2020
January
1 January 2020
o The Huanan Seafood Wholesale Market was closed for environmental cleaning and disinfection (situation report #1) [2]
2 January 2020
o The WHO activated the Incident Management Support Team (IMST) – headquarters, regional headquarters, and the country level (situation report #1) [2]
o The WHO shared details about the cluster of pneumonia cases in China with Global Outbreak Alert and Response Network (GOARN) partners [3]
5 January 2020
o The WHO provided details about the cluster through the International Health Regulations (IHR 2005) Event Information System (information about cases and precautions to take) – shared with the Member States [3]
o The WHO shared its first Disease Outbreak News report [4]
7 January 2020
o Chinese authorities isolated and identified a new type of coronavirus - tentatively called “2019-nCoV” (situation report #1) [2, 5, 6]
o The U.S. Centers for Disease Control and Prevention (CDC) established a 2019-nCoV Incident Management Structure - following the preparedness plan that was implemented for Middle East Respiratory Syndrome (MERS-CoV) (situation report #3) [7]
9 January 2020
o The WHO issued a statement on the preliminary determination of a novel coronavirus [8]
At the time, the WHO did not recommend any specific measures for travellers – they advised against any travel or trade restrictions on China based on the data available)
10 January 2020
o Several meetings were held to discuss the coronavirus outbreak:
Strategic and Technical Advisory Group on Infectious Hazards (STAG-IH) [3]
Global Coordination Mechanism for Research and Development (prevention and response to epidemic) [3]
Scientific Advisory Group (Research and Development Blueprint) [3]
11-12 January 2020
o The National Health Commission China provided further information to the WHO - the association between the outbreak with exposures in the Huanan Seafood Wholesale Market was being investigated (situation report #1) [2]
12 January 2020
o The genetic sequence of the virus was shared by China for the development of diagnostic kits/tools (situation report #1) [2]
13 January 2020
o In Thailand, the Ministry of Public Health reported the first imported case of lab-confirmed 2019-nCoV from Wuhan, Hubei Province, China (situation report #1) [2]
o The WHO published the protocol for a reverse transcription polymerase chain reaction (RT-PCR) assay that was developed in Germany [9, 10]
15 January 2020
o An imported case of lab-confirmed 2019-nCoV from Wuhan was reported by the Ministry of Health, Labour and Welfare, Japan (situation report #1) [2]
16 January 2020
o An epidemiological alert was issued by the Pan American Health Organization/WHO Regional office for the Americas (PAHO/AMRO) [11]
17 January 2020
o The CDC began screening passengers who had been on direct and connecting flights from Wuhan, China - initially occurred at the three main ports of entry in the U.S. (situation report #3) [12]
20 January 2020
o The National IHR Focal Point for the Republic of Korea reported the first case of 2019-nCoV (situation report #1) [2]
o The CDC confirmed that a traveller who visited family in Wuhan, China (returned on 15 January) tested positive for 2019-nCoV by real-time RT-PCR assay - confirmed 20 January 2020 (first case in the United States of America) [13]
20-21 January 2020
o Delegates from the WHO conducted a field visit to Wuhan to learn about the response to 2019-nCoV [14]
Evidence of human-human transmission was found
21 January 2020
o The Chinese Government released the primers and probes used in the rRT-PCR test kit [14]
o The CDC activated its Emergency Response System and updated its interim travel health notice for persons traveling to Wuhan City, China (situation report #3) [12]
22 January 2020
o A report from the field visit was issued - data collected through the epidemiological investigation suggested human-to-human transmission was taking placing in Wuhan [14]
23 January 2020
o Although the initial source of 2019-nCoV was unknown, there was more evidence demonstrating that the virus was spreading from human- to- human and across generations of cases + family clusters involving individuals with no reported travel to Wuhan were emerging from Guangdong Province (situation report #3) [12]
o Wuhan entered lockdown on 23 January 2020 [15]
22-23 January 2020
o The first meeting of the IHR (2005) Emergency Committee (EC) was convened by the WHO Director-General (Dr Tedros Adhanom Ghebreyesus - teleconference) to discuss the outbreak of 2019-nCoV (situation report #4) [16, 17]
o Due to the limited information available, it was advised that the event did not constitute a Public Health Emergency of International Concern (PHEIC) – members agreed on the urgency of the situation and suggested that they should reconvene in a matter of days to examine the situation further [17]
o Chinese authorities provided evidence that revealed an increase in the number of confirmed and suspected cases, provinces that have been affected, and the proportion of deaths in currently reported cases of 4% - this resulted in strong containment measures being implemented [17]
The Emergency Committee were also informed about the situation in Japan, Republic of Korea, and Thailand, and one new possible case in Singapore
Human-to-human transmission was found to be occurring and the R0 was estimated to be 1.4-2.5
The source was still unknown and the extent of human-to-human transmission was under investigation
24 January 2020
o Three cases of 2019-nCoV were reported in France - the affected individuals recently stayed in Wuhan - first cases in Europe (situation report #5 – data as reported by 25 January 2020) [18, 19]
o There was an informal consultation on therapeutic agents that may be used for the 2019-nCoV infection (WHO Research and Development (R&D) Blueprint) [20]
In China, lopinavir and ritonavir were being evaluated in clinical trials + a randomised control trial evaluating the safety and efficacy of remdesivir was being planned
Candidate therapeutics
Antiretroviral medicine - lopinavir/ritonavir (either alone or in combination with interferon-beta-1b)
Monoclonal and polyclonal antibodies
Convalescent sera
Transmembrane serine protease 2 (TMPRSS-2) inhibitors
Ribavirin – (based on the evidence available, this did not appear like a candidate worth further investigation)
Immunosuppressants and immunostimulators (eg. corticosteroids/steroids) were identified as products to be deprioritised due to a lack of evidence (important to differentiate between mild and severe disease)
Chloroquine – insufficient evidence to support its further investigation
Non-antiviral products - statins, heparin and high dose vitamin C could be considered (require more discussion)
o The Director of the Pan American Health Organization (PAHO) urged countries to have systems in place for the detection of cases, isolation, and care for patients infected with the new coronavirus [21]
25 January 2020
o The first case of 2019-nCoV was reported in Australia (Victoria)
The patient was a man from Wuhan, who flew to Melbourne from Guandong on 19 January 2020 (situation report #5) [18, 22]
o The WHO Regional Director for Europe issued a statement encouraging countries to continue to prepare for testing samples, detecting the virus, and managing patients [23]
27 January 2020
o The WHO Director-General and colleagues were in Beijing to meet with leaders and health experts involved in the response (situation report #7) [24]
Based on the latest evidence, the incubation period of the virus was estimated to range from 2-10 days
o In a statement, the WHO Regional Director for South-East Asia urged countries to focus on being equipped for the detection of cases and preventing the spread of the virus [25]
28 January 2020
o The Global 2019-nCoV Clinical Data Platform was launched by the WHO - anonymised clinical data provided by Member States could help to strengthen the public health response (situation report #8) [26]
o A sequence carrying the D614G mutation was collected from Germany [27, 28]
29 January 2020
o The Pandemic Supply Chain Network (PSCN) was established by the WHO and World Economic Forum - one of the first tasks was to develop an assessment for the global demand and supply of personal protective equipment (PPE) (situation report #9) [29]
o Former President Donald J. Trump announced the formation of the Coronavirus Task Force [30]
The Coronavirus Task Force will be responsible for leading the U.S. Government response against 2019-nCoV – monitor, contain, and mitigate the spread of the virus
Members - Secretary Alex Azar (Secretary of Health and Human Services), Robert O’Brien, Dr. Robert Redfield, Dr. Anthony Fauci, Deputy Secretary Stephen Biegun, Ken Cuccinelli, Joel Szabat, Matthew Pottinger, Rob Blair, Joseph Grogan, Christopher Liddell, and Derek Kan
o The Peter Doherty Institute for Infection and Immunity (Doherty Institute, Melbourne, Victoria) announced that they had grown the virus in cell culture for the first time outside of China [31]
This would be important for the generation of antibody tests and assessing the effectiveness of vaccine candidates
A sample from a patient was used to grow the virus - the sample arrived at the Royal Melbourne Hospital’s Victorian Infectious Diseases Reference Laboratory at the Doherty on Friday, 24 January
o The United Arab Emirates reported the first cases of 2019-nCoV - The WHO Regional Director for the Eastern Mediterranean stated that disease trends will be monitored [32]
30 January 2020
o The IHR Emergency Committee was reconvened – they concluded that the outbreak constituted a Public Health Emergency of International Concern (PHEIC) (situation report #10) [33]
The WHO announced that the interim name of the disease responsible for the current outbreak should be “2019-nCoV acute respiratory disease” or “2019-nCoV” – International Committee on Taxonomy of Viruses would provide the final name of the disease (International Classification of Diseases)
31 January 2020
o The WHO Information Network for Epidemics (EPI-WIN) was launched (situation report #11) [34]
By the 31st of January 2020, 2019-nCoV had spread to 19 countries outside of China
Japan, Republic of Korea, Viet Nam, Singapore, Australia, Malaysia, Cambodia, Philippines, Thailand, Nepal, Sri Lanka, India, United States of America, Canada, France, Finland, Germany, Italy, and the United Arab Emirates
Globally – 9826 confirmed cases (106 confirmed outside of China, 9720 confirmed in China), China (15238 suspected cases, 1527 severe, and 213 deaths)
WHO Risk Assessment – China (Very High), Regional Level (High), and Global Level (High)
The recommendations and advice for the public were to:
Avoid close contact with people suffering from acute respiratory infections
Wash hands frequently
Avoid unprotected contact with farm or wild animals
Practice cough etiquette (disposable tissues or clothing, washing hands)
Enhance standard infection prevention and control measures in hospitals or healthcare facilities (especially emergency departments)
*No specific health measures for travellers (individuals who were symptoms were encouraged to seek medical attention and share their travel history with their healthcare provider)
o The WHO Regional Director for Africa released a statement with guidance on how to prepare for a possible novel coronavirus outbreak [35]
February
1 February 2020 (data within 24 hours – situation report #12)
o Key points [36]:
It was mentioned that symptomatic cases were the main drivers of transmission (compared to asymptomatic cases)
It was announced that for the first time outside China, a healthcare worker was diagnosed with 2019-nCoV (occurred in France)
The first case of third-generation human-human transmission outside China was recorded
It was the first time that a case was exported from a country other than China (a patient in South Korea was exposed to 2019-nCoV in Japan)
2 February 2020
o The Philippines reported the first COVID-19 death outside of China (a 44-year old male patient) (situation report #13) [37]
4 February 2020
o The WHO published the Strategic Preparedness and Response Plan (public health measures that the international community can provide for 2019-nCoV were outlined) [38]
o The U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorisation (EUA) for the first 2019-nCoV RT-PCR diagnostic panel (allowed any CDC-qualified lab across the country to use the test) [39]
7 February 2020
o Through official reports, statements, and the media, a total of 72 States Parties were found to be implementing travel restrictions (situation report #18) [40]
9 February 2020
o Japanese National Health Authorities provided the WHO with details on the situation of the Cruise Ship Diamond Princess - 64 individuals (passengers and crew members) were found to have been infected with 2019-nCoV (situation report #20) [41]
11-12 February 2020
o 11 February 2020 - The WHO named the disease COVID-19, short for “coronavirus disease 2019” + announced the launch of a United Nations (UN) Crisis Management Team (situation report #22) [42] [43]
Increasing evidence of a link between 2019-nCoV and coronaviruses circulating in bats (Rhinolophus bat sub-species) - most likely hypothesis is that an intermediary host has played a role in transmission
o 11-12 February 2020
The WHO convened the global research and innovation forum (to identify knowledge gaps and research priorities, and improve international action - part of the R&D Blueprint) (situation report #21) [44]
14 February 2020
o The WHO Operations Support and Logistics (OSL) team started dispatching laboratory COVID-19 testing kits for 56 countries (situation report #29) [45]
o Egypt reported its first confirmed COVID-19 case (second country in the Eastern Mediterranean region and the first reported case from the African continent) - (situation report #26) [46]
15 February 2020
o The WHO Director-General spoke at the Munich Security Conference - there were three requests for the international community; use the window of opportunity to strengthen preparedness; a whole-of-government approach will be needed; the response must be guided by solidarity, not stigma (situation report #26) [46, 47]
16-24 February 2020
o WHO-China Joint Mission
A team was sent to Beijing to prepare an international mission – to determine knowledge gaps and questions that need to be investigated (ie. characteristics of the virus to China’s public health response) (situation report #22) [42]
19 February 2020
o The WHO highlighted their work with statisticians and mathematical modellers to predict epidemiological parameters of COVID-19 (incubation period, case fatality ratio, and the serial interval) (situation report #30) [48]
Preliminary estimates - median incubation period of 5-6 days (ranging from 0-14 days), serial interval range from 4.4 to 7.5 days, case fatality ratio within China of 2.3%, outside China the case fatality ratio estimates among confirmed cases is lower, current infection fatality ratio estimates range from 0.94% to 1% (situation report #30 and #31)
23 February 2020
o Due to the high levels of transmission in Italy, the Decree-Law 6/2020 was issued - to attempt to contain and manage COVID-19 [49]
24 February 2020
o Experts from WHO and the European Centre for Disease Prevention and Control (ECDC) arrived in Italy to provide guidance/assistance – Italy reported a rapid increase in laboratory-confirmed cases since 21 February 2020 (situation report #36) [50, 51]
25 February 2020
o Algeria reported its first COVID-19 case (first Member State of the African region) (situation report #37) [52]
o More new cases have been reported from countries outside of China than from China [52]
27 February 2020
o As of 27 February, 41 States Parties reported the implementation of additional health measures to the WHO (denial of entry of travellers from China or from countries with on-going transmission of COVID-19, quarantine and self-isolation requirements, and visa restrictions) (situation report #39) [53]
o The WHO published interim guidance on the use of PPE (situation report #40) [54]
28 February 2020
o The risk of spread and the impact of COVID-19 (globally) was upgraded to very high by the WHO (situation report #39) [53]
o The results from the Joint Mission were released [55]
29 February 2020
o By 29 February 2020 (situation report #40) [54]
Globally – 85 403 confirmed
China – 79 394 confirmed and 2838 deaths
Outside of China – 6009 confirmed, 53 countries, 86 deaths
WHO Risk Assessment – China (Very High), Regional level (Very High), Global level (Very High)
o The FDA issued a new policy - to assist with the rapid development of diagnostic tests for COVID-19 [56]
March
1 March 2020 (situation report #41)
o Key points [57] :
The majority of patients with COVID-19 were adults - commonly reported symptoms included fever, dry cough, and shortness of breath
Most patients experienced mild illness – evidence suggested that severity was associated with age and co-morbid disease
For patients with severe COVID-19, oxygen therapy was the main treatment intervention
At the time, no known effective antiviral therapies were available – many ethics-approved clinical trials (ritonavir/lopinavir and remdesivir) were occurring
2 March 2020
o Experts from the WHO arrived in Tehran, Islamic Republic of Iran, to provide support for the COVID-19 outbreak (situation report #42) [58]
o The FDA and CDC took action to make more respirators (including certain N95s) available to health care workers [59]
6 March 2020
o The Grand Princess cruise ship was stranded off the coast of California with more than 3,500 people aboard [7]
7 March 2020
o As of 7 March 2020, the global number of reported COVID-19 cases surpassed 100,000 (situation report #47) [60]
11 March 2020
o The WHO declared COVID-19 to be a pandemic – they were deeply concerned about the spread and severity of the virus, and by the alarming levels of inaction (situation report #51) [61]
It was reported that COVID-19 infects people of all ages – higher risk groups included those who were older and individuals with underlying medical conditions
12 March 2020
o The WHO Director-General reiterated that countries need to focus on stopping the outbreak –“a shift from containment to mitigation would be wrong and dangerous – this is a controllable pandemic” (situation report #52) [62]
o A news report was released, informing the public that experts from the WHO, GOARN partners, Robert Koch Institute in Berlin and the Chinese Center for Disease Control concluded their Iran mission (on 10 March, 2020) [63]
13 March 2020
o The WHO Director-General stated that Europe has become the epicenter of the pandemic (reported more cases and deaths compared to the rest of the world - apart from China) (situation report #54) [64, 65]
o The Trump Administration declared a nationwide emergency [66]
15 March 2020
o In addition to supplying test kits and PPE to Iraq, three negative-pressure rooms were being developed by the WHO in Baghdad, Erbil, and Basra - to accommodate patients requiring more sophisticated medical treatment (situation report #55) [67, 68]
16 March 2020
o As of 16 March 2020, the total number of cases and deaths outside China had surpassed the total number of cases in China (situation report #56) [69]
o The commencement of the Phase 1 clinical trial of the mRNA-1273 vaccine was announced - developed by the National Institute of Allergy and Infectious Diseases (NIAID) Vaccine Research Center and Moderna (first participant in the study was dosed) [70]
17 March 2020
o The University of Minnesota launched a clinical trial testing hydroxychloroquine as a post-exposure treatment for COVID-19 [71]
18 March 2020
o The WHO Solidarity Trial was announced – a large international study to compare treatments (situation report #60) [72] [73]
19 March 2020
o As of 19 March 2020, the number of confirmed cases surpassed 200,000
It took more than three months for 100,000 COVID-19 cases to be reached - only 12 days to reach another 100,000 cases (situation report #59) [74]
o The FDA advised that the use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19 needs further investigation - not aware of scientific evidence linking NSAIDs with worsening symptoms [75]
20 March 2020
o New South Wales (NSW) Health announced that passengers on the Ruby Princess cruise ship tested positive to COVID-19 (8 March - 19 March) [76]
21 March 2020
o The FDA issued the first EUA for a point-of-care diagnostic test (Cepheid Xpert Xpress SARS-CoV-2 test) [77]
23 March 2020
o As of 23 March 2020, the number of COVID-19 cases surpassed 300,000 globally (situation report #63) [78]
o In a press release, the collaboration between the FDA and European Medicines Agency (EMA) was discussed - on 18 March 2020, they jointly charged a meeting on SARS-CoV-2 vaccine development [79]
24 March 2020
o The Government of Japan and the International Olympic Committee made the decision to postpone the Olympic and Paralympic Games [80]
o The FDA provided information about their efforts to facilitate access to convalescent plasma that has been collected from the blood of fully recovered COVID-19 patients - given as treatment to very ill patients [81]
They also took action to increase PPE and other medical supplies
25 March 2020 (situation report #66)
o Key points [82]:
The WHO recommended individuals to maintain physical distance but not social distance + maintain hand hygiene, respiratory etiquette, and cleaning of surfaces
Evidence suggested that COVID-19 is transmitted during close contact through respiratory droplets and by fomites – spreads directly from person to person (ie. by coughing or exhaling, or by landing on objects and surfaces)
Airborne transmission – limited to aerosol generating procedures during clinical care of COVID-19 patients
Use of medical masks – recommended for those caring for COVID-19 patients + respirators (N95, FFP2 or FFP3) for settings where aerosol generating procedures take place
o A COVID-19 technical support mission to Egypt was concluded on 25 March 2020 – the aims were to gain more insight into the situation, evaluate their response activities, identify strengths/gaps, and provide support (situation report #67) [83] [84]
26 March 2020
o The WHO Director-General addressed the G20 Extraordinary Leader’s Summit (called on countries to fight, unite, and ignite - so that the situation never happens again) (situation report #67) [83]
27 March 2020 (situation report #67)
o As of 27 March 2020, the global number of cases exceeded 500,000 [83]
o The WHO-Director General made a speech [85]:
Almost 2 million items of protective gear has been shipped to 74 countries – preparing to send a similar amount to a further 60 countries (shortage of PPE)
It was announced that in Norway and Spain, the first patients will soon be enrolled in the Solidarity Trial
The safety and effectiveness of four different drugs or drug combinations against COVID-19 will be compared - global effort
Individuals and countries were warned to avoid using therapeutics that have not been found to be effective in the treatment of COVID-19
o The FDA took action to help increase the supply of ventilators and respirators for the protection of healthcare workers and patients [86]
28 March 2020
o The WHO published a manual on how to set up/manage a severe acute respiratory infection (SARI) treatment centre and a SARI screening facility in healthcare facilities (situation report #68) [87]
o The FDA issued an EUA for hydroxychloroquine sulfate and chloroquine phosphate products - to be distributed and used for hospitalised patients (adolescent and adults) with COVID-19 (where a clinical trial may not be available or feasible) [88]
31 March 2020 (situation report #71)
o By 31 March 2020, there were 750,890 confirmed COVID-19 cases and 36,405 deaths [89]
o The FDA introduced the Coronavirus Treatment Acceleration Program (C-TAP) [90]
April
2 April 2020
o A summary was provided about the routes of transmission (situation report #73) [91]
Primarily transmitted from symptomatic individuals to close contacts - via respiratory droplets, direct contact with infected persons, or by contact with contaminated surfaces
Shedding is highest in the upper respiratory tract– within the first 3 days from the onset of symptoms
Incubation period – on average 5-6 days (can be up to 14 days)
Some people can test positive 1-3 days before they develop symptoms
There have been few reports of laboratory-confirmed cases who are truly asymptomatic - no documented asymptomatic transmission to date
4 April 2020
o By 4 April 2020, the number of cases climbed above 1 million and there were over 50,000 deaths globally (situation report #75) [92]
o The Doherty Institute issued a news release on ivermectin as a potential antiviral drug against SARS-CoV-2 [93]
10 April 2020
o The FDA authorised a blood purification device to treat patients over the age of 18 with COVID-19 (admitted to the intensive care unit (ICU) – with confirmed or imminent respiratory failure) [94]
6 April 2020
o Almost 90% of the students worldwide have been affected by school closures (more than 1.5 billion children and young people) (situation report #77) [95]
o The WHO issued guidance on the use of medical masks in the context of COVID-19 - although medical masks are an important tool, wearing a mask alone is insufficient to provide an adequate level of protection [96]
7 April 2020
o The WHO listed the first two diagnostic tests for emergency use - in vitro diagnostics (genesig Real-Time PCR Coronavirus and cobas SARS-CoV-2 Qualitative assay) (situation report #79) [97] [98]
12 April 2020
o By 12 April 2020, the global death toll surpassed 100,000 (situation report #83) [99]
13 April 2020
o The WHO released a declaration from scientists, physicians, funders, and manufactures – “to help speed the availability of a vaccine against COVID-19” (situation report #85) [100, 101]
o Two clinical trials were underway - to evaluate the efficacy of the Bacille Calmette-Guérin (BCG) vaccine against COVID-19 infection - the WHO did not recommend using the BCG vaccine until evidence from the trials had been reviewed (situation report #84) [102]
14 April 2020
o The U.S. government halted funding to the WHO – claims of mismanagement of the coronavirus outbreak [103]
15 April 2020
o No evidence that the poliovirus vaccine provided protection against infection with COVID-19 - a clinical trial was being planned in the U.S. to evaluate its efficacy (situation report #86) [104]
17 April 2020
o By 17 April 2020, the number of reported confirmed cases exceeded 2 million (situation report #88) [105]
18-19 April 2020
o The WHO and Global Citizen joined forces with many of the world’s artists for the “One World, Together At Home” global special - raised a total of $127.9 million ($55.1 million to the COVID-19 Solidarity Response Fund and $72.8 million to local and regional responders) (situation report #89) [106]
19 April 2020
o The WHO published a scientific brief on the use of NSAIDs in COVID-19 patients - “no evidence of severe adverse events, acute health care utilisation, long-term survival, or quality of life in patients with COVID-19” (situation report #91) [107, 108]
21 April 2020
o As of 21 April 2020, over 100 countries had joined the Solidarity Trial (situation report #92) [109]
o The FDA authorised the first at home diagnostic test (RT-PCR test) - permitted patients to self-swab at home and mail their nasal samples to a lab for testing [110]
23 April 2020
o Researchers reported that the evidence available supports the hypothesis that SARS-CoV-2 has zoonotic origins (evidence does not support the virus being a laboratory construct) (situation report #94) [111]
24 April 2020 (situation report #96)
o Key points [112]:
A virtual event was held (organised by the WHO, President of France, the President of the European Commission, and the Bill and Melinda Gates Foundation) à launched the Access to COVID-19 Tools (ACT) Accelerator to speed up the production of diagnostics, therapeutics, and vaccines
Leaders from around the world expressed their support for this collaboration [113]
They also addressed “immunity passports” or “risk-free certificates” – some governments suggested that the detection of antibodies could serve as the basis for this (at the time, there was no evidence that people who had recovered and had antibodies were protected)
26 April 2020 (situation report #97)
o The WHO published the core protocol for therapeutics against COVID-19
A large international study/clinical trial was being designed to evaluate potential treatments - consistent across multiple countries [114]
27 April 2020
o Reports emerged of children and adolescents being admitted into intensive care units in the U.S. and United Kingdom (U.K.) with Multisystem Inflammatory Syndrome in Children (MIS-C) – similar to Kawasaki disease and toxic shock syndrome [115] [116]
28 April 2020 (situation report #99)
o Key points [117]:
The WHO published a list of the experimental treatments being investigated for COVID-19 “COVID classification of treatment types”
By 28 April 2020, the number of deaths exceeded 200,000
29 April 2020 (situation report #100)
o By 29 April 2020, the total number of confirmed cases exceeded 3 million [118]
30 April 2020 (situation report #101)
o By 30 April 2020, there were 3,090,445 confirmed cases and 217,769 deaths [119]
o The FDA issued an EUA for a ventilator developed by the National Aeronautics and Space Administration (NASA), which is tailored to treat patients with COVID-19 [120]
o The third meeting of the IHR Emergency Committee was convened by the WHO Director-General - declared that the outbreak continued to constitute a PHEIC (situation report #102) [121]
May
1 May 2020
o The FDA issued an EUA for the antiviral drug remdesivir - treatment of suspected or laboratory-confirmed COVID-19 in hospitalised patients with severe disease (adults and children) [122]
4 May 2020 (situation report #106)
o The COVID-19 Global Response International Pledging Event was hosted by the European Commission - 40 countries came together to support the ACT Accelerator and €7.4 billion was pledged (for research and development) [123, 124]
6 May 2020 (situation report #108)
o The WHO-Director General held a media briefing on lockdowns - suggested six criteria for countries to follow when easing restrictions [125, 126]:
There must be strong surveillance systems, declining cases, and controlled transmission
Health system capacities must be in place to detect, isolate, test, and treat every case + trace every contact
Outbreak risks must be minimised in special settings like healthcare facilities and nursing homes
Preventative measures must be implemented in settings such as workplaces and schools
Importation risks need to be managed
Communities must be provided with tools to be educated, engaged, and empowered
7 May 2020
o Over 3.5 million COVID-19 cases and 250,000 deaths have been reported [125]
o The WHO published a scientific brief on the use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) (situation report #111) [127, 128]
There were concerns that ACE inhibitors and ARBs increase the susceptibility to SARS-CoV-2 and the risk of severe disease - low-certainty evidence that patients on long-term therapy are not at increased risk of poor outcomes
8 May 2020
o The FDA issued an EUA for the first diagnostic test that can be performed at home, using a saliva sample [129]
9 May 2020
o The FDA issued an EUA for the first antigen test to help in the rapid detection of COVID-19 [130]
11 May 2020 (situation report #113)
o The number of COVID-19 cases exceeded 4 million [131]
o WHO made a statement on tobacco use and COVID-19
Risk factor for many respiratory infections – increased severity of respiratory diseases (based on available research, smokers are more likely to develop severe disease compared to non-smokers) [132]
o In addition to the six criteria that was recommended to lift lockdowns, the WHO established three key questions countries should ask prior to making decision: [133]
Is the epidemic manageable and under control?
Is the healthcare system prepared to deal with an increase in the number of cases that may arise once measures are relaxed?
Is the public health surveillance system able to detect cases and trends, as well as contact trace?
15 May 2020
o The WHO published a scientific brief on MIS-C in children and adolescents with COVID-19 (situation report #117) [134]
o Operation Warp Speed was announced by the Trump administration – a joint effort (public-private partnership) to support the development of COVID-19 vaccines, therapeutics, and diagnostics + scale up their manufacturing/distribution [135]
16 May 2020
o By 16 May 2020, there were over 300,000 deaths from COVID-19 (situation report #117) [134]
o The FDA authorised the first at-home sample collection kit (nasal swab) that can be used with multiple tests and can be sent to multiple labs [136]
18 May 2020 (situation report #119)
o Provided more details about the Solidarity Trial [137]:
Unproven treatments should not be recommended or administered to patients with COVID-19
Four treatment options will be compared to the standard of care (laboratory, animal, and clinical studies) - chloroquine or hydroxychloroquine, remdesivir, lopinavir/ritonavir, and lopinavir/ritonavir with interferon beta-1a
Outcomes - all-cause mortality, duration of hospital stay, and time to receiving ventilation or intensive care
18-19 May 2020
o The 73rd World Health Assembly was held virtually (there was a global commitment to fighting the COVID-19 pandemic) (situation report #122) [138]
23 May 2020
o By 23 May 2020, the number of COVID-19 cases surpassed 5 million (situation report #124) [139]
25 May 2020 (situation report #127)
o The WHO-Director General made a speech – discussed the findings from an observational study (the Lancet) on hydroxychloroquine and chloroquine [140]
Authors reported that when used alone or with a macrolide, a higher mortality rate was estimated among patients
The Executive Group put into effect a temporary pause of the hydroxychloroquine arm of the Solidarity Trial - while the data gets reviewed (hydroxychloroquine and chloroquine) [141]
27 May 2020 (situation report #129)
o The WHO published the updated Clinical Management Guidance for COVID-19 [142, 143]
Suspected or confirmed mild COVID-19 cases – the use of antibiotic therapy or prophylaxis should not be used
Suspected or confirmed moderate COVID-19 cases – antibiotics should not be prescribed unless a bacterial infection is suspected
Patients hospitalised with COVID-19 – pharmacological prophylaxis (eg. low molecular weight heparin), can be used to prevent venous thromboembolism
Antivirals, immunomodulators and other adjunctive therapies that have not yet been approved should only be used in the context of clinical trials
Systemic corticosteroids should not be routinely used for the treatment of viral pneumonia
o The WHO Foundation was established – supports efforts to address global health challenges [144]
29 May 2020 (situation report #132)
o An update on the C-TAP was provided - several countries, international partners, and institutions signed up [145, 146]
Aims to make vaccines, tests, treatments, and other technologies accessible to all
31 May 2020
o By 31 May 2020, there were 5,934,936 cases and 367,166 deaths (situation report #132) [145]
June
1 June 2020
o By 1 June 2020, the number of cases exceeded 6 million (situation report #133) [147]
Following the Global Research and Innovation forum hosted by the WHO in February, over 120 candidate vaccines were mapped - the challenge has been knowing how to prioritise the ones that will move from phase I to phase 2b/3 clinical trials
o The WHO issued a news release on antimicrobial resistance - concerns that the rates may rise due to the inappropriate use of antibiotics during the pandemic (situation report #135) [148]
4 June 2020
o The Lancet and the New England Journal of Medicine retracted papers on the antimalarial drug hydroxychloroquine – unable to verify the data that was used [149]
o The WHO welcomed funding that was pledged at the Global Vaccine Summit [150]
5 June 2020 (situation report #137)
o In the media briefing, the WHO Director-General provided updated guidance on the use of masks for COVID-19 [151, 152]
Reiterated that masks should only be used alongside other measures to fight COVID-19
Changes to the advice - the WHO advised that masks should be worn by people working in clinical settings, where community transmission is occurring, those aged 60 and over, or those with underlying health conditions (where physical distancing may not be possible); the general public should be encouraged to wear masks where widespread transmission occurs and where physical distance cannot be maintained
8 June 2020
o The number of deaths surpassed 400,000 (situation report #140) [153]
9 June 2020 (situation report #141)
o Over 7 million cases and 400,000 deaths were reported to the WHO – more than 136,000 cases were reported on Sunday (most in a single day so far) [154]
10 June 2020
o The FDA issued an EUA for the first next-generation sequencing test for diagnosing COVID-19 (detection of viral RNA from respiratory specimens collected by healthcare providers) [155]
13 June 2020 (situation report #145)
o As of 13 June 2020, China reported 12 new confirmed cases to the WHO (6 in Beijing) – an investigation was taking place [156]
15 June 2020
o The FDA revoked the EUA for chloroquine and hydroxychloroquine (unlikely to be effective and the benefits no longer outweighed the risks) [157]
o The FDA also warned of a potential drug interaction that may reduce the effectiveness of remdesivir (hydroxychloroquine or chloroquine phosphate should not be administered with remdesivir) [158]
o At the media briefing, the WHO Director-General stated that “despite the ongoing global response to the COVID-19 pandemic, we cannot lose sight of other significant public health issues, including influenza” [159]
The co-circulation of COVID-19 and influenza can negatively impact health systems - influenza surveillance had either been suspended or was declining in many countries (situation report #154)
16 June 2020 (situation report #149)
o Preliminary findings from clinical trials in the U.K. showed that dexamethasone (corticosteroid) could be lifesaving for critically ill patients with COVID-19 - reduced mortality by about one third for patients requiring ventilation, and about one fifth for patients requiring oxygen only [160]
17 June 2020
o The total number of cases surpassed 8 million (situation report #149) [160]
o An announcement was made by the WHO that the hydroxychloroquine arm of the Solidarity Trial was being stopped - based on evidence from the Solidarity Trial, UK’s Recovery trial and a Cochrane review - showed that in comparison to standard of care, hydroxychloroquine did not reduce mortality rates of hospitalised COVID-19 patients (situation report #151) [161]
23 June 2020
o The WHO released a scientific brief on COVID-19 and breastfeeding - recommended that mothers with suspected or confirmed COVID-19 should continue to breastfeed their infants and young children (not enough data to conclude vertical transmission through breastfeeding) [162]
24 June 2020
o The total number of cases surpassed 9 million (situation report #156) [163]
25 June 2020
o The Ad5-nCoV vaccine was approved for use by military personnel in China (Cansino Biologics Inc.) [164, 165]
27 June 2020
o The Global Goal: Unite for Our Future campaign, concert, and summit took place - organised by Global Citizen (situation report #155) [166]
28 June 2020
o A record number of new cases had been reported within the past 24 hours (189,077 cases) (situation report #160) [167]
29 June 2020
o To tackle the ‘infodemic’ (overabundance of information), the WHO announced that it was holding its first Infodemiology Conference (public conference on 29 June followed by a scientific conference from 30 June to 16 July) (situation report #160) [167]
o As of 29 June 2020, there were over 10 million cases and nearly 500,000 COVID-19 deaths (situation report #161) [168]
30 June 2020
o By the 30 June 2020, there were 10,185,374 cases and 503,862 deaths (situation report #162) [169]
July
1-2 July 2020
o The WHO held a second summit (Global Research and Innovation Forum) - reviewed data from the Solidarity Trial and other complete/ongoing trials (more evidence emerged that transmission can occur from humans to animals - felines, dogs, and minks) [170]
2 July 2020
o The FDA issued an EUA for a combination diagnostic that can test for flu and COVID-19 - third diagnostic test that can differentiate between viruses that cause flu and COVID-19 [171]
Two EUAs had been issued before this (in addition to SARS-CoV-2, they can detect other respiratory organisms) - BioFire Diagnostics LLC and QIAGEN GmbH
4 July 2020 (situation report #167)
o The WHO discontinued the hydroxychloroquine and lopinavir/ritonavir arms of the Solidarity Trial, as recommended by the International Steering Committee - when compared to the standard of care, these agents had little or no effect on the mortality of hospitalised patients [172] [173]
o The number of cases surpassed 11 million [172]
6 July 2020
o A commentary was published on the need for international/national bodies to recognise airborne transmission and implement preventive measures - signed by 239 scientists (Clinical Infectious Diseases) [174]
7 July 2020
o In a statement, the WHO provided details about experts travelling to China to identify the zoonotic source of the virus (situation report #170) [175]
9 July 2020
o An update on the transmission of SARS-CoV-2 was provided by the WHO (situation report #172) [176]
In addition to spreading via coming into direct, indirect or close contact with secretions or respiratory droplets from infected people, airborne transmission can occur (was acknowledged - health care settings or indoor crowded spaces)
Transmission may occur from symptomatic and asymptomatic individuals
To prevent transmission - all cases and close contacts need to be identified and quarantined, testing systems must be in place, masks should be used in certain situations (fabric), healthcare workers should use medical masks, contact/droplet/airborne precautions need to be followed + individuals should practice hand hygiene, physical distancing, and respiratory etiquette
o The WHO announced the initiation of the Independent Panel for Pandemic Preparedness and Response (IPPPR) – evaluate the global response to the pandemic (situation report #173) [177, 178]
10 July 2020
o The number of cases surpassed 12 million (situation report #172) [176]
15 July 2020
o The number of cases surpassed 13 million (situation report #177) [179]
o Countries submitted their expression of interest to join the COVAX Facility - a partnership would occur with lower-income countries - the goal is to guarantee rapid and equitable access to vaccines (situation report #178) [180] [181]
18 July 2020
o The FDA issued an EUA for sample pooling in COVID-19 diagnostic testing
Up to four individual swab samples could be collected at once under observation (reduces the amount of tests that need to be performed) [182]
19 July 2020
o The number of cases surpassed 14 million (situation report #181) [183]
20 July 2020
o The number of deaths surpassed 600,000 (situation report #182) [184]
22 July 2020 (situation report #185)
o The WHO launched an expert advisory committee/panel to evaluate and provide advice on the safety/efficacy of traditional medicines for COVID-19 in Africa [185] [186]
o The Trump administration announced their historic agreement with Pfizer once the vaccine has been approved à deliver 100 million doses + another 500 million doses shortly thereafter (part of Operation Warp Speed) [103]
23 July 2020
o The number of deaths surpassed 15 million (situation report #185) [185]
As of 23 July 2020, over 70,000 sequences were available on GISAID
The D614G mutation was reported to be widely distributed - first observed in February 2020
24 July 2020
o The FDA expanded the EUA for the LabCorp COVID-19 RT-PCR test - to include people not displaying COVID-19 symptoms or have no reason to suspect infection + allow for pooled sampling [187]
o A draft landscape of candidate vaccines was published and 25 candidate vaccines were being evaluated clinically (as of 24 July) (situation report #188) [188]
27 July 2020
o The number of cases surpassed 16 million (situation report #189) [189]
o The WHO published a draft of the Target Product Profiles for COVID-19 therapeutics (situation report #194) [190]
31 July 2020
o By 31 July 2020, the number of cases surpassed 17 million - 17,1006,007 cases and 668,910 deaths (situation report #193) [191]
o The fourth Emergency Committee meeting was convened under the IHR - came to the decision that the pandemic still constituted a PHEIC (situation report #194) [190]
o The FDA authorised the first two (semi-quantitative) serology tests that provide an estimated quantity of antibodies produced against SARS-CoV-2 [192]
August
3 August 2020
o The WHO published the updated COVID-19 Preparedness and Response Progress Report - 1 February to 30 June 2020 (situation report #203) [193]
4 August 2020
o The number of cases surpassed 18 million (situation report #197) [194]
5 August 2020
o PAHO advised against the use of chlorine products as treatments for patients with suspected or diagnosed COVID-19 (situation report #199) [195] [196]
o The number of deaths surpassed 700,000 [195]
6 August 2020
o The WHO published documents on the COVAX facility - “global procurement for COVID-19 vaccines” and “COVAX, the ACT-Accelerator vaccines pillar” [197] [198]
8 August 2020
o The number of cases surpassed 19 million (situation report #201) [199]
11 August 2020
o The Trump administration announced that they reached an agreement with Moderna (manufacture/deliver 100 million doses of the vaccine candidate) - they also secured partnerships with Johnson & Johnson, Sanofi and GSX/GSK[200]
o Three candidates were in phase three trials (final stage) - the government announced that they would invest in the development/manufacture of the top six candidates [200]
o The Sputnik V (Gamaleya) vaccine was approved for use in Russia [165, 201]
12 August 2020
o The number of cases surpassed 20 million (situation report #205) [202]
15 August 2020
o The number of cases surpassed 21 million (situation report #208) [203]
o The FDA issued an EUA to Yale School of Public Health for SalivaDirect – utilises a new method of saliva sample processing (specimens can be collected in any sterile container, a separate nucleic acid extraction step is not required, and can be used with different combinations of reagents/instruments) [204]
17 August 2020
o The WHO situation reports changed from daily to weekly
20 August 2020
o The WHO Director-General encouraged countries to join the COVAX Facility and stated that vaccines will be allocated in two phases: (weekly situation report #2) [205]
Phase 1 –participating countries will receive doses proportionally to reduce risk
Phase 2 – assessments will be made on threat and vulnerability
Priority will be given to frontline workers, those over the age of 65 and those who are most vulnerable [206]
21 August 2020 (weekly situation report #2)
o The WHO published interim guidance on the use of masks for children - some evidence demonstrating that young children may have a lower susceptibility to infection (varies among age) + the benefits of wearing masks should be weighed against the risks [205, 207]
23 August 2020
o The FDA issued an EUA for investigational convalescent plasma for hospitalised patients with COVID-19 [208]
24 August 2020
o Researchers from the University of Hong Kong identified a patient who was reinfected with SARS-CoV-2 (different genome sequences) - reported to be the first confirmed case of reinfection [209]
o As of 24 August 2020, 172 countries had joined the COVAX Facility – nine vaccine candidates + a further nine that were under evaluation for the longer term (weekly situation report #2) [205, 210]
26 August 2020
o The FDA authorised the first diagnostic test where results could be read directly from the testing card (similar to a pregnancy test) [211]
27 August 2020
o The WHO released the results of the Pulse survey - assessed the effects on essential health services during the pandemic (weekly situation report #3) [212]
28 August 2020
o The FDA broadened the EUA for remdesivir to include the treatment of all adult and paediatric patients hospitalised with suspected/confirmed COVID-19 (irrespective of the severity) [213]
September
2 September 2020
o The WHO published advice for using corticosteroids in the treatment of COVID-19. Two recommendations were made: (weekly situation report #4) [214]
For patients who have severe/critical COVID-19, systemic corticosteroid therapy (eg. dexamethasone or hydrocortisone) is strongly recommended for 7-10 days
Corticosteroid therapy should not be administered to patients with non-severe COVID-19
8-9 September 2020
o The WHO-Director General convened a Review Committee to evaluate the international health response to COVID-19 (including the functioning of the IHR and the recommendations that have been made) (weekly situation report #5) [215]
9 September 2020
o The WHO warned that the disruption of child and maternal health services are putting millions of lives at stake (weekly situation report #5) [215]
10 September 2020
o The first meeting of the ACT Accelerator Facilitation Council was held (weekly situation report #5) [215]
11 September 2020
o The WHO published interim guidance on the potential role of antigen-detecting rapid diagnostic tests in diagnosing SARS-CoV-2 infection (immunoassays) (weekly situation report #5) [215]
15 September – 2 October 2020
o The 75th United Nations General Assembly was held - 193 Member States (virtual meeting + limited presence in the building) (weekly situation report #6) [216]
One of the key message was that preparation for the next pandemic must start now [217]
17 September 2020
o The first meeting of the Independent Panel for Pandemic Preparedness and Response (The Independent Panel) was held [218]
21 September 2020
o The WHO Strategic Advisory Group of Experts (SAGE) on Immunisation released interim guidance for prioritising ‘at-risk’ groups for influenza vaccination during the pandemic [219]
22 September 2020
o The WHO issued the first Emergency Use Listing for a quality antigen based rapid diagnostic test (weekly situation report #8) [220]
23 September 2020
o The FDA reissued the EUA for the first point-of-care antibody test to authorise the use of fingerstick blood samples [221]
25 September 2020
o The WHO-Director General discussed the progress of the COVAX facility – 67 high-income countries formally joined (34 expected to sign) + 92 low-income countries are eligible for financial support (weekly situation report #7) [222]
The ACT Accelerator required an additional U.S $35 billion (financing gap)
Aims: “to deliver 2 billion doses of vaccine; 245 million courses of treatment; and 500 million diagnostic tests to low- and middle-income countries”
27 September 2020
o As of 27 September 2020, there were 32,730,945 cases and 991,224 deaths (weekly situation report #7) [222]
28 September 2020
o A set of agreements between various organisations were made to make the Abbott and SD Biosensor tests available (especially in low- and middle-income countries) - part of the ACT Accelerator (announced 120 million tests) (weekly situation report #8) [220, 222, 223]
o WHO also published the final version of the Target Product Profiles (TPP) for diagnostics (weekly situation report #8) [220]
30 September 2020
o Nearly U.S. $1 billion was pledged to the ACT Accelerator initiative from governments, the private sector, civil society, and international organisations [224]
October
1 October 2020
o The WHO encouraged manufacturers of COVID-19 vaccines to apply for approval for prequalification and/or Emergency Use Listing (weekly situation report #8) [220, 225]
2 October 2020
o The WHO granted Emergency Use Listing for a second antigen based diagnostic test (weekly situation report #8) [220]
o An update on COVAX was provided - 168 countries had joined and 25 expressed interest [225]
o The White House
Physician to the President - DO (FACEP) Sean P. Conley released a memorandum about former President Donald J. Trump and First Lady Melania Trump (issued on 2 October, 2020) [226]
Both have tested positive for SARS-CoV-2 (1 October, 2020)
Vice President Mike Pence tested negative for SARS-CoV-2 - was not considered a close contact and was not required to quarantine [227]
As a precautionary measure, former President Trump was administered a single dose of Regeneron’s polyclonal antibody cocktail (8 g) – he was also taking zinc, vitamin D, famotidine, melatonin, and a daily aspirin [226]
The President was moved to the Walter Reed National Military Medical Center for further monitoring - did not require supplemental oxygen but specialists recommended remdesivir therapy (has completed his first dose) [226]
3 October 2020
o It was reported that former President Trump was doing well – he had received a second dose of remdesivir (fever-free and off supplemental oxygen with a saturation level between 96 and 98%) [226]
4 October 2020
o As of 4 October 2020, the number of deaths exceeded 1 million (weekly situation report #8) [220]
5 October 2020
o The results from a survey were published ahead of the WHO’s “Big Event for Mental Health” on October 10 - showed that the pandemic disrupted mental health services in 93% of countries worldwide (survey of 130 countries) (weekly situation report #9) [228]
o An Executive Board Meeting took place (5-6 October) to evaluate the COVID-19 response (weekly situation report #9) [228, 229]
6 October 2020
o Former President Trump’s team of physicians met with him in the Residence – his vital signs and physical exam were stable (spent the first night at home) [226]
7 October 2020
o The President’s physical exam and vital signs remained stable - SARS-CoV-2 IgG antibodies were detected from the labs drawn on October 5 [226]
8 October 2020
o The President completed his course of therapy for COVID-19 [226]
10 October 2020
o At day 10 from symptom onset, the President met CDC criteria for the safe discontinuation of isolation – the PCR sample demonstrated that he was no longer a transmission risk (no longer evidence of actively replicating virus) [226]
12 October 2020
o The President’s physician clarified that former President Trump tested negative on consecutive days – the negative status was confirmed from repeated antigen tests, clinical and laboratory data, and ongoing assessment of viral culture data [226]
o The WHO-Director General discussed the concept of “herd immunity” – some countries suggested this as an option (this has never been used as a strategy in the history of public health) (weekly situation report #10) [228, 230]
14 October 2020
o The EpiVacCorona vaccine received regulatory approval in Russia (Federal Budgetary Research Institution - State Research Center of Virology and Biotechnology/Vector Institute) [165, 231]
15 October 2020
o The WHO Solidarity Trial produced conclusive evidence on the effectiveness of repurposed drugs against COVID-19 (weekly situation report #10) [230]
Remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimes were found to have little to no effect on 28-day mortality or the in-hospital course of COVID-19 among patients [232]
16 October 2020
o In the media briefing, the WHO-Director General stated that the Solidarity Trial will focus on other treatments, including monoclonal antibodies and new antivirals – dexamethasone has been the only effective therapeutic against COVID-19 (severe disease) so far (weekly situation report #10) [230]
o The WHO recommended that pregnant women, people with underlying health conditions, older adults, health workers, and children should receive the influenza vaccination in preparation for winter in the northern hemisphere [233]
19 October 2020
o Kim Sledge partnered with the World We Want and the WHO Foundation to record a special edition cover of “We Are Family” – the campaign invited celebrities, frontline workers, leaders, and members of the public to participate - the money raised was going to be donated to the WHO Foundation to support COVID-19 efforts (weekly situation report #10) [230, 234]
22 October 2020
o The FDA approved the first antiviral treatment for COVID-19 (remdesivir) - for hospitalised adult and paediatric patients aged 12 years and older (weighing at least 40 kg) [235]
25-27 October 2020
o The World Health Summit took place (fully digital) – one of the major topics was pandemic preparedness (weekly situation report #11) [236]
29 October 2020
o The fifth meeting of the IHR Emergency Committee took place – the pandemic still constituted a Public Health Emergency of International Concern (PHEIC) (weekly situation report #12) [237]
30 October 2020
o In a media briefing, the WHO-Director General acknowledged the mid to long-term effects of COVID-19 (fatigue, cough and shortness of breath, inflammation, injury of major organs etc.) [238]
November
5 November 2020
o The WHO released a “terms of references for the China part” - outlined short-term and longer-term studies that were going to provide further insight into the origins of the virus (weekly situation report #13) [239]
The SARS-CoV-2 mink-associated variant strain was identified in Denmark (cluster 5) - 12 cases with a unique variant (the Danish Prime Minister announced the plan to cull all mink in the country)
6 November 2020
o The United Nations Children’s Fund (UNICEF) and WHO highlighted the importance of implementing preventative measures to avert measles and polio epidemics - COVID-19 disrupted the progress that has been made (ie. global immunisation services) (weekly situation report #13) [239, 240]
o The ICMRA (International Coalition of Medicines Regulatory Authorities) and WHO released a joint statement on the importance of countries having equitable access to safe, effective, and quality-assured medicines/vaccines for COVID-19 (sound scientific evidence) [241]
o The FDA issued an EUA for the first test that detects neutralising antibodies from prior or recent infection with SARS-CoV-2 [242]
9 November 2020
o The FDA issued an EUA for bamlanivimab (investigational monoclonal antibody) for the treatment of mild to moderate COVID-19 in adult and paediatric patients (12 years and older + weighing at least 40 kg; those who are at high risk of developing severe disease and/or being hospitalised) [243]
o Pfizer announced that their vaccine candidate (BNT162b2) was more than 90% effective in preventing COVID-19 (without evidence of prior infection) - first interim efficacy analysis was performed on 8 November [244]
13 November 2020
o U.S $360 million was pledged to COVAX (Vaccines Pillar) from the European Commission, France, Spain, the Republic of Korea, and the Bill & Melinda Gates Foundation [245]
9-14 November 2020
o The resumed 73rd World Health Assembly (WHA73) took place virtually (weekly situation report #13) [239]
16 November 2020
o Moderna announced preliminary results and found the vaccine to be 94.1% effective (mRNA-1273) [7, 246]
o The 147th session of the Executive Board took place virtually (situation report #14) [247]
o In collaboration with UNICEF, the WHO published interim guidance on developing a plan for the deployment, implementation, and monitoring of COVID-19 vaccines – can assist national governments (situation report #15) [248]
17 November 2020
o The FDA issued an EUA for the first diagnostic test that individuals can use at home to self-test for COVID-19 (Lucira COVID-19 All-In-One Test Kit) [249]
18 November 2020
o Pfizer announced that the BNT162b2 was demonstrated to be 95% effective (in the 28 days after the first dose) - primary efficacy analysis [250, 251]
19 November 2020
o The FDA issued an EUA for the use of a combination treatment (baricitinib in combination with remdesivir) - treatment of suspected or laboratory confirmed COVID-19 in adult and paediatric patients (two years or older) who have been hospitalised + require oxygen, ventilation, or extracorporeal membrane oxygenation (ECMO) [252]
20 November 2020
o The WHO published a “living guideline” on therapeutics and COVID-19 (situation report #15) [248, 253]
Discussed the conditional recommendation against the use of remdesivir in hospitalised patients with COVID-19, irrespective of disease severity - adds to the previous recommendations for the use of systemic corticosteroids in patients with severe and critical COVID-19 + the conditional recommendation against systemic corticosteroids in patients with non-severe COVID-19
There was no evidence to show that remdesivir made an improvement to patient-important outcomes
21 November 2020
o The WHO-Director General addressed the G20 Leaders Summit - discussed vaccines, preparedness, and leadership [254]
o The FDA issued an EUA for the monoclonal antibodies casirivimab and imdevimab to be administered (combination) for the treatment of mild to moderate COVID-19 in adult and paediatric patients (12 years or older – at least 40 kg) who have tested positive and are at high risk for progressing to severe COVID-19 [255]
27 November 2020
o In a media briefing, the WHO Director-General emphasised that testing will continue to play a crucial role in controlling the pandemic, even after vaccines have been made available (weekly situation report #16) [256, 257]
December
3 December 2020
o The WHO released an updated disease outbreak report on the SARS-CoV-2 mink-associated variant strain [258]
3-4 December 2020
o The UN General Assembly held a special session on the pandemic response [259]
4 December 2020
o The FDA authorised the first diagnostic test for both COVID-19 and influenza A and B (at home collection of samples - sent to the laboratory for analysis) [260]
9 December 2020
o The FDA authorised the first COVID-19 test that did not require a prescription - for use by individuals 18 years of age and older (a nasal swab sample can be collected at home and sent to the lab for testing) [261]
11 December 2020
o The FDA issued the first EUA for a COVID-19 vaccine (Pfizer-BioNTech) - for individuals 16 years of age and older [262]
14 December 2020
o The United Kingdom reported the SARS-CoV-2 VUI 202012/01 (Variant Under Investigation, year 2020, month 12, variant 01) (weekly situation report #19) - Alpha variant [263]
15 December 2020
o The FDA issued an EUA for the first fully at-home COVID-19 diagnostic test that could be accessed over-the-counter (without the need to send the sample to the lab - individuals aged 2 years and older) [264]
16 December 2020
o The FDA issued a new EUA for the BinaxNOW COVID-19 antigen card home test – patients can use this at home with a prescription (patients can access a telehealth service, where the provider can assist in interpreting/reading/reporting the results) [265]
18 December 2020
o It was announced that COVAX had arrangements in place to access nearly two billion doses of COVID-19 vaccine candidates (190 participating and eligible economies) à allows participating economies to have access to doses in the first half of 2021 à first deliveries to be made in the first quarter of 2021 (weekly situation report #19) [263, 266]
The deals included signing an advanced purchase agreement with AstraZeneca (170 million doses) and a memorandum of understanding with Johnson & Johnson (500 million doses)
This was in addition to the agreements with the Serum Institute of India for 200 million doses of either the AstraZeneca/Oxford or Novavax candidates (options for up to 900 million doses more) + statement of intent for 200 million doses of the Sanofi/GSK candidate
o In the announcement, the Coalition for Epidemic Preparedness Innovations (CEPI – part of the COVAX R&D portfolio) mentioned that they have invested in 10 vaccine candidates: [266]
AstraZeneca/ University of Oxford (Phase 3)
Clover Biopharmaceuticals, China (Phase 1)
CureVac, Germany (Phase 2B/3)
Inovio, USA (Phase 2)
Institut Pasteur/Merck/Themis, France/USA/Austria (Phase 1)
Moderna, USA (Phase 3)
Novavax, USA (Phase 3)
SK bioscience, South Korea (Preclinical)
University of Hong Kong, Hong Kong (Preclinical)
University of Queensland/ CSL, Australia (Phase 1, programme discontinued)
o Researchers in South Africa presented preliminary findings of a new recently identified variant called 501Y.V2 - South Africa announced the detection of this new variant on the 18th of December 2020 - Beta variant (Pangolin lineage B.1.351) (weekly situation report #20) [267]
o The Alpha and Beta variants were designated as variants of concern (VOC) [268]
o The FDA issued an EUA for the second COVID-19 vaccine (Moderna) - individuals aged 18 and older [269]
21 December 2020
o The WHO released a disease outbreak report on the VUI 202012/01 variant (Alpha) [270]
27 December 2020
o The first International Day of Epidemic Preparedness was held - to ensure that governments/populations understand the significance of epidemic prevention, preparedness, and partnership [271]
30 December 2020
o The AstraZeneca/Oxford vaccine was approved for emergency use in the U.K. - for those aged 18 years or older [272]
31 December 2020
o The WHO released a disease outbreak report on circulating variants (D614G, mink, VOC 202012/01, and 501Y.V2) [273]
o The WHO issued an emergency use validation for the Pfizer-BioNTech COVID-19 vaccine (weekly situation report #22) [274, 275]
o The BiBP inactivated vaccine (BBIBP-CorV) developed by Sinopharm/China National Biotec Group (CNBG) was granted conditional marketing authorisation in China - also known as Hayat-Vax, which was registered by the United Arab Emirates Ministry of Health and Prevention on 9 December 2020 [165, 276, 277]
o *In addition to the BBIBP-CorV vaccine, Sinopharm also developed the WIBP-CorV vaccine (with the Wuhan Institute of Biological Products) [165]