Global Update from WHO
- Total (new cases in last 24 hours) Globally 12 552 765 cases (230 370) 561 617 deaths (5 285)
- Africa 461 296 cases (17 884) 8 092 deaths (162)
- Americas 6 540 222 cases (142 992) 283 357 deaths (3 500)
- Eastern Mediterranean 1 271 338 cases (15 361) 30 652 deaths (510)
- Europe 2 907 654 cases (18 804) 203 285 deaths (448)
- South-East Asia 1 130 247 cases (33 173) 28 640 deaths (650)
- Western Pacific 241 267 cases (2 156) 7 578 deaths
Subject in Focus:
Transmission of SARS-CoV-2: implications for infection prevention precautions On 9 July 2020, WHO updated the scientific brief on the transmission of SARS-CoV-2, the virus that causes COVID-19. This replaces a previous version of the scientific brief, published on 29 March 2020. As the spread of the virus continues to intensify around the world, we are gaining more knowledge as to how and when the virus is able to spread between people. This is important in order to continuously ensure that the most effective measures to suppress transmission of the virus and prevent associated illness and death are used. Below, we provide the key points of the brief. The full scientific brief and a Q&A are available online. Key points of the brief Main findings
• Understanding how, when and in what types of settings SARS-CoV-2 spreads between people is critical to developing effective public health and infection prevention measures to break chains of transmission.
• Current evidence suggests that transmission of SARS-CoV-2 occurs primarily between people through direct, indirect, or close contact with infected people through infected secretions such as saliva and respiratory secretions, or through their respiratory droplets, which are expelled when an infected person coughs, sneezes, talks or sings.
• Airborne transmission of the virus can occur in health care settings where specific medical procedures, called aerosol-generating procedures, generate very small droplets called aerosols. Some outbreak reports related to indoor crowded spaces have suggested the possibility of aerosol transmission, combined with droplet transmission, for example, during choir practice, in restaurants or in fitness classes.
• Respiratory droplets from infected individuals can also land on objects, creating fomites (contaminated surfaces). As environmental contamination has been documented by many reports, it is likely that people can also be infected by touching these surfaces and touching their eyes, nose or mouth before cleaning their hands.
• Based on what we currently know, the transmission of COVID-19 is primarily occurring from people when they have symptoms, and can also occur just before they develop symptoms when they are in close proximity to others for prolonged periods of time. While someone who never develops symptoms can also pass the virus to others, it is still not clear to what extent this occurs and more research is needed in this area.
• Urgent high-quality research is needed to elucidate: the relative importance of different transmission routes; the role of airborne transmission in the absence of aerosol-generating procedures; the dose of virus required for transmission to occur; the settings and risk factors for superspreading events; and the extent of asymptomatic and pre-symptomatic transmission. How to prevent transmission The over-arching aim of the Strategic Preparedness and Response Plan for COVID-19 is to control COVID19 by suppressing transmission of the virus and preventing associated illness and death. To the best of our understanding, the virus is primarily spread through contact and respiratory droplets. Under some circumstances airborne transmission may occur (such as when aerosol-generating procedures are conducted in healthcare settings or potentially, in indoor crowded poorly ventilated settings elsewhere). More studies are urgently needed to investigate such instances and assess their actual significance for transmission of COVID-19. To prevent transmission, WHO recommends a comprehensive set of measures including:
• Identify suspect cases as quickly as possible, test, and isolate all cases (infected people) in appropriate facilities;
• Identify and quarantine all close contacts of infected people and test those who develop symptoms so that they can be isolated if they are infected and require care;
• Use fabric masks in specific situations, for example, in public places where there is community transmission and where other prevention measures, such as physical distancing, are not possible;
• Use of contact and droplet precautions by health workers caring for suspected and confirmed COVID-19 patients, and use of airborne precautions when aerosol-generating procedures are performed;
• Continuous use of a medical mask by health workers and caregivers working in all clinical areas, during all routine activities throughout the entire shift;
• At all times, practise frequent hand hygiene, physical distancing when possible, and respiratory etiquette; avoid crowded places, close-contact settings and confined and enclosed spaces with poor ventilation; wear fabric masks when in closed, over-crowded spaces to protect others; and ensure good environmental ventilation in all closed settings and appropriate environmental cleaning and disinfection.
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