4 days earlier.

On November 24, 32,591 cases of infection were recorded, 83% more than the previous week. The incidence of COVID is now 193 per 100,000. The replication rate of the virus is 1.44. Critical care admissions increased by 37% over 7 days.

The Minister of Health Olivier Véran announced new measures to limit the spread of the epidemic: wearing a mask has become mandatory again in establishments open to the public and outdoors in areas of high population density; PCR tests are only now valid for 24 hours (instead of 72 hours); a booster dose is now recommended for those aged 18 years and older with a shortened time to 5 months after the second dose. The health authority agency HAS has announced that its happy with the changes to the booster dose, and has also specified that the booster procedure should be followed in the event of a COVID infection before or after vaccination.

Note that for more than a week, Guadeloupe and Martinique, where the COVID epidemic is on the rise again, have been plagued by urban violence. Some point to forced vaccination for caregivers and firefighters as the starting point of the riots.

Meanwhile, the French Minister of Health Olivier Véran has launched a new call for vaccination and the High Authority for Health has come out in favour of a booster dose at 6 months for all adults from the age of 40. The institution has also specified the procedure to be followed in the event of a COVID-19 infection before or after vaccination.

Faced with the surge in cases, the Italian government has decided that unvaccinated people will no longer be able to access restaurants, bars, cinemas, theaters, nightclubs, and gyms. In addition, since Wednesday, all Italians aged over 40 can receive the booster dose 5 months after the second dose, the Ministry of Health having decided to shorten the 6-month period that was initially planned. Those aged over 18 will be able to obtain a booster dose from December 1.

Belgium has made working from home compulsory again - at least 4 days per week - and required masks to be worn in all venues and events covered by the COVID Safe Ticket. The coronavirus consultative committee has also confirmed that an extra dose of the vaccine will be offered to all fully vaccinated residents in due course and has reduced the minimum age for mask-wearing from 12 years to 10. Prime Minister Alexander De Croo and Interior Minister Annelies Verlinden have received negative coronavirus test results, after coming into contact with French prime Minister Jean Castex on Monday, who later tested positive for COVID. 

The nationwide 7-day incidence in Germany exceeded the 400 mark on Wednesday for the first time since the beginning of the pandemic. The Robert Koch Institute reported 404.5 new infections per 100,000 persons for the week. The previous day was 399. In the previous week was 319, and 106 a month earlier. The number of new infections per day was 66,884.

In view of these rapidly rising numbers, stricter measures have been in place as of this week. For example, from November 24, the new Infection Protection Act states that employers, employees, and visitors to surgeries and other health facilities must present a daily antigen test, regardless of whether they have been vaccinated or have recovered from infection. Patients are exempt.

The Standing Commission on Vaccination (STIKO) wants to decide before the end of the year whether a COVID-19 vaccination will be recommended for children from the age of 5 in Germany. According to STIKO chairman Thomas Mertens, the aim is to "finalise this recommendation by the end of December, if possible by the start of delivery of the vaccine for children to the Länder".

In Switzerland, 8585 people were newly infected with SARS-CoV-2 from November 23 to November 24, and 103 were admitted to hospital, as reported by the Federal Office of Public Health (FOPH). In addition, 17 people died of or with COVID-19.

The rising number of cases is increasing the pressure on hospitals. The president of the COVID task force, Tanja Stadler, said on November 23 that this rise in numbers must be stopped immediately. She drew parallels to the currently prevailing situation in neighbouring Austria and did not rule out a similar situation in Switzerland by mid-December. She and Patrick Mathys of the FOPH are, therefore, appealing to the population to minimise risks in their own behaviour. This means vaccinating oneself, reducing contacts and protecting oneself better in case of contact.

To date, 65.4% of the population in Switzerland has been fully vaccinated. The Medicines Agency also cleared the way for booster vaccinations with the Pfizer/ BioNTech vaccine for people aged 16 and over, and for particularly vulnerable groups as young as 12. Provided that the vaccination was given 6 months previously.

In Austria, 74.7% of the vaccine-eligible population had received an active vaccination certificate by November 23, and 79.1% have been vaccinated against COVID-19 at least once. The 7-day incidence on 23 November was 1084 - the first slight downward trend since the lockdown for the unvaccinated began on November 15. The previous day, the 7-day incidence had been 1114.7.

The last few weeks in Portugal were marked by collective dismissals of doctors from large public hospitals. Professionals allege poor working conditions. Doctors and nurses even called general strikes for the beginning of November to draw attention to the situation. The strikes, however, ended up being suspended after the confirmation of the dissolution of the Parliment and the calling of early elections for January 30th. Between November 21 and 22, the country registered 1475 new cases and 18 deaths – most of individuals aged over 80 years. This is the highest number of daily deaths recorded since August 8. The incidence at the national level once again showed a significant increase, reaching 228.9 cases per 100,000 population, while the transmissibility rate (Rt) rose to 1.19. Last week, it was at 191.2 cases per 100,000 population, with Rt at 1.17, according to the Directorate-General for Health (DGS).

In Spain the Ministry of Health and the regional governments will meet again on Wednesday in the Interterritorial Council of the National Health System to discuss the implementation of the Covid Passport. The requirement of the certificate to access restaurants and other places of entertainment is gaining strength. 

On Tuesday, the Ministry of Health notified 6777 new infections and added 34 deaths to the official count. The incidence has risen seven points and has reached 139 cases per 100,000 inhabitants in the last 14 days. The Public Health Commission approved Tuesday the administration of a third dose to those aged over 60 years and to health and social health workers. The experts from the ministry and the regions debated the modification of the COVID-19 traffic light criteria and only "the indicators and risk levels were approved, but without measures," said Minister Carolina Darias.

The Secretary of State for Health talked on Tuesday about the difference in numbers between vaccinated and unvaccinated people, highlighting that "the incidence for vaccinated people last week stood at 23, while in the unvaccinated raised to 181.5".

To date, more than 37.5 million people (79.2% of the population) have received the complete vaccination schedule against COVID-19, and 38.2 million (80.6% of the population) have at least one dose.

In the Americas, there were 880,583 new COVID-19 infections and more than 15,000 COVID-related deaths reported in the past week.

In the US, cases and hospitalizations are rising again as the nation enters its fifth surge. The timing of the increase is troubling since it is coming ahead of a busy holiday travel season. All adults are now eligible for booster shots. Children as young as age 5 are now eligible for the primary series of vaccines, and about 11% of this age group has received a first shot. About two-thirds of the US population is fully vaccinated.

According to PAHO director, Dr Carissa F. Etienne, Central America saw a 37% reduction in new infections. But most of the countries in South America are reporting an increase in new cases and hospitalisations; in Bolivia the cases have increase 400%. In the Caribbean, Trinidad and Tobago, Barbados, the Cayman Islands, and the Dominican Republic, are reporting high rates of new infections.

A reported 51% of people in Latin America and the Caribbean have been fully vaccinated against COVID-19, but there are 19 countries in the region that have not reached the WHO targets to vaccinate 40% of their population by the end of this year.

In Brazil, the Ministry of Health finally started talks with pharmaceutical companies Pfizer and AstraZeneca for the purchase of new oral medicines against COVID-19. The antiviral produced by Merck, which is being tested in the country by Fiocruz, is one more possibility. Many countries have already reserved large quantities of the new drugs to reduce the risk of hospitalisations and deaths. Last Saturday, a national campaign began to encourage the 21 million people who did not return for a second dose or the booster dose of the vaccine. By Monday, almost 61% of the Brazilian population had been fully immunized against COVID-19 with a complete vaccine schedule (129,703,343 people). Another 74.09% took at least the first dose of vaccines (158,049,247 people). The booster dose was given to 294,031 people.

In Africa, to date, there have been at least 8,690,000 reported infections and 222,000 reported deaths. In South Africa, the average number of new infections reported has been increasing for 10 days straight. In Mauritius, the average number of new infections has risen by more than 130 over the last 3 weeks, 27% of its previous peak.

According to the African CDC, 9.52% of the population has at least one dose of the vaccine and 6.48% the full regime. 

New Zealand has announced that its international borders will open to fully vaccinated travelers from April 30, 2022. 

On November 22, Australia announced reopening of its borders for students and certain foreign visa holders from December 1. There have been ongoing protests in the country against the mandatory vaccinations for people in specific occupations implemented by some states.

South Korea's new daily COVID-19 infections crossed the 4000 mark for the first time since the beginning of the pandemic. Majority of the 4116 cases reported on November 24 were from Seoul and its adjacent metropolitan region.

Singapore's relaxation of certain COVID restrictions came into effect from November 22. Vaccinated people are now allowed to meet in groups of up to five, up from two previously. Other protocols like wearing masks in public spaces remain in force. 

Hong Kong has approved the Chinese Sinovac COVID-19 vaccine for children aged 3 years and above, with adolescents aged 12-17 years being given priority in vaccination.

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

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