Global epidemiological situation

In the week from 7 through 13 September, there were over 1.8 million new cases of COVID-19,
comparable to the previous seven days (Table 1); while deaths increased slightly as compared to the
previous week, with over 40 600 deaths reported.
The Region of the Americas has consistently registered the greatest number of reported cases for many
weeks. It continues to account for nearly half of the global total of cases even as cases have declined in
the reporting week. The African Region also showed a decline in reported cases this week and was the
only region to report a decline in deaths.

African Region

The African Region has witnessed declining trends in the number of new cases reported (a 14% decrease
in cases and a 15% decrease in deaths in the past seven days), with 26 of the 47 affected countries
reporting decreases in the past week. While this is encouraging, vigilance is still essential as many factors
may be influencing these trends such as testing capacity and strategy, along with delays in reporting in
some areas.

While South Africa continues to account for the greatest number of cumulative reported cases in the
region (Table 2), disease incidence by 1 million population is highest in Mayotte (12 367 per million).
Cumulative deaths per million population remains the highest in South Africa (260 per million

Elsewhere in the region, WHO has donated life-saving equipment and medical supplies and helped
established a new WHO-supported COVID-19 testing molecular laboratory in Makeni City,
northern Sierra Leone, to facilitate scaling up of testing capacity for the disease in the country. Sierra
Leone has continued to report COVID-19 cases throughout the pandemic amidst other ongoing
communicable diseases outbreaks. Sierre Leone reported 53 cases and 1 death this week, resulting in a
cumulative total of 263 cases per million population and 9 deaths per million population.

Region of the Americas

As cases in the Region of the Americas continues to rise and social dynamics change, the WHO Regional
Office has compiled infographics covering a range of issues related to COVID-19, including tips on how to
stay safe and healthy during the pandemic for different ages, risk groups and settings.

While the numbers are relatively low (Table 2) as compared to other countries in the region,
Guadeloupe has reported its highest number of cases this week, rising from 428 new cases in the
previous weekly update to 1717 new cases this week, and the transmission pattern has now moved from
clusters of cases to community transmission. Cumulative cases and deaths have increased relative to the
territory’s population, over 100% in cases (3 406 to 7 698 per million population) and a 20% increase in
cumulative deaths (50 to 60 per million population) in the past seven days.

In the past week, Curaçao has shown the highest weekly increase in the number of cases since the start
of the outbreak in the country, a 250% increase in weekly new cases reported which translates to a 73%
increase in cumulative cases from 475 to 823 per million population.
While cases reported this week in Costa Rica are in line with the average for the country in the past few
weeks, the number of deaths reported has increased by 84% and a 24% in the incidence of deaths
relative to the country’s population (92 to 114 per million population) in the past week.


Eastern Mediterranean Region

Cases in the Region continue to rise, an increase of 14% in the past seven days, and currently account for
6% of global cases. Seasonal religious and cultural mass gatherings, wedding celebrations and other
social events have contributed to the upsurge of cases in different countries in the region. Upticks of
cases reported in Tunisia and Jordan have been linked to ceremonies and celebrations.

Cases in Morocco have reached a peak at approximately 2 000 per day, an increase of 41% in weekly
new cases, resulting in 2 288 cases per million population. The majority of new cases (42%) are being
reported in the Casablanca-Settat region, where public health and safety measures are being scaled up
in response. In Jordan, the number of weekly new cases has increased by 54%, increasing the cumulative
cases per million population from 231 to 300. Deaths have remained stable at 2 per million population.
Additionally, the first two cases of COVID-19 were confirmed in a refugee camp hosting Syrian refugees.
In Libya, the number of new confirmed cases of COVID-19 has more than doubled over the past two
weeks; both the cumulative cases and deaths per million population in Libya has increased by 30% in the
past seven days. Given the acute shortages of tests and laboratory capacity, the real number of cases is
likely to be much higher. WHO is supporting the efforts of Libyan authorities to increase the number of
COVID-19 tests and trace all contacts.


European Region

The European Region accounts for 16% of global COVID-19 cases and 25% of the deaths. While France
reported the highest number of new cases in the past seven days, the top three countries in the region
reporting the highest cumulative cases per million population are San Marino (21 834 cases per million
population), Andorra (17 395 per million population) and Israel (16 430 per million population). The
countries reporting the highest cumulative number of deaths relative to their population are San Marino
(1 238 per million population), Belgium (856 per million population) and Andorra (686 per million


South-East Asia Region

In the South-East Asia Region, India, Indonesia and Bangladesh continue to report the highest number
of cases, although the Maldives accounts for the highest number of cumulative cases relative to its
population (16 746 per million population). The region recorded 22% of all new deaths in the last seven
days but retains low overall cumulative deaths relative to the region’s population (46 per million

Myanmar is continuing to show increasing case numbers, with a greater than 250% increase in weekly
new cases, resulting in more than a doubling of cumulative incidence from 24 to 51 per million
population. Deaths remain low, with an incidence of <1 per million population. An influx of local
travelers from Rakhine State to Yangon Region occurring since the end of August has contributed to
increasing trends; as incidence rises, there are concerns of spread of cases from Myanmar across its
border with Thailand, where cases have remained low (50 per million population) since peaks in early


Western Pacific Region

Overall, the Western Pacific Region has the lowest cumulative cases (278) and deaths (6) per million
population. The Philippines, Japan and the Republic of Korea have the greatest number of new cases in
the region; however, Singapore holds the largest number of cumulative cases per million population at
9 804. Malaysia showed an increase in weekly new cases of nearly 650%, averaging about 68 cases per
day. Prior to this, Malaysia had been reporting fewer than 20 cases per day since the end of July. In the
last seven days the cumulative cases per million population rose by 5% to 305 cases per million


Key weekly updates

The first meeting of the International Health Regulations (IHR 2005) Review Committee on the
functioning of the IHR during the COVID-19 pandemic was held this week. WHO Director-General Dr
Tedrosstated that the committee would review the functioning of the IHR during the COVID-19
response, including IHR provisions related to, but not limited to, the following six areas:

o The convening of the Emergency Committee and its working modalities, and in particular, the
binary mechanism for declaring a Public Health Emergency of International Concern;

o The international coordination and collaboration for response, including the role and functioning
of national IHR focal points;

o Outbreak alert, verification and risk assessment, information sharing and communication;

o Additional health measures in relation to international travel;

o Implementation and reporting of IHR core capacities, including the possibility of establishing peer
review processes for capacity assessments;

o Examining progress made on the implementation of recommendations from previous IHR review

• As public health and safety measures begin to reduce COVID-19 cases to manageable levelsin some
countries, the epidemiological practice of contact tracing must go into full force.This becomes
complicated and time-consuming very quickly, especially in the context of COVID-19, as the virus can
be transmitted between people without even causing symptoms. While conventional contact tracing
methods will always remain relevant, digital tools present an opportunity to optimize traditional
approaches. WHO is pursuing multiple avenues at once: behind the scenes bringing together private
sector, innovators and governments to scale up technology and digital inclusion; and on the ground,
for example in humanitarian settings.

• In his second regular media briefing of last week, WHO Director-General Dr Tedros highlighted that
COVID-19 is like no other disease in history, in that it has seen such rapid development in research. In
April, together with the European Commission and severalother partners, WHO launched the Access
to COVID-19 Tools (ACT) Accelerator, to catalyze the development of and equitable access to
vaccines, diagnostics and therapeutics. WHO co-hosted the first ACT Accelerator Facilitation Council
meeting last week. The Council reiterated that there is a need for a significant increase in funding in
order for the ACT Accelerator to be able to deliver on its goals.

• The ability to confirm COVID-19 disease relies on the accurate detection of the SARS-CoV-2 virus.
WHO has published interim guidance for countries who are considering the integration of rapid
immunoassays into COVID-19 outbreak management programs and has also revised guidance on
diagnostic testing for SARS-CoV-2 which provides more background information on clinical diagnostic
algorithms and new findings from the literature and best practices.

• Surveys by UNICEF and WHO reveal that the COVID-19 pandemic has resulted in major disruptions to
health services, which threaten to undo decades of hard-won progress, particularly in the number of
global deaths in children under five years old, which was at its lowest point on record in 2019.