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For citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
Aug 13
30
COVID-19
Situation Report 476
Centre for Infectious Disease Epidemiology and Research (CIDER)For citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
s
i. Background
In December, China notified the World Health Organization (WHO) of several cases of human respiratory
illness, which appeared to be linked to an open seafood and livestock market in the city of Wuhan. The
infecting agent has since been identified as a novel coronavirus, previously known as 2019-nCoV and now
called SAR-CoV-2; The new name of the disease has also been termed COVID-19, as of 11th February 2020.
Although the virus is presumed zoonotic in origin, person-to-person spread is evident. Screening of
travellers, travel bans and quarantine measures are being implemented in many countries. Despite these
precautions, it is anticipated that more cases will be seen both inside China and internationally. The WHO
declared the outbreak of COVID-19 constitutes a Public Health Emergency of International Concern on 30
January. On 11 March, 2020, WHO declared the coronavirus outbreak a pandemic as the global death toll
rose above 4,600 and the number of confirmed cases topped 125,000. This report aims to update Global
Risk Assessment, Global Epidemiology, Quarantine Orders, Travel Ban/Advisory by countries, WHO’s and
CDC’s Guidance and Protocols and Scientific publication on a daily basis. New updates in the tables are
bolded.
1|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
ii. Global Risk Assessment
Table 1. Risk assessment of COVID-19 by WHO regions (Updated as of 13 August 2021, 1230H SGT)
Severity of Availability of Treatment/ Overall
Environmental Risk Transmissibility
Disease Vaccination# Risk%
Global (n=198 countries)
High Limited
Globally, 189 (95.5%) countries (excluding Based on CDC Case The number of countries that have
territories*) have reported the outbreak. data, median R0 fatality rate commenced mass vaccination in each
is estimated to is currently region are as follows: Combined WPRO
Using an incidence >20 cases/100,000 be 5.8 (95% CI at 2.11% and SEARO (33 countries), EURO (53
people over the past 14-days as cut-off for 4.4–7.7), but globally. countries), EMRO (20 countries),
a surge in cases, the number of countries the estimated Most cases Americas (35 countries), and Africa (45
reporting a surge in cases in each region effective present as countries).&
are as follows: Combined WPRO and reproduction flu-like
SEARO (20 countries), number in 177 illness. International clinical trials published on 2
EURO (47 countries), countries September confirm that cheap, widely
EMRO (15 countries), Americas (31 ranged from available steroid drugs can help seriously
countries), and Africa (24 countries). 0.36 to 2.5.$ ill patients survive Covid-19. The World
Health Organization issued new
Only 4 (2%) countries/territories have no treatment guidance, strongly
reported restrictions on inbound arrivals, recommending steroids to treat severely
while 146 (79%) countries/territories have and critically ill patients, but not to those
partially reopened their borders – require with mild disease. [4]
arrivals to produce a negative COVID-19
test result and/or undergo self-quarantine Researchers have found all regimens of
upon arrival. 49 (26%) anticoagulants to be far superior to no
countries/territories are totally closed to anticoagulants in COVID-19 patients.
international arrivals. [1] More specifically, patients on both a High
“therapeutic” or full dose and those on a
On October 7, the Centers for Disease “prophylactic” or lower dose, showed
Control and Prevention (CDC) confirmed about a 50% higher chance of survival
airborne transmission of SARS-CoV-2. [2] and roughly a 30% lower chance of
intubation, than those not on
The U.S. CDC has revised its guidance on anticoagulants. It was observed that
COVID-19 quarantine period from 14 days therapeutic and prophylactic
to 7-10 days, based one's test results and subcutaneous low-molecular weight
symptoms. Individuals without symptoms heparin and therapeutic oral apixaban
only need quarantine for 10 days without may lead to better results. [3]
testing; those tested negative can
quarantine for 7 days. [14] A new strain known as B.1.525
containing the same E484K mutation
The US Centers for Disease Control and found in the Brazilian and South African
Prevention (CDC) on 10 Feb announced variants has been detected in Britain
that fully vaccinated people did not need [18].
to quarantine if they received their last
dose within three months and 14 days As of 6 July, the WHO recommended
after their last shot, the time it takes to using arthritis drugs Actemra
develop immunity. [16] (tocilizumab) and Kevzara (sarilumab)
with corticosteroids for severe and
critical COVID-19 patients. [27]
2|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
On 4 Aug, the WHO called for a
moratorium on COVID-19 vaccine
boosters until at least the end of
September, to enable that at least 10% of
the population of every country was
vaccinated. [28]
Western Pacific Region and South-East Asia Region (n=41 countries)
Moderate High
33 (80.5%) countries have reported As of Aug 11, Case 33 countries have commenced
outbreaks; but only 20 (48.8%) countries the estimated fatality rate vaccination as of 13 August 2021.
are reporting a surge in cases. effective is 1.51%. Coverage was available for the following:
reproduction i) at least 1 dose was at 70%
constant decreasing change in incidence countries for 3 countries ii) full vaccination was at
or no case in the last 14 days. ranged from 70% for 2 countries.&
Highest incidence over the past 14 days Indonesia has approved Russian drug
were reported from Fiji, Malaysia, Avifavir for emergency use. [22]
Maldives, Mongolia and Thailand, and High
highest case numbers were reported from China has approved the use of 3
India, Indonesia, Japan, Malaysia and traditional chinese medicines, Qingfei
Thailand. Paidu Formula, Huashi Baidu Formula
and Xuanfei Baidu Formula, for COVID-19
At least 19 countries have closed their treatment. [20]
borders, 21 countries have opened their
borders partially conditionally, and none is As of 4 June, India has approved a
allowing free travel. combination of monoclonal antibodies,
bamlanivimab and etesevimab for
restricted use in emergency situations in
hospital settings in adults [24].
European Region (n=53 countries)
High High
52 (98.1%) countries have reported with As of Aug 11, Case 53 countries have commenced
outbreaks; 47 (88.7%) countries are the estimated fatality rate vaccination as of 13 August 2021.
reporting a surge in cases. effective is 1.99%. Coverage was available for the following
reproduction i) at least 1 dose was at 70%
decreasing change in incidence or no case countries for 9 countries; ii) full vaccination was at
in the last 14 days. ranged from 70% for 2 countries. &
Highest incidence over the past 14 days
were reported from Cyprus, Gerogia, On February 28, France authorized its High
Israel, Kazakhstan and United Kingdom, first ever use of synthetic monoclonal
and highest case numbers were reported antibody, bamlanivab by Eli Lilly, for use
from France, Russia, Spain, Turkey and on severe COVID-19 patients. [19]
United Kingdom.
As of February 14, Italy authorized the
At least 6 countries have closed their use of the two monoclonal antibodies of
borders, 46 countries have opened their companies Eli Lilly and Regeneron aimed
borders partially conditionally, and only 1 mainly at more serious patients with
country is allowing free travel. COVID-19 [17].
3|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
Eastern Mediterranean Region (n=22 countries)
High High
22 (100%) countries have reported with As of Aug 11, Case 20 countries have commenced
outbreak; 15 (68.2%) countries are the estimated fatality rate vaccination as of 13 August 2021.
reporting a surge in cases. effective is 1.84%. Coverage was available for the following:
reproduction i) at least 1 dose was at 70%
decreasing change in incidence or no case countries for 3 countries; ii) full vaccination was at
in the last 14 days. ranged from 70% for 1 country. &
Highest incidence over the past 14 days
were reported from Iran, Iraq, Libya, As of June 25, the Abu Dhabi Stem Cell
High
Morocco and Tunisia, and highest case Centre has treated more than 2,000
numbers were reported from Iran, Iraq, COVID-19 patients using UAECell19.
Morocco, Pakistan and Tunisia. 1,200 have fully recovered. [6]
At least 5 countries have closed their As of April, an Israeli firm is using
borders, 16 countries have opened their placenta pluristem cells to treat COVID-
borders partially conditionally, and only 1 19 patients on a compassionate use
country is allowing free travel. basis. [5]
As of June 4, UAE authorised the
emergency use of Sotrovimab, a kind of
monoclonal antibody drug [25].
Region of the Americas (n=35 countries)
High High
35 (100%) countries have reported with As of Aug 11, Case 35 countries have commenced
outbreak; 31 (88.6%) countries are the estimated fatality rate vaccination as of 13 August 2021.
reporting a surge in cases. effective is 2.56%. Coverage was available for the following:
reproduction i) at least 1 dose was at 70%
decreasing change in incidence or no case countries for 3 countries ii) full vaccination was at
in the last 14 days. ranged fromFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
The Food and Drug Administration has
allowed the combination use of
baricitinib and Remdesivir under
emergency use authorization. The EUA
covers dosing of patients (above the age
of two) who are on supplemental
oxygen, receiving invasive mechanical
ventilation or extracorporeal membrane
oxygenation. [12]
Health Canada has approved
bamlanvimab, for the treatment of
COVID-19 in patients 12 years and older
with mild to moderate symptoms who
are at risk of severe disease progression.
[11]
FDA has allowed emergency use of Eli
Lilly & Co’s bamlanivimab for non-
hospitalized patients at risk of serious
illness due to age or other conditions.
[10]
FDA has issued emergency authorisation
for convalescent plasma to treat COVID-
19. [9]
RLF-100 (aviptadil) by NeuroRx and Relief
Therapeutics was approved for
emergency use in COVID-19 patients who
are too ill to participate in the trial. [8]
As of October 22, remdesivir is the first
and only FDA-approved COVID-19
treatment in the U.S. [7].
FDA has issued emergency authorisation
for sotrovimab to treat mild-to-moderate
Covid-19 adults and paediatric patients
(12 years old and older weighing at least
40kg) who are at risk of severe disease
progression. [23]
As of 25 June, US FDA has issued
emergency authorisation for
Actemra/RoActemra (tocilizumab) to
treat hospitalized adults and pediatric
patients receiving corticosteroids and
requiring supplemental oxygen,
breathing support or ECMO. [26]
As of 5 Aug, FDA has expanded the use of
antibody cocktail, REGEN-COV, updating
its emergency use authorisation (EUA) to
include those at high risk of developing
5|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
severe COVID-19 who have been
exposed to the virus. [29]
As of Aug 11, Brazil has issued
emergency authorisation to Celltrion’s
regdanvimab for high-risk patients with
mild and moderate Covid-19. [30]
African Region (n=47 countries)
High High
47 (100%) countries have reported with As of Aug 11, Case 45 countries have commenced
outbreak; 24 (52.2%) countries are the estimated fatality rate vaccination as of 13 August 2021.
reporting a surge in cases. effective is 2.40%. Coverage was available for the following:
reproduction i) at least 1 dose was at 70%
decreasing change in incidence or no case countries for 1 country; ii) full vaccination was at
in the last 14 days. ranged from 70% for 1
0.49-1.5.$ country. &
Highest incidence over the past 14 days High
were reported from Botswana, Eswatini, Ethiopia has approved the use of
Namibia, Seychelles and South Africa, and Dexamethasone treatment for seriously
highest case numbers were reported from ill COVID-19 patients. [13]
Algeria, Botswana, Kenya, Mozambique
and South Africa.
At least 9 countries have closed their
borders, 38 countries have opened their
borders partially conditionally, and no
country is allowing free travel.
*Only WHO member states are included. 30 territories that have reported cases (with the exception of Palestine)
are excluded from the tabulation of total countries affected/imported/local cases and case fatality rate. Refer to
WHO situation reports or table 4 for information.
$
https://epiforecasts.io/covid/posts/global/
^
Differences between R0 and effective R can be found here https://www.coronavirustoday.com/r-number-refers-
either-basic-or-effective-reproduction-number
&
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/; High vaccine coverage
defined as >70% population with full vaccination
%
In view of the reduction in case fatality rate and effective reproduction number with increasing vaccination, the
two metric are no longer conferred a risk level in our risk assessment matrix; overall risk of each region is compiled
using risk of the environment and availability of treatment only.
6|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
iii. Global Epidemiology
Table 2. Summary of COVID-19 cases & fatalities globally (Updated as of 13 August 2021, 1230H SGT)
Case-
No. of Total Cases Case-
Fatality
Countries/ Total Global Outside Total Fatality
Rate (%) R0
Territories Cases Mainland Deaths Rate (%)
[outside
with Cases China [overall]
China]
5.8 (95% CI 4.4–
220 206,251,780 206,157,520 4,348,193 2.11% 2.11%
7.7)^
^Based on early release as of 10th April, 2020: https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
Table 3. Comparison with other viruses
Virus Incubation Period (Days) Case Fatality Rate (%) R0
Median = 5.1$
SARS-CoV-2 2.11 5.8 (95% CI 4.4–7.7) ^
(2-14) or up to 24*
SARS-CoV 2-7 9.6 2.0For citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
Figure 2. Growth Factor excluding mainland China
Figure 3. Growth Factor of Novel Coronavirus Daily Deaths (Mainland China + Other Countries)
Growth Factor = every day’s cases/cases on previous day. A growth factor above 1 indicates an increase, whereas one between 0 and 1 is a sign
of decline, with the quantity eventually becoming zero. A growth factor below 1 (or above 1 but trending downward) is a positive sign, whereas
a growth factor constantly above 1 is the sign of exponential growth.
Source: https://www.worldometers.info/coronavirus/coronavirus-cases/
8|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
Case Breakdown by Countries
Live update of COVID-19 global cases can be found at
https://storymaps.arcgis.com/stories/a1746ada9bff48c09ef76e5a788b5910
Table 4. Breakdown of COVID-19 confirmed cases and deaths from 7 – 13 August 2021
(Updated as of 13 August 2021, 1230H SGT)
Change
Change in Total Total
No. Country Total Cases in Region
Cases Deaths Recovered
Deaths
1 USA 37,203,649 +901,905 636,298 +4,419 30,097,898 Americas
2 Iran 4,320,266 +262,508 96,215 +3,587 3,647,016 EMRO
3 India 32,117,826 +262,043 430,285 +3,500 31,302,345 SEARO
4 Brazil 20,285,067 +218,480 566,988 +6,187 19,151,021 Americas
5 Indonesia 3,774,155 +205,824 113,664 +11,289 3,247,715 SEARO
6 UK 6,179,506 +196,925 130,701 +615 4,746,302 EURO
7 Turkey 6,018,485 +171,701 52,703 +828 5,558,722 EURO
8 France 6,398,983 +165,107 112,487 +389 5,840,584 EURO
9 Russia 6,534,791 +154,887 168,049 +5,540 5,828,972 EURO
10 Thailand 863,189 +148,505 7,126 +1,272 643,884 SEARO
11 Malaysia 1,342,215 +138,509 11,691 +1,672 1,093,503 WPRO
12 Mexico 3,045,571 +122,908 246,811 +3,646 2,390,075 Americas
13 Spain 4,677,883 +111,312 82,407 +476 3,877,494 EURO
14 Japan 1,069,554 +99,094 15,330 +102 920,862 WPRO
15 Argentina 5,066,253 +76,851 108,569 +1,546 4,713,411 Americas
16 Bangladesh 1,396,868 +74,214 23,613 +1,711 1,262,065 SEARO
17 Philippines 1,700,363 +72,547 29,539 +1,112 1,583,161 WPRO
18 South Africa 2,568,511 +70,856 76,247 +2,374 2,344,896 Africa
19 Iraq 1,751,176 +66,221 19,466 +466 1,566,703 EMRO
20 Morocco 731,084 +65,759 10,711 +624 639,534 EMRO
21 Kazakhstan 672,322 +61,578 7,313 +911 554,178 EURO
22 Cuba 491,904 +60,891 3,757 +573 444,019 Americas
23 Vietnam 246,568 +57,502 4,813 +2,093 89,145 WPRO
24 Italy 4,420,429 +43,241 128,334 +171 4,170,810 EURO
25 Colombia 4,856,595 +34,992 123,097 +1,198 4,675,215 Americas
26 Israel 924,762 +34,561 6,604 +95 874,977 EURO
27 Pakistan 1,089,913 +31,508 24,266 +564 979,411 EMRO
28 Georgia 466,326 +29,753 6,279 +293 412,420 EURO
29 Myanmar 344,730 +25,480 12,667 +1,679 260,025 SEARO
30 Germany 3,814,316 +24,875 92,348 +93 3,675,800 EURO
31 Sri Lanka 345,118 +23,689 5,620 +799 302,455 SEARO
32 Guatemala 403,348 +21,834 10,960 +382 351,996 Americas
33 Greece 528,474 +21,802 13,126 +126 480,198 EURO
34 Nepal 725,769 +17,690 10,212 +218 677,377 SEARO
35 Netherlands 1,894,667 +16,453 17,894 +44 1,726,806 EURO
36 Portugal 995,949 +15,962 17,525 +103 934,017 EURO
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COVID-19 Situation Report 476. 13 August 2021
37 Tunisia 618,124 +15,367 21,310 +760 552,606 EMRO
38 Belgium 1,147,855 +14,921 25,285 +27 1,071,747 EURO
39 Botswana 136,758 +14,184 1,973 +269 121,987 Africa
40 Libya 276,739 +13,791 3,835 +172 203,045 EMRO
41 S. Korea 220,182 +12,776 2,144 +31 192,248 WPRO
42 Ireland 318,937 +11,918 5,059 +15 273,994 EURO
43 Costa Rica 426,474 +11,729 5,199 +91 348,388 Americas
44 Azerbaijan 359,732 +11,658 5,109 +66 337,021 EURO
45 Lebanon 578,367 +11,323 7,962 +36 540,493 EMRO
46 Canada 1,447,446 +11,264 26,692 +55 1,406,013 Americas
47 Switzerland 733,275 +10,474 10,918 +9 695,341 EURO
48 Honduras 314,351 +10,170 8,339 +287 103,969 Americas
49 UAE 698,166 +9,677 1,992 +25 675,566 EMRO
50 Kenya 217,276 +9,014 4,273 +216 199,998 Africa
51 Peru 2,130,018 +8,957 197,209 +449 N/A Americas
52 Mongolia 179,889 +8,792 871 +30 171,011 WPRO
53 Mozambique 136,566 +7,530 1,671 +133 115,931 Africa
54 Algeria 185,042 +7,029 4,695 +254 124,087 Africa
55 Belarus 457,422 +6,977 3,572 +69 451,598 EURO
56 Denmark 327,972 +6,818 2,555 +3 312,907 EURO
57 Venezuela 316,449 +6,468 3,764 +98 302,556 Americas
58 Uzbekistan 140,210 +6,358 956 +46 133,362 EURO
59 Chile 1,626,594 +6,205 36,243 +437 1,582,781 Americas
60 Ukraine 2,262,601 +6,204 53,173 +124 2,194,791 EURO
61 Panama 445,651 +6,052 6,932 +57 427,755 Americas
62 Saudi Arabia 536,693 +5,712 8,378 +81 518,911 EMRO
63 Sweden 1,109,112 +5,419 14,621 +1 1,078,954 EURO
64 Finland 115,305 +5,323 995 +11 46,000 EURO
65 Jordan 780,542 +5,291 10,173 +73 759,217 EMRO
66 French Polynesia 27,036 +5,231 184 +29 22,095 Non
67 Eswatini 34,585 +5,188 905 +78 25,134 Africa
68 Serbia 729,150 +5,053 7,152 +20 712,762 EURO
69 Ethiopia 287,184 +4,686 4,452 +46 264,935 Africa
70 Austria 665,885 +4,526 10,753 +8 647,883 EURO
71 Bulgaria 431,292 +4,360 18,321 +78 399,755 EURO
72 Zimbabwe 118,754 +4,265 4,047 +293 94,925 Africa
73 Senegal 69,576 +4,243 1,554 +113 52,498 Africa
74 Martinique 27,255 +4,226 166 +37 104 Non
75 Nigeria 180,661 +4,084 2,200 +22 166,560 Africa
76 CAR 11,195 +4,044 98 0 6,859 Africa
77 Rwanda 78,303 +3,939 930 +70 45,045 Africa
78 Fiji 38,812 +3,924 345 +62 14,301 WPRO
79 Kuwait 405,442 +3,745 2,380 +24 395,348 EMRO
80 Lithuania 288,173 +3,741 4,438 +14 271,957 EURO
81 Kyrgyzstan 170,770 +3,694 2,426 +54 160,794 EURO
82 Cambodia 83,839 +3,614 1,634 +127 78,431 WPRO
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COVID-19 Situation Report 476. 13 August 2021
83 Réunion 43,835 +3,590 298 +10 38,315 Non
84 Bolivia 480,229 +3,434 18,109 +174 418,580 Americas
85 Cyprus 107,887 +3,418 454 +21 90,755 EURO
86 Ecuador 493,767 +3,411 31,870 +116 443,880 Americas
87 Zambia 201,770 +3,315 3,512 +65 194,004 Africa
88 Norway 142,895 +3,117 807 +3 88,952 EURO
89 Ghana 109,428 +2,994 899 +45 101,984 Africa
90 North Macedonia 159,908 +2,982 5,527 +26 150,635 EURO
91 Malawi 57,273 +2,558 1,919 +171 42,199 Africa
92 Australia 38,168 +2,470 949 +16 30,735 WPRO
93 Jamaica 56,165 +2,326 1,268 +57 47,365 Americas
94 Montenegro 105,002 +2,123 1,640 +5 99,989 EURO
95 Paraguay 456,291 +2,097 15,383 +176 431,006 Americas
96 Armenia 233,400 +2,078 4,669 +37 221,919 EURO
97 Mauritania 29,307 +2,076 627 +44 25,136 Africa
98 Afghanistan 151,770 +1,964 7,000 +121 105,490 EMRO
99 Romania 1,086,109 +1,883 34,334 +34 1,049,156 EURO
100 Laos 9,363 +1,852 9 +2 4,240 WPRO
101 Dominican Republic 345,325 +1,813 3,975 +4 334,863 Americas
102 El Salvador 90,129 +1,758 2,759 +78 77,768 Americas
103 Estonia 136,228 +1,749 1,279 +3 130,165 EURO
104 Burundi 9,408 +1,694 38 0 773 Africa
105 Palestine 319,223 +1,689 3,621 +12 312,879 EMRO
106 Trinidad and Tobago 41,207 +1,630 1,159 +42 34,033 Americas
107 Oman 299,642 +1,622 3,974 +68 287,244 EMRO
108 Namibia 121,817 +1,596 3,244 +102 108,553 Africa
109 Croatia 366,049 +1,558 8,278 +8 356,219 EURO
110 Qatar 228,543 +1,488 601 0 225,566 EMRO
111 DRC 52,432 +1,384 1,050 +5 30,380 Africa
112 Moldova 261,524 +1,341 6,298 +28 253,503 EURO
113 Uganda 96,224 +1,320 2,832 +80 93,260 Africa
114 Albania 134,761 +1,319 2,460 +3 130,549 EURO
115 Guinea 27,507 +1,319 271 +33 25,031 Africa
116 Czechia 1,675,675 +1,265 30,372 +1 1,642,877 EURO
117 Togo 17,434 +1,202 163 +8 15,244 Africa
118 Poland 2,884,780 +1,156 75,291 +16 2,654,874 EURO
119 Slovenia 260,867 +1,103 4,433 +4 254,533 EURO
120 Ivory Coast 51,926 +1,033 354 +16 50,632 Africa
121 Bahamas 16,141 +950 311 +16 13,070 Americas
122 Aruba 12,929 +929 115 +4 11,761 Non
123 Angola 44,174 +905 1,070 +38 41,024 Africa
124 French Guiana 31,633 +877 197 +4 9,995 Non
125 Bahrain 270,590 +853 1,384 0 268,090 EMRO
126 Uruguay 382,997 +842 5,996 +14 375,488 Americas
127 Maldives 78,815 +816 222 0 76,491 SEARO
128 Bosnia and Herzegovina 206,835 +804 9,698 +9 192,034 EURO
11 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
129 China 94,260 +762 4,636 0 87,740 WPRO
130 Mauritius 5,349 +757 21 +1 1,854 Africa
131 Iceland 9,246 +738 30 0 7,914 EURO
132 Timor-Leste 11,870 +645 29 +3 10,169 SEARO
133 Latvia 139,814 +610 2,561 +3 136,163 EURO
134 Suriname 26,318 +602 672 +14 22,509 Americas
135 Isle of Man 5,787 +552 36 +3 5,013 Non
136 Egypt 285,061 +538 16,604 +47 233,729 EMRO
137 Singapore 66,012 +504 43 +3 64,380 WPRO
138 Curaçao 14,396 +489 132 +2 13,629 Non
139 Somalia 16,195 +460 870 +33 7,888 EMRO
140 Benin 9,065 +457 113 +3 8,136 Africa
141 Guyana 23,244 +455 569 +16 21,848 Americas
142 Saint Lucia 6,112 +424 95 +5 5,497 Americas
143 Malta 35,091 +423 429 +5 33,525 EURO
144 Tajikistan 15,862 +422 123 +1 15,428 EURO
145 Gambia 8,920 +415 251 +13 8,038 Africa
146 Hungary 810,212 +409 30,037 +5 763,801 EURO
147 Sudan 37,543 +405 2,803 +27 31,473 EMRO
148 Slovakia 393,302 +404 12,544 +3 379,993 EURO
149 Nicaragua 10,251 +398 197 +1 4,225 Americas
150 Cameroon 82,454 +390 1,338 +4 80,433 Africa
151 Belize 14,738 +356 344 +6 13,831 Americas
152 Tanzania 1,367 +350 50 +29 183 Africa
153 Luxembourg 74,545 +333 827 +3 72,993 EURO
154 Seychelles 18,895 +313 98 +4 18,314 Africa
155 Guinea-Bissau 4,986 +307 84 +5 4,313 Africa
156 Cabo Verde 34,235 +294 298 0 33,402 Africa
157 Channel Islands 9,815 +260 92 +1 9,173 Non
158 Lesotho 13,862 +259 391 +14 6,711 Africa
159 Brunei 543 +204 3 0 322 WPRO
160 Sint Maarten 3,088 +197 38 +4 2,768 Non
161 Dominica 412 +194 0 0 209 Americas
162 Haiti 20,507 +181 576 +13 15,659 Americas
163 Syria 26,205 +146 1,930 +11 22,100 EMRO
164 St. Barth 1,336 +141 2 +1 462 Non
165 Congo 13,356 +140 179 +1 12,421 Africa
166 Saint Martin 2,713 +134 39 +1 1,399 Non
167 Yemen 7,233 +129 1,395 +12 4,438 EMRO
168 Madagascar 42,795 +110 950 +7 42,484 Africa
169 Andorra 14,908 +99 129 +1 14,579 EURO
170 Gibraltar 5,187 +98 95 0 4,885 Non
171 Gabon 25,529 +89 165 0 25,309 Africa
172 Monaco 3,040 +79 33 0 2,891 EURO
173 Greenland 221 +70 0 0 135 Non
174 Taiwan 15,820 +67 817 +26 14,375 WPRO
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175 Barbados 4,509 +66 48 0 4,354 Americas
176 Bermuda 2,645 +56 33 0 2,529 Non
177 Mali 14,669 +54 534 0 14,001 Africa
178 South Sudan 11,143 +53 120 0 10,514 Africa
179 British Virgin Islands 2,552 +52 37 +6 2,469 Non
180 Antigua and Barbuda 1,372 +52 43 0 1,255 Americas
181 Niger 5,716 +47 196 0 5,424 Africa
182 San Marino 5,194 +47 90 0 5,029 EURO
183 Turks and Caicos 2,546 +47 19 +1 2,461 Non
184 Burkina Faso 13,635 +36 170 +1 13,411 Africa
185 Liechtenstein 3,127 +35 59 0 3,028 Non
186 New Zealand 2,914 +34 26 0 2,844 WPRO
187 Papua New Guinea 17,806 +32 192 0 17,479 WPRO
188 Saint Kitts and Nevis 630 +30 3 0 578 Americas
189 Sierra Leone 6,332 +29 121 +1 4,324 Africa
190 Mayotte 19,546 +28 175 +1 2,964 Non
191 Caribbean Netherlands 1,738 +25 17 0 1,702 Non
192 Eritrea 6,597 +24 36 +1 6,525 Africa
193 Hong Kong 12,026 +23 212 0 11,733 WPRO
194 Equatorial Guinea 8,951 +23 123 0 8,757 Africa
195 Djibouti 11,672 +16 156 0 11,503 EMRO
196 Grenada 180 +16 1 0 167 Americas
197 Sao Tome and Principe 2,480 +15 37 0 2,379 Africa
198 Anguilla 127 +14 0 0 117 Non
199 Bhutan 2,553 +10 3 +1 2,518 SEARO
200 St. Vincent Grenadines 2,307 +9 12 0 2,252 Americas
201 Cayman Islands 651 +7 2 0 644 Non
202 Chad 4,981 +5 174 0 4,800 Africa
203 Comoros 4,035 +5 147 0 3,881 Africa
204 Saint Pierre Miquelon 30 +2 0 0 28 Non
205 Montserrat 22 +1 1 0 20 Non
206 Guadeloupe 23,821 0 247 0 2,250 Non
207 Liberia 5,459 0 148 0 2,715 Africa
208 Faeroe Islands 987 0 2 0 963 Non
209 Diamond Princess 712 0 13 0 699 NA
210 Wallis and Futuna 445 0 7 0 438 Non
211 New Caledonia 134 0 0 0 58 Non
212 Falkland Islands 66 0 0 0 63 Non
213 Macao 63 0 0 0 57 WPRO
214 Vatican City 27 0 0 0 27 Non
215 Solomon Islands 20 0 0 0 20 WPRO
216 Western Sahara 10 0 1 0 8 Non
217 MS Zaandam 9 0 2 0 7 NA
218 Vanuatu 4 0 1 0 3 WPRO
219 Marshall Islands 4 0 0 0 4 WPRO
220 Samoa 3 0 0 0 3 WPRO
13 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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221 Saint Helena 2 0 0 0 2 Non
222 Micronesia 1 0 0 0 1 WPRO
Total 206,251,780 +4,548,336 4,348,193 +67,759 183,381,663
Figure 4. Areas with reported confirmed cases of COVID-19 ( 2– 8 August 2021)
Source: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
14 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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Table 5. COVID-19 cases and deaths reported by states/UT in India between 7 – 13 August, 2021
(Updated as of 13 August 2021, 1230H SGT)
Change Change Change Change
Total Total
Name of State from from Total from Total from
Diagnosed Active
/ UT previous previous Recovered previous Deaths previous
Cases Cases
week week week week
Andaman and 7548 +7 6 +2 7413 +5 129 0
Nicobar
Islands
Andhra 1988910 +12769 18688 -1614 1956627 +14256 13595 +127
Pradesh
Arunachal 50973 +1532 2395 -831 48327 +2348 251 +15
Pradesh
Assam 577970 +6399 10427 -1597 562092 +7888 5451 +108
Bihar 725369 +302 273 -92 715450 +394 9646 0
Chandigarh 62009 +43 37 +9 61161 +34 811 0
Chhattisgarh 1003537 +688 1509 -321 988483 +997 13545 +12
Dadra and 10655 +3 5 -9 10646 +12 4 0
Nagar Haveli
and Daman
and Diu
Delhi 1436938 +359 502 -16 1411368 +367 25068 +8
Goa 172276 +668 993 -36 168117 +694 3166 +10
Gujarat 825118 +140 182 -24 814858 +162 10078 +2
Haryana 770146 +119 672 -31 759820 +142 9654 +8
Himachal 209344 +2256 2668 +1058 203134 +1187 3542 +11
Pradesh
Jammu and 323061 +919 1307 -51 317359 +961 4395 +9
Kashmir
Jharkhand 347498 +194 211 -12 342157 +205 5130 +1
Karnataka 2924732 +11220 22754 -1685 2865067 +12699 36911 +206
Kerala 3631638 +138035 177040 -1401 3436318 +138484 18280 +952
Ladakh 20430 +61 87 +25 20136 +36 207 0
Lakshadweep 10274 +39 40 -36 10183 +74 51 +1
Madhya 791998 +79 131 -21 781353 +100 10514 0
Pradesh
Maharashtra 6375390 +39170 65808 -12604 6175010 +50732 134572 +1042
Manipur 106707 +4560 6835 -1851 98189 +6342 1683 +69
Meghalaya 70661 +3069 4539 -1035 64922 +4037 1200 +67
Mizoram 47471 +4663 11620 -1481 35677 +6130 174 +14
Nagaland 28955 +620 1347 +2 27015 +606 593 +12
Odisha 991182 +7659 9729 -2188 974756 +9386 6697 +461
Puducherry 121989 +656 914 +26 119272 +625 1803 +5
Punjab 599758 +454 533 +69 582891 +352 16334 +33
Rajasthan 953887 +114 194 -37 944739 +151 8954 0
Sikkim 28275 +749 2398 -972 25517 +1712 360 +9
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Tamil Nadu 2583036 +13638 20399 +261 2528209 +13179 34428 +198
Telangana 651288 +3477 7996 -748 639456 +4206 3836 +19
Tripura 80980 +1203 1953 -813 78252 +2003 775 +13
Uttarakhand 342526 +219 418 -115 334739 +331 7369 +3
Uttar Pradesh 1708851 +202 490 -169 1685581 +361 22780 +10
West Bengal 1536446 +4784 10127 -594 1508051 +5303 18268 +75
Total 32117826 +261069 385227 -28932 31302345 +286501 430254 +3500
Source: https://www.mohfw.gov.in/
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iv. Travel Bans/Advisories & Quarantine Orders
[1,2] Canada
Flight ban from India has been extended until 21 Sept.
From 9 Aug, American citizens and permanent residents of US will be allowed to enter the
country if they are residing and traveling from US, provide proof of being fully vaccinated and
negative Covid-19 test taken before entry. Canada is also planning to reopen to all fully
vaccinated travelers from 7 Sept.
[3] Cyprus- From 9 Aug, travelers from Croatia, Sweden and Serbia will be required to undergo testing
upon arrival. Travelers from Estonia and Lebanon will be required to undergo additional entry
requirement.
[4] Denmark- From 7 Aug, non-vaccinated and have not been infected with Covid-19 travelers from
Switzerland, Greece, Belgium and France are required to show proof of negative test result and also
get tested on arrival. Citizens are advised against travelling to Czechia, Estonia and Turkey.
[5] Germany- Netherlands has been removed from the list of high-risk area. Unvaccinated travelers will
not be required to undergo quarantine upon arrival from 8 Aug.
[6] Malaysia- From 9 Aug, fully vaccinated returning citizens and residents will be allowed to serve
quarantine at home instead of designated hotel.
[7] Netherlands- From 8 Aug, travelers from Georgia will be required to show proof of full vaccination,
negative PCR test from the past 72 hours and undergo a 10-day mandatory quarantine.
[8] New Zealand- From the first quarter of 2022, New Zealand plans to allow vaccinated travelers from
low risk countries to travel quarantine-free, travelers from medium and high risk countries will
undergo combination of quarantine measures ranging from self-isolation to 14-days quarantine.
[9] Norway- From 9 Aug, travelers from Monaco will undergo double testing and quarantine at
government designated facilities as Monaco moves to dark red category. Iceland and Estonia will
move to red category while Croatia and Lithuania move to orange category where travelers in both
categories will undergo double testing and quarantine.
[10] Philippines- Travel ban on traveler arriving from India, Pakistan, Bangladesh, Sri Lanka, Nepal, the
United Arab Emirates, Oman, Thailand, Malaysia and Indonesia has been extended to 31 Aug.
[11] Russia- Flights to Egyptian resorts, Dominican Republic, Moldova, Bahrain will resume on 9 Aug
while flights to Tanzania will remain suspended until 17 Aug.
[12, 13] Singapore
From 10 Aug, entry approvals for vaccinated work visa holders and dependents with travel
history to higher risk countries will resume.
From 21 Aug, fully vaccinated travelers from Australia, Austria, Canada, Germany, Italy,
Norway, South Korea and Switzerland will serve their 14-days stay home notice at their
residential place instead of dedicated facilities.
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[14] UK- From 9 Aug, fully vaccinated travelers from France has been exempted from quarantine.
Travelers from Austria, Germany, Latvia, Norway, Romania, Slovakia and Slovenia will enter the
country without restriction.
[15] USA- The CDC has added 7 countries, Aruba, Eswatini, France, French Polynesia, Iceland, Israel and
Thailand to the level 4 (very high) risk level warning citizen against travelling to these countries.
18 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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v. Lockdowns
[1-6] Australia
New South Wales- A seven-day lockdown has been imposed on Tamworth and Byron Bay on 9
Aug and on Canberra on 12 Aug.
Queensland- Lockdown in Brisbane has been lifted on 8 Aug. Restriction on leaving city and
gathering will be in place for at least 2 weeks. A three-day lockdown was imposed in a northern
city of Cairns. Borders with ACT will be closed and anyone entering Queensland from 14 Aug
1pm will undergo mandatory hotel quarantine for 14 days.
Victoria- Lockdown in the regional Victoria has been lifted on 10 Aug while lockdown in
Melbourne has been extended for another 7 days until 19 Aug. In the regional, private gathering
at home will be banned while public gathering outdoor will be limited to 10 people. Hospitality
and retail will reopen and community sports will resume. Wedding and funerals will be
restricted to 50 people. Travel to Melbourne will be allowed for permitted reason. Mask will
remain mandatory indoors and outdoors.
[7] Bangladesh- Lockdown has been lifted on 11 Aug with certain measures in place. Shops and malls
will reopen and operate from 10am to 8pm. Public transport will resume with capacity limited to the
available number of seats. Half of the buses will be in operation carrying full passenger capacity.
Hotels and restaurant will operate with half capacity.
[8] Bhutan- A three-day lockdown has been imposed on Jomotshangkha and Langchenphu gewog.
Schools, institutions and offices will be closed.
[9] Brunei- Tighter social distancing measures were introduced on 7 Aug for 2 weeks. Schools will move
to online learning, dine-in for restaurants will be banned and religious places, cinemas and indoor
and outdoor sports facilities leisure centers will be closed.
[10] Dominica- Night curfew has been extended until 17 Aug and run from 6pm to 5am for weekday and
3pm on Saturday to 5am Monday.
[11] France- French overseas territory of Martinique has entered a tougher lockdown on 10 Aug for
three weeks. Beaches and shops selling non-essential items will be closed and movement will be
restricted. Lockdown rule in overseas territory of Guadeloupe will also be strengthened.
[12-14] India
Tamil Nadu- Lockdown has been extended until 23 Aug. Religious places will be closed from
Friday to Sunday. Schools will reopen with 50% capacity on 1 Sept for classes 9 to 12. Medical
and nursing colleges will reopen from 16 Aug.
Kerala- Shops in malls have reopened from 11 Aug. All shops, banks, factories, tourist places are
allowed to operate from Monday to Saturday 7am to 9pm. Lockdown will be imposed on
Sunday. Public observation and mass gathering for Onam, Muharram, Janmashtami, Ganesh
Chathurthi, and Durga Pooja will be banned. Special intensified stringent lockdown restrictions
will be imposed in the Panchayats or urban wards from 12 Aug.
Maharashtra- From 15 Aug, shops, malls and restaurants will be allowed to operate till 10pm.
Private offices will be allowed to operate 24 hours daily with staggered shift hours. Employees in
shops, establishments and offices are required to be fully vaccinated. Religious places and
theatres, multiplexes and auditoriums will remain close. Restaurants, gym and spas will operate
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with 50% capacity. Outdoor wedding will be limited to 200 and 100 or 50% capacity for indoor.
Indoor game will be allowed for fully vaccinated people up to 10pm.
[15] Indonesia- Measures in Jakarta, Bandung, Semarang and Surabay have eased from 10 Aug.
Shopping malls has reopen to vaccinated individuals but limited to 25% capacity. Level four
containment measures in some parts of Java and Bali has been extended until 16 Aug and 23 Aug
for regions beyond the two islands.
[16] Jamaica- Curfew has been imposed from 11 Aug to 31 Aug. It will run from 7pm to 5am on
weekdays, 6pm to 5am on Saturdays and 2pm to 5am on Sunday. Establishments will be closed one
hour before the curfew. Beaches without management or control will be closed while the other
beaches will open from 6am to 4am from Monday to Saturday and 6am to 1pm on Sunday. Places
of worship with be limited to 50 people depending on the physical distance rule.
[17] Japan- Coronavirus quasi-emergency has been expanded to eight prefectures of Fukushima, Ibaraki,
Tochigi, Gunma, Shizuoka, Aichi, Shiga and Kumamoto until 31 Aug. Restaurants and bars will close
before 8pm and ban sales of alcohol. Establishments in areas with decrease of new cases will be
allowed to sell alcohol until 7pm.
[18] Malaysia- Restrictions for fully vaccinated people will be relaxed in in states and federal territories
under second and third phase of the National Recovery Plan. From 10 Aug, interstate travels will be
allowed for fully vaccinated long-distance couples and parents visiting children below 18 years old.
Dine-in with seating capacity of 50% per table, cross-district travel and intrastate tourism in
homestays or hotel, practice non-contact sports from 6am to 10pm will be allowed while contact
sports and group exercise as well as changing and shower in clubhouse premises are banned. Fully
vaccinated resident will be allowed to enter houses of worship for prayers from 9 Aug.
[19] Nepal- Restriction measures in Kathmandu Valley have been extended until 24 Aug. New
restrictions on the ban of non-essential vehicles after 8pm has been introduced from 12 Aug.
[20] North Macedonia- From 16 Aug, proof of at least one dose of vaccination will be required to attend
outdoor events with more than 30 people and entering hospitality venues. Indoor events will be
banned.
[21] Singapore- From 10 Aug, fully vaccinated individuals will be allowed to dine-in at restaurants in
groups of 5 and gathering limit will increase to 5 people.
[22] Uganda- Passenger train service in the capital Kampala have resumed. Each coach will carry 50% of
its capacity allowing space for 65 passenger and mask will be mandatory.
[23] Pakistan- From 1 Oct, unvaccinated individuals will be ban from travelling on train.
[24] Philippines- Manila has been placed under 2-week lockdown from 6 Aug.
[25] South Korea- Restrictions have been extended for another 2 weeks.
[26] UK- Social distancing rules and gathering limit in Wales have been lifted while face masks remain
mandatory in many public places.
20 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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[27] USA- Chicago has added 12 states, Idaho, North Carolina, Washington, Oregon, California, New
Mexico, Montana, Delaware, New York, Indiana, Wisconsin, and Iowa to its travel advisory where
unvaccinated travelers entering the states are advised to undergo 10 days quarantine or produce a
negative test result taken 72 hours prior to arrival.
vi. Military Surveillance
[1-6] South Korea – Between 7 to 13 Aug, 25 covid-19 cases were reported in the military bringing the
total number of infection in the military to 1,545. Cases were reported from Paju (9), Nonsan (4),
Incheon (2), Busan (1), Okcheon County (1), Jinhae (1) and Dongducheon (1). In addition, three
Army soldiers, a Marine, a Seoul-based officer at South Korea- US Combined Forces Command and
a military civilian employee were also identified.
As of 10 Aug, all infected service members from the 301-strong Cheonghae unit have recovered.
[7-11] United States Forces Korea – Between 6 to 13 Aug, the USFK reported 51 cases consisting of 47
service members and four family members. 15 service members were based in Osan Air Base
including one who was identified before returning to US, two service members were from Camp
Humphreys, and 30 service members were new arrivals to South Korea between 13 Jul and 10 Aug.
The latest cases raised the total number of infections reported among the USFK-affiliated
population to 1,210.
[12-16] United States Forces Japan –Between 6 to 12 Aug, the US military in Japan reported 107 new cases.
Cases were reported from Yokosuka Naval Base (23), Naval Air Facility Atsugi (7), Yokota Air Base
(7), Sasebo Naval Base (1), Marine Corps Air Station Iwakuni (4), US Army Japan Camp Zama (12),
Kadena Air Base (17) and Marine Corps base in Okinawa (36).
[17, 18] United States – As of 11 Aug, there were a total of 326,604 cases consisting of 217,982 military,
31,580 dependents, 56,983 civilians and 20,059 Defense Department contractors reported. Among
the military cases, there are 208,287 recoveries and 1,962 hospitalized. There are 29 deaths
including a recent death of an Army officer who had passed away on 2 Aug. There are 76,917 cases
in the Army, 24,710 in the Marine Corps, 42,048 in the Navy, 36,227 in the Air Force, 36,798 in the
National Guard and 1,282 cases among other elements.
21 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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vii. WHO Guidance & Other Protocols
The following update was published by the WHO from 7 – 13 August:
Training on handling, storing and transporting Pfizer BioNTech COVID-19 Vaccine COMIRNATY®
(Tozinameran)
Available at: https://www.who.int/publications/m/item/training-on-handling-storing-and-
transporting-pfizer-biontech-covid-19-vaccine-comirnaty-(tozinameran)
Guidance for surveillance of SARS-CoV-2 variants: Interim guidance, 9 August 2021
Available at: https://www.who.int/publications/i/item/WHO_2019-nCoV_surveillance_variants
viii. CDC Guidance & Protocols
US CDC
The following updates were published by the US CDC from 7 – 13 August:
CDC Diagnostic Tests for COVID-19
Available at: https://www.cdc.gov/coronavirus/2019-ncov/lab/testing.html
Resuming Business Toolkit
Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/resuming-business-
toolkit.html
Safer Travel Tips for Families with Unvaccinated Children
Available at: https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-risk.html
Construction COVID-19 Checklists for Employers and Employees
Available at: https://www.cdc.gov/coronavirus/2019-
ncov/community/organizations/construction-worker-checklists.html
COVID-19 Vaccines That Require 2 Shots
Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/second-shot.html
Considerations for Non-emergency Vehicle Transportation for Tribal Communities During
COVID-19
Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/tribal/non-ems-
transportation.html
Engaging Community Health Workers to Support Home-based Care for People with COVID-19
in Low-Resource Non-U.S. Settings
Available at: https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/home-based-
care.html
COVID-19 Vaccines While Pregnant or Breastfeeding
Available at: https://www.cdc.gov/coronavirus/2019-
ncov/vaccines/recommendations/pregnancy.html
Pregnant and Recently Pregnant People
Available at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-
people.html
Families and COVID-19
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Available at: https://www.cdc.gov/coronavirus/2019-ncov/groups/families-covid-19.html
How to Engage the Arts to Build COVID-19 Vaccine Confidence
Available at: https://www.cdc.gov/vaccines/covid-19/vaccinate-with-confidence/art.html
Selected Adverse Events Reported after COVID-19 Vaccination
Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-
events.html
EU CDC
No updates were published by the EU CDC from 7 – 13 August.
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ix. Vaccines/Therapeutics Development
Noteworthy reports are included to inform main developments of COVID-19 pharmaceutics. Past updates
are available from situation report 211 onwards. A global map and registry of trials is also visualised &
accessible at: https://www.covid-nma.com/dataviz/ and trial results are available at: https://covid-
nma.com/living_data/index.php. A living systematic review of vaccine trials is also accessable at
https://covid-nma.com/vaccines/ or https://covid-nma.com/ .
Vaccines
[1] Australia- Provisional approval has been given for Moderna vaccine making it the fourth vaccine
to be approved. The vaccine will be administered to individuals 18 years old and above in 2
doses with 28 days apart.
[2] France- Valneva SE has commenced a further phase 3 clinical trial (VLA2001-304) for its
inactivated, adjuvanted Covid-19 vaccine, VLA2001. This study will complement the ongoing trial
and support additional regulatory submission. It will be conducted in New Zealand and recruit
about 150 subjects aged 56 years old and above.
[3] Israel- BriLife™ vaccine developed by Israel Institute for Biological Research will commence
phase 2b clinical trial in the Nation of Georgia.
[4] Singapore- SingHealth's Investigational Medicine Unit will be conducting phase 1/2 clinical trial
study on two new vaccines, ARCT-154 and ARCT-165 as well as the original ARCT-021 vaccine. A
total of 72 participants will be involved in the study with 36 who are unvaccinated and another
36 who have been administered with second dose of Pfizer vaccine at least 6 months ago.
Participants will receive two doses of any one of the three vaccines with one month apart while
the vaccinated ones will receive one dose of the vaccine.
[5] South Korea- Vaccination reservation for all adults above 18 will be opened on 9 Aug as
vaccination runs from 26 Aug to 30 Sept.
[6] USA- Majority of the individuals fully vaccinated with Moderna vaccine in a study had
maintained detectable blinding and function antibodies against the SARS-CoV-2 variants
supporting the durable efficacy of 93% through six months.
[7] USA- The US Food and Drug Administration has permit the use of booster dose of Pfizer and
Moderna vaccine for immunocompromised people on 12 Aug.
Therapeutics
[8] Global- Findings from three clinical trials, the Randomised, Embedded, Multi-factorial Adaptive
Platform Trial for Community-Acquired Pneumonia (REMAP-CAP), Accelerating COVID-19
Therapeutic Interventions and Vaccines-4 (ACTIV-4), and Antithrombotic Therapy to Ameliorate
Complications of COVID-19 (ATTACC) showed that anticoagulation with heparin could increase
survival and decrease the need for organ support in hospitalized patients with moderate COVID-
19. There was a 98.6% probability that anticoagulation with heparin increased the number of
organ support-free days when compare to usual care.
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[9] Global- Solidarity PLUS trial will be studying the potential of three new drugs, artesunate,
imatinib and infliximab in reducing the risk of death in hospitalized Covid-19 patients. The study
will be conducted in 52 countries.
[10]South Korea- Celltrion has obtained the EUA from Brazil’s Anvisa for its COVID-19 monoclonal
antibody treatment, Regkirona (regdanvimab) to treat high-risk adult patients with mild and
moderate Covid-19 symptoms on 11 Aug.
[11]South Korea- Celltrion has obtained the approval from Therapeutic Goods Administration (TGA)
of Australia to commence phase 1 clinical trial of its inhaled version of Regkirona. The study will
recruit 24 healthy participants.
Vaccine Approval Status
Table 6: Number of approving countries per vaccine as of 6 August 2021
Number of countries
Developer Vaccine
approving
Anhui Zhifei Longcom RBD-Dimer 2
Bharat Biotech Covaxin 9
CanSino Ad5-nCoV 8
Center for Genetic
Engineering and CIGB-66 1
Biotechnology (CIGB)
Chumakov Center KoviVac 1
FBRI EpiVacCorona 2
Gamaleya Sputnik Light 12
Gamaleya Sputnik V 70
Johnson & Johnson Ad26.COV2.S 59
Kazakhstan RIBSP QazVac 1
Medigen MVC-COV1901 1
Minhai Biotechnology Co SARS-CoV-2 Vaccine (Vero Cells) 1
Moderna mRNA-1273 65
Oxford/AstraZeneca AZD1222 121
BioNTech/Pfizer BNT162b2 97
Serum Institute of India Covishield 45
Shifa Pharmed Industrial Co COVID-19 Inactivated Vaccine 1
Sinopharm BBIBP-CorV 59
Sinopharm Inactivated 1
Sinovac CoronaVac 39
Takeda TAK-919 (Moderna formulation) 1
Source: https://covid19.trackvaccines.org/vaccines/
Adverse Reactions & Effects
[1] Australia- Between 2-8 Aug, 2075 adverse events were reported bringing the total cases
reported to 48,143 among 13.7 million vaccine doses administered. Among 7.4 million doses of
AstraZeneca vaccine administered, 104 (59 confirmed and 45 probable) cases of thrombosis
with thrombocytopenia syndrome (TTS) were reported. Of the cases reported between 2-8 Aug,
10 were 60 years old and above. Of the new probable TTS cases, 5 might be related to the
second dose. TTS had resulted in 6 deaths (5.75% case fatality). There were 149 cases of
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myocarditis and pericarditis among the 6.3 million Pfizer doses administered with 38 new cases
reported.
[2] Barbados- More than 180,000 doses of vaccine had been administered. 442 adverse reactions
were reported and three of them were moderate to severe.
[3] EU- The European Medicines Agency (EMA) will be studying on three new possible side effects,
erythema multiforme, glomerulonephritis and nephrotic syndrome which had been reported by
small number of people after administered with Pfizer and Moderna.
[4] Ireland- The Health Products Regulatory Authority had recorded 24 suspected side effects in
vaccinated children under 17 years old. Common symptoms were dizziness, abdominal pain or
nausea, headache, blurred vision, fainting and fever. A small number of cases had cardiac
related symptom with possible link to anxiety and stress-related reaction due to vaccination. As
of 3rd Aug, 13,529 suspected side effects were reported out of 3.14 million doses administered.
Of the side effects reported, 5,850 cases had received AstraZeneca and Janssen and 7,589 cases
had Pfizer and Moderna. There were 24 reports of myocarditis and pericarditis in people
administered with Pfizer or Moderna vaccine and 10 reports in those with AstraZeneca or
Janssen vaccines.
[5] Japan- In a pre-print study, among 3,998 people who were vaccinated with the first dose of
Moderna vaccine in the workplace vaccination program, 0.5% had adverse events at the
vaccination site and an anaphylaxis case (0.03%) was reported in an individual with history of
anaphylaxis to flu vaccine. Among 1877 subjects who had responded to the questionnaire
survey and were included in the analysis, 82% had reported local adverse events after leaving
the vaccination site with injection site pain the most common (71%). 48% had reported systemic
adverse events with myalgia being the most common (34%).
[6] Israel- A preliminary study observed similar side effects in Pfizer-BioNTech booster shot and the
second dose. Approximately 4,500 participants aged 60 years and above were involved in the
study. 84% had reported feeling similar or better as compared to the second dose, 31% had side
effect with common symptoms being soreness at infection site, 0.4% had breathing difficult and
1% had received medical treatment due to side effects.
26 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
x. Scientific Publications with Epidemiology and Clinical Focus
Clinical Characteristics and Outcomes of COVID-19 Patients with Overweight and Obesity: Turkish
Nationwide Cohort Study (TurCObesity) [1]
Purpose: While obesity is related to more severe outcomes of coronavirus disease 2019 (COVID-19),
factors leading to poor prognosis still remain unclear. The present study evaluated the outcomes of
COVID-19 patients who were overweight or obese and variables associated with severe disease in a
large group of consecutive cases.
Methods: A nationwide retrospective cohort study was performed using the Turkish National Healthcare
Database. Demographic characteristics, laboratory tests, comorbidities, and medications of patients
registered between March 11 and May 30, 2020, were recorded.
Results: A total of 14, 625 patients (median age:42, IQR:26 years; female 57.4%) with normal weight
(34.7%), overweight (35.6%), and obesity (29.7%) were included. Hospitalization, ICU admission,
intubation/mechanical ventilation, pulmonary involvement, and mortality were significantly higher in
patients who were overweight or obese. In adjusted analyses, both overweight (OR, 95% CI: 1.82, 1.04-
3.21; p=0.037) and obesity (OR, 95% CI: 2.69, 1.02-1.05; pFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 476. 13 August 2021
disease with worse inflammatory response and respiratory parameters, compared to those without or
just one of these conditions.
Conclusions: We showed, for the first-time, a strict association of VD levels with blood glucose and BMI
in COVID-19 patients. VD-deficiency might be a novel common pathophysiological mechanism involved
in the detrimental effect of hyperglycemia and adiposity on disease severity.
Household transmission of SARS-CoV-2 in the United States: living density, viral load, and
disproportionate impact on communities of color [3]
Background: Households are hotspots for SARS-CoV-2 transmission. In the US, the COVID-19 pandemic
has had a disproportionate impact on communities of color.
Methods: Between April-October 2020, the CO-HOST prospective cohort study enrolled 100 COVID-19
cases and 208 of their household members in North Carolina, including 44% who identified as Hispanic
or non-white. Households were enrolled a median of 6 days from symptom onset in the index case.
Incident secondary cases within the household were detected by quantitative PCR of weekly nasal swabs
(days 7, 14, 21) or by seroconversion at day 28.
Results: Excluding 73 household contacts who were PCR-positive at baseline, the secondary attack rate
among household contacts was 32% (33/103, 95% CI 22%-44%). The majority of cases occurred by day 7,
with later cases confirmed as household-acquired by viral sequencing. Infected persons in the same
household had similar nasopharyngeal viral loads (ICC=0.45, 95% CI 0.23-0.62). Households with
secondary transmission had index cases with a median viral load that was 1.4 log10 higher than
households without transmission (p=0.03) as well as higher living density (>3 persons occupyingYou can also read
