COVID-19 Outbreak: Weekly Global Report for Friday, December 18, 2020
AdvaMed recognizes that its members, particularly those with global government affairs responsibilities, are tracking COVID-19 related developments around the world to assess the public health and economic impacts on their businesses. Knowing that companies are consuming information from a variety of sources, AdvaMed's global team would like to provide members with a weekly snapshot of the key statistics, policy developments and advocacy initiatives underway in our priority markets. If you have any suggestions, we welcome your feedback.
Global
- Weekly COVID-19 statistics--global cases reached 74.4 million, a 4 million increase over the previous week. Deaths around the world surpassed 1.65 million. The countries with the most reported cases continue to be the U.S. (17 million), India (10 million), and Brazil (7 million).
- U.S. cases exceeded 17 million with deaths increasing to 307,000.
- Staff Contact: Ralph Ives (rives@advamed.org).
China
- Weekly COVID-19 statistics–China’s total COVID cases now stand at 94,722, an increase of 712 cases over last week. There were 10 new deaths over the previous week, bringing the death count to 4,758. Almost all new cases have been linked to foreign arrivals.
- On December 4, China’s National Health Commission released updated figures on the number of hospital visits and medical consultations by Chinese patients this year. In January through August, the total number of hospital visits/medical consultations reached 3.39 billion, a decrease of 16% over the same period in 2019. It is important to note that this percentage decrease has gotten progressively smaller since June, perhaps indicating Chinese patients have become more comfortable in visiting medical institutions in the second half of 2020.
- China reportedly has five coronavirus vaccine candidates in the third and final stage of clinical trials.
- Deputy head of China’s national vaccine research and development taskforce Wang Junzhi announced that the country will have 600 million doses of a COVID-19 vaccine ready for market by the end of 2020. He further stated that the government will make a major announcement in the next two weeks with regard to China’s development of a vaccine.
- The Chinese government is reportedly considering the establishment of a new disease control agency that will combine the National Health Commission and the China Center for Disease Control and Prevention.
- A World Health Organization (WHO) team of international experts will join Chinese scientists “as soon as possible” in Wuhan to investigate the origins of COVID-19. Phase one of the investigation will work to establish how the virus broke out through research of hospital records, blood samples and interviews with early patients.
- The United Arab Emirates issued the first government approval of a Chinese coronavirus vaccine on Wednesday, citing preliminary data showing that it was 86 percent effective, a move that could bring Chinese vaccines a step closer to widespread use. If results from elsewhere show similar findings, the Chinese vaccines could offer a lifeline to developing countries that cannot afford vaccines from the United States that are likely to be more expensive and more difficult to transport
- Government attention has largely turned towards preventing a second wave outbreak, with imported frozen food now considered the major risk vector. The smattering of recent transmissions linked to frozen food indicate the government is right to be cautious, but scientific experts remain divided over contaminated frozen food in fact causing new transmissions. The State Council issued its Work Plan for the Preventive and Comprehensive Disinfection of Imported Cold Chain Food, mandating that the packaging of all imported cold food must be disinfected before distribution.
- Both Chinese nationals and foreigners traveling to China are now required to present negative nucleic acid and serum IgM antibody tests taken within the 48 hours prior to departure. Passengers transiting through a third country or territory will be required to undergo a second round of the same tests within that country or territory before continuing their journey. All tests must be verified by the local Chinese embassy or consulate, which will then grant passengers a green health code to be presented upon boarding.
- The General Administration of Customs released November trade data indicating a 21 percent year-on-year increase in exports and a 4.5 percent year-on-year growth in imports. While this represented this year’s fastest rate of export growth, third party analysis questioned the longevity of this demand, as a vaccine may revive overseas manufacturing and dampen global demand for protective healthcare equipment.
- U.S.-China relations remain strained. The Phase One trade deal remains intact and has emerged as a key area of cooperation. NEC Director Larry Kudlow said this week that President Trump will not impose any new tariffs on China. China continues to make record buys of U.S. farm products, most notable soybeans and corn.
- Staff Contact: Kyle Churchman (kchurchman@advamed.org)
India
- Weekly COVID-19 statistics – 9,762,326 total cases, 372,293 active cases/141,772 deaths as compared to 9,531,295 total cases, 422,943 active cases/138,648 deaths last week. India's Covid-19 caseload crossed 97 lakhs on Wednesday, December 9, while the number of people who have recuperated from the disease crossed 92 lakh, pushing the national recovery rate to 94.66 per cent, according to the Union health ministry.
- The Drugs Controller General of India (DCGI) has given conditional approval for Phase 1 and 2 clinical trials of India's first mRNA Covid-19 vaccine candidate -- HGCO19 -- that is being developed by Gennova Biopharmaceuticals.
- The Union Health Ministry on Tuesday, December 8, charted out a list of preparatory activities which are being carried out by it in collaboration with states and union territories for the roll-out of Covid-19 vaccine. Addressing the press conference, Health Ministry Secretary Rajesh Bhushan listed out six consultative processes and five key strategies the government is adopting to roll out the most-awaited vaccination for the disease.
- Pfizer India has become the first pharma firm to seek an emergency use authorisation from the DCGI for its Covid vaccine in India after its parent company secured such approval in the UK and Bahrain.
- Bharat Biotech is expected to initiate Phase-1 trials of its intranasal vaccine for Covid-19 next month, chairman and MD Krishna Ella said on Tuesday, December 8. He said his firm is setting up two more facilities for manufacturing vaccines, including for Covaxin.
- Hyderabad-based Bharat Biotech filed an application seeking emergency use authorisation for Covaxin on Monday, December 7, becoming the third company to seek such regulatory approval in India after Pfizer and Serum Institute of India (SII).
- Prime Minister Narendra Modi on December 7 said Indians will not have to wait for a COVID-19 vaccine for "too long” but warned against laxity in the prevention of coronavirus infection.
- The government plans to significantly scale up operations to cover around 80 crore people — 60% of the country’s population — in an exercise aimed at achieving herd immunity In the second phase of vaccination against Covid-19.
- The central government has started preparations to set up a cold storage chain for the COVID-19 vaccine that is likely to be approved soon in the country. It is also working on transportation of the vaccine with leading airlines.
- The Serum Institute of India (SII) on Sunday, December 6, became the first indigenous company to apply to DCGI seeking emergency use authorisation for the Oxford COVID-19 vaccine in the country, citing unmet medical needs due to the pandemic and in the interest of the public at large, official sources said.
- Staff Contact: Abby Pratt (apratt@advamed.org).
Japan
- Weekly COVID-19 statistics – 191,647 reported cases and 2,806 reported deaths compared to 173,121 reported cases and 2,526 reported deaths the previous week.
- Japan recorded its highest-ever level of COVID-19 patients in intensive care last week.
- With overall infections in Japan exceeding 2,000 a day, authorities across the country have called for a three-week period of concentrated efforts against the virus. In four hardest hit metropolitan areas (Tokyo, Osaka, Sapporo, and Nagoya), bars and restaurants have been asked to close early.
- Japan announced that it plans to inoculate its entire population with a COVID-19 vaccine by the time the Olympics start in July 2021.
- While Japan has made no final decisions on who will get priority for the vaccine, it has discussed first providing it to healthcare workers taking care of COVID-19 patients, then to those who support the elderly, those with underlying diseases, and disabled people in facilities. The next priority would be pregnant women.
- Japan has contracted with Pfizer to purchase 120 million doses of its COVID-19 vaccine to be delivered in the first half of 2021. Pfizer is currently conducting a small-scale trial of the vaccine in Japan, the results of which will determine when the company applies for regulatory approval there. Japan has also contracted for 50 million doses of the Moderna vaccine and 120 million doses of the Astra Zeneca vaccine.
- Hospital beds are running low in many of the hardest hit regions.
- Japan’s third wave differs from the second wave over the summer in that cases among the elderly are more prevalent now.
- Tokyo set a record for COVID-19 cases in November, reaching a monthly total of 9,857 – far outpacing its last record of 1,700 cases in August.
- The increase in cases in Japan appears to be having some impact on return to procedure as many hospitals are struggling to deal with the increase in COVID patients, but the evidence so far is anecdotal.
- The pandemic has had a severe impact on the financial situation of Japan’s hospitals. Nearly 70% of Japan’s hospitals are now operating in the red.
- Japan decided to conditionally exempt business travelers and returnees from its 14-day quarantine policy, which was imposed on all arrivals from overseas to curb the spread of the novel coronavirus. The change covers both Japanese nationals returning from overseas business trips and foreign residents with valid residence permits in Japan, with no restrictions on their overseas travel destinations. However, the change only applies to residents of Japan who are planning to spend no more than seven days at their overseas destinations.
- Under the revised policy, Japan has also relaxed entry restrictions for travelers from Australia, Brunei, China, Hong Kong, Macau, New Zealand, South Korea, Singapore, Taiwan, Thailand and Vietnam, where the pandemic is considered to be kept relatively under control. Such travelers will be exempted from testing upon arrival as long as they observe a 14-day quarantine and don’t use public transport during that period.
- The pre-arrival PCR test requirement will remain in place for 152 countries and regions still covered by the entry restrictions.
- Japan and China have opened a fast-track business travel lane. Travelers between the countries will be able to forego mandatory quarantine requirements following the submission of itineraries and negative PCR test results.
- Japan's Ministry of Health has adopted priority regulatory review procedures for new COVID-related medical devices.
- Staff Contact: Phil Agress (PAgress@AdvaMed.org).
Korea
- South Korea’s numbers are again increased from last week. Korea is reporting 1,014 new daily case, including 993 local cases (the remainder of cases originated overseas). Seoul recorded an all-time high of 423 new cases, as Seoul’s Deputy Mayor indicated that the city will not hesitate to raise its social distancing level to Level 3 if the daily case count remains high. Although increased, Korea is nonetheless not seeing the dramatic spikes or infection levels that many other countries are experiencing.
- Still, Korea ranks 90 in the world in cumulative cases and 89th in the world in number of deaths (663).
- South Korea has 46,453 total cases, 12,209 active cases, with 634 deaths, reporting 22 deaths per day. Total cases per million population have increased significantly, but still remain one of the lowest at just 906, as do deaths per million population at just 12.
- Significant bed shortages are straining hospitals in Seoul, which has long been Korea’s COVID-19 epicenter, as the city counted a record number of 423 new cases on Thursday.
- Public health officials said Thursday a Seoul resident in their 60s had died while waiting to be admitted to a hospital after a COVID-19 diagnosis, marking the first such case to be reported in the capital since the pandemic began. They said the patient died at home Tuesday after having waited three days for a hospital bed since testing positive for the virus on Saturday. The patient did not exhibit severe symptoms initially.
- Authorities can adopt Level 3, the third highest under the five-tier virus restrictions, when locally transmitted cases surge to 800 to 1,000 or the daily tally doubles from the previous day. Health authorities raised social distancing measures to Level 2.5, the second highest, early last week, but they have failed to slow the spread of the virus so far. They have acknowledged that the current level of social distancing has failed to flatten the virus curve and hinted they will not hesitate to adopt Level 3 when necessary. But health authorities remain cautious about doing so, as the move will cause economic damage to shop owners and self-employed people.
- On Thursday, the authorities stated they will ban the operation of poker pubs and dining inside unmanned cafes starting Saturday for the next 10 days.
- Intensive care unit hospitalizations are at an all-time high, even as guidelines have been revised to discharge patients faster. Currently, there are 226 severely or critically ailing patients in ICUs. Only one ICU bed for COVID-19 patients was available in Seoul as of Tuesday afternoon.
- A series of nursing home outbreaks threaten a further surge in hospitalizations. At least 335 residents at nursing homes in Gyeonggi Province, South Chungcheong Province and Ulsan have tested positive for the disease as of Tuesday.
- Prime Minister Chung Sye-kyun hinted at a “near-lockdown” in a government meeting Wednesday morning. “That may be coming and we need to get ready for that beforehand,” he told ministries.
- Yoon Tae-ho, a senior official at the Ministry of Health and Welfare, said in a news briefing held the same day that Korea, having averaged between 800 and 1,000 cases per day over the past week, qualified for the strictest tier of its social distancing system. “Before tightened rules can come into effect, a societywide consensus appears necessary. We are talking about rules that are akin to a lockdown,” he said, citing damage to the economy, especially small businesses.
- The top social distancing tier, if implemented, limits indoor gatherings of more than 10 people, religious services, in-person classes at schools and operations of businesses that are 300 square meters or larger. Wearing face masks becomes mandatory even in outdoor settings where putting a 2-meter distance between people is difficult. Food outlets including pubs and bars can stay open until 9 p.m., after which point only to-go orders are permitted.
- Public health officials are urging against all nonessential activities, asking people to stay home as much as possible, without enforcing orders.
- According to a survey of 1,500 adults by a research team led by psychiatry professor Kim Sung-wan at Chonnam National University Medical School, there was a noticeable decrease in prejudice, fear and anxiety among those who have more knowledge of COVID-19. “The more knowledge people have about the infectious disease the less afraid they were, but the media did not contribute to increasing the level of knowledge among people. Rather, the more people were exposed to news about the coronavirus, the bigger their fear, prejudice and anxiety got,” Kim said in his dissertation, which was published in the Journal of Korean Medical Science on Monday. Despite the need to deliver information about the scale of coronavirus outbreaks, there needs to be cooperation between journalists and medical personnel not to fan excessive fear and anxiety about the coronavirus, he added.
- South Korea maintains its 2-week quarantine for all other incoming international travelers and a requirement for all inbound flights to check passengers' temperatures. Anyone with a temperature over 37.5 degrees Celsius (99.5 Fahrenheit) is denied entry. Korea has not issued any guidance on an exemption that is supposedly available. Korea has indicated all US inbound travelers will be tested for symptoms prior to being moved to quarantine.
- South Korea’s movement toward implementation of a proposal that would potentially reduce the price of certain cardiac and peripheral stents has been at least temporarily postponed. A December meeting that was scheduled to occur to discuss the proposal has been postponed. AdvaMed is in touch with members and the medtech association in Korea and has had several discussions with the US Government on this topic. We have sent a letter to the health ministry expressing opposition to the proposal.
- Last week we submitted a letter in response to a recently issued request for comments on the proposal for potential implementation of pricing controls. Please contact Joseph Gatewood (jgatewood@advamed.org) if you have an interest in this matter and are not already engaged.
- Resources: http://ncov.mohw.go.kr/en/.
- Staff Contact: Joseph Gatewood (jgatewood@advamed.org).
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ASEAN
- Weekly COVID-19 statistics – ASEAN now has 1,353,775 reported cases and 30,983 reported deaths compared to 1,279,458 reported cases and 29,519 reported deaths the previous week.
- ASEAN has seen more than 50,000 new cases for each of the past thirteen weeks, with the vast majority of those accounted for by Indonesia, the Philippines, and more recently Myanmar and Malaysia. Indonesia surpassed 636,000 total cases and the Philippines has reported over 454,000 cases.
- Myanmar continues to experience a major surge that started in September. It is now reporting 110,667 total cases. The number of deaths is 2,346. To prevent further spread, the government has extended stay-at-home orders in 74 townships, while grounding all commercial flights until at least December 15.
- The Philippines and Indonesia account for 90.6% of the deaths from COVID-19 in the region. Indonesia’s total COVID-19 deaths have reached 19,248, the highest level in East Asia. The Philippines reported 8,833 deaths.
- Cambodia and Laos have each reported zero deaths, while Brunei has reported 3 deaths, and Singapore has reported 29 deaths (despite having over 58,000 cases), and Thailand has reported 60 deaths. These numbers are unchanged from the previous week.
- Last week, Indonesia received 1.2 million doses of China's Sinovac vaccine. The first batch of doses will be distributed to medical workers and other high-risk groups.
- Elective surgeries have resumed in Thailand and Vietnam.
- In Indonesia, provincial hospitals are resuming elective surgery with COVID-19 protocols in place.
- Malaysia maintains limits on elective surgery except in emergency cases.
- Singapore restricts most elective surgeries but allows certain procedures including cancer screening, surgical operations for advanced cataracts, flu vaccinations, and dental procedures.
- The Philippines extended its State of Calamity by a year to counter the pandemic. This extension will give national and local governments latitude to continue utilizing appropriate disaster relief funds and affords the government powers to monitor and control necessities and provide essential services to the affected populations.
- In Malaysia, schools and entertainment venues have been closed in much of the country and a ban on inter-state trave has been reinstituted.
- Malaysia has imposed an entry ban on citizens of countries recording more than 150,000 cases of COVID-19.
- The Malaysian government relaxed its recent entry ban on expatriate and professional visit pass holders from 23 countries, provided they receive approval from the Malaysian Immigration Department and a support letter from the Malaysian Investment Development Authority.
- Malaysia and Singapore partially reopened their border on August 10. Both governments have agreed to implement a Reciprocal Green Lane (RGL) and Periodic Commuting Arrangement (PCA). The RGL will enable cross-border travel for essential business and official purposes between both countries and the PCA will allow residents of Singapore and Malaysia who hold long-term immigration passes for business and work purposes in the other country to enter the country for work.
- Malaysia is considering fully reopening the Malaysia-Singapore border for daily commuters in January 2021 if conditions warrant.
- Myanmar gave clearance for domestic flights to resume. Myanmar had grounded all domestic flights on September 11 after a surge of coronavirus cases. State Counselor Daw Aung San Suu Kyi stated that the government is planning to resume international commercial flights as soon as possible.
- Singapore will pilot quarantine-free business travel starting in January. Short-term business travelers from all countries will be able to stay, work and meet at dedicated facilities here from mid-January, without the need for prior quarantine, as efforts get under way to draw them back to Singapore.
- Vietnam and Singapore are planning to launch a green lane for business and official travel by the start of next year.
- Singapore and France are working on a travel green lane for short-term business and official trips.
- Singapore is requiring travelers who are not Singaporeans or permanent residents entering Singapore from high-risk countries to take a COVID-19 PCR test within 72 hours before their departure.
- The Singapore Government is looking into phase 3 of reopening by end of 2020 if the number of COVID-19 community cases remain low. Phase 3 is expected to further relax social distancing measures.
- Singapore and Indonesia announced a green lane between the two countries aimed at keeping essential business going. Applications for travel include strict health protocols and controlled itineraries. Singapore also maintains agreements with Australia, Brunei, China, Malaysia, and Korea on fast-lane arrangements for essential travel.
- Singapore is piloting a new business travel pass for senior executives with regional or international responsibilities. Travelers on this pass would need to keep to a strict itinerary while abroad. On returning to Singapore, they would have the option of a COVID-19 test in lieu of a stay-home notice and would need to self-isolate until the results are released.
- Singapore has lifted border restrictions for all visitors from mainland China and Australia’s Victoria State.
- Singapore is lifting border restrictions for visitors from Taiwan beginning December 18. Upon arrival, visitors from Taiwan will undergo COVID-19 testing and if the result is negative, will be allowed to enter Singapore without serving a stay-home notice.
- Singapore and Japan agreed to launch a Reciprocal Green Lane for essential business and official travel between the two countries.
- Singapore and Hong Kong have postponed the start of their bilateral air travel bubble, which will allow quarantine-free air travel between the two Asian hubs, through at least December due to a spike in cases in Hong Kong.
- The Philippines has extended the implementation of General Community Quarantine (GCQ) in Metro Manila for the entire month of December. Apart from Metro Manila, areas also under GCQ until the end of the year are Batangas, Iloilo City, Tacloban City, Lanao del Sur, Iligan and Davao City. The rest of the country will be under modified GCQ.
- Thailand now allows long-term stay visitors, including business travelers and tourists, who will be able to remain in the country for up to 90 days (with up to two extensions possible). Visitors must be from a designated low-risk country, must undergo testing, and must quarantine for 14 days upon arrival in Thailand.
- Thailand has extended its nationwide state of emergency through January 15 and deferred a proposal to shorten the quarantine period for foreign tourists to 10 days to prevent a COVID-19 resurgence during the peak holiday season.
- The Thai Government adopted a fifth phase of lockdown easing, allowing most daily activities and businesses to resume. It has lifted the ban on international flights and allows certain categories of individuals from Japan, China, South Korea, Hong Kong, and Singapore to enter the country. The Civil Aviation Authority will still apply stringent international travel restrictions preventing the entry of tourists.
- Vietnam and Japan have lifted mandatory quarantine for short-term visits for businessman and officials. However, there will be strict testing and medical surveillance protocols in place.
- Vietnam is finalizing an agreement to allow South Korean business travelers to fly in without serving the mandatory 14-day quarantine. The agreement is expected to take effect on January 1, 2021.
- Cambodia recorded its first COVID-19 community transmission from a cluster linked to a prison chief on November 28, after going months without domestic infections. Public gatherings of more than 20 people have been banned for at least two weeks, while schools, museums, and cinemas will also temporarily close.
- Staff Contact: Phil Agress (PAgress@AdvaMed.org)
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Europe
- There is continued increase across the EU. Belgium, Spain and France are among the countries with the highest numbers of cases per million. In terms of raw numbers, Germany now has the lead in new cases at 28,969 followed by Russia (26,509) and UK (25,161). Italy, Poland, the Netherlands and Sweden are also on the high end in new cases. Italy has the most deaths, followed by the UK, France, Spain and Russia. Although not in the EU, Russia's reported numbers on COVID remain problematic with perhaps the highest number of total cases of any country at 2,734,454, new cases at 26,509 and 48,564 reported deaths (and reporting one of the lowest death rates in Europe at 333 per million). By comparison, Italy, with much fewer (1,888,144) cases, reports 66,537 deaths.
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