Global overview
Data as of 13 June 2021
Global numbers of cases and deaths continued to decrease over the past week (7-13 June 2021) with over 2.6 million new weekly cases and over 72 000 deaths, a 12% and a 2% decrease respectively, compared to the previous week (Figure 1). While the number of cases reported globally now exceeds 175 million, last week saw the lowest weekly case incidence since February 2021. Declines in the number of new weekly cases were reported across all Regions except for the African Region. The South-East Asia, European and Western Pacific Regions reported marked declines in the number of new cases in the past week, whereas the Region of the Americas and the Eastern Mediterranean Region reported similar numbers as compared to the previous week (Table 1). While the number of new deaths reported in the past week decreased across all Regions except for the African and the South-East Asia Regions, globally mortality remains high with more than 10 000 deaths reported each day. While the epidemics in some of the most affected countries have started to show signs of slowing down, and the global weekly mortality rate continues to decline for a sixth consecutive week, many countries across all WHO Regions continue to struggle with access to vaccines, the spread of emerging SARS-CoV-2 variants, and overburdened healthcare systems.
The highest numbers of new cases were reported from India (630 650 new cases; 31% decrease), Brazil (454 710 new cases; similar to the previous week), Argentina (177 693 new cases; 17% decrease), Colombia (176 661 new cases; similar to the previous week) and the United States of America (105 019 new cases; 6% increase).
Table 1. Newly reported and cumulative COVID-19 cases and deaths, by WHO Region, as of 13 June 2021**
For the latest data and other updates on COVID-19, please see:
• WHO COVID-19 Dashboard
• WHO COVID-19 Weekly Operational Update and previous editions of the Weekly Epidemiological Update
Special focus: Strengthening public health intelligence through event-based surveillance – learning from the COVID-19 pandemic
Public health intelligence and event-based surveillance
Public health intelligence (PHI) is a conceptual framework that encompasses all activities that relate to the detection, verification, assessment, investigation and communication of information on events that pose a potential risk to human health (e.g., disease, natural disaster, chemical exposure). PHI serves as an early warning and response system, which is informed by indicator-based surveillance (IBS), which uses structured data from formal sources, and event-based surveillance (EBS) which uses informal sources such as media articles, hotlines and community reports, in order to detect acute public health events and/or risks.
EBS aims to rapidly collect, monitor, assess and interpret information in an organized manner and complement information derived from IBS. EBS involves the detection, triaging (filtering and selection) and verification of new public health threats as well as relevant changes in ongoing events. It also triggers risk assessments that may consequently lead to a response (Figure 3). Successful EBS depends on efficient networks, timely information sharing, diverse sources, collaboration and buy-in of stakeholders. A signal is information that is collected and triaged as a potential public health risk and can include changes in an ongoing event. Signals are rapidly detected from media and community sources to complement IBS data, demonstrating the importance of systematic integration of EBS in PHI. EBS can more readily be established in limited-resource settings compared to IBS, where surveillance structures may be limited or absent.
Figure 3. Processes and information flow for public health intelligence
EBS informs the COVID-19 response
In the context of COVID-19, EBS has informed WHO’s COVID-19 response by providing important contextualization of epidemiological data in a timely manner. Media monitoring in multiple languages has been the main method for EBS. Signals of interest from around the world are identified, assessed and documented daily based on predefined criteria. These criteria consider changes in epidemiology, virus mutations/variants, testing, impact on vulnerable populations, clusters related to various settings (e.g., workplaces, schools, prisons and long-term care homes), as well as the implementation of public health and social measures (PHSM), changes in travel patterns and restrictions, social gatherings and events. Criteria are adapted over time depending on emerging knowledge and are tailored to specific needs at global and regional levels. EBS is also used to identify potential areas of concern, by monitoring reports of health system capacity, and to inform
estimates of disease dynamics in areas where surveillance or reporting are limited.
The Epidemic Intelligence from Open Sources (EIOS) system is one of the main tools used by WHO to conduct monitoring of publicly available information, including for COVID-19. It is a fit-for-purpose but constantly evolving web-based system designed to augment and accelerate global public health intelligence activities. The core of the EIOS system is developed by the Joint Research Centre of the European Commission based on a long-standing collaboration with WHO. The EIOS system is the technological centerpiece of the broader EIOS initiative, a unique collaboration between various public health stakeholders around the globe. EIOS brings together new and existing initiatives, networks and systems to create a unified all-hazards, One Health approach to early detection, verification, assessment and communication of public health threats using publicly available information.
Evolution of COVID-19 EBS
Since the beginning of the COVID-19 pandemic, the scope and processes for EBS has evolved to reflect the changing response priorities. Early in 2020, during the early weeks and months of the pandemic, EBS media monitoring complemented official reporting of case and death counts through the International Health Regulations (IHR 2005) mechanism. As the pandemic evolved, EBS more regularly identified epidemiological trends in COVID-19 disease patterns, sometimes unusual, that were not readily captured by global indicatorbased surveillance. Topics of interest have also evolved over time, such as health systems capacity, the introduction of vaccines, emergence of new variants, unusual clinical presentations and manifestations as well as upsurges in case and deaths in localized areas and among population groups at risk; for example, health care workers, rapid response teams, indigenous populations, children, pregnant women and the elderly.
Consistent and systematic media monitoring, however, has been challenging due to the unprecedentedly high volume of reports and media articles, and the rapid evolution of risks and response needs. In response to these challenges, WHO strengthened the collaboration across all regions throughout 2020 through the shared use of the EIOS system to maximize the use of resources and to jointly address challenges. This collaboration has facilitated information sharing and increased efficiency of work, particularly around detection and assessment of SARS-CoV-2 variants and supported a rapid response.
The COVID-19 pandemic has highlighted an opportunity for new and strengthened collaborations among WHO, Member States and partners, as well as strengthened communication between WHO offices. EBS has provided critical public health intelligence during the COVID-19 pandemic and can continue adapting to align with evolving needs of this pandemic. Sustained, multi-level collaboration is needed to enable continuous adaptation to the changing surveillance landscape and to further improve geographical representativeness of EBS sources. Best practices and lessons learned in EBS during the COVID-19 pandemic can also be applied to strengthen and optimize non-COVID-19 surveillance.
Additional resources
• A Guide to Establishing Event-based Surveillance
• Epidemic Intelligence from Open Sources
• Early detection, assessment and response to acute public health events: Implementation of Early Warning and Response with a focus on Event-Based Surveillance Epidemic Intelligence process
Special Focus: Update on SARS-CoV-2 Variants of Interest and Variants of Concern
WHO, in collaboration with national authorities, institutions and researchers, routinely assess if variants of SARS-CoV-2 alter transmission or disease characteristics, or impact effectiveness of vaccines, therapeutics, diagnostics, or public health and social measures (PHSM) applied by national authorities to control disease spread. Systems have been established to detect “signals” of potential Variants of Concern (VOCs) or Variants of Interest (VOIs) and assess these based on the risk posed to global public health. As these risks evolve, WHO will update lists of global VOIs and VOCs (Table 2) to support setting priorities for surveillance and research, and ultimately guide response strategies.
National authorities may choose to designate other variants of local interest/concern and are encouraged to investigate and report on impacts of these variants. Here we provide updates on classifications of VOCs and VOIs, including a newly designated global VOI – Lambda (lineage C.37) – as well as the updated countries/territories/areas reporting the detection of VOCs.
Table 2: SARS-CoV-2 Variants of Concern (VOCs) and Variants of Interest (VOIs), as of 15 June 2021
VOI Lambda
On 14 June 2021, a variant assigned to Pango lineage C.37, GISAID clade GR/452Q.V1, NextStrain clade 20D, was designated as a global VOI, and assigned the WHO label “Lambda”. This variant has been monitored as an alert for an extended period, and upon more information and updated assessments, is now considered as meeting the VOI working definition based upon evidence of continued emergence and suspected phenotypic implications.
Lambda has been associated with substantive rates of community transmission in multiple countries, with rising prevalence over time concurrent with increased COVID-19 incidence. The earliest sequenced samples were reported from Peru in August 2020. As of 15 June 2021, over 1730 sequences have been uploaded to GISAID from 29 countries/territories/areas in five WHO regions.1 Elevated prevalence has been noted particularly in South America in countries such as Chile (31% overall prevalence among submitted sequences since first detected in this location to date), Peru (9%), Ecuador (8%), and Argentina (3%).2 Authorities in Peru reported that 81% of COVID-19 cases sequenced since April 2021 were associated with Lambda.3 Argentina reported increasing prevalence of Lambda since the third week of February 2021, and between 2 April and 19 May 2021, the variant accounted for 37% of the COVID-19 cases sequenced.4 In Chile, prevalence of Lambda has increased over time, accounting for 32% of sequenced cases reported in the last 60 days – co-circulating at similar rates to variant Gamma (33%), but outcompeting variant Alpha (4%) over the same period.5
Lambda carries a number of mutations with suspected phenotypic implications, such as a potential increased transmissibility or possible increased resistance to neutralizing antibodies.6 It is characterised by mutations in the spike protein, including G75V, T76I, del247/253, L452Q, F490S, D614G and T859N; however, there is currently limited evidence on the full extent of the impact associated with these genomic changes, and further robust studies into the phenotypic impacts are needed to better understand the impact on countermeasures and to control the spread. Further studies are also required to validate the continued effectiveness of vaccines.
Geographic distribution of VOCs
As surveillance activities to detect SARS-CoV-2 variants are strengthened at local and national levels, including by strategic genomic sequencing and the sharing of sequences and supporting meta-data, the number of countries/areas/territories reporting VOCs has continued to increase (Figure 4). This distribution should be interpreted with due consideration of surveillance limitations, including differences in sequencing capacities and sampling strategies between countries.
WHO recommendations
Virus evolution continues to be expected, and the more SARS-CoV-2 circulates, the more opportunities it has to evolve. Reducing transmission through established and proven disease control methods such as those outlined in the COVID-19 Strategic Preparedness and Response Plan, as well as avoiding introductions into animal populations, are fundamental to and crucial aspects of the global strategy to reduce the occurrence of mutations that have negative public health implications. PHSM remain critical to curb the spread of SARS-CoV- 2, including all variants that evolve.
Evidence from multiple countries with extensive transmission of VOCs has indicated that PHSM, including infection prevention and control (IPC) measures in health facilities, have been effective in reducing COVID-19 case incidence, which has led to a reduction in hospitalizations and deaths among COVID-19 patients. National and local authorities are encouraged to continue strengthening existing PHSM, IPC and disease control activities. Authorities are also encouraged to strengthen surveillance and sequencing capacities and apply a systematic approach to provide a representative indication of the extent of transmission of SARS-CoV-2 variants based on the local context, and to detect unusual events.
Additional resources
• Tracking SARS-CoV-2 variants
• COVID-19 new variants: Knowledge gaps and research
• Genomic sequencing of SARS-CoV-2: a guide to implementation for maximum impact on public health
• Considerations for implementing and adjusting PHSM in the context of COVID-19
• COVID-19 Situation Reports from WHO Regional Offices and partners: AFRO, AMRO/PAHO, EMRO, EURO/ECDC, SEARO, WPRO
• ACT accelerator diagnostic pillar, FIND test directory
References
1. GISAID. Tracking of variants. www.gisaid.org/hcov19-variants.
2. Latif AA, et al. C.37 Lineage Report. https://outbreak.info/situation-reports?pango=C.37.
3. Peru Ministerio de Salud: Instituto Nacional de Salud. INS confirma presencia de variante C-37 del coronavirus en Perú, 25 Mayo 2021.
https://web.ins.gob.pe/index.php/es/prensa/noticia/minsa-ins-confirma-presencia-de-variante-c-37-del-coronavirus-en-peru.
4. Argentina.gob.ar. Vigilancia de variantes de SARS-CoV-2 en CABA, Provincia de Buenos Aires, Córdoba, Entre Ríos, Neuquén y Santa Fe.
https://www.argentina.gob.ar/noticias/vigilancia-de-variantes-de-sars-cov-2-en-caba-provincia-de-buenos-aires-cordoba-entre-rios
5. Latif AA, et al. Chile Mutation Report. https://outbreak.info/location-reports?loc=CHL&pango=C.37.
6. Romero PE. et al. (2021). Novel sublineage within B.1.1.1 currently expanding in Peru and Chile, with a convergent deletion in the ORF1a gene
(Δ3675-3677) and a novel deletion in the Spike gene (Δ246-252, G75V, T76I, L452Q, F490S, T859N). Virologica.org, 24 Apr 2021.
WHO regional overviews
Epidemiological week 7-13 June 2021
African Region
The African Region reported over 95 000 new cases and over 1400 new deaths, a 44% and a 20% increase respectively compared to the previous week. The region reported a marked increase in weekly case incidence for the third consecutive week, with the largest increases in countries in the Southern,
Eastern and Northern parts of Africa. The highest numbers of new cases were reported from South Africa (47 934 new cases; 80.8 new cases per 100 000 population; a 48% increase), Zambia (10 792 new cases; 58.7 new cases per 100 000; a 125% increase), and Uganda (8574 new cases; 18.7 new cases per
100 000; a 49% increase).
The highest numbers of new deaths were reported from South Africa (724 new deaths; 1.2 new deaths per 100 000 population; a 28% increase), Kenya (132 new deaths; 0.2 new deaths per 100 000; a 7% increase) and Namibia (88 new deaths; 3.5 new deaths per 100 000; a 1% increase).
Region of the Americas
The Region of the Americas reported over 1.1 million new cases, a similar number to the previous week, and just under 32 000 new deaths, a 7% decrease compared to the previous week. Despite this decrease, high levels of transmission and mortality are still being recorded in many countries in South
and Central America. The highest numbers of new cases were reported from Brazil (454 710 new cases; 213.9 new cases per 100 000; similar to the previous week), Argentina (177 693 new cases; 393.2 new cases per 100 000; a 17% decrease), and Colombia (176 661 new cases; 347.2 new cases per 100 000; a 1% increase).
The highest numbers of new deaths were also reported from Brazil (13 393 new deaths; 6.3 new deaths per 100 000; a 14% increase), Argentina (4217 new deaths; 9.3 new deaths per 100 000; a 13% increase), and Colombia (3725 new deaths; 7.3 new deaths per 100 000; similar to the previous week).
Eastern Mediterranean Region
The Eastern Mediterranean Region reported over 191 000 new cases and over 3300 new deaths, a 5% and a 4% decrease respectively compared to the previous week. While declining weekly case incidence trends have been recorded for the eighth consecutive week, a number of countries across the region are starting to report increasing case and death incidence, including Oman, Tunisia and Afghanistan. The highest numbers of new cases were reported from the Islamic Republic of Iran (59 771 new cases; 71.2 new cases per 100 000; an 11% decrease), Iraq (29 013 new cases; 72.1 new cases per 100 000; a 3% increase), and the United Arab Emirates (14 820 new cases; 149.8 new cases per 100 000; a 6% increase). The highest numbers of new deaths were reported from the Islamic Republic of Iran (970 new deaths; 1.2 new deaths per 100 000; a 19% decrease), Tunisia (488 new deaths; 4.1 new deaths per 100 000; a 30% increase), and Pakistan (444 new deaths; 0.2 new deaths per 100 000; a 13% decrease).
European Region
The European Region reported over 332 000 new cases, a 13% decrease when compared to the previous week and a declining trend for the ninth consecutive week. The Region reported over 7200 new deaths, a 17% decrease when compared to the previous week. While most countries across the Region continue to see decreasing or stabilizing trends, some countries, such as the Russian Federation, the United Kingdom and Kyrgyzstan have reported increases in case incidence this week compared to the previous week. The highest numbers of new cases were reported from Russian Federation (82 250 new cases; 56.4 new cases per 100 000; a 31% increase), The United Kingdom (46 825 new cases; 69.0 new cases per 100 000; a 52% increase), and Turkey (42 841 new cases; 50.8 new cases per 100 000; an 8% decrease).
The highest numbers of new deaths were reported from Russian Federation (2643 new deaths; 1.8 new deaths per 100 000; a 1% increase), Germany (612 new deaths; 0.7 new deaths per 100 000; a 25% decrease), and Turkey (600 new deaths; 0.7 new deaths per 100 000; a 25% decrease).
South-East Asia Region
The South-East Asia Region reported over 763 000 new cases, a 27% decrease compared to the previous week. Weekly case incidence has been decreasing sharply for five consecutive weeks, largely driven by decreases in the number of cases in a small number of countries. While the number of newly reported cases continues to decrease in India, Bangladesh has reported an increasing trend in cases for the past four weeks. The Region reported over 26 000 new deaths a 12% increase when compared to the previous week. The highest numbers of new cases were reported from India (630 650 new cases; 45.7 new cases per 100 000; a 31% decrease), Indonesia (55 320 new cases; 20.2 new cases per 100 000; a 38% increase), and Nepal (20 348 new cases; 69.8 new cases per 100 000; a 34% decrease).
The highest numbers of new deaths were also reported from India (23 625 new deaths; 1.7 new deaths per 100 000; a 14% increase), Indonesia (1267 new deaths; 0.5 new deaths per 100 000; a 5% increase), and Nepal (514 new deaths; 1.8 new deaths per 100 000; an 18% decrease).
Western Pacific Region
The Western Pacific Region reported over 124 000 new cases and over 2300 new deaths, a 10% and a 7% decrease respectively compared to the previous week. While the region has an overall decreasing trend in cases, some countries, including Fiji, Vietnam and Mongolia are reporting increases and
peak numbers of cases. The highest numbers of new cases were reported from the Philippines (46 087 new cases; 42.1 new cases per 100 000; a 1% increase), Malaysia (41 630 new cases; 128.6 new cases per 100 000; a 20% decrease), and Japan (13 499 new cases; 10.7 new cases per 100 000; a 28% decrease).
The highest numbers of new deaths were also reported from the Philippines (920 new deaths; 0.8 new deaths per 100 000; a 9% decrease), Malaysia (553 new deaths; 1.7 new deaths per 100 000; a 14% decrease), and Japan (510 new deaths; 0.4 new deaths per 100 000; a 15% decrease).
Key weekly updates
WHO Director-General's key messages
• In his opening remarks at the media briefing on COVID-19 – 14 June 2021, the Director-General highlighted that the global decline in cases of COVID-19 reported to WHO masks a worrying increase in cases and deaths in many countries, and that the steep increase in Africa is especially concerning
because it is the region with the least access to vaccines, diagnostics and therapeutic oxygen. • The emergence of more transmissible variants means public health and social measures (PHSM) may need to be more stringent and applied for longer, particularly in areas where vaccination rates remain low. To improve the evidence base on the effectiveness of PHSM, WHO is collecting data globally on which measures are used and the level at which they are applied. WHO has also established a new working group, with the support of Norway, to study the impact of PHSM during COVID-19 and other health emergencies.
• In his opening remarks at the G7 Summit – 12 June 2021, the Director-General said that to end the pandemic, our shared goal must be to vaccinate at least 70% of the world’s population by the time the G7 meets again in Germany in 2022. He welcomed the announcement that the G7 countries will
donate 870 million vaccine doses, primarily through COVAX. “This is a big help, but we need more, and we need them faster. More than 10 000 people are dying every day.”
Updates and publications
• Young people and COVID-19: Behavioural considerations for promoting safe behaviours
• COVID-19 Vaccine Introduction and deployment Costing tool (CVIC tool)
• Update on WHO Interim recommendations on COVID-19 vaccination of pregnant and lactating women
• Statement for healthcare professionals: How COVID-19 vaccines are regulated for safety and effectiveness
• G7 announces pledges of 870 million COVID-19 vaccine doses, of which at least half to be delivered by the end of 2021
• The ACT Accelerator partnership welcomes commitment of 870 million vaccine doses and calls for more investment in all tools to end the pandemic
Technical guidance and other resources
• Technical guidance
• WHO Coronavirus Disease (COVID-19) Dashboard
• Weekly COVID-19 Operational Updates
• WHO COVID-19 case definitions
• COVID-19 Supply Chain Inter-Agency Coordination Cell Weekly Situational Update
• Research and Development
• Online courses on COVID-19 in official UN languages and in additional national languages
• The Strategic Preparedness and Response Plan (SPRP) outlining the support the international community can provide to all countries to prepare and respond to the virus
• Updates from WHO regions: o African Region
o Region of the Americas
o Eastern Mediterranean Region
o South-East Asia Region
o European Region
o Western Pacific Region
• Recommendations and advice for the public: o Protect yourself
o Questions and answers
o Travel advice
• EPI-WIN: tailored information for individuals, organizations and communities • WHO Academy COVID-19 mobile learning app
*Newly reported in this update.
“Delta+” reflects countries/territories/areas reporting detection of B.1.617 without further specification of lineage at this time. These will be reallocated as further details become available.
“●” indicates that information for this variant was received by WHO from official sources.
“○” indicates that information for this variant was received by WHO from unofficial sources and will be reviewed as more information become available.
Variant Beta for Ecuador was excluded this week based on further information received.
Annex 3. Data, table and figure notes
Data presented are based on official laboratory-confirmed COVID-19 case and deaths reported to WHO by country/territories/areas, largely based upon WHO case definitions and surveillance guidance. While steps are taken to ensure accuracy and reliability, all data are subject to continuous verification and change, and caution must be taken when interpreting these data as several factors influence the counts presented, with variable underestimation of true case and death incidence, and variable delays to reflecting these data at global level. Case detection, inclusion criteria, testing strategies, reporting practices, and data cut-off and lag times differ between countries/territories/areas. A small number of countries/territories/areas report combined probable and laboratory-confirmed cases. Differences are to be expected between information products published by WHO, national public health authorities, and other sources. Due to public health authorities conducting data reconciliation exercises which remove large numbers of cases or deaths from their total counts, negative numbers may be displayed in the new cases/deaths columns as appropriate. When additional details become available that allow the subtractions to be suitably apportioned to previous days, graphics will be updated accordingly.
A record of historic data adjustment made is available upon request by emailing epi-data-support@who.int. Please specify the country(ies) of interest, time period(s), and purpose of the request/intended usage. Prior situation reports will not be edited; see covid19.who.int for the most up-to-date data.
Global totals include 758 cases and 13 deaths reported from international conveyances.
The designations employed, and the presentation of these materials do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Countries, territories and areas are arranged under the administering WHO region. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
[1] All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999). In the map, number of cases of Serbia and Kosovo (UNSCR 1244, 1999) have been aggregated for visualization purposes.
i Excludes countries, territories, and areas that have never reported a confirmed COVID-19 case (Annex 1), or the detection of a variant of concern (Annex 2).
ii Transmission classification is based on a process of country/territory/area self-reporting. Classifications are reviewed on a weekly basis and may be revised as new information becomes available. Differing degrees of transmission may be present within countries/territories/areas. For further information, please see: Considerations for implementing and adjusting public health and social measures in the context of COVID-19.
iii “Territories” include territories, areas, overseas dependencies and other jurisdictions of similar status.
Post time: Jun-15-2021