COVID-19 update

19 March

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Current Situation (As of 18 Mar, 18H Geneva Time)
Updates from last 24 hours
– 19,779 new confirmed cases from 133
countries/states/territories:
– 8 countries/states/territories reported the 1st
confirmed case: Montenegro (2), Barbados (2),
Gambia (1), Zambia (2), Djibouti (1), Greenland (2),
Kyrgyzstan (3), Montserrat (1)
– 872 new death: Italy (473), Iran (Islamic Republic of)
(147), Spain (107), United States of America (39),
France (27), Indonesia (14), China (11), Bahrain (9),
Belgium (9), Switzerland (7), The United Kingdom (5),
Republic of Korea (3), San Marino (3), Algeria (2), Egypt
(2), Malaysia (2), Philippines (2), Australia (1), Austria
(1), Azerbaijan (1), Brazil (1), Japan (1), Lebanon (1),
Luxembourg (1), Portugal (1), Turkey (1), Ukraine (1)
– 4 countries/states/territories reported the 1st
death: Turkey (1), Malaysia (2), Azerbaijan (1), Brazil
(1)
Globally, between 31 Dec 2019 - 18 Mar 2020
– 207,996 cases from 169 countries/states/territories and 1
international conveyance
– 8,659 deaths: China(3242), Italy(2978), Iran (Islamic Republic
of)(1135), Spain(598), France(175), United States of
America(97), Republic of Korea(84), The United Kingdom(60),
Netherlands(58), Japan(29), Switzerland(21), Indonesia(19),
Belgium(14), Philippines(14), San Marino(14), Germany(13),
Iraq(11), Bahrain(10), International conveyance (Diamond
Princess)(7), Algeria(6), Australia(6), Egypt(6), Poland(5),
Austria(4), Denmark(4), Greece(4), Lebanon(4), India(3),
Norway(3), Argentina(2), Bulgaria(2), Ecuador(2), Ireland(2),
Luxembourg(2), Malaysia(2), Morocco(2), Portugal(2),
Ukraine(2), Albania(1), Azerbaijan(1), Brazil(1), Canada(1),
Cayman Islands(1), Dominican Republic(1), Guatemala(1),
Guyana(1), Hungary(1), Panama(1), Slovenia(1), Sudan(1),
Thailand(1), Turkey(1)
– Countries/states/territories with no new cases for >14
days: Nepal (54 days), Saint Martin (15 days)
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Number of confirmed cases notified under IHR or from official
government sources as of 18 Mar 18H

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Number of confirmed cases notified under IHR or from official
government sources as of 18 Mar 18H

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Cases reported per day for EURO countries with >500 cases

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Global COVID-19 Strategy
Goal 
• To save lives, minimize disruption of societies, and protect
economies

The Four Things that Every Country Must Do

• Prepare and Be Ready
• Detect, Protect & Treat
• Reduce and Suppress Transmission
• Learn, Innovate, Improve and Improve

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Operational Considerations for Case Management in
Health Facilities and Communities

• Guidance focuses on two key messages:

1) Key public health interventions regardless of transmission scenario; and 

2) Key actions to be taken by transmission scenario (4Cs) to enable timely surge of clinical
operations  

• Key recommendations based on Space, Staff, Supplies, Standard of care, Care

areas expansion
• Assumes 15% of patients have severe disease where hospitalization required for oxygen therapy

or other inpatient interventions; ~5% have critical disease requiring mechanical ventilation 

• Some countries have shown higher proportion of severe and critical cases; case doubling of 3
days has been observed

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 17/03/2020

Severity profile of COVID-19

Patients need Hypothetical estimate of numbers

mechanical ventilation requiring hospitalization based on
5% critical current size of outbreak:
Country Number of 20%
Patients need oxygen reported (# people
15% severe therapy cases requiring
oxygen &
40% moderate ventilation)
Pneumonia
Italy 27,980 5,596

40% mild Iran 14,991 2,998

Spain 9,942 1.988
Republic of 8,320 1,664
Korea
Germany 7,272 1,454
There are no data from populations with high Based on the following assumption: all severe (15%) and critical cases (5%) require

prevalence of HIV, malnutrition etc.

hospitalization.
These numbers represent the current situation (as of 17.03.2020) which will change as
more cases are confirmed.

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3 important points for
Health system
preparedness
• TRIAGE
• Space and Supplies
• Health care workers
Travel measures (as of 17 March 2020)

• Surge in travel restrictions

during last week 
– 89 reports (38 more
since 13 February: AFR-1,
AMR-25, EMR-4, EUR-35,
SEAR-7, WPR-17)
• Ongoing revision of travel
recommendations based on
evolving situation
• Compliance with IHR: Art
43 and Art 44 (international
collaboration)
http://unwfp.maps.arcgis.com/apps/opsdashboard/index.html#/42b8837bb25049b9b1f69a9555d55808 – export bans reported
from multiple countries

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 Operational coordination
• WB/IMF acceleration of emergency
support to countries and global
analysis of socio-economic impact
• Weekly coordination calls with
Resident Coordinators and Health
Clusters
• DCO and OCHA coordination and
sharing of responsibilities for
country support
• WHO/UNICEF/WFP coordinated supply
chains failures analysis and
mitigation strategies
• ICAO/IMO official travel circulars to
Member States and operators based on
WHO guidance
• Research and development
• Coordination of business
continuity planning and staff
advice, precautionary and treatment
measures
• FAO’s animal origins and spill-over
analysis and follow-up
• UN-wide coordination on all media
and external communication
messaging;
• Coordinated approach, guidance and
workflow on mass gatherings, and
meetings management;
• OHCHR toolkit & guidance for
systematic monitoring of human
rights impacts HEALTH
• Coordination with EMERGENCIES
G7/G20 programme
Overall estimated resources required
February-April 2020
Strategic preparedness and response pillars Estimated requirement (USD)

A) Rapidly establishing international coordination and operations 30,577,500

B) Scaling up country preparedness and response operations 640,361,927

C) Accelerating priority research and innovation 4,741,000

Total estimated resource requirement 675,680,427

Funding status Funding (USD) %

Funding received by WHO 153,482,419
Funding pledged to WHO 95,874,311
Other pledges to SPRP (globally) 344,078,788
Total 593,435,518 88%
Gap 82,244,909 12%

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COVID-19 Global Preparedness and Response Summary Measures
Data as of 16 March 2020

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Progress update: COVID-19 Partners Platform
https://covid-19-response.org
Global level updates
• UNDCO (NY) interest for use in wider UN response
• World Bank piloting for specific countries

Region level updates

• Regional focal points engaged in AFRO, EURO, PAHO
• Ongoing on-boarding in EMRO, SEARO and WPRO

Country level updates

• Increasing engagement from countries
– 25 countries participated in live demo sessions
– 11 countries identified “Country Admins”
– 3 countries actively using the Platform
• Increasing exposure in donor community Main challenge:
– 22 donors from 12 countries registered • UN Country Teams to identify “Country Admins Users”
• Global support team involvement
– 15-20 country coaching sessions planned per week

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 Personal Protective Equipment
Shipments (as of 13 March)
SHIPPED Mask, Surgical Mask, N95 Gloves, Examination Gown Goggles Faceshield

AFRO 26,700 7,400 52,300 8,013 680 2,710

PAHO 12,000 210 12,000 1,004 200 1,400
EMRO 154,000 12,420 304,000 43,072 2,400 10,000
EURO 109,080 2,450 109,100 15,300 2,500  
SERO 260,000 24,715 160,000 14,000 5,250 6,500
WPRO 139,700 4,700 90,200 3,700 2,640 220
TOTAL 701,480 51,895 727,600 85,089 13,670 20,830

SHIPPED: Regional Breakdown

Cambodia, Fiji, Kiribati, Lao People's Democratic Republic, Mongolia, Nauru, Papua New Guinea, Samoa,
WPRO 11
Solomon Islands, Tonga and Vanuatu
SEARO 9 Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste
EMRO 11 Afghanistan, Djibouti, Lebanon, Somalia, Pakistan, Sudan, Morocco, Iran, Jordan, Iraq and Tunisia
Algeria, Angola, Benin, Cape Verde, Equatorial Guinea, Ethiopia, Gambia, Ghana, Guinea, Ivory Coast,
AFRO 24 Kenya, Madagascar, Mauritania, Mauritius, Mozambique, Nigeria, Rwanda, Senegal, Seychelles,
Tanzania, Togo, Uganda, Zambia and Zimbabwe
PAHO 1 Bolivia
Armenia, Bosnia and Herzegovina, Kazakhstan, Kosovo, Kyrgyzstan, Republic of Moldova, Montenegro,
EURO 12
North Macedonia, Serbia, Tajikistan, Ukraine and Uzbekistan
TOTAL COUNTRIES 68  
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 Personal Protective Equipment
Shipments (as of 13 March)
Mask, Surgical Mask, N95 Gloves, Examination Gown Goggles Face shield 
TO BE SHIPPED
 
AFRO 86,950 5,840 105,300 10,585 1,620 6,900
PAHO 56,000 1,630 56,000 9,012 900 5,700
EMRO 20,000 400 20,000 2,400 400  
EURO 40,000 1,100 30,000 4,000 800  
SERO 142,000 8,630 122,000 9,500 2,800 6,100
WPRO 70,000 2,000 240,000 6,000 2,000 5,000
TOTAL 414,950 19,600 573,300 41,497 8,520 23,700

TO BE SHIPPED: Regional Breakdown

WPRO 3 China, Mongolia and the Philippines
Bangladesh, Bhutan, Korea, Democratic People's Republic of, Maldives
SEARO 7 Nepal, Sri Lanka and Thailand
EMRO 2 Syria and Yemen
Algeria, Benin, Burkina Faso, Cameroon, Congo, Eritrea, Ethiopia, Ivory Coast, Kenya, Mali, Nigeria,
AFRO 14
Senegal, South Africa and Togo
PAHO 4 Ecuador, Haiti, Honduras and Venezuela, Bolivarian Republic of
EURO 4 Albania, Azerbaijan, Belarus and Turkmenistan
TOTAL COUNTRIES 34  

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LPV/r in patients with severe
COVID-19

Key findings:
• Open label (not blinded) - n= 199
• 1 hospital in Whuan ( China)
• time to clinical improvement, 28 day
mortality rate and throat viral RNA
detectability were similar in both
arms
• median time to clinical improvement
was shorter by 1 day in LPV/r arm
(modified ITT)
• Gastrointestinal adverse events were
more common in LPV/r arm
• Continuous follow up planned
.

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Cao et al, NEJM, March 2020
WHO recommendations supporting DSD for clinically stable
clients

WHEN
• 3-6 monthly ART refills
• 3-6 monthly clinic visits
WHERE
• ART maintenance at community level
WHO
• Trained non-physicians/nurses/midwives can initiate and maintain ART
• Trained/supervised lay providers can distribute ART
• Trained/supervised CHWs can dispense ART between clinic visits
 Country uptake of clinic visit frequency
80

70
Number of countries
60

50

40

30

20

10

0
Monthly Every 3 months Every 6 months Every 12 months

Clinic visits ART refills

 Updated evidence: Retention
Reduced clinic visit frequency vs. 1 monthly clinic visit frequency
 Benefits of differentiated service delivery
6 monthly clinic visits Good adherence Home delivery of 3 monthly clinic visits
improves retention in with 3 monthly ART feasible and reduces costs to
Zambia clinic visits in Spain improves outcomes patients and health
in UK & Spain system in Kenya and
Uganda

Mody, Clin Inf Dis 2017

Munoz-Moreno, IAS 2016 Thirumurthy, IAS 2016

Leon PlosONE 2011; Harte I J STD AIDS 2008