COVID-19 — a timeline of the coronavirus outbreak

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A glimpse at the front line in the fight against COVID-19 in Madagascar. Photo by: World Bank / Henitsoa Rafalia / CC BY-NC-ND

MANILA/NAIROBI — On Dec. 31, 2019, Chinese authorities alerted the World Health Organization of pneumonia cases in Wuhan City, Hubei province, China, with an unknown cause. What started as a mystery disease was first referred to as 2019-nCoV and then named COVID-19.

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The timeline below tracks the development of the outbreak as it unfolds. Total cases as of Oct. 30: 45,304,036 and 1,184,565 deaths.

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Oct. 30 — Members of an international group of experts had their first virtual meeting with their Chinese counterparts on efforts to establish the origin of the coronavirus, says WHO Director-General Tedros Adhanom Ghebreyesus during a news briefing.

"It sometimes takes a very long time to get these missions in place. I cast my mind back to MERS [Middle East respiratory syndrome], to SARS [severe acute respiratory syndrome], and to other diseases in which it's taken months, and sometimes years, to establish animal origins and sometimes years to get fully fledged investigations carried out on the ground," says Mike Ryan, WHO Health Emergencies Programme chief. "It's a complex, complex issue. And we need to get the right answers."

"Although we are still learning about the virus, what's clear is that this is not just a virus that kills people. To a significant number of people, this virus poses a range of serious, long-term effects. While people do recover, it can be slow — sometimes weeks or months — and it’s not always a linear route to recovery," Tedros says.

The International Health Regulations emergency committee on COVID-19 advises WHO on where to focus its efforts in coming months, including "evidence-informed, risk-based and coherent measures in relation to international traffic, surveillance and contract tracing efforts, maintaining essential health services including mental health services, and preparing plans for future COVID-19 vaccines."

Globally, confirmed COVID-19 cases surpass 45 million. Over the past week, cases have increased at a rate of about 1 million every two days.

Oct. 29 — African nations should prepare for a second wave of COVID-19 outbreaks that will undoubtedly hit the continent, Africa CDC Director John Nkengasong says during a news briefing. While the continent has done a good job overall in "bending the curve," some countries are seeing the number of cases creep up. To prepare for the second wave, countries should enhance surveillance systems, and increase testing, including the use of rapid diagnostic tests, community engagement, and the use of masks, he says. Some countries are reporting unusually high case fatality rates, including Western Sahara, Sudan, Egypt, Liberia, and Niger.

A WHO analysis finds that more than 120 health technologies have been piloted or adopted in Africa during the COVID-19 pandemic — which accounts for about 13% of innovations globally. The countries with the most innovations include South Africa, Kenya, Nigeria, and Rwanda.

Taiwan has not reported a locally transmitted case of COVID-19 in 200 days.

Oct. 28 — Sanofi and GSK release a statement saying they intend to make available 200 doses of their adjuvanted recombinant protein-based COVID-19 vaccine candidate to the COVAX Facility. The vaccine is currently in a phase 1-2 study, initial results of which are expected in early December.

Globally, confirmed cases surpass 44 million. Cases in the Americas are now over 20 million, while those in Europe have passed 10 million confirmed cases.

Marshall Islands confirms first COVID-19 cases. Two members of the U.S. military travelling from Hawaii tested positive upon arrival in the country on Tuesday. They had both tested negative of COVID-19 before boarding their flight.

Oct. 27 — The Russian Direct Investment Fund, a sovereign wealth fund, submitted applications for WHO prequalification of Russia’s Sputnik V vaccine, according to a news release.

Ninety-two percent of officially confirmed COVID-19 cases in Syria cannot be traced back to a known case, says U.N. humanitarian chief Mark Lowcock in a briefing to the U.N. Security Council. The scale of the outbreak in the country is likely “far greater” than the known confirmed cases.

In Nigeria, there are reports of mass lootings in a number of government-owned warehouses that contained food relief for people during the country’s COVID-19-related lockdown. The items were meant to be distributed to low-income and vulnerable households, but delays triggered protests and led to hoarding suspicions.

Oct. 26 — Data from a clinical trial of Eli Lilly’s COVID-19 antibody treatment bamlanivimab found it is ineffective in helping hospitalized patients with advanced stages of disease to recover. As a result, the treatment will no longer be administered to patients under the ACTIV-3 trial, run by the National Institute of Allergy and Infectious Diseases. ACTIV-3 was the only trial evaluating the efficacy of the treatment in hospitalized patients, but other trials of bamlanivimab will continue, Eli Lilly said in a statement.

The same trial was paused two weeks ago due to potential safety concerns. But on Monday, the company said there were no significant differences in safety outcomes between the groups that received the treatment and those on placebo.

Globally, confirmed cases of COVID-19 surpass 43 million.

WHO Director-General Tedros Adhanom Ghebreyesus again warns leaders to stop the politicization of COVID-19. The world recorded the highest number of cases in the past week, and cases and hospitalizations are again rising in Europe and North America.

“When leaders act quickly and deliberately, the virus can be suppressed. But, where there has been political division at the national level; where there has been blatant disrespect for science and health professionals, confusion has spread and cases and deaths have mounted,” he said during a press briefing.

“A pandemic is not a political football. Wishful thinking or deliberate diversion will not prevent transmissions or save lives. What will save lives is science, solutions and solidarity,” he added.

Oct. 24 — Globally, confirmed cases of COVID-19 surpass 42 million.

Oct. 23 — “We are at a critical juncture in this pandemic, particularly in the northern hemisphere. The next few months are going to be very tough, and some countries are on a dangerous track. Too many countries are seeing an exponential increase in cases and that's now leading to hospitals and ICUs running close or above capacity,” says WHO Director-General Tedros Adhanom Ghebreyesus during a news briefing.

Estimates suggest that some of the lowest-income countries only have 5% to 20% of the oxygen they need for COVID-19 patient care, Tedros says. Somalia, Chad, and South Sudan have had to rely exclusively on oxygen cylinders from private vendors — often needing long distance transport at expensive prices. WHO is working with these governments to design local oxygen plants.

Oct. 22 — New analysis from the International Rescue Committee finds fewer children receiving treatment for malnutrition in several conflict-affected countries. Patients seeking malnutrition treatment in IRC-supported clinics in Somalia, South Sudan, Democratic Republic of the Congo, and Yemen dropped by 20%, 19%, 15%, and 12.5%, respectively, when compared to numbers in 2019. The figures suggest that “life-saving treatments have been less accessible to families during the COVID-19 pandemic.”

Roll out of rapid testing could be a 'game changer' for Africa

Testing has been one of the biggest challenges of the COVID-19 response in Africa, but the recent approval of two rapid diagnostic tests could change that.

African nations will begin to widely use rapid diagnostic tests for COVID-19 following WHO’s recent approval of two of these tests for emergency use, said Dr. Matshidiso Moeti, the agency’s regional director for Africa, during a press conference. While African countries have been advised to use polymerase chain reaction, or PCR tests, throughout the pandemic, and still will use these types of tests, rapid tests will help countries to decentralize testing away from urban areas. The tests are cheaper and easier to use and provide results more quickly.

Globally, confirmed cases of COVID-19 surpass 41 million.

Belgian Foreign Minister Sophie Wilmès, who previously served as prime minister of Belgium, is in intensive care with COVID-19.

Oct. 21 — A clinical trial volunteer for the AstraZeneca and Oxford University vaccine has died in Brazil, according to Brazil’s National Health Surveillance Agency. The volunteer was reportedly a 28-year-old man living in Rio de Janeiro who died from COVID-19 complications. He was reportedly part of the control group of the trial, which received the meningococcal vaccine.

Oxford says the trial will continue and that there are currently no safety concerns.

Around 100,000 people continue to test positive for COVID-19 in the Americas every day, with cases rising in the United States and Canada. Most new cases in the Caribbean are related to non-essential international travel, Pan American Health Organization Director Carissa Etienne says.

Oct. 20 — A survey carried out in 19 countries finds high acceptance of a potential COVID-19 vaccine. But 28% of the 13,400 respondents said they would hesitate to get, or completely refuse, a coronavirus vaccination.

What do people in BRICS countries think about a COVID-19 vaccine?

There is a generally high acceptance of a potential COVID-19 vaccine among respondents in BRICS countries, except in Russia.

Oct. 19 — Globally, confirmed cases of COVID-19 surpass 40 million. COVID-19 cases in Argentina surpass 1 million.

The African Development Bank approves a $50.7 million loan to Tanzania for its COVID-19 response.

Ecuador and Uruguay have joined COVAX, bringing the number of countries participating in the global vaccine initiative to 184.

UNICEF to stockpile 520 million syringes before year’s end. This is part of a plan to preposition 1 billion syringes by 2021 for COVID-19 vaccine delivery.

Oct. 18 — South Africa’s Minister of Health Zweli Mkhize tests positive for COVID-19.

Oct. 16 — Globally, confirmed cases of COVID-19 surpass 39 million.

Countries will "need to make a call" on whether or not to use remdesivir as a treatment for COVID-19 following interim trial results showing it had “little or no effect” on outcomes for patients, says Dr. Soumya Swaminathan, chief scientist at WHO, during a press briefing.

Many countries deployed emergency use authorizations for the drug because “clinicians were desperate for a drug they could use to treat their really sick patients,” following early studies that suggested the drug could reduce the duration of hospital visits. WHO will come out with policy guidance regarding the drug in the next few weeks, Swaminathan says.

WHO's Solidarity Trial will continue to examine other treatments, including monoclonal antibodies and new antivirals, says WHO Director-General Tedros Adhanom Ghebreyesus during the briefing. Dexamethasone, a corticosteroid, is the only therapeutic currently known to be effective against COVID-19.

Oct. 15 — Interim results from WHO’s Solidarity Trial find that the drugs remdesivir, hydroxychloroquine, lopinavir, and interferon had “little or no effect” on mortality, the need for ventilation, or the length of hospital stay for COVID-19 patients.

Oct. 14 — Globally, confirmed cases of COVID-19 surpass 38 million.

An open letter, signed by over 80 researchers, calls the herd immunity approach “a dangerous fallacy unsupported by scientific evidence.”

Oct. 13 — Drugmaker Eli Lilly pauses its U.S. government-sponsored clinical trial examining an antibody treatment for COVID-19 because of a potential safety concern.

Nearly half of the world’s workforce is at risk of losing their jobs, with informal economy workers the most vulnerable, according to a press release from the International Labour Organization, the Food and Agriculture Organization, the International Fund for Agricultural Development, and WHO.

The World Bank board approves a $12 billion financial package to support low- and middle-income countries in the purchase of COVID-19 vaccines, tests, and treatments. It is part of the bank’s $160 billion financing announced in April.

Oct. 12 — Johnson & Johnson temporarily pauses clinical trials of its COVID-19 vaccine candidate after an “unexplained illness in a study participant.” The case is now being reviewed and evaluated by the independent Data Safety Monitoring Board of the ENSEMBLE trial — the large-scale, multicountry phase 3 trial for J&J’s COVID-19 vaccine candidate JNJ-78436735 — as well as by the company’s internal and safety physicians, according to a news release.

Researchers found evidence of COVID-19 reinfection in a patient in the United States, according to a new case study published in The Lancet Infectious Diseases journal. The patient is a 25-year-old male from Nevada who first tested positive for SARS-CoV-2 in April 2020. He tested negative for the virus thereafter, but tested positive again in June 2020 when he was hospitalized after experiencing severe symptoms of COVID-19.

“There are still many unknowns about SARS-CoV-2 infections and the immune system’s response, but our findings signal that a previous SARS-CoV-2 infection may not necessarily protect against future infection,” says study lead author Mark Pandori in a news release.

It’s the first study to confirm COVID-19 reinfection in the United States. The first known case of reinfection worldwide was in August in Hong Kong.

“Herd immunity is achieved by protecting people from a virus, not by exposing them to it.”

— Tedros Adhanom Ghebreyesus, director-general, WHO

Using herd immunity to respond to an outbreak is “scientifically and ethically problematic,” says WHO Director-General Tedros Adhanom Ghebreyesus.

There is still a lot to be learned about immunity to COVID-19 and the disease’s long-term health impacts. In addition, the vast majority of people in most countries remain susceptible to SARS-CoV-2, the virus causing COVID-19, the WHO chief says.

Herd immunity against measles requires that 95% of the population be vaccinated, and herd immunity against polio requires that 80% of the population be vaccinated.

“Herd immunity is achieved by protecting people from a virus, not by exposing them to it,” Tedros explains.

“Allowing a dangerous virus that we don’t fully understand to run free is simply unethical. It’s not an option,” he adds.

Oct. 9 — China joins COVAX, Foreign Ministry Spokesperson Hua Chunying announces on Twitter.

Oct. 8 — The World Bank predicts economic growth in sub-Saharan Africa to fall to -3.3% in 2020 due to the pandemic, meaning the region would experience its first recession in 25 years. The pandemic could also drive up to 40 million people in extreme poverty in Africa this year, according to the bank. This is in line with the International Monetary Fund’s forecast for the region back in June.

Moderna releases a statement saying it will not enforce patents on its COVID-19 vaccine for vaccine manufacturers combatting the pandemic.

Oct. 7 — U.N. High Commissioner for Refugees Filippo Grandi tests positive for COVID-19.

Eleven countries and territories in the Caribbean have moved from moderate to intense COVID-19 transmission over the past 60 days, says Pan American Health Organization Director Carissa Etienne. She says this is “a concerning development as countries reopen airspace.”

Oct. 6 — The pilot for the Solidarity Trial of candidate COVID-19 vaccines will start at the end of October, and the initial results could be released in January 2021. The Solidarity Trial is a global initiative launched by WHO to compare COVID-19 treatments and rapidly assess their effectiveness. The approach is now being applied to vaccines.

“We are still in the process of advocating to countries who would hopefully be part of this Solidarity Trial for vaccines, and WHO has already released what we call an assessment tool for the countries to assess their readiness ... to be part or to host the clinical trials,” says Dr. Socorro Escalante, essential medicines and health technologies coordinator at the WHO regional office for Western Pacific, in a press briefing.

Oct. 5 — The Lancet publishes results from a large-scale clinical trial known as the Randomised Evaluation of COVID-19 Therapy — or RECOVERY — Trial, showing that the drug combination lopinavir-ritonavir is not an effective treatment for patients admitted to the hospital with COVID–19. This supports findings from an earlier, smaller trial and interim results from WHO’s Solidarity Trial that the drug combination did not show any significant benefits.

Oct. 3 — The Solomon Islands reports its first case of COVID-19: a student who arrived in the country on a repatriation flight from the Philippines. The student tested negative three times in the Philippines before boarding the flight but tested positive upon arrival in the Solomon Islands’ capital, Honiara.

“It pains me to say that we have lost our COVID-19-free status, despite our collective efforts to prevent the pandemic from entering our country,” says Prime Minister Manasseh Sogavare during the broadcast of a nationwide address.

Oct. 2 — U.S. President Donald Trump and first lady Melania Trump test positive for COVID-19. Both underwent testing after one of the president’s senior aides tested positive for COVID-19.

A global laboratory network, led by the Coalition for Epidemic Preparedness Innovations, plans to assess COVID-19 vaccine candidates against a common set of protocols. “With hundreds of COVID-19 vaccines in development ... it’s essential that we have a system that can reliably evaluate and compare the immune response of candidates currently undergoing testing,” Melanie Saville, director of vaccine R&D at CEPI, told Reuters.

WHO finalizes approval of a second COVID-19 rapid test kit for emergency-use listing and says it has published a call for expressions of interest for COVID-19 vaccine manufacturers to apply for prequalification or emergency-use listing.

Oct. 1 — On Monday, travelers can access information on topics such as COVID-19 laboratories and entry and exit requirements for different African countries from an online platform called My COVID-19 Pass at the Africa Centres for Disease Control and Prevention website. This is part of the Africa Against COVID-19 campaign launched in August that aims to ensure the protection of lives and livelihoods as a number of African countries start easing lockdowns and resuming economic activities.

Africa CDC Director John Nkengasong underscores the importance of consolidating this information. He says as of Tuesday, Sept. 29, a total of 29 countries were requesting negative polymerase chain reaction test results before arrival, nine others required a PCR test upon arrival, and 13 continued to require a quarantine period of 14 days. He says 35 of 55 African Union member states have already registered and included information on the platform.

The African continent has registered over 51,000 new coronavirus cases, representing a decrease of 7.6% from the previous week. Only one region on the continent — North Africa — is recording an increase, driven by a high number of cases in Morocco, Tunisia, and Libya.

“We should be very very careful not to read too much into these numbers,” Nkengasong says during a press briefing. “It will be a dangerous thing to be complacent. We have seen and we are watching in total dismay what is going on in Europe, when the numbers came down and now countries are battling [an increase in cases].”

Africa CDC has expanded its antibody testing to 15 countries on the continent.

Sept. 30 — World leaders pledge roughly $1 billion at a high-level event for the Access to COVID-19 Tools Accelerator. The pledges include funding from Canada, Germany, and Sweden, as well as previously announced commitments from the U.K. Sixteen pharmaceutical companies also commit to ensuring broad distribution of COVID-19 tools as part of a joint agreement with the Bill & Melinda Gates Foundation.

Johnson & Johnson commits to allocate up to 500 million doses of its COVID-19 vaccine candidate to lower-income countries.

Sept. 29 — The World Bank seeks board approval for up to $12 billion in fast-tracked financing to help low- and middle-income countries purchase COVID-19 vaccines. The plan is part of the $160 billion in financing that the bank announced in April.

The latest analysis of the open-label phase 1 study of Moderna’s COVID-19 vaccine candidate, mRNA-1273, shows it can generate neutralizing antibodies in adults ages 56 years and older. The older cohorts also did not have any serious adverse reactions to the vaccine at either the 25 microgram or 100 microgram dose levels.

Sept. 28 — The world surpasses 1 million COVID-19 deaths and 33 million confirmed cases.

A total of 120 million antigen-based rapid diagnostic tests from SD Biosensor and Abbott are being made available to low- and middle-income countries through volume guarantee agreements made by the Bill & Melinda Gates Foundation with both manufacturers. The tests will be rolled out in the next six months, and the first orders are expected to be made this week.

The Global Fund to Fight AIDs, Tuberculosis and Malaria is providing seed funding of $50 million. However, a total of $600 million is needed, with each test priced at no more than $5. The volume guarantee agreements are not tied to a particular purchasing mechanism, according to Global Fund Executive Director Peter Sands, so any organization or country can buy the tests, as long as they are for the benefit of the 133 low- and middle-income countries covered by the agreements.

Meanwhile, Unitaid and the Africa Centres for Disease Control and Prevention are rolling out the tests in up to 20 African countries starting in October, in collaboration with several partners, for implementation research. The aim is to better understand how the tests will be used in countries and how they best fit into health systems. For now, the tests use nasopharyngeal swabs, so health workers are required. But nasal swab testing is in the works to make them easier to administer in the future.

Sept. 25 — WHO publishes an updated version of the ACT-Accelerator investment case and details plans for the next phase of the initiative.

Health worker infections account for 14% of all COVID-19 cases reported to WHO, says Edward Kelley, WHO director of service delivery.

“Don't put all your eggs in one basket. … We have to invest in vaccines, but at the same time, let's be very serious in using the tools we have at hand.”

— Tedros Adhanom Ghebreyesus, director-general, WHO

Taiwan joins the COVID-19 Vaccine Global Access Facility.

WHO publishes draft criteria for the assessment of COVID-19 vaccines for emergency use listing or prequalification. The draft is open for public comment until Oct. 8.

“Don't put all your eggs in one basket — that's the message we have, meaning we have to invest in vaccines, but at the same time, let's be very serious in using the tools we have at hand,” says WHO Director-General Tedros Adhanom Ghebreyesus.

Sept. 24 — Socioecological factors such as low population density, a younger demographic, and hot and humid weather have likely contributed to the COVID-19 disease pattern in Africa, resulting in fewer infections. Cases in the region have also been declining over the past two months. But WHO Africa Regional Director Matshidiso Moeti warns against complacency.

“Other regions of the world have experienced similar trends only to find that as social and public health measures are relaxed, cases start ramping up again,” she says.

She also says there is no evidence of COVID-19 death miscalculation in the region.

Sept. 23 — Johnson & Johnson begins the final stage of clinical trials for its COVID-19 vaccine candidate. The trial includes up to 60,000 people. If proven effective, this vaccine might only require one dose rather than two.

The number of COVID-19 cases reported in displacement camps in northwestern Syria is 10 times higher than it was a month ago, Médecins Sans Frontières writes in a press release.

Sept. 22 — At the 75th session of the U.N. General Assembly, Russian President Vladimir Putin proposes an online high-level conference for countries interested in developing coronavirus vaccines, saying Russia is ready to share its experience and supply Russia’s COVID-19 vaccine, including to U.N. staff, free of charge.

U.S. President Donald Trump says the U.N. must hold China accountable for its actions relating to the pandemic.

Chinese President Xi Jinping says China will contribute another $50 million to the U.N. COVID-19 Global Humanitarian Response Plan, and that China will honor its $2 billion commitment in international assistance for over two years. He also says COVID-19 vaccines developed by China, once completed and available for use, “will be made a global public good, and they will be provided to other developing countries on a priority basis.”

The U.S. supasses 200,000 reported deaths from COVID-19 — the highest number of any country in the world.

Sept. 21 — WHO is releasing a fully revised investment case for the Access to COVID-19 Tools Accelerator later in the week, which includes costing for the accelerator’s “fourth pillar,” known as the “health systems connector.” This brings the total funding ask of the accelerator from $31 billion to $38 billion. Only $3 billion of the ask has been funded to date, leaving a gap of $35 billion. Of that, $15 billion is needed now, says Bruce Aylward, who leads the ACT-Accelerator Hub.

Seth Berkley, CEO of Gavi, the Vaccine Alliance, says it has signed agreements for up to 850 million vaccine doses as part of the advance market commitments for the COVID-19 Vaccines Global Access Facility. But to reach its goal of 2 billion doses of safe and efficacious vaccines, it needs to secure more deals.

“We know the failure rate for vaccines historically is quite high, with 4 out of 5 even in clinical trials failing. So what this means is we’re going to have to cut many more deals to get to the numbers we want,” he says during a WHO press conference.

Berkley also says 64 higher-income countries have submitted legally binding commitments to join the COVAX Facility and 38 more countries are expected to join in the coming days.

China has not yet signed up to the COVAX Facility, according to Berkley, but it has publicly mentioned an interest in joining.

The goal of 2 billion vaccine doses by 2021 is predicated on the idea of a two-dose vaccine regimen, although it is not yet clear which vaccines will be successful, says Kate O’Brien, director of the WHO’s department of immunization, vaccines, and biologicals.

Sept. 18 — Global COVID-19 cases surpass 30 million. The U.S. has the highest number of infections followed by India and Brazil.

Sept. 16 — Ursula von der Leyen, president of the European Commission, says she will convene a Global Health Summit in 2021 in Italy, “because this was a global crisis [and] we need to learn the global lessons.” She also announces plans for the establishment of a European BARDA, an agency for biomedical advanced research and development, during her State of the Union Address.

Sept. 15 — The United Arab Emirates grants emergency approval for use of the COVID-19 candidate vaccine developed by China’s Sinopharm. The vaccine is still in phase 3 trials.

Sept. 14 — The Global Preparedness Monitoring Board, a high-level body monitoring the world’s preparedness for outbreaks and other health emergencies, recommends the convening of a U.N. Summit on Global Health Security to agree a new international framework for health emergency preparedness and response.

Sept. 12 — The pharmaceutical company AstraZeneca says that it has resumed its clinical trials of a potential COVID-19 vaccine in the United Kingdom. The trials were paused following reports of an adverse reaction in a participant.

Sept. 10 — In a global survey of children in low-income settings, Save the Children finds that two-thirds of children had no contact with teachers during country lockdowns because of COVID-19 and that violence at home doubled when schools were closed.

WHO and the Africa Centres for Disease Control and Prevention launch a COVID-19 genome sequencing laboratory network that include 12 laboratories. Genome sequencing is used to determine the types of the virus that is circulating in countries.

“No disease in history has seen such rapid development in research. It is a testament to the incredible advances in science and technology the world has made in recent years,” says Tedros during a press briefing.

U.S. Senators Cory Booker and Dick Durbin introduce a bill ensuring continued U.S. funding to WHO.

“With the United States leading in the number of COVID-19 infections, we do not have time to play along with the president’s political stunt to withdraw from vital international organizations like the World Health Organization, which is leading a global effort to find and distribute a vaccine for a disease responsible for the death of more than 190,000 Americans,” Durbin says.

Total deaths from COVID-19 surpass 900,000.

Sept. 9 — The African Development Bank approves $27.3 million in grants for the African Union's COVID-19 Response Initiative.

The funding will support the Africa Centres for Disease Control and Prevention in providing technical assistance and building capacity in 37 countries that are eligible for the African Development Fund, which is the bank's concessional financing window, to combat COVID-19. This includes surveillance at points of entry into countries, building capacity for surveillance, and supplying testing tools and personal protective gear for health workers.

The funding will also help with the collection of gender-disaggregated data for Africa CDC's emergency response center.

Sept. 8 — Trials of the COVID-19 vaccine candidate by AstraZeneca and the University of Oxford are on hold after a reported adverse reaction in a participant. A safety review is being conducted before trials can resume.

Sept. 7 — More than 200 U.N. staff members in Syria have been infected with COVID-19, according to a letter by a U.N. official reported by Reuters.

Globally, confirmed cases of COVID-19 surpass 27 million.

The committee tasked with reviewing the functioning of the International Health Regulations during COVID-19 begins work on Sept. 8-9. The scope of the review includes the declaration of a public health emergency of international concern, role and functioning of national IHR focal points, and progress made in implementing recommendations of previous IHR reviews, says WHO Director-General Tedros Adhanom Ghebreyesus.

Negotiations are still ongoing for countries interested in joining the COVAX facility and are likely to continue until Sept. 18. So far, 170 countries have joined the facility, 78 of those countries will be self-financing the purchase of a vaccine, while 92 will be eligible for assistance in procuring a vaccine, says Bruce Aylward, senior adviser to the WHO director-general. Countries should not only focus on procurement, but also start thinking about the delivery of the vaccine when it becomes available. WHO Chief Scientist Soumya Swaminathan says delivery of a COVID-19 vaccine will be different from child immunization campaigns, and will be a challenge, particularly for countries with large populations.

Sept. 4 — Early phase trials of Russia’s Sputnik V vaccine showed no serious side effects and elicited antibody response, according to a peer-reviewed study published in The Lancet. Neutralizing antibody and T cell responses were also found in participants in the vaccine’s phase 2 trials.

However, the study had several limitations, including that it was open-label and nonrandomized, only involved a small number of participants, and did not include a placebo or control group. The study also included mostly young volunteers in their 20s and 30s. Thus, further research is required.

The phase 3 trial of the vaccine, approved on Aug. 26, will involve 40,000 volunteers from different age and risk groups, according to Alexander Gintsburg of the Gamaleya Research Institute of Epidemiology and Microbiology in Moscow.

When vaccines for COVID-19 are available, they should initially go to people most vulnerable to contracting the disease or a severe form of it — essential workers, elderly populations, and people with underlying health conditions — rather than the general public, says WHO Director-General Tedros Adhanom Ghebreyesus during a press conference. This is because supplies initially will be limited.

"The first priority must be to vaccinate some people in all countries, rather than all people in some countries," he says.

Sept. 3 — Seventy-eight countries have "signaled their intent" to join the COVAX Facility, which is coordinated by Gavi, the Vaccine Alliance, and will finance the vaccine purchases from their national budgets. A further 92 low-resource countries have expressed interest in the advanced market commitment mechanism, which will support the distribution of vaccines in their countries through donations to the plan, says Dr. Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovation, during a press conference. The initiative aims to ensure equitable access globally to any future COVID-19 vaccines. These expressions of interest are "still rolling in," he says.

The key lessons learned on manufacturing from the pandemic for the African continent are that there is a need to invest in local manufacturing of diagnostics, production of drugs and personal protective equipment, as well as vaccine development, says John Nkengasong, head of the Africa Centres for Disease Control and Prevention, during a press briefing. The continent must be “very deliberate” in focusing on these areas moving forward, he says.

Gilead will be able to meet real-time global demand for its antiviral drug, remdesivir, next month, with more than 2 million treatment courses of the drug by the end of the year, company chairman and CEO Daniel O’Day says in a media briefing. O’Day says this is made possible because of early investments in manufacturing and process development, even before there was any evidence of the drug’s treatment potential against COVID-19. Another contributing factor is collaboration. Gilead is working with 30 partners, including Pfizer, to scale up manufacturing.

O’Day didn’t specify how much a treatment course of the drug would cost, only saying that the company has priced remdesivir “well below the value.” The company is “pricing it at a level that will meet the lowest spending power of developed countries, while ensuring that we can continue to invest in research and development both for this pandemic and also future pandemics,” he says. Gilead has also licensed remdesivir to nine generic manufacturers to make and sell the drug for more than 127 countries.

In the same media briefing, Pfizer chairman and CEO Albert Bourla says that the company is in “very intense” discussions with Gavi regarding its candidate vaccine for COVID-19, but that nothing has been concluded yet.

The co-chairs of the Independent Panel for Pandemic Preparedness and Response, a committee of experts set up to review the global response to COVID-19, announce the full list of panel members.

Globally, confirmed cases of COVID-19 surpass 26 million.

Sept. 2 — COVID-19 has infected nearly 570,000 health workers and killed over 2,500 in the Americas, says Pan American Health Organization Director Carissa Etienne. The United States and Mexico account for nearly 85% of health care worker deaths in the region.

WHO publishes new guidance recommending the use of corticosteroids in COVID-19 patients with severe and critical conditions. The guidance comes months after preliminary data from a U.K. trial showed dexamethasone, a corticosteroid, reduced mortality among critically ill COVID-19 patients.

Sept. 1 — A study is published in the New England Journal of Medicine that finds antibodies against SARS-CoV-2 did not decline within four months of diagnosis — bringing greater clarity around the questions of whether having had COVID-19 prevents someone from becoming reinfected and how long that protection lasts. The study examined over 30,500 people in Iceland.

Sanofi halts its trial of the rheumatoid arthritis drug Kevzara as a treatment for COVID-19 after adverse effects, including deaths, were reported in participants.

There has been a 220% increase in COVID-19 cases in Lebanon one month following the explosion in Beirut, according to the International Rescue Committee.

Aug. 31 — The European Union announces €400 million ($478 million) in guarantees for COVAX.

Confirmed cases of COVID-19 surpass 6 million in the United States, the highest number of any country.

A WHO survey of 105 countries finds that 90% of countries have had disruption to their health services due to the pandemic, with low- and middle-income countries most affected. Up to 70% of essential services have been disrupted, including immunization, diagnosis, and treatment for non-communicable diseases, cancer, and mental health, as well as family planning and contraception. WHO's recommendations for reducing service disruptions include triaging patients, online patient consultations, and changing prescribing practices. Only 14% of countries removed user fees, which is also a WHO recommendation for improving access.

AstraZeneca launches a large-scale, final stage trial of its candidate COVID-19 vaccine in the United States. It plans to enroll up to 30,000 people.

Aug. 30 — Confirmed cases of COVID-19 globally surpass 25 million.

India reports the highest single-day increase of any nation thus far during the pandemic, with 78,761 new COVID-19 cases.

Aug. 27 — Over the past four weeks, on average, there has been a 17% decrease in the number of COVID-19 cases reported each week for the African continent, says John Nkengasong, head of the Africa Centres for Disease Control and Prevention, during a press briefing. This includes a 37% decrease in the number of cases reported in central Africa, a 28% decrease in Southern Africa, and a 16% decrease in West Africa. In East Africa, reported cases have increased by 6.3% and in North Africa they have increased by 6.6%. Twenty-three countries have reported sustained decreases in the number of new cases and 27 countries have reported stable numbers. Four countries have reported increases: Tunisia, Morocco, Uganda, and Burkina Faso.

UNICEF finds that 1 in 3 school children — 463 million children globally — have not had access to remote learning options during the pandemic.

Globally, the number of confirmed cases of COVID-19 surpasses 24 million.

Aug. 26 — "With the pandemic, Africa has lost over a decade of gains of economic growth. Africa’s recovery will be long and difficult. Now we must help Africa to build back, boldly, but smartly, paying greater attention to quality growth: health, climate, and the environment," says African Development Bank President Akinwumi Adesina, during the opening session of the bank's annual meetings.

Aug. 25 — Long turnaround times for test results are hindering the COVID-19 response on the African continent, says Dr. Matshidiso Moeti, WHO regional director for Africa, during a virtual meeting of African health ministers. Lab results should be received by people in 48 hours so that contact tracing, isolation, and quarantine measures are more effective, she says.

"We still have cases where it takes several days — five days, a week — to get the results back," she added.

Aug. 24 — University of Hong Kong researchers report the world’s first case of reinfection of COVID-19. A 33-year-old man who had a mild case of COVID-19 in April tests positive again — infected by a different strain of the virus, calling into question the length of immunity that people acquire after they have the disease.

While it's important to document these cases, it's also important to “not jump to any conclusions” about what this means about immunity to COVID-19, says Maria Van Kerkhove, technical lead at WHO’s emergencies program, during a press briefing. There are ongoing studies that follow patients over time which do show a “strong antibody response that stays,” she says.

There are 172 countries involved in discussions around possibly joining COVAX, which is a global initiative aimed at ensuring equitable access to future COVID-19 vaccines. The initiative is led by Gavi, the Vaccine Alliance, and WHO. It is a pooled procurement mechanism that will use buying power to provide volume guarantees of promising vaccine candidates, to enable large-scale manufacturing.

“By pooling resources and acting in solidarity through the ACT Accelerator and the COVAX Facility, we can ensure that once a vaccine is available for COVID-19, it’s available equitably to all countries," writes Dr. Tedros Adhanom Ghebreyesus, WHO director-general, in the release.

Countries will confirm their intent to participate in COVAX by Aug. 31, and these will become binding commitments by Sept. 18 and the first upfront payments are due by Oct. 9.

Aug. 22 — Globally, the number of confirmed COVID-19 cases surpasses 23 million and the number of deaths surpasses 800,000.

Aug. 20 — A WHO survey of 39 countries in sub-Saharan Africa finds that schools are fully operational in six countries, closed in 14, and partially open in 19. About a dozen countries plan to resume in-person classes in September.

The Africa Centres for Disease Control and Prevention launches a campaign called Africa Against COVID-19: Saving Lives, Economies, and Livelihoods, which aims to harmonize strategies across the continent in areas such as the criteria around COVID-19 tests needed to enter countries.

This is aimed at creating more fluid transport across the continent in a safe way, says John Nkengasong, head of the Africa CDC. Air transport losses on the continent are about $8 billion as a result of the pandemic, and the tourism industry has lost between $50 billion and $55 billion, he says.

Aug. 19 — Globally, confirmed cases of COVID-19 surpass 22 million.

Aug. 18 — A letter signed by former world leaders, people in the education sector, and economists calls for urgent action in response to the global education emergency created by the pandemic, noting that children who are out of school are at an increased risk of forced marriage, as well as exploitive and dangerous labor. According to the United Nations Educational, Scientific and Cultural Organisation, 30 million children may never return to school.

“Resources are now urgently needed to get young people back into education and enable them to catch-up,” the letter says.

Aug. 14 — Globally, confirmed cases of COVID-19 surpass 21 million.

Aug. 13 — Seven African nations — Liberia, Sierra Leone, Zambia, Zimbabwe, Cameroon, Nigeria, and Morocco — will start to administer antibody tests for COVID-19, says John Nkengasong, head of the Africa Centres for Disease Control and Prevention, during a press briefing. This will help these countries better understand how many people within their population have had the disease.

There is a funding gap of $31.3 billion for the ACT-Accelerator, which is a global framework for ensuring the fair and equitable allocation of tools aimed to fight COVID-19, such as future vaccines, says Tedroa, during another press conference. This gap cannot be covered by traditional development assistance alone, he says, it needs a blend of development assistance and additional financing from stimulus packages.

"The ACT-Accelerator enables governments to spread the risk and share the reward,” he says.

Russia’s candidate COVID-19 vaccine is not part of the COVAX Global Vaccines Facility portfolio, which is the vaccine arm of the ACT-Accelerator, says Bruce Aylward, senior adviser to the WHO director-general, during the press briefing. WHO is still in talks with Russia to gain more information on the vaccine, he says. Nine vaccine candidates are currently in the portfolio, in phase 2 or 3 trials.

Aug. 12 — The U.S. government secures 100 million doses of Moderna’s candidate vaccine, mRNA-1273, which is in late-stage clinical trials. The deal also gives the U.S. option to purchase an additional 400 million vaccine doses.

Aug. 11 — New Zealand reports fresh new cases of COVID-19 in a family that had not traveled overseas. The announcement comes two days after the government celebrated 100 days of no community transmission.

Russia grants regulatory approval for a COVID-19 vaccine. Russian President Vladimir Putin says “it has passed all the needed checks,” Reuters reports, even though the vaccine is yet to enter large-scale safety and efficacy trials. Philippines President Rodrigo Duterte has publicly announced his support for the vaccine, and has volunteered to be among its first recipients.

Aug. 10 — Globally, confirmed cases of COVID-19 hit 20 million.

“My message is crystal clear: Suppress, suppress, suppress the virus. If we suppress the virus effectively, we can safely open up societies,” says WHO Director-General Tedros Adhanom Ghebreyesus, during a press conference.

“Behind these statistics is a great deal of pain and suffering,” he adds. “But I want to be clear, there are green shoots of hope and no matter where a country, a region, a city or a town is — it’s never too late to turn the outbreak around.”

He says the WHO-led ACT-Accelerator, which requires an investment of $31.3 billion and aims to accelerate development, production, and equitable access to COVID-19 tools, is only 10% funded.

Brazil is sustaining a “very high level of [COVID-19] epidemic,” says WHO’s head of the Health Emergencies Programme, Dr. Michael Ryan. While the curve has “somewhat flattened,” he says it’s “not going down.” COVID-19 continues to actively spread in the country, which continues to have 50,000 to 60,000 cases a day.

Brazilian President Jair Bolsonaro continues to tout the use of the drug hydroxychloroquine against the disease, but Ryan says the drug “is not a solution.”

“It is the sovereign right of any nation to decide what it believes is the best treatment and the best course of action for clinically managing disease. At present, from all the randomized controlled trials that have been published, the hydroxychloroquine is not proven to be an effective treatment against COVID-19,” he says.

Aug. 9 — New Zealand reports 100 days without community transmission, although there are 23 COVID-19 cases in isolation facilities.

Aug. 8 — Confirmed cases of COVID-19 surpass 5 million in the United States.

Aug. 7 — Cases of COVID-19 on the African continent surpass 1 million.

A new collaboration between the Serum Institute of India, Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation aims to deliver up to 100 million doses of future COVID-19 vaccines for low- and middle-income countries by the first half of next year. Through the partnership, upfront capital will be provided to SII to increase its manufacturing capacity now so that once a vaccine is available, manufacturing can start quickly. SII set a ceiling price of $3 per dose.

Aug. 6 — Globally, confirmed cases of COVID-19 surpass 19 million.

Commenting on the United States' decision to withdraw from the organization, WHO Director-General Tedros Adhanom Ghebreyesus says money is not the issue.

“The problem is not about the money. It’s not the financing issue. It’s actually the relationship with the U.S. which is more important, and its leadership role,” he says during a press briefing.

“We hope the U.S. will reconsider its position,” Tedros says, noting that the organization is open for any evaluation or assessment. “The truth can be known, and this can be done from inside, without leaving the organization,” he adds.

Aug. 5 — Confirmed deaths from COVID-19 surpass 700,000 globally.

Aug. 4 — Pan American Health Organization Director Carissa Etienne says half of programs on diabetes and hypertension management are stopped at primary care level, as health workers increasingly cater to COVID-19 patients, and many of them become sick, according to a survey on 27 countries in the Americas. Pregnancy-related visits are also down by 40% compared to 2019. Eleven countries in the region also have less than three months supply of antiretrovirals, needed to treat HIV.

Aug. 3 — Globally, the number of confirmed COVID-19 cases surpasses 18 million.

WHO launches a mask challenge, encouraging people to send in photos of themselves wearing a mask. Apart from being a key tool in stopping the virus, WHO Director-General Tedros Adhanom Ghebreyesus says “the mask has come to represent solidarity.”

Chinese and WHO experts have now drafted the terms of reference for an investigation into the origins of the COVID-19 pandemic. The work will be done by an international team of experts, which is yet to be assembled. Tedros says epidemiological studies will begin in Wuhan to identify the source of infection of the early cases there.

More extensive study is needed to look at early cases and fully understand the links between cases, to determine at what point, “in Wuhan or elsewhere,” the virus crossed from animals to humans, says Mike Ryan, WHO Health Emergencies Programme chief. Once it is clear where that took place, it will help lead the way to identify potential animal sources of the disease, he says. “Otherwise, it’s like needles in the haystack. You can sample every animal in China and outside, you might have no luck because you’re guessing.”

A few studies have estimated the infection fatality rate of COVID-19 at 0.6%, adds WHO’s Maria van Kerkhove. “That may not sound like a lot, but it is quite high,” she says.

That means just over 1 in 200 people infected will potentially die, but it is hugely skewed by age, with the risk much higher in older people, Ryan says. By comparison, the infection fatality rate for the 2009 H1N1 pandemic is believed to be somewhere between 1 in 10,000 and 1 in 100,000, showing just how deadly COVID-19 is. In addition, long-term health effects of COVID-19 infection are still not well understood, he says.

Aug. 1 — The COVID-19 outbreak is still a public health emergency of international concern, says the International Health Regulations Emergency Committee. Its latest advice to WHO includes providing “nuanced, pragmatic guidance” on COVID-19 response activities to “reduce the risk of response fatigue in the context of socio-economic pressures,” and counter misinformation and disinformation. The committee also advises WHO to accelerate research into the unknowns of the virus such as its animal source, potential reservoirs, and improved understanding of the epidemiology and severity of COVID-19.

Russia announces plans to launch a COVID-19 vaccination campaign in October, with a vaccine that has not completed clinical trials.

July 31 — COVID-19 Emergency Committee meets again to discuss and review the global pandemic response via videoconference.

July 30 — Globally, confirmed cases of COVID-19 surpass 17 million.

In the past 25 days, COVID-19 cases on the African continent have almost doubled, says WHO Africa Regional Director Matshidiso Moeti during a press conference.

"We are seeing in Africa and in other parts of the world that when measures to suppress COVID-19 transmission are eased, cases creep up,” she says.

Not only does testing need to increase across the African continent, but people need to get their test results back more quickly, says John Nkengasong, director of the Africa Centres for Disease Control and Prevention, during a separate press briefing.

"Reduce the turnaround time, track those who have tested positive, and make sure that they are isolated appropriately," he says.

Six months have passed since WHO declared COVID-19 a public health emergency of international concern.

A report published in JAMA found that children 5 years old and younger, with mild to moderate COVID-19 symptoms, have up to 100 times the viral load in their upper throat as people who are older. “Behavioral habits of young children and close quarters in school and day care settings raise concern for SARS-CoV-2 amplification in this population as public health restrictions are eased," the report says.

July 27 — Nearly 15 million children were vaccinated against measles in a 10-day vaccination campaign in Ethiopia, according to a WHO press release. It was originally scheduled for April but delayed because of the challenges of conducting a vaccination campaign during the pandemic.

In the first quarter of this year, 1.5 million children in Africa missed their first dose of the measles vaccine compared to the same timeframe last year. There are at least nine scheduled measles vaccination campaigns that "were or continue to be at risk of being cancelled" because of COVID-19.

“By taking the appropriate measures, we can continue to provide essential services while striving to end this pandemic. Millions of children are at risk of vaccine-preventable diseases and waiting for the end of COVID-19 to restart immunization campaigns is a gamble we cannot afford,” writes Dr. Matshidiso Moeti, WHO regional director for Africa.

New research from WHO and the London School of Hygiene & Tropical Medicine shows that the world has reached a milestone in the fight against hepatitis B infections, with prevalence rate among children under 5 years old at less than 1% in 2020. However, further progress is hampered by COVID-19 and low hepatitis B vaccination coverage in regions like sub-Saharan Africa. The pandemic has disrupted prevention, testing, and treatment services, as well as supply chains for hepatitis, and financial and human resources are being diverted to address COVID-19.

July 26 — Vietnam reimposes social distancing restrictions in the city of Danang after confirming new locally transmitted COVID-19 cases over the weekend. The last case of local transmission was reported in April.

Globally, confirmed cases of COVID-19 surpass 16 million.

July 24 — Fifteen lawmakers and 11 parliamentary staff test positive for COVID-19 in Zambia.

In March and April, HIV tests reduced by 33% in Kenya, says Mutahi Kagwe, cabinet secretary for health, during a national briefing. There has also been a “notable decrease” in the identification of pregnant women with HIV. Additionally, while the country was previously experiencing an upward trend in new enrollments on HIV antiretroviral treatment, there is now a decline.

“I’m appealing to our people not shy away from utilising our HIV testing services which we have seen has had a major decline since the pandemic struck in our country,” Kagwe says.

July 23 — Low levels of testing for COVID-19 in the Central African region — which comprises nine countries — is a serious concern, says John Nkengasong, director of the Africa Centres for Disease and Control, during a press briefing. Roughly 330,000 tests have been conducted in this region, he says. One of the main challenges is access to tests.

“A country like Chad only has about one or two testing sites so it becomes very difficult to ramp up testing,” he says.

Over 10,000 health workers in Africa have been infected with COVID-19, according to a press release from WHO. The continent has more than 750,000 confirmed cases.

In response to a question on the declaration by Tanzania President John Magufuli that COVID-19 has been eliminated in the country and the country's lack of reporting data on cases, Dr. Matshidiso Moeti, WHO regional director for Africa, says during a press conference that there are significant numbers of truck drivers testing positive, including from Tanzania, entering Uganda.

“We have been in touch with the Tanzanian government, requesting them to take into account this information and advising that it then needs to be incorporated into their reporting to WHO,” she says.

July 22 — Globally, confirmed cases of COVID-19 surpass 15 million.

WHO and the Africa Centres for Disease Control and Prevention launch an expert advisory committee to provide support to African nations to conduct clinical trials of traditional medicines as potential treatments for COVID-19, according to an emailed press release.

WHO, the United Nations Development Programme, the Joint United Nations Programme on HIV/AIDS, and O’Neill Institute for National and Global Health Law at Georgetown University launch the COVID-19 Law Lab, which is a database of laws that countries have put in place to respond to the pandemic. 

“Harmful laws can exacerbate stigma and discrimination, infringe on people’s rights and undermine public health responses,” writes Winnie Byanyima, executive director at UNAIDS in press release. “To ensure responses to the pandemic are effective, humane and sustainable, governments must use the law as a tool to uphold the human rights and dignity of people affected by COVID-19.”

July 21 — Three out of 10 people in the Americas are at increased risk of developing severe COVID-19 due to underlying health conditions, warns Pan American Health Organization Director Carissa Etienne. She tells countries in the region to “use data to tailor your response and make health your top priority.” The region recorded almost 900,000 new cases and close to 22,000 deaths in the past week. Brazil, Mexico, and the United States account for the majority of cases.

The New Development Bank, led by the BRICS group of countries, approves a $1 billion loan to Brazil in response to the economic impact of COVID-19.

July 20 — WHO raises concerns over the spread of COVID-19 among Indigenous peoples in the Americas. WHO Director-General Tedros Adhanom Ghebreyesus says more than 70,000 cases have been reported among such people in the region, with more than 2,000 deaths, as of July 6. The Pan American Health Organization, WHO’s regional office, has released guidelines on how to prevent and respond to COVID-19 among Indigenous populations. Tedros emphasizes the importance of contact tracing in suppressing virus transmission.

Dr. Michael Ryan, executive director of the WHO Health Emergencies Programme, shares concerns about the continued acceleration of virus transmission in several countries in Africa, saying that what is happening in South Africa could happen for the rest of the continent.

A new study shows a promising vaccine candidate developed by the University of Oxford. The candidate, a chimpanzee adenovirus-vectored vaccine referred to as ChAdOx1 nCoV-19, generated T cells and neutralizing antibodies in participants, and a stronger immune response was found among 10 people who received a second dose, according to interim results published by The Lancet.

The authors of the study report no serious side effects from ChAdOx1 nCoV-19. Some participants experienced fever, chills, muscle aches, and headache. Participants were healthy individuals between the ages of 18 and 55 with no history of SARS-CoV-2 infection or COVID-19-like symptoms. Large-scale trials of the vaccine are already underway.

The U.K. announces it has secured 90 million doses of three promising vaccine candidates in advance.

July 18 — Confirmed deaths from COVID-19 surpass 600,000 globally.

July 17 — Globally, confirmed cases of COVID-19 surpass 14 million.

The United Nations releases the third updated appeal for the global COVID-19 humanitarian response plan, amounting to $10.3 billion — a more than fivefold increase from the original $2 billion appeal in March.

U.N. humanitarian chief Mark Lowcock says the revised appeal can be seen as a “metaphor for the explosive impact of the virus” and tells G-20 countries and other rich nations that “unless we act now, we should be prepared for a series of human tragedies more brutal and more disruptive than any of the direct impacts of the virus itself.”

The money will help 63 vulnerable countries and cover the global transport system needed to deliver relief, he says during a WHO press conference. The bulk of the revised appeal — $8.4 billion — is targeted for country-level responses, with $300 million in supplemental funding for NGOs and $500 million for famine prevention.

While the plan has attracted funding amounting to $1.7 billion since its launch, Lowcock says the response by rich countries has been “grossly inadequate” in helping poorer countries, describing it as “dangerously shortsighted.”

The cost of protecting the poorest 10% of the global population from the worst effects of the pandemic is estimated at $90 billion, Lowcock says. Inaction could lead 70 million to 100 million people to be pushed back into extreme poverty and could put 130 million people on the brink of starvation by the end of 2020.

Some studies have found RNA fragments of the coronavirus in the stool of COVID-19 patients, and scientists are looking into the possibility of oral-fecal transmission of the virus, but WHO’s Maria Van Kerkhove says that has not yet been demonstrated.

The issue of COVID-19 reinfection is an area of active research globally, Kerkhove says. It is known that people infected with the SARS-CoV-2 virus will develop an immune response providing some protection against reinfection. But it is not clear how long the protection lasts or whether a person can be reinfected after the immunity wears off.

July 16 — Research from the Jubilee Debt Campaign finds that $11.3 billion in International Monetary Fund loans to countries impacted by the COVID-19 pandemic are “effectively being used to bail out private lenders,” as those loans are enabling these countries to continue to pay interest and debt payments.

“Countries urgently need more money to tackle the health and economic crises caused by Covid-19. But unless there are debt restructurings, IMF loans to highly indebted countries just pay off private lenders, while not providing any new money for the country concerned,” says Tim Jones, head of policy at Jubilee Debt Campaign.

July 15 — An open letter to the director of the U.S. National Institutes of Health — signed by 15 Nobel laureates, among others — calls for the use of “challenge trials” to speed up vaccine development. In this type of trial, people are deliberately infected by the virus that causes COVID-19, whereas in the trials currently ongoing, the people given the candidate vaccine are observed in areas of transmission. These types of “challenge trials” have drawn controversy over ethical concerns.

Seventy-five countries have expressed interest in joining the COVID-19 Vaccine Global Access — or COVAX — Facility, which is a mechanism aimed at increasing equitable access to future COVID-19 vaccines, according to a WHO press release. These countries would finance vaccines in their budgets and partner with 90 lower-income countries that could have vaccine access supported through donations to Gavi, the Vaccine Alliance’s COVAX Advance Market Commitment.

The idea behind the facility is “sharing the risks associated with vaccine development, investing in manufacturing upfront so vaccines can be deployed at scale as soon as they are proven successful, and pooling procurement and purchasing power to achieve sufficient volumes to end the acute phase of the pandemic by 2021,” according to the release.

July 14 — The American biotech firm Moderna publishes interim results from its ongoing human clinical trials of its candidate vaccine for COVID-19, finding that it was safe and provoked an immune response in all of its 45 volunteers. The company was the first to start a human trial of a potential COVID-19 vaccine.

July 13 — The 2020 “State of Food Security and Nutrition in the World” report estimates that between 83 million and 132 million people could be pushed into hunger this year because of COVID-19, many by job losses amid lockdown measures.

Tedros says during a news briefing that the agency has not yet received a formal letter from the U.S. about its intentions to withdraw from WHO.

Globally, confirmed cases of COVID-19 surpass 13 million.

July 12 — WHO receives reports of 230,000 new cases of COVID-19. Almost 80% of those cases are from 10 countries, says WHO chief Tedros during a news briefing.

July 11 — A U.K. study that analyzed 90 patients and health care workers finds that only 17% of patients retained a potent antibody response to COVID-19 three months later.

July 9 — Former New Zealand Prime Minister Helen Clark and former Liberian President Ellen Johnson Sirleaf will co-chair the Independent Panel for Pandemic Preparedness and Response tasked with evaluating the global response to COVID-19, Tedros says in a member state briefing.

The announcement follows WHO member states’ calls in May for an independent evaluation of the response, including a review of WHO’s actions. The panel is expected to present an interim report this November and the full report at the World Health Assembly in May 2021.

The African Union launches a new consortium aimed at increasing the number of COVID-19 vaccine clinical trials conducted in Africa. This will help ensure that any successful vaccines that come to market will be safe and effective for African populations.

WHO updates a scientific brief on transmission of COVID-19, saying more research on airborne transmission is needed.

“There have been reported outbreaks of COVID-19 in some closed settings, such as restaurants, nightclubs, places of worship or places of work where people may be shouting, talking, or singing. In these outbreaks, aerosol transmission, particularly in these indoor locations where there are crowded and inadequately ventilated spaces where infected persons spend long periods of time with others, cannot be ruled out. More studies are urgently needed to investigate such instances and assess their significance for transmission of COVID-19,” the brief says.

July 8 — Confirmed cases of COVID-19 surpass 500,000 in Africa. Over the past month, cases have doubled in more than 22 countries, according to an emailed press release from WHO. Algeria, Egypt, Ghana, Nigeria, and South Africa account for about 71% of the continent's cases.

Globally, confirmed cases of COVID-19 surpass 12 million — five days after the figure reached 11 million. Confirmed cases in the U.S. surpass 3 million.

July 7 — Brazilian President Jair Bolsonaro tests positive for COVID-19, following months of downplaying the crisis while cases and deaths from the virus continued to increase. Brazil has the second-largest confirmed caseload, with 1.7 million cases, following the U.S.

Bolsonaro says he is taking hydroxychloroquine, a drug that has not been proved to treat COVID-19. He has touted the politically charged drug while criticizing public health measures, including quarantine efforts.

“I think it brings home for us all the reality of this virus. No one is special in that regard. We’re all potentially exposed to this virus. The virus doesn’t really know who we are, whether we’re prince or pauper. We’re equally vulnerable,” says Ryan during a press conference.

Benedetta Allegranzi, WHO's technical lead for infection prevention and control, says during the briefing that there is emerging evidence — which is not definitive — about "the possibility of airborne transmission in public settings, especially in very specific conditions: crowded, closed, poorly ventilated settings."

WHO, in its recommendations on preventing COVID-19, has focused on the use of masks for health care workers due to the risk of the virus spreading in the air when aerosol-generating procedures are performed, says Maria Van Kerkhove, technical lead at WHO’s emergencies program, during the briefing. WHO plans to issue a scientific brief on this topic soon, she says.

“We have been talking about the possibility of airborne transmission and aerosol transmission as one of the modes of transmission of COVID-19,” she says.

July 6 — The U.S. submits its formal notification to withdraw from WHO. United Nations Secretary-General António Guterres is reviewing whether the U.S. has met the conditions to do so.

In an open letter to WHO, 239 scientists urge the agency to “recognize the potential for airborne spread of COVID-19.”

“Most public health organizations, including the World Health Organization (WHO) [16], do not recognize airborne transmission except for aerosol-generating procedures performed in healthcare settings. Hand washing and social distancing are appropriate, but in our view, insufficient to provide protection from virus-carrying respiratory microdroplets released into the air by infected people,” the letter reads.

A WHO survey finds that 73 countries are at risk of stock-outs of antiretroviral medicines as a result of the pandemic. Twenty-four countries report having critically low stock or disruptions in the supply of these drugs. In these countries, 8.3 million people were taking these medicines last year — approximately 33% of all people taking HIV treatment globally.

A study published in The Lancet finds that only 5% of Spain’s population has developed antibodies to the new coronavirus, which challenges the idea that societies can achieve herd immunity if a large number of people are infected.

“Despite the high impact of COVID-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity. This cannot be achieved without accepting the collateral damage of many deaths in the susceptible population and overburdening of health systems. In this situation, social distance measures and efforts to identify and isolate new cases and their contacts are imperative for future epidemic control,” the study says.

July 4 — WHO discontinues the lopinavir/ritonavir treatment arm of the Solidarity Trial following a recommendation from the trial’s International Steering Committee that found the treatment produced little or no reduction in patient mortality when compared to standard of care. The decision follows a previous WHO announcement stopping the hydroxychloroquine arm of the trial.

July 3 — UNITAID and UNICEF agree to an initial purchase of dexamethasone to expand the drug’s access for low- and middle-income countries.

Confirmed cases of COVID-19 surpass 11 million globally — only five days after the global caseload hit 10 million.

July 2 — New Zealand health minister David Clark resigns after a series of blunders amid the country’s COVID-19 response.

July 1 — WHO holds a second research and innovation forum to discuss progress and knowledge gaps, and define research priorities for the rest of the year.

WHO Regional Director for the Eastern Mediterranean Ahmed Al-Mandhari says Iran, Saudi Arabia, and Pakistan make up more than 50% of cases in the region, and almost 87% of deaths are reported from Iran, Iraq, Saudi Arabia, Egypt, and Pakistan. He says the regional polio program has been instrumental in the fight against COVID-19, but more than 200 polio workers have tested positive for the disease, and two have died.

Ryan says the planned mission to China will involve defining the scope of the mission and areas of study, and two experts from WHO headquarters are expected to join. He clarifies that the reported Eurasian avian-like H1N1 swine influenza virus from China is not new, but has been under surveillance since 2011.

Ryan says it remains to be seen if the vaccine that would be developed for COVID-19 would provide cross-protection for other coronaviruses, but it should be a long-term objective in the vaccine development community. Today, the priority is a vaccine against the SARS-CoV-2, he adds.

June 30 — Six months have passed since WHO received the first reports from China of a cluster of cases of which was then only known as cases of pneumonia with unknown cause.

The first cases of COVID-19 are confirmed among asylum-seekers in a migrant camp near Mexico’s northern border. The camp is in the city of Matamoros and hosts 2,000 migrants.

African health ministers publish a communiqué that expresses concern over the role that patents, trade secrets, and other technological barriers could play in ensuring equitable access to future COVID-19 vaccines in developing countries, noting that these have delayed access to affordable vaccines in the past. It calls on countries to "ensure that all relevant technologies, intellectual property, data and knowhow are openly and immediately made available and the rapid scale-up of geographically diverse production to be made possible.”

June 29 — The International Monetary Fund projects that real GDP will contract by 3.2% in sub-Saharan Africa, which is double the contraction that the fund estimated in April. This is the sharpest economic contraction in the region since the 1970s.

Tedros says during a news briefing that countries arguing that contact tracing of COVID-19 cases is too difficult — because there are now too many cases — are not considering that other health responses have involved contact tracing with large caseloads in incredibly volatile situations where contact tracers risk their lives. For example, people have risked their lives to trace contacts of Ebola patients amid armed conflict in eastern Congo.

"If any country is saying contact tracing is difficult, it is a lame excuse," he says.

WHO plans to send a team to China to investigate the origin of the COVID-19 pandemic, Tedros says.

The United States has bought almost all stocks of Gilead’s remdesivir until September.

June 28 — Globally, confirmed cases of COVID-19 surpass 10 million — only six days after the global caseload hit 9 million. Confirmed deaths surpass 500,000.

June 27 — A pledging summit hosted by the European Commission and Global Citizen raises €6.15 billion ($6.91 billion) for the development of COVID-19 vaccines, tests, and treatments, as well as to ensure their equitable access. This includes €4.9 billion in loans and guarantees from the European Investment Bank, in partnership with the European Commission, as well as €485 million pledged by European Union member states. Forty governments participate in the summit.

Brazil signs an agreement to locally produce AstraZeneca's experimental vaccine, which is considered the most advanced of the candidates for a COVID-19 vaccine in terms of development.

June 26 — WHO publishes a consolidated investment case for three pillars of the Access to COVID-19 Tools Accelerator initiative, which finds that the international community still must raise $27.9 billion of the $31.3 billion needed over the next 12-18 months to ensure the development and delivery of critical tools in the fight against COVID-19.

The amount covers investment needs for COVID-19 diagnostics, vaccines, and therapeutics. It does not yet include estimates for the health systems connector pillar of the initiative, which is meant to ensure that all tools developed will be efficiently deployed in countries.

Ngozi Okonjo-Iweala, special envoy for the initiative, says in a press briefing that the amounts needed are huge, but “they are not when we think of the alternative. … If we spend billions now, we’ll be able to avoid spending trillions later.”

June 25 — The African Union hosts a virtual conference focused on the role that the continent hopes to play in the development, production, and distribution of future coronavirus vaccines. Some of the challenges identified by African leaders include raising funds to pay for vaccines, strengthening local manufacturing, increasing the number of local clinical trials, and ensuring communities actually want to be vaccinated.

Africa is “no longer the WHO region least-affected by COVID-19” as of this week, says WHO Africa Regional Director Matshidiso Moeti, as COVID-19 cases on the continent surpass 300,000 with over 8,000 deaths. In some African countries, more than 5% of infections have been among health care workers, she adds.

June 24 — A report from The Global Fund to Fight AIDs, Tuberculosis and Malaria finds that in the countries it invests in, about $28.5 billion is needed over the next year to adapt HIV, TB, and malaria programming to “mitigate the impact of COVID-19, to train and protect health workers, to reinforce systems for health … and to respond to COVID-19 itself, particularly through testing, tracing and isolation and by providing treatments as they become available.” This estimate does not include the costs related to a potential vaccine.

According to the report, deaths from HIV, TB, and malaria could double over the next year if health systems are overwhelmed, treatment and prevention programs are disrupted, and resources are pulled away from fighting these three diseases.

WHO Director-General Tedros Adhanom Ghebreyesus says the world needs 620,000 cubic meters of oxygen per day, or about 88,000 large cylinders, as new COVID-19 cases now number 1 million a week. WHO expects COVID-19 cases to total 10 million globally within the next week.

But many countries are facing challenges in obtaining oxygen concentrators, with 80% of the market owned by a few companies, Tedros says during Wednesday’s press briefing. In recent weeks, WHO has been able to buy 14,000 oxygen concentrators to be sent to 120 countries, and Tedros says a further 170,000 concentrators have been identified that can be available over the next six months.

The epidemic in the Americas in general is “still intense,” with many countries experiencing a rise in cases ranging from 25% to 50% over the last week, says Dr. Michael Ryan, executive director of WHO’s emergencies program. He says the pandemic in many countries in the region “has not peaked.”

June 23 — A report from the United Nations Educational, Scientific and Cultural Organization finds that 40% of low- and lower-middle-income countries have not supported disadvantaged students during school shutdowns from COVID-19. 

June 22 — Preliminary data from a U.K. trial that shows that the steroid dexamethasone has the potential to save the lives of critically ill COVID-19 patients, but the next challenge is increasing production and distribution of the drug, Tedros says during a press conference. Demand has already surged for the drug, he adds, but it is an inexpensive drug and many manufacturers already make it globally.

"It is also important to check that suppliers can guarantee quality, as there is a high risk of substandard or falsified products entering the market," he says.

Thailand reports three imported cases of COVID-19 and has had 28 days without local transmission.

Globally, confirmed cases of COVID-19 surpass 9 million. This comes just a week after the caseload hit 8 million.

June 21 — COVID-19 deaths surpass 50,000 in Brazil.

June 19 — The pandemic is in a “new and dangerous phase,” as many people are tired of staying home and governments are eager to reopen their economies, but the virus is spreading fast and most people globally are still susceptible to contracting it, Tedros says during a press conference.

COVID-19 cases in Brazil reach over 1 million. The country reports over 54,000 cases in one day.

June 18 — A study published in Nature Medicine finds that the levels of antibodies in recovered COVID-19 patients declines significantly two to three months after infection, which calls into question the length of immunity that survivors have against contracting the virus again.

Lower-income countries in Asia will “barely grow” in 2020, the Asian Development Bank says as it revises its growth forecast for the region to 0.1%, down from April’s forecast of 2.2%. This would be the slowest growth the region has experienced since 1961, according to the bank.

Over 150,00 new cases of COVID-19 have been reported to WHO in one day — the highest number in a single day since the start of the pandemic, Tedros says during a news briefing. Almost half of those cases are from the Americas.

June 17 — WHO says it is dropping hydroxychloroquine from its Solidarity Trial — a global effort to identify treatments for COVID-19 — based on a review of evidence suggesting that the drug does not result in a reduction in the mortality of hospitalized COVID-19 patients.

Ana Maria Henao Restrepo, who leads the agency’s research and development blueprint, says during a news briefing that this does not reflect an official WHO policy recommendation or affect other efforts to evaluate the efficacy of the drug for patients exposed to the coronavirus. The decision follows WHO’s announcement on June 3 that it would resume testing hydroxychloroquine in its trials.

June 16 — Initial clinical trial results show that a steroid called dexamethasone can reduce mortality by about one-third for COVID-19 patients on ventilators. This is the first drug shown to save the lives of people requiring oxygen or ventilator support. The drug, which has been in use since the 1960s, is off-patent and affordable in most countries, according to WHO.

Following 24 days with no new cases, New Zealand reports that two women who recently arrived in the country from the U.K. have tested positive for COVID-19.

The number of confirmed COVID-19 cases surpasses 8 million globally.

June 15 — It took over two months for the world to reach the initial 100,000 confirmed cases of COVID-19 — but more than 100,000 new cases have been reported almost every day of the past two weeks, Tedros says during a press briefing. Nearly 75% of these new cases have come from 10 countries, which are mostly in the Americas and South Asia.

Influenza surveillance has been suspended or is declining in many countries, Tedros says at the briefing. The reasons include the reallocation of staff and supplies to fight COVID-19, as well as overburdened laboratories and transport restrictions. Compared with the last three years, the health agency has seen a dramatic decrease in the number of specimens tested for influenza globally.

Tedros confirms that the U.S. is still a member of WHO. On May 29, U.S. President Donald Trump said during a press conference that the country is “terminating” its relationship with WHO.

The U.S. Food and Drug Administration revokes authorization for the emergency use of hydroxychloroquine as a treatment for COVID-19, following several clinical trials suggesting that the drug is ineffective.

June 14 — China reports 57 new cases of COVID-19 — the highest daily toll the country has seen in two months.

June 13 — Beijing shuts down its largest fruit and vegetable market following the positive COVID-19 tests of 45 people at the market. This occurs after more than 50 days without a case in the Chinese capital.

Coronavirus cases surpass 7.5 million globally.

June 12 — According to a paper from the Institute of Labor Economics in Bonn, Germany, masks can reduce the daily spread of new infections by 40%.

June 11 — The number of COVID-19 cases in the U.S. surpasses 2 million.

June 10 — The number of cases on the African continent surpasses 200,000. It took 98 days to reach 100,000 cases in Africa and only 18 additional days to reach 200,000 cases, according to WHO.

Ethiopian lawmakers approve an extension of Prime Minister Abiy Ahmed’s term, after elections scheduled for August are postponed due to the pandemic.

The African Development Bank approves $20 million in grant funding to fight COVID-19 in Mauritania, Mali, Burkina Faso, Niger, and Chad.

The International Monetary Fund approves $594 million in emergency financial assistance for Guatemala’s COVID-19 response.

CEPI CEO: Scarcity, 'vaccine nationalism' biggest barriers for COVID-19 vaccine access. Via YouTube.

June 9 — Dr. Anthony Fauci, the top U.S. infectious disease expert, calls the COVID-19 pandemic his "worst nightmare."

The President of Burundi Pierre Nkurunziza dies, reportedly of a heart attack, though questions are swirling over whether that was the actual cause. According to Kenya's Standard, Nkurunziza’s wife is receiving medical care in Nairobi for COVID-19 symptoms. Nkurunziza was expected to leave office in August in a transfer of power, after a 15-year rule.

South Africa releases the first set of data examining the risk of death for people living with tuberculosis or HIV who contract COVID-19. The data, based on patients in Western Cape province, finds that those living with HIV have a risk of death that is 2.75 times higher, whereas those living with TB have a risk that is 2.5 times higher.

Still, the South African research suggests that TB and HIV pose less of a risk than several other health factors, such as diabetes. Unexpectedly, the data also finds that HIV-positive people on treatment — who are virally suppressed — and those who are not virally suppressed both had an increased risk.

June 8 — The number of COVID-19 cases surpasses 7 million globally.

June 7 — The death toll from COVID-19 surpasses 400,000 globally.

The highest number of new cases in a single day is reported: 136,000. About 75% of those cases come from 10 countries, predominantly in the Americas and South Asia.

June 6 — A project from The Guardian and Kaiser Health News finds that nearly 600 frontline health workers have died from the coronavirus in the United States.

Brazil’s ministry of health removes months of COVID-19 data from its website that document the rapid escalation in cases. The country has the world’s second-largest outbreak, after the U.S.

June 5 — WHO updates its guidance on the use of masks. It advises that medical masks be worn by all people working in clinical areas of a health facility, not just those caring for patients with COVID-19; it advises that people over 60, or those with underlying conditions, in areas with community transmission should wear a medical mask in situations where physical distancing is not possible; and it advises governments to encourage its citizens to wear masks in places of widespread transmission where physical distancing is difficult, such as public transport or in shops. The agency also says that fabric masks should consist of at least three layers of different material, depending on the material used.

June 4 — The Lancet retracts its study on COVID-19 patients using hydroxychloroquine that found the drug increased death rates and increased heartbeat irregularities. The retraction was made, at the request of its authors, because the medical journal could “no longer vouch for the veracity of the primary data sources."

The Africa Centres for Disease Control and Prevention rolls out a new initiative to ramp up the coronavirus response across the continent. The Partnership to Accelerate COVID-19 Testing in Africa aims to support the testing of 10 million people on the continent over four months, deploy 1 million community health workers, and train 100,000 health care workers. It also plans to launch a procurement mechanism next week that allows countries to request diagnostic kits through the Africa CDC at a fixed price, rather than having to seek them out in global markets.

Gavi, The Vaccine Alliance launches the Gavi Advance Market Commitment for COVID-19 Vaccines, which is a financing instrument to incentivize manufacturers to produce enough vaccine doses and ensure access for developing countries. It has an initial goal of raising $2 billion.

COVID-19 cases surpass 6.5 million globally.

June 3 — Following a safety review, WHO decides it will restart its trial of hydroxychloroquine as a COVID-19 treatment, says WHO Director-General Tedros Adhanom Ghebreyesus, during a press briefing. The agency had put a temporary pause on its trials of the drug on May 25, following an observational study of the drug and its effects on COVID-19 patients that have been hospitalized, which found that patients that took the drug had increased rates of death and heart arrhythmias.

"On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol," he says.

India experiences a record increase: 8,909 new COVID-19 cases in one day.

WHO has received reports of over 100,000 new cases of COVID-19 every day for the past five days, Tedros says.

June 2 — The first death from COVID-19 is confirmed in the Rohingya refugee camps in Bangladesh — a 71-year-old man who was treated at a camp’s isolation center.

June 1 — WHO Director-General Tedros Adhanom Ghebreyesus says during a press briefing that the U.S. has not contacted WHO directly about President Donald Trump's decision to withdraw from the agency.

"The announcement was last Friday, as you — as we — all heard from the media, and the only communication we have — or announcement — was actually that Friday's media announcement from the U.S.," he says.

Confirmed cases of COVID-19 in Afghanistan grew by 684% in May, according to a press release from the International Rescue Committee. The country's Ministry of Public Health only has the capacity to test 2,000 cases per day, but it receives between 10,000 and 20,000 samples daily, suggesting high levels of undetected cases. The country has over 15,700 confirmed cases.

Cases of COVID-19 in Brazil surpass 500,000.

May 31 — Cases of COVID-19 surpass 6 million globally.

May 30 — Brazil reports a record 33,274 new cases of COVID-19.

A vaccine developed by the Beijing Institute of Biological Products and China National Biotec Group Co. may be available by the end of the year, according to a report.

May 29 — U.S. President Donald Trump says during a press conference the country is “terminating” its relationship with WHO and “redirecting those funds to other worldwide and deserving urgent global public health needs.” He says the move comes because WHO failed to make requested reforms.

WHO and Costa Rica launch the COVID-19 Technology Access Pool — a voluntary mechanism aimed at making vaccines, tests, treatments, and other health technologies universally accessible and affordable by pooling the scientific knowledge, data, and intellectual property around the tools created to fight COVID-19.

“Tools to prevent, detect, and treat COVID-19 are global public goods that must be accessible by all people,” Tedros says during the launch of the initiative.

One of the big challenges is getting pharmaceutical companies on board, participants in the launch say.

"There has to be returns to those who are making their research, although much of the money is coming from the government, we should be clear about that — it's been de-risked," says Joseph Stiglitz, economics professor at Columbia University. "But we can do that through royalties, through charging for appropriate prices — that can be done within the patent pool."

May 28 — Albert Bourla, chief executive officer of Pfizer, says the distribution of vaccines could be challenging in Africa because of the lack of widespread infrastructure to deliver them at a cold temperature.

"I'm sure that we will come to the Western world with this vaccine first, but as a second wave, we are working on making sure that we can develop and manufacture products that are not requiring a different, extreme temperature with different technologies," Bourla says during a press conference.

Bourla also calls WHO and Costa Rica's plans to launch a COVID-19 Technology Access Pool 'nonsense,' saying that it is ‘“dangerous” to tell companies, which are investing billions in efforts to find vaccines, that they will lose the patent.

In terms of manufacturing, there are not enough glass vials globally to meet the expected demand for the distribution of a coronavirus vaccine around the world, according to Pascal Soriot, chief executive officer of AstraZeneca. Typically, vaccines are produced in single-dose vials. Soriot says the company is exploring the feasibility of delivering multidose vials.

May 27 — WHO launches an independent grant-making foundation to broaden its contributor base. One of the reasons for its creation is that the agency has been constrained by having the majority of its funding as earmarked and inflexible, Tedros says during a press conference.

The foundation aims to increase WHO’s funding base through nontraditional sources, such as the general public, individual major donors, and corporate partners. Broader than the COVID-19 pandemic, its mandate includes global health programming more generally. The idea for the foundation started more than two years ago, Tedros says. It is legally separate from WHO but will facilitate contributions to the agency.

The death toll in the U.S. from COVID-19 surpasses 100,000.

May 26 — The number of COVID-19 cases surpasses 5.5 million globally.

A final decision on whether hydroxychloroquine causes harm or benefit to COVID-19 patients is expected in mid-June, following a review of data from ongoing trials and already published evidence, according to WHO.

Antibody tests for COVID-19 are accurate only about half of the time, and it is still unclear whether people who have antibodies are protected against contracting the disease again, according to new guidance published by the U.S. Centers for Disease Control and Prevention.

May 25 — WHO puts a temporary pause on its trials of hydroxychloroquine as a treatment for COVID-19, following an observational study of the drug and its effects on COVID-19 patients that have been hospitalized, published in The Lancet on May 22. The study found that patients that took the drug had increased rates of death and heart arrhythmias.

Assuming that a second wave of COVID-19 cases will be tied to a change in the seasons is problematic, says Ryan during a press briefing.

"My concern right now is that people may be assuming the current drop in infections represents a natural seasonality,” he says. “A huge effort has been made to suppress transmission of this virus, and to remove pressure from the virus, at this point, making an assumption that it’s on a downward trajectory, and the real next danger point is sometime in October or November, I think that would be a dangerous assumption.”

May 24 — The first indications of whether a potential vaccine is effective could be available in autumn, Gavi head Seth Berkley tells Swiss newspaper NZZ am Sonntag.

“Unfortunately, we really do not know which vaccine will work and whether there will be one at all. If we’re lucky, we’ll receive indications in autumn as to [a potential vaccine’s] effectiveness,” he said. 

May 23 — The first death from COVID-19 is reported in the Gaza Strip.

Indigenous people in Brazil are dying from COVID-19 at twice the rate of the rest of the country's population, CNN reports.

May 22 — Brazil surpasses Russia as the country with the second highest number of cases, following the United States. Ryan says during a news briefing that South America is becoming "a new epicenter" of the pandemic.

An estimated 80 million children under the age of 1 are at risk of diseases including diphtheria, measles, and polio because the pandemic is disrupting routine vaccination efforts, according to data collected by WHO, UNICEF, Gavi, and the Sabin Vaccine Institute.

Vaccination efforts have been disrupted for reasons including the reluctance or inability of parents to leave their homes to take children to be vaccinated, health workers facing movement restrictions or redeployment to focus on COVID-19, and a lack of personal protective equipment. There are also delays in the transport of vaccines.

Countries with large populations of non-immunized children, such as Nigeria, Ethiopia, the Democratic Republic of the Congo, Chad, the Philippines, and Ukraine, should make plans for restarting their vaccination campaigns, says Henrietta Fore, executive director of UNICEF, during a press briefing.

A study finds that the use of hydroxychloroquine among hospital patients with COVID-19 is linked to increased rates of death and heart arrhythmias.

The daily death toll from the coronavirus in New York City is the lowest it's been in two months, according to New York Governor Andrew Cuomo.

COVID-19 cases surpass 100,000 on the African continent.

May 21 — The number of COVID-19 cases surpasses 5 million globally.

According to the Africa Centres for Disease Control and Prevention, five countries account for 56% of coronavirus cases on the African continent: South Africa, Egypt, Algeria, Morocco, and Nigeria. The countries with the highest number of cases per 100,000 people include Djibouti, São Tomé and Príncipe, Gabon, Cape Verde, and Guinea-Bissau.

May 20 — The World Health Organization receives reports of 106,000 new cases of COVID-19 — the most the agency has seen in a single day since the outbreak began.

In response to a question about the implications of the U.S. potentially pulling funding from WHO indefinitely, Ryan says during a press briefing: “Much of the U.S. funding that reaches us here actually goes directly out in the Emergencies Programme to humanitarian health operations all over the world in all types of fragile and difficult settings. It's of the order of 200 million or 100 million a year, which is actually the greatest proportion of funding that we receive from WHO within the Emergencies Programme.”

Bolivian Health Minister Marcelo Navajas is arrested as part of an investigation into the importation of overpriced ventilators from Spain.

May 19 — A report from the World Food Programme finds that the number of people facing food insecurity in East Africa and the Horn of Africa over the next three months could double because of the socioeconomic consequences of the pandemic. An estimated 20 million people already faced acute food insecurity in Ethiopia, South Sudan, Kenya, Somalia, Uganda, Rwanda, Burundi, Djibouti, and Eritrea before the crisis.

Refugees are one of the most affected groups. “A shortage of funding already means most refugees in the region are not receiving all the food they need, and they could face further cuts as scarce resources become even more over-stretched,” writes UN Refugee Agency Regional Director Clementine Nkweta-Salami, in a press release.

The World Bank Group announces its emergency support has reached 100 low- and middle-income countries, which is home to 70% of the world’s population. This initial assistance — part of its pledge to make available $160 billion in grants and financial support over 15 months — is the largest and fastest crisis response in the bank's history.

According to a study published in the academic journal Nature Climate Change, daily carbon emissions have dropped by 17% this year, through April, as compared to last year, because of reduced transportation and changed consumption patterns due to the pandemic. These reductions “are likely to be temporary as they do not reflect structural changes in the economic, transport or energy systems,” according to the study.

The Lancet refutes claims made by U.S. President Donald Trump that it published reports regarding the novel coronavirus outbreak in Wuhan, China, in December 2019, saying it is “factually incorrect.” The first reports the journal published about the virus was on Jan. 24, according to the journal.

May 18 — Over 100 countries back a draft resolution to the World Health Assembly calling for an independent inquiry into the handling of the coronavirus crisis, including an impartial, comprehensive evaluation into “the actions of WHO and their timelines pertaining to the COVID-19 pandemic.”

Welcoming the resolution, World Health Organization Director-General Tedros Adhanom Ghebreyesus says, “To be truly comprehensive, such an evaluation must encompass the entirety of the response by all actors, in good faith.”

U.S. President Donald Trump sends a letter to WHO chief Tedros warning if the agency “does not commit to major substantive improvements within the next 30 days, I will make my temporary freeze of United States funding to the World Health Organization permanent and reconsider our membership in the organization.”

Trump also says he has been taking hydroxychloroquine for over a week — a drug the president has been touting as a potential treatment for COVID-19, although the U.S. Food & Drug Administration cautions against its unproven use, warning of harmful side effects.

Preliminary data from the first COVID-19 vaccine trial in humans shows that the vaccine is creating an immune response and is "generally safe and well tolerated," according to the manufacturer, Moderna. This data is based on eight people in the trial who have received two doses of the vaccine.

South Sudan Vice President Riek Machar and his wife test positive for COVID-19.

May 17 — Chinese officials quarantine 8,000 people in the northeast part of the country after a cluster of new infections are reported.

May 16 — The Kenyan government says 78 foreign truck drivers tested positive for COVID-19 at the border and were denied entry into the country in the past week. The government announces there will be no passenger traffic through its Tanzania and Somalia land borders, and that all drivers of cargo vehicles will undergo mandatory testing. Uganda also announces that only truck drivers with negative test results can enter the country.

May 15 — For the third time, the Asian Development Bank revises its estimates on the economic impact of the coronavirus. The global impact is estimated to range from $5.8 trillion on a short term containment scenario of 3 months, to $8.8 trillion for a longer term containment scenario of 6 months.

The latest estimates are higher than the World Bank and International Monetary Fund-released estimates in April — and are more than double the figures ADB released in April that estimated global economic losses at over $2 trillion to $4.1 trillion. The bank noted that the latest figures factor in a significant increase in COVID-19 infections from April, and a difference in modeling approach.

Brazil's Health Minister Nelson Teich resigns, less than a month into the new position. This is the second health minister the country has lost in less than a month — the previous one was fired after clashing with the country's president over the national coronavirus response.

The World Health Organization publishes a scientific brief on multisystem inflammatory syndrome in children with COVID-19.

"So far we understand that it's rare but we are hearing more and more reports about it because people are on the look-out ... we need clinicians to be on alert for this, to look for it but also to ensure that we collect standardized information so that we can better describe what this is and so that we can develop better treatment," says Maria Van Kerkhove, technical lead at the WHO Health Emergencies Programme, during a news briefing.

May 14 — The number of deaths from COVID-19 surpasses 300,000 globally.

The first COVID-19 case is confirmed in the densely-populated Rohingya refugee camps in Bangladesh. Home to nearly 900,000 people, this is the “realization of a nightmare scenario,” writes Refugees International in a statement.

The government of Burundi confirms that it expelled WHO country representative Walter Kazadi Mulombo, declaring him “persona non grata,” without providing a reason.

Heads of state, among others, pen an open letter calling on health ministers at the upcoming World Health Assembly to create a global agreement that “ensures rapid universal access to quality-assured vaccines and treatments with need prioritized above the ability to pay.”

"We should not be waiting to see if opening of lockdowns has worked by counting the cases in an ICU or counting bodies in the morgue."

— Dr. Michael Ryan, executive director, WHO Health Emergencies Programme

“Now is not the time to allow the interests of the wealthiest corporations and governments to be placed before the universal need to save lives, or to leave this massive and moral task to market forces,” the letter says.

Most food produced in Africa is by smallholder farmers, who tend to be elderly because many youth have left the rural areas for the cities, says Chris Nikoi, regional director for West and Central Africa at the World Food Programme, during a news briefing.

If coronavirus cases among these elderly farmers begin to escalate, it will have “serious implications for food production going forward,” he says. “If I look at West and Central Africa, we are now about to enter into the planting season and just imagine if, in most of rural Africa, people who farm are falling ill.”

The head of pharmaceutical giant Sanofi in France, Olivier Bogillot, says for a future COVID-19 vaccine developed by the company, “the goal is to have this vaccine available to the U.S. as well as France and Europe at the same time." The remarks came after Paul Hudson, Sanofi CEO, said in an interview with Bloomberg News that the “U.S. government has the right to the largest pre-order [of the vaccine] because it’s invested in taking the risk.” The comment caused outrage in France, with French Prime Minister Édouard Philippe saying equal access for all to the vaccine is not negotiable.

May 13 — During a news briefing, Ryan warns against lifting lockdowns prematurely and without the right public health surveillance measures in place to detect it, including community-based surveillance and widespread testing.

"If that virus transmission accelerates, and you don't have the systems to detect it, it will be days or weeks before you know something has gone wrong," he says. "We should not be waiting to see if opening of lockdowns has worked by counting the cases in an ICU or counting bodies in the morgue."

Lesotho confirms its first case of COVID-19.

Watch: UNAIDS director warns of 'colliding epidemics'

May 12  Five COVID-19 patients in intensive care die in a fire in St. Petersburg, Russia, that might have been caused by a ventilator short circuit. Russia now has the second-highest caseload, following the United States.

The first case of COVID-19 in a crowded civilian protection camp is reported in Juba, South Sudan. The country has 126 confirmed cases of COVID-19.

“This pandemic is also coinciding with the start of the lean season in South Sudan. There is still a real worry that the measures taken to suppress the spread of coronavirus run the risk of disrupting livelihood activities, delaying access to food assistance, and placing additional strain on poor households’ abilities to buy food, seeds and other essentials. They risk having a particularly bad effect on the urban poor and those living in displacement sites,” writes Mercy Laker, deputy country director for programs in South Sudan for CARE, in a press release.

Both Brazil and Mexico report the highest daily fatalities in their countries since the pandemic began.

May 11  The Chinese government reports the first new cluster of cases in Wuhan since the government lifted the lockdown measures in the city at the epicenter of the pandemic.

"Humans are not herds ... It can lead to a very brutal arithmetic which does not put people, and life and suffering at the center of that equation.”

— Dr. Michael Ryan, executive director, WHO Health Emergencies Programme

According to a projection from the World Health Organization and UNAIDS, a six-month disruption of antiretroviral therapy due to the pandemic could lead to more than 500,000 additional deaths from AIDs-related illnesses, including tuberculosis, in sub-Saharan Africa, this year and next. Disruption in efforts to curtail mother-to-child transmission of the virus for six months could also lead to a sharp rise in HIV infections in children, including up to 37% in Mozambique, 78% in Malawi, 78% in Zimbabwe, and 104% in Uganda.

Herd immunity, a term rooted in animal husbandry, looks at the overall health of a herd of animals, rather than an individual's health. Globally, there have been conversations that countries could achieve this if enough people in a population contract and recover from COVID-19, creating some level of immunity.

"Humans are not herds ... It can lead to a very brutal arithmetic which does not put people, and life and suffering at the center of that equation," says Ryan, during a press conference.

"I think this idea that: Well, maybe countries who had lax measures and hadn't done anything, will all of the sudden magically reach some herd immunity and ‘so what’ if we lose a few old people along the way? This is a really dangerous, dangerous calculation,” he says.

Vanuatu is preparing a request to defer its graduation from the category of "least developed countries," scheduled for December, because of the pandemic’s impact.

May 10  The Chinese government reports its first case in Wuhan, where the pandemic originated, since April 3. This follows the government’s lifting of lockdown measures.

Ethiopian troops may have shot down a plane on May 4 carrying humanitarian supplies to assist Somalia in its fight against the coronavirus, The New York Times reports. A leaked report suggests there were fears that the private plane would carry out a suicide attack.

May 9 — The number of COVID-19 cases surpasses 4 million globally.

An editorial in The Lancet suggests that Brazil’s President Jair Bolsonaro is “perhaps the biggest threat to Brazil's COVID-19 response.”

“He not only continues to sow confusion by openly flouting and discouraging the sensible measures of physical distancing and lockdown brought in by state governors and city mayors but has also lost two important and influential ministers in the past 3 weeks,” writes The Lancet.

Only 34% of all confirmed global cases are reported to have recovered, according to data from Johns Hopkins University.

Former U.S. President Barack Obama calls President Donald Trump's handling of the country's COVID-19 pandemic an "absolute chaotic disaster" in a conference call with former members of his administration.

May 8 — The United States blocks a vote in the U.N. Security Council calling for a resolution for a global ceasefire so that countries can more effectively fight COVID-19 in their countries, over mention of the World Health Organization. Trump has been critical of WHO’s handling of the crisis, including the agency’s relationship with China. In April, he announced he was suspending the country’s contributions to WHO.

Devex has pulled together a timeline documenting WHO's warnings of the coronavirus' severity in the initial months of the crisis. Via YouTube.

During a press conference, Maria Van Kerkhove, technical lead at the World Health Organization Health Emergencies Programme, says that the scientific community is still a long way off from fully understanding COVID-19.

“Although it has seemed like an incredibly long time, we are at the very, very early stages of our understanding of how this virus affects the body, how the disease progresses, what disease that this infection causes,” she says. “It’s very difficult to collect a standardized set of data from patients when you are in the middle of a very intense outbreak and you are just trying to save as many lives as you can.”

May 7 — The United Nations increases its Global Humanitarian Response Plan to nearly $7 billion.

UN triples COVID-19 appeal, calls for 'extraordinary response'

If funded, the $6.7 billion appeal to help the world's poorest and most fragile countries can help offset a "bigger humanitarian problem" in the next several months, according to U.N. Emergency Coordinator Mark Lowcock.

As part of this response plan, the World Health Organization updates its Strategic Preparedness and Response Plan, estimating the agency’s financial needs for its operations until the end of this year to $1.7 billion. This includes funding WHO has already received from its initial response plan, leaving WHO with a funding gap of $1.3 billion for 2020.

A study examining male COVID-19 patients at Shangqiu Municipal Hospital in China found that the virus was present in their semen, including some who were recovering.

Between 29 million and 44 million people could become infected with COVID-19 in Africa, and between 83,000 and 190,000 people could die in the first year of the pandemic, "if containment measures fail," according to a press release from WHO. This includes an estimated 3.6 million to 5.5 million hospitalizations, of which 82,000 to 167,000 of these would be severe cases requiring oxygen, and between 52,000 and 107,000 would be critical cases that would require breathing support.

“COVID-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region. We need to test, trace, isolate and treat,” writes Dr. Matshidiso Moeti, WHO Regional Director for Africa, in a press release.

Almost 1,000 African health workers have been infected with COVID-19.

Eighty-five children are released from prison in South Sudan, as part of an effort to reduce crowding to prevent the spread of COVID-19.

May 6 — At least five years of progress on efforts to control tuberculosis could be lost because of the pandemic, limiting efforts to diagnose, treat, and prevent the disease, according to a new report by the Stop TB Partnership. According to a modeling analysis, under the scenario of a three-month lockdown and 10-month restoration of services, there could be an additional 6.3 million cases of TB globally between now and 2025 and an additional 1.4 million deaths.

Tuberculosis can backslide to 2013 levels, new study reveals
The executive director of the Stop TB Partnership, Lucica Ditiu, says modeling can help national TB program managers quantify the seriousness of the issue and make people understand that "this is not a joke."

While 750 COVID-19 cases have been confirmed in Somalia, there is concern that many cases have gone untested.

“The IRC is extremely concerned that Somalia is becoming quickly overwhelmed by a major uptick in COVID-19 cases. The situation is on the verge of spiraling out of control. We are seeing widespread community transmission in a country that will not be able to handle a multitude of severely ill patients at once.

“IRC staff are reporting that people with symptoms are being told to stay home to save the limited health resources for those who become severely ill, showing that the official count is far off from reality," writes Richard Crothers, country director for Somalia at the International Rescue Committee, in a press release.

May 5 — A survey, conducted across 28 cities in 20 African countries, found that 32% of respondents said they do not have enough information about COVID-19; 62% believe the pandemic will have a major impact on their country; 44% believe it is a threat to them personally; 69% said food and water would be a problem if they were forced to remain at home for 14 days; and 51% said that they would run out of money. The report was produced by the Partnership for Evidence-Based Response to COVID-19.

U.K. coronavirus adviser Neil Ferguson resigns after disobeying the lockdown rules that he helped create.

WHO, UNICEF, and the International Federation of the Red Cross publish guidance for community-based health care in the context of COVID-19. This includes recommendations around telemedicine and leaving insecticide-treated mosquito nets at people's doors, rather than asking them to collect them for a central point.

May 4 — A pledging conference hosted by the European Union and attended by dozens of world leaders raises €7.4 billion ($8.1 billion) to fund the research and equitable distribution of COVID-19 diagnostics, treatments, and vaccines.

The African Union says it’s in discussion with the government of Madagascar to receive technical data on the safety and efficiency of an herbal tonic that has been touted by the country’s president as a cure for COVID-19. Tanzanian President John Magufuli also says he will send a plane to bring the herbal remedy to Tanzania.

"As efforts are under way to find treatment for COVID-19, caution must be taken against misinformation, especially on social media, about the effectiveness of certain remedies," WHO writes in a press release.

A plane carrying humanitarian supplies for an INGO to assist in the COVID-19 response crashed near Baidoa, Somalia, killing six people on board.

May 3 — A random testing of 500 people in Kabul results in 150 positive cases of COVID-19, according to Afghanistan's public health ministry. A ministry spokesperson calls the results concerning.

The West and Central Africa region accounts for 54% of cases and 35% of deaths in the World Health Organization's Africa region, with cases in Guinea and Nigeria increasing most rapidly. Eight countries in the region are reporting community transmissions. The number of cases in the region could double each week, if this trend continues, according to WHO.

A French hospital tells BFM TV that it retested samples from pneumonia patients and found a man with COVID-19 as early as Dec. 27. The French government confirmed its first three cases of the disease on Jan. 24. 

“The window of opportunity to surge medical and humanitarian equipment into Africa to curb the pandemic is closing fast.”

— Amer Daoudi, COVID-19 response director, WFP

May 2 — Russia records a one-day record for the country with 9,623 new coronavirus infections. According to Moscow Mayor Sergei Sobyanin, 2% of the city’s population has coronavirus.

India records 2,293 new cases in one day — the first time its daily count has surpassed 2,000. 

Meanwhile, Iran, with 802 new COVID-19 cases, sees its lowest daily count in nearly two months.

Cases of coronavirus on the African continent surpass 40,000.

In Yemen there are seven confirmed cases of COVID-19 in the southern part of the country, and two deaths, but WHO, in a statement writes that "we anticipate the virus is actively circulating throughout the country."

May 1 — “The window of opportunity to surge medical and humanitarian equipment into Africa to curb the pandemic is closing fast,” writes Amer Daoudi, COVID-19 response director for the World Food Programme, in a press release. Humanitarian actors and health officials are struggling to get supplies to fragile settings because of disruptions to supply chains and travel restrictions, according to the release. The agency previously launched a network of global logistic hubs to help ensure the delivery of medical and humanitarian supplies. May 1 sees the first flight of humanitarian workers transported from Ethiopia to Ghana.

WHO and the European Investment Bank, which is the world’s largest international public bank, announce a new partnership for the COVID-19 response. The first phase of the partnership aims to strengthen primary health care in 10 African countries and scale up financing to support supply chains, including those for personal protective equipment and diagnostics.

"Many countries right now are struggling to capture the deaths that are occurring from COVID-19. There is a very good example across Europe through the EuroMOMO project, which is capturing excess mortality in many countries across Europe. And excess mortality right now is very high," says Maria Van Kerkhove, technical lead at the WHO Health Emergencies Programme, during a press conference.

April 30 — Three months have passed since WHO declared the COVID-19 outbreak a public health emergency of international concern.

While it is not ideal, in situations where widespread testing is not taking place, health workers should use “case definitions” — or rely on the presence of symptoms as a signal that a person is positive for COVID-19 — to trigger control measures and treatment, says Michel Yao, WHO’s emergency operations manager in Africa, during a press conference. This is important because early detection leads to better outcomes.

"It is done in many other outbreaks. In cholera, for example, where in the past we were not able to test everybody, we just confirm a few cases and rely on case definitions," he says.

Countries in WHO's African region are only conducting an average of 9 coronavirus tests per 10,000 people.

Dr. Zwelini Mkhize, South Africa’s minister of health, says during the news briefing that he expects the peak of the outbreak in his country to take place between July and September. South Africa currently has the largest outbreak in sub-Saharan Africa. The country is considering lifting some of its strict lockdown measures, using a “case-by-case” strategy that depends on the nature of the outbreak in different areas, he says.

“Lockdowns are being eased in some parts of Africa, but we cannot just revert back to how things were before the outbreak. If governments abruptly end these measures, we risk losing the gains countries have made so far against COVID-19," writes Dr. Matshidiso Moeti, WHO regional director for Africa, in a press release.

Russian Prime Minister Mikhail Mishustin tests positive for COVID-19. The country has over 100,000 confirmed cases.

Tajikistan and Comoros confirm their first cases of COVID-19.

We’ve lifted our paywall on all COVID-19 coverage. Looking for more in-depth global development coverage? Please consider supporting our journalism with a Pro subscription.

April 29 — There are 370 million children missing out on school meals because of school closures to prevent the spread of COVID-19, according to the United Nations Children's Fund and World Food Programme.

Despite an announced ceasefire in Yemen, airstrikes are up 30%, according to the Yemen Data Project, complicating the COVID-19 response.

"With an increase in fighting and COVID-19 hitting the world’s largest humanitarian crisis, Yemen is on the brink of catastrophe. A ceasefire means an end to fighting, yet, we are seeing the opposite on the ground. An increase in airstrikes in Yemen is putting COVID-19 mitigation efforts and the overall humanitarian response at serious risk," writes Tamuna Sabadze, Yemen Country Director at the International Rescue Committee, in a press release.

Dr. Anthony Fauci, a member of the U.S. government's coronavirus task force, says during a news briefing that results from a clinical trial of remdesivir, a potential COVID-19 treatment, show “quite good news.” In the study, patients taking the drug recovered 31% faster than those given placebos. “What it has proven is that a drug can block this virus,” he says.

April 28 — The number of coronavirus cases in the United States surpasses 1 million — accounting for one-third of the cases globally. The number of Americans killed by COVID-19 surpasses 58,000. Now, more Americans have died from this disease than were killed in the Vietnam War.

An analysis from the International Rescue Committee estimates that COVID-19 infections could reach between 500 million and 1 billion in 34 conflict-affected and fragile countries, including Afghanistan, Syria, and Yemen. This could lead to between 1.7-3.2 million deaths.

The World Bank’s controversial Pandemic Emergency Financing Facility announces it is allocating $195.8 million under its insurance scheme to 64 low-income countries. The facility has faced criticism in recent years for not issuing payments.

A group of scientists warn against the use of a tuberculosis vaccine to protect people from COVID-19 — it has not yet proven effective, although there are ongoing clinical trials aimed at determining whether it is. The scientists are concerned there could be global shortages of the vaccine, which could limit access to those using it to prevent TB.

April 27 — Globally, the number of COVID-19 cases surpasses 3 million.

The United Nations Population Fund projects that 47 million women in 114 low- and middle-income countries could lose access to modern contraceptives because of the pandemic. If the lockdown persists for six months, this could result in 7 million unintended pregnancies.

ViiV Healthcare announces it is creating a £3 million ($3.7 million) emergency response fund for COVID-19 and HIV. The funds will go toward research to study the medical and scientific impact that COVID-19 has on people living with HIV, as well as community-based grants to assist with challenges faced by these communities.

New Zealand’s Prime Minister Jacinda Ardern says that there is currently no widespread community transmission of COVID-19 in the country, saying “we have won that battle,” but that the country must remain vigilant to prevent a resurgence. New Zealand lifts some of its restrictions, allowing most businesses to reopen.

WHO expects to launch its second Strategic Preparedness and Response Plan this week, which will estimate the resources needed for the next stage of the response.

The U.S. House Foreign Affairs Committee launches an inquiry into the White House’s decision to half funding to the World Health Organization. In a letter to U.S. Secretary of State Mike Pompeo, Rep. Eliot Engel, a Democrat and chair of the committee, writes that the funding freeze “will only worsen an already dire situation by undermining one of our key tools to fight the spreading disease.”

Watch: A conversation with UNHCR HR chief Catty Bennet Sattler. This is part of our Careers During COVID series.

April 26 — The Australian government launches a voluntary tracking app that uses a Bluetooth signal to determine when a person has been in contact with someone with COVID-19. Authorities can then alert this person about their exposure to the virus. The software is based on Singapore's TraceTogether app.

Kenya reports COVID-19 cases in the Nairobi informal settlement of Kibera.

The United Nations launches a knowledge hub for the COVID-19 response in Africa.

In an interview with the Financial Times, Bill Gates says his foundation will give its “total attention” to the COVID-19 response.

April 25 — The global death toll from COVID-19 surpasses 200,000.

April 24 — The World Health Organization launches the Access to COVID-19 Tools Accelerator, a global initiative to speed up the development and production of vaccines, diagnostics, and therapeutics to respond to COVID-19. The launch is attended virtually by heads of state, leaders of international health organizations, and representatives of private sector players in the health industry, who emphasize the importance of collaboration and ensuring equitable and affordable access to the tools being developed.

“Equity, access, and affordability are key tenets of our efforts. … We must come together to achieve all of these,” says Ngozi Okonjo-Iweala, special envoy for the ACT accelerator.

The launch will be followed by a virtual pledging conference on May 4, to be hosted by the European Commission. The event is meant to raise funding for COVID-19 vaccine research.

Polio eradication efforts under threat as vaccine campaigns halted

Money has been poured into winning the fight against polio, but those gains are now in a precarious position.

Niger reports a new polio outbreak. WHO says that a vaccination campaign will not be possible due to the COVID-19 pandemic.

“Niger stopped the previous polio outbreaks by mounting high-quality mass vaccination campaigns in 2019. Unfortunately, that will not be possible now as we have suspended the polio mass vaccination campaigns due to the novel coronavirus (COVID-19) pandemic responses that requires global standards for social distancing and hand washing hygiene practices,” says Dr. Pascal Mkanda, WHO polio eradication program coordinator for the African region, in a press release. “The poliovirus will inevitably continue to circulate and may paralyse more children as no high-quality immunization campaigns can be conducted in a timely manner."

Some governments are considering “immunity passports" or “risk-free certificates" for individuals that have developed antibodies after they've had COVID-19, as a strategy to allow parts of society to return to work and travel. In a scientific brief, WHO says there is no evidence showing that people who recovered from COVID-19 are protected against a second infection of the disease.

"People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission," according to the brief.

The U.S. death toll from COVID-19 passes 50,000.

April 23 — On the African continent, there are over 25,000 COVID-19 cases and more than 1,200 deaths, says Dr. Matshidiso Moeti, the World Health Organization’s regional director for Africa, during a news briefing. South Africa is the most affected country there, with 3,300 cases, but the nation is “starting to see a bending of their curve,” she says. There are “concerning” increases in some countries in West Africa and in Tanzania.

“We saw with the Ebola disease outbreak in West Africa that we actually lost more people to diseases that we previously managed to control, like malaria, than we lost to the outbreak itself. Let us not repeat that again with COVID-19.”

— Dr. Matshidiso Moeti, regional director for Africa, WHO

“We are observing some countries take an approach to the response which is not quite what we are recommending. So certainly in Tanzania, we have observed that the physical distancing, including the prohibition of mass gatherings, took some time to happen, and we believe these might have been factors — or probably factors — in expanding the number of cases. We are seeing a rapid increase in cases there,” she says.

Recent analysis finds that if the distribution of insecticide-treated bed nets, stops and case management reduces during the pandemic, malaria deaths in sub-Saharan Africa could double in comparison with 2018, Moeti says. This would be the highest number of malaria deaths seen in the region since 2000.

The analysis states that malaria deaths could reach an estimated 769,000 across sub-Saharan Africa by the end of 2020 if bed net campaigns are not implemented, while distribution of antimalarial treatments could be reduced by up to 75%. Seventy percent of those deaths will be children under 5 years old.

“We saw with the Ebola disease outbreak in West Africa that we actually lost more people to diseases that we previously managed to control, like malaria, than we lost to the outbreak itself. Let us not repeat that again with COVID-19,” she says.

WHO accidentally posts a draft document, then removes it, showing that the drug remdesivir was not shown to be effective in its first full trial, reports the Guardian. The trial was stopped early because of side-effects.

The first patients are injected with the first human COVID-19 vaccine trial in Europe.

“Make no mistake: We have a long way to go. This virus will be with us for a long time.”

— Tedros Adhanom Ghebreyesus, director-general, WHO

April 22 — Outbreaks in Western Europe “appear to be stable or declining,” says World Health Organization Director-General Tedros Adhanom Ghebreyesus during a press conference. “Although numbers are low, we see worrying upward trends in Africa, Central and South America, and Eastern Europe. Most countries are still in the early stages of their epidemics. And some that were affected early in the pandemic are now starting to see a resurgence in cases. Make no mistake: We have a long way to go. This virus will be with us for a long time.”

We’ve lifted our paywall on all COVID-19 coverage. Looking for more in-depth global development coverage? Please consider supporting our journalism with a Pro subscription.

Of the countries that have reported data to WHO, only 66% have a clinical referral system in place for COVID-19 patients, 48% have a community engagement plan, and 48% have an infection prevention and control program and standards for water, sanitation, and hygiene in health facilities, Tedros says. “There are still many gaps in the world’s defenses, and no single country has everything in place," he says.

When asked whether WHO should have declared a pandemic sooner than March 11, Dr. Michael Ryan, executive director of the WHO Health Emergencies Programme, clarifies that the highest level of alert that WHO can declare is a public health emergency of international concern, which it did on Jan. 30. “The characterization of the disease as a pandemic, in itself, has no basis, other than a description of the event at that time,” he says. When the emergency declaration was made, there were only 82 cases outside of China — mostly “in the neighborhood” of the country — and no deaths, Tedros says.

Iran, NKorea, Syria: How sanctions are hindering coronavirus response

Years of sanctions have impacted the ability of Iran, North Korea, and Syria to respond to the novel coronavirus outbreak. Experts tell us why.

The U.S. rejects the European Union's calls to ease sanctions on Iran, preventing the International Monetary Fund from assisting the country with its COVID-19 response.

A Palestinian woman from Syria tests positive for COVID-19 in Lebanon — the first case identified in the country’s refugee camps.

April 21 — The number of COVID-19 cases surpasses 2.5 million globally, and the number in the U.S. surpasses 800,000.

The World Food Programme warns the COVID-19 pandemic could nearly double the number of people suffering from acute hunger. This figure could surpass 250 million by the end of the year.

Health worker infections from COVID-19 are high in the Philippines at 13% compared to the estimated average of 2-3% in the region, says Abdi Mahamud, WHO COVID-19 incident manager for Western Pacific, during a press conference. The exact reasons are unclear, but the official mentioned PPE, or personal protective equipment, shortages, and an overwhelmed health care system potentially contributing to this high infection rate.

While COVID-19 cases in Japan continue to climb, reaching over 11,000, WHO Western Pacific Regional Director Dr. Takeshi Kasai says during the briefing that Japan has not yet reached the stage of a large-scale community outbreak. Kasai also said the source of the virus remains unknown to date, amid speculations that the virus came from the Wuhan Institute of Virology and not from the Huanan seafood market.

The rapid rise of COVID-19 infections in Singapore, oft-cited as a model of success in fighting the disease, provides lessons for countries to pay attention to vulnerable groups of the population, he says.

Simon McDonald, permanent undersecretary of the U.K. Foreign & Commonwealth Office, says to the Foreign Affairs Committee that U.S. officials have discussed the idea of a body separate from WHO, which would be responsible for pandemics, drawing parallels to when the World Food Programme “broke out” of the Food and Agriculture Organization in the 1960s. He says the U.K. “needs to be open at this stage to all these ideas.”

April 20 — Early data from some seroepidemiologic surveys suggest a relatively small percentage of the population — not more than 2% to 3% — may have been infected by COVID-19, even in heavily hit areas, World Health Organization Director-General Tedros Adhanom Ghebreyesus, says during a press conference.

“... a lower percentage of people are actually — it appears — are infected. That means a large proportion of the public remains susceptible. That means that the virus can take off again," says Maria Van Kerkhove, technical lead of the WHO Health Emergencies Programme.

In response to criticisms that WHO ignored early warnings of human-to-human transmission, Tedros says that an email sent on December 31, 2019, by health officials in Taiwan was a call for WHO clarification on the outbreak. It was not a report of human-to-human transmission. “We have all the documentation,” he says.

The World Bank’s pandemic bond is set to pay out $132.5 million to some of the world’s poorest countries impacted by COVID-19. The financial instrument was launched in 2017, following the West Africa Ebola crisis.

WHO translates its press conference for the first time into all U.N. official languages: Arabic, Chinese, French, Russian, and Spanish. It will soon also add Swahili and Hindi.

A WHO worker is killed by gunfire while transporting COVID-19 test samples in Myanmar’s Rakhine state.

Watch: How Rwanda got ahead of the pandemic curve. Via YouTube.

April 19 — The death toll in Europe from COVID-19 surpasses 100,000. The death rate in Europe, according to data compiled by Johns Hopkins University, is nearly 9%.

United Nations agency heads, as well as the heads of the Steering Committee for Humanitarian Response, International Council of Voluntary Agencies, InterAction, and the International Federation of Red Cross and Red Crescent Societies write an open letter to the donor community asking for $350 million to rapidly scale up the U.N.’s global logistics system to respond to the COVID-19 pandemic.

The U.N. World Food Programme, which is managing the logistics around the global response, “urgently needs additional funding to establish the necessary transport hubs, charter vessels and provide aircraft for cargo, health workers and other essential staff,” according to the letter.

April 18 — Singapore sees a record spike of 942 new cases of COVID-19, bringing total cases to nearly 6,000.

We’ve lifted our paywall on all COVID-19 coverage. Looking for more in-depth global development coverage? Please consider supporting our journalism with a Pro subscription.

In a letter to World Health Organization Director-General Tedros Adhanom Ghebreyesus, the World Medical Association calls on WHO to allow Taiwan into the organization, noting that “failure to listen to early warnings from Taiwan about the COVID-19 pandemic, coupled with its decision to ignore Taiwan during much of the SARS crisis, were errors that led to the world paying a high price.” While in the past Taiwan has been given observer status at WHO, in recent years it has been “locked out by the WHO as a result of the ‘One China’ policy,’” according to the letter.

April 17 — During a press conference, Dr. Michael Ryan, executive director of the World Health Organization Health Emergencies Programme, emphasizes that there is no evidence to prove whether someone who had COVID-19 and recovered is immune from the disease.

"We're not — nobody is sure — whether someone with antibodies is fully protected against having the disease or being exposed again."

— Dr. Michael Ryan, executive director, WHO Health Emergencies Programme

"We're not — nobody is sure — whether someone with antibodies is fully protected against having the disease or being exposed again," he says.

WHO Director-General Tedros Adhanom Ghebreyesus also says during the press conference that if “wet markets” are allowed to reopen, they must conform to stringent food safety and hygiene standards and that governments must "rigorously enforce" bans on the sale and trade of wildlife for food. He says an estimated 70% of all new viruses come from animals.

The Asian Infrastructure Investment Bank announces it will double the funds in its COVID-19 crisis recovery facility, providing up to $10 billion in financing.

The prevention and control taskforce in Wuhan, China, revises the death toll in the city up 50%, from 2,579 to 3,869 deaths.

Cases of COVID-19 in Cameroon surpass 1,000 — a country already facing armed violence and an influx of refugees from Nigeria and Central Africa Republic.

April 16 — On the African continent, there has been a rapid increase in cases over the past week in Niger, Guinea, Côte d'Ivoire, and Cameroon, as well as high death rates in Burkina Faso, Congo, and Algeria, says Dr. Matshidiso Moeti, WHO’s regional director for Africa, during a press conference.

“Eleven out of 17 [African] countries with more than 100 cases of COVID-19 are in West and Central Africa,” she writes in a press release. “We are working with the governments to better understand what is happening on the ground, but this is worrisome as countries in these subregions often have particularly fragile health systems.”

A lack of personal protective equipment is already impacting the COVID-19 response in many African countries, according to the release. In Niger, 32 health workers have tested positive for COVID-19. In Liberia, 20 health workers have tested positive for the virus.

WHO’s budget for the 47 countries in sub-Saharan Africa will need about $300 million over the next six months, Moeti says during the press conference.

Trump vs WHO.

Beyond having an impact on the COVID-19 response, U.S. President Donald Trump's threats to withhold funding from the agency could also cause harm to existing programming across the continent.

"The impact, potentially, of this decision will be quite significant on areas such as polio eradication. We are on the way to having the declaration of certification of polio being eradicated from Africa — the U.S. is one of the biggest supporters of that, as well as other priority programs that address communicable diseases such as HIV, malaria, and work on strengthening of our health systems. This I can describe as the extent of the U.S. contribution and potential impact of this decision, which we are very much hoping will be rethought," Moeti says.

One projection estimates that Africa could have more than 10 million severe cases of COVID-19, Michel Yao, WHO’s emergency operations manager in Africa, says during a press conference, noting that it’s difficult to make estimations because of the many factors involved.

There is one COVID-19 testing facility in Cox’s Bazar, one isolation space in the Rohingya camp and the local hospital has only 10 intensive care beds, Mohammed Riyas, director of programs in Cox’s Bazar for Plan International Bangladesh, writes in a press release, adding that Bangladesh's government and humanitarian agencies are working to increase this capacity.

Saudi Arabia pledges $500 million to the global COVID-19 response.

April 15 — The number of COVID-19 cases surpasses 2 million.

French President Emmanuel Macron tells Radio France Internationale that placing a hold on the debt payments of African governments is "an indispensable step" to assist the continent in its fight against COVID-19.

“When we are divided, the virus exploits the cracks between us.”

 —Tedros Adhanom Ghebreyesus, director-general, WHO

In a press conference, Tedros says that the agency is internally assessing how the U.S. withdrawing financial support will affect its programs and that it will aim to fill any financial gaps left by the U.S. with other partners. He adds that WHO’s member states and independent bodies will conduct a performance review of the agency’s actions following the pandemic, as is standard for any outbreak.

“When we are divided, the virus exploits the cracks between us. We are committed to serving the world’s people and to accountability for the resources with which we are entrusted,” he says. “But for now, our focus, my focus, is on stopping this virus and saving lives. … WHO is getting on with the job.”

The Bill & Melinda Gates Foundation announces it will increase its funding for the global COVID-19 response by $150 million to fund the development of diagnostics, therapeutics, and vaccines. The funds will also be used to help partners in Africa and South Asia scale up efforts at detection, treatment, and isolation efforts. With these new funds, the foundation has allocated a total of $250 million to the global response. The foundation will also leverage a portion of its $2.5 billion Strategic Investment Fund.

April 14 — U.S. President Donald Trump announces he is cutting off the nation’s contributions to the World Health Organization, criticizing the agency for mismanaging the response. It is unclear whether he has the authority to do so.

The United Nations Children’s Fund warns that more than 117 million children in 37 countries could miss out on the measles vaccine because of the COVID-19 pandemic. Measles immunization campaigns have already been delayed in 24 countries.

The Ethiopian government and the World Food Programme launch a humanitarian air hub for the transport of supplies, equipment, and workers at the international airport in Addis Ababa.

The number of COVID-19 cases on the African continent surpasses 15,000.

April 13 — The International Monetary Fund approves immediate debt service relief to 25 countries through its Catastrophe Containment and Relief Trust, which will provide about $500 million in grants to those countries. IMF Managing Director Kristalina Georgieva urges donors to give more resources so the fund can provide debt service relief for two years to its poorest member countries.

The Asian Development Bank expands its COVID-19 response package to $20 billion from the initial $6.5 billion announced in March. The package, largely aimed at helping governments in the Asia-Pacific region mitigate the impact of the pandemic, includes $2.5 billion in concessional and grant resources.

China has imposed restrictions on the publication of research that focuses on the origins of COVID-19, CNN reports.

During a press conference, WHO Director-General Tedros Adhanom Ghebreyesus urges countries to only ease control efforts, such as stay-at-home orders, if the right public health measures are in place, including "significant capacity” for contact tracing. If countries are going to make this move, they must do it slowly, he added.

"While COVID-19 accelerates very fast, it decelerates much more slowly. In other words, the way down is much slower than the way up. That means control measures must be lifted slowly, and with control. It cannot happen all at once," he says.

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April 12 — The International Rescue Committee launches an initiative that aims to help trained medical and health professionals who are refugees and immigrants but aren't credentialed in the United States to help in the nation's fight against COVID-19. There are currently about 165,000 refugees and immigrants in the U.S. that obtained their health-related education abroad.

The African Union appoints Dr. Ngozi Okonjo-Iweala, Dr. Donald Kaberuka, Tidjane Thiam, and Trevor Manuel as special envoys to mobilize international support to help Africa deal with the economic impacts of COVID-19.

The U.K. government pledges £200 million ($250 million) to slow the spread of COVID-19 in vulnerable countries. The funds will go to U.N. agencies, including WHO, as well as the Red Cross and other organizations.

April 11 — The United States records over 2,000 deaths in one day — the highest death rate recorded for any country during the pandemic.

April 10 — The number of COVID-19 deaths around the world surpasses 100,000.

COVID-19 is spreading to rural areas in Africa, according to Tedros, who says there are clusters of cases and community spread in more than 16 countries.

The newly established United Nations Supply Chain Task Force, which will coordinate procurement and distribution of medical supplies, will need about $280 million for the costs of storing and moving supplies, Tedros says. The supply chain may need to cover more than 30% of the world’s needs in the acute phase of the pandemic and, every month, would need to ship at least 100 million medical masks and gloves; up to 25 million N95 masks, gowns, and face shields; up to 2.5 million diagnostic tests; and other equipment. Hubs will be located in Belgium, China, Ethiopia, Ghana, Malaysia, Panama, South Africa, and the United Arab Emirates.

A food distribution, as part of COVID-19 relief, results in a stampede in Nairobi, Kenya.

A report published in The New England Journal of Medicine finds that an experimental drug, from Gilead Sciences, Inc., showed improvements of two-thirds of severe COVID-19 cases.

Yemen reports its first case of COVID-19.

April 9 — One hundred days have passed since WHO was initially notified of COVID-19 in China, which was then only known as cases of “pneumonia with unknown cause.”

A two week ceasefire begins in Yemen, following calls from United Nations Secretary-General António Guterres to halt fighting amid the global pandemic.

“More than half of Yemen’s health facilities are no longer functioning and 18 million people do not have access to proper hygiene, water, and sanitation. Warring parties agreed to a ceasefire last weekend to allow for a COVID-19 scale-up, only to violate it two days later, and on Monday this week an isolation facility outside of Hodeidah was hit by an airstrike.

 “We cannot control a global pandemic amongst bombs and airstrikes.”

 — Tamuna Sabedze, Yemen country director, International Rescue Committee

“This cannot happen again. We cannot control a global pandemic amongst bombs and airstrikes. We commend the Kingdom of Saudi Arabia for the announcement, and we encourage them to stay true to their word,” says Tamuna Sabedze, Yemen country director at the International Rescue Committee.

A new report from IRC shows there are only four ventilators in South Sudan, 11 in northeast Syria, 13 in Sierra Leone, and 90% of hospitals lack critical supplies in Venezuela.

The Global Fund board approves the COVID-19 response mechanism, with an initial allocation of $500 million. The mechanism allows countries to request funding for COVID-19 response, and mitigate its impact on HIV, tuberculosis, and malaria programs. This follows the fund’s announcement in March that allowed countries to use up to 5% of their grants to prepare and respond to COVID-19.

“If you don’t want many more body bags, then you refrain from politicizing it.”

— Tedros Adhanom Ghebreyesus, director-general, WHO

April 8 — China lifts its lockdown on Wuhan, the city where the COVID-19 outbreak began.

In response to U.S. President Donald Trump’s threats to withhold funds from WHO because the agency “missed the call” on the pandemic response, Tedros urges governments not to politicize the response.

“If you don’t want many more body bags, then you refrain from politicizing it,” he says at a press conference.

“When there are cracks at national level and global level, that’s when the virus succeeds. For God’s sake, we have lost more than 60,000 citizens of the world,” he says, adding that there is no time to waste by “pointing fingers.”

WHO also launches the U.N. COVID-19 Supply Chain Task Force to meet needs and “dramatically scale up the supply" of lifesaving medical supplies, such as personal protective equipment and diagnostic tests.

South Sudan confirms its second case of COVID-19. Both cases are United Nations staff members.

April 7 — The Wellcome Trust launches an initiative that aims to raise at least $8 billion through the private sector by the end of the month to cover the global funding shortfall for vaccines, treatments, and testing for COVID-19.

"Scientists globally are working at tremendous pace to develop vaccines, test existing drugs that could treat COVID-19 and improve diagnostic tests. But they're running out of funding fast which means new developments may never reach clinical trials and, ultimately, achieve regulatory approval," according to a Wellcome Trust press release.

The Rwandan government decides to cut the salary for a group of its officials in order to raise funds for social protection programs as part of its COVID-19 response.

WHO’s “State of the World’s Nursing 2020” report identifies a global shortage of 5.9 million nurses as the world fights the pandemic. Many of those gaps are found in Africa, Southeast Asia, the Eastern Mediterranean, and parts of Latin America.

The African Union and the Africa Centres for Disease Control and Prevention launch a public-private partnership with the AfroChampions Initiative, called the Africa COVID-19 Response Fund. It aims to initially raise $150 million for immediate needs to prevent transmission and up to $400 million for the medical response and for socio-economic support to vulnerable populations.

Cases of COVID-19 in Africa surpass 10,000 with over 500 deaths.

April 6 — Almost 90% of students globally are affected by school closures — over 1.5 billion children and young people, according to WHO.

U.K. Prime Minister Boris Johnson is moved to intensive care after his COVID-19 symptoms worsen.

The death toll in Europe from COVID-19 surpasses 50,000.

Countries that still have only a small number of cases, including those with imported cases rather than community transmission, still have a “window of opportunity” to prevent larger outbreaks, says Maria Van Kerkhove, technical lead of the WHO Health Emergencies Programme, during a press conference.

"There is an opportunity to prevent the worst from happening in a number of countries across Africa and across countries that are still seeing their first case; in some island countries," she says.

April 5 — South Sudan reports its first case of COVID-19: A United Nations Mission in South Sudan staff member.

The African Union estimates that 20 million jobs could be lost on the continent as a result of the pandemic.

April 4 —The African Development Bank estimates COVID-19 could cost Africa losses in GDP ranging between $22.1 billion and $88.3 billion. Deficits are estimated to widen by 3.5 to 4.9 percentage points, increasing the continent’s financing gap by $110 billion to $154 billion this year. Total public debt could increase from $1.86 trillion, at the end of last year, to over $2 trillion this year.

In an op-ed, Akinwumi Adesina, president of the AfDB Group, calls for a temporary deferment of debt owed to multilateral development banks and international financial institutions through the re-profiling of loans in order to create fiscal space for countries to deal with their response.  He added that loan principals due to international financial institutions this year would be deferred, calling for temporary forbearance, rather than forgiveness.

"That way, we will avoid moral hazards, and rating agencies will be less inclined to penalize any institution on the potential risk to their Preferred Creditor Status," he writes. "Multilateral and bilateral financial institutions must work together with commercial creditors in Africa, especially to defer loan payments and give Africa the fiscal space it needs."

He also calls for a lift of sanctions: "Sanctions work against economies but not against the virus. If countries that are under sanctions are unable to respond and provide critical care for their citizens or protect them, then the virus will soon ‘sanction’ the world.”

April 3 — The global economic impact of the COVID-19 pandemic is now estimated to be between $2 trillion and $4 trillion, according to the latest Asian Development Bank estimates. For low- and middle-income countries in Asia, excluding China, that means estimated economic losses of $93 billion to $200 billion, up from bank estimates of $15 billion to $42 billion in early March.

Those estimates are based on a 3 to 6-month scenario in which the pandemic is contained. The impact on the global economy could be higher if the pandemic is not contained by the end of September.

Watch: Amref Health Africa CEO on COVID-19's impact on NGO finances

“The pandemic could leave permanent scars admittedly on the global economy, including retreat from globalization,” says ADB Chief Economist Yasuyuki Sawada.

Sawada says no economy in Asia would escape unscathed from the pandemic. Tourism-dependent economies, such as Maldives, Cambodia, Fiji, and Thailand, are likely to be hit hardest. Sawada said the pandemic could turn into a financial crisis, but with containment efforts and stimulus packages underway, the chance of a global recession is “very slim.”

The pandemic could also impact poverty eradication efforts in Asia, providing challenges to achieve the Sustainable Development Goals.

The United States, with the highest number of cases in the world, now has more than double the number of Italy, which has the second-highest number of cases in the world.

Billionaire philanthropist Bill Gates tells The Daily Show host Trevor Noah how the Bill & Melinda Gates Foundation can use its resources to “accelerate things” such as, for example, funding factories working on seven of the most promising vaccine candidates against COVID-19. While that may lead to billions of dollars wasted, since not all of those vaccine candidates will eventually be used, he said in the current situation where the global economy is losing trillions of dollars, “it is worth it.”

Gates has shared the same thoughts in an opinion piece for The Washington Post.

“Creating a vaccine is only half the battle. To protect Americans and people around the world, we’ll need to manufacture billions of doses … We can start now by building the facilities where these vaccines will be made,” he wrote.

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April 2 — Cases of COVID-19 surpass 1 million.

After 20 asylum-seekers test positive for COVID-19, Greece quarantines a refugee camp.

Cases of COVID-19 are growing “exponentially in the African region,” says Dr. Matshidiso Moeti, WHO’s regional director for Africa, in a press release. “It took 16 days from the first confirmed case in the region to reach 100 cases. It took a further 10 days to reach the first thousand. Three days after this, there were 2000 cases, and two days later we were at 3000.”

A handful of cases have been reported in the eastern part of the Democratic Republic of the Congo, which is recovering from the second-largest Ebola outbreak in history. All provinces in South Africa have confirmed cases. There are also widespread outbreaks in Burkina Faso, Cameroon, and Senegal, according to WHO.

Watch: Unacceptable — community health workers without COVID-19 protective gear. Via YouTube.

The World Bank Group announces it will "deploy up to $160 billion over the next 15 months to support COVID-19 measures that will help countries respond to immediate health consequences of the pandemic and bolster economic recovery."

Malawi records its first cases of COVID-19.

April 1 — The COP26 U.N. climate change conference, which was scheduled to take place this November in Glasgow, Scotland, is postponed and will be rescheduled for 2021.

The Global Partnership for Educationannounces $250 million to "help developing countries mitigate both the immediate and long-term disruptions to education being caused by the COVID-19 pandemic." The funds will go to 67 countries in areas such as producing educational radio and television programs, as well as distributing radios and textbooks.

The number of deaths from COVID-19 globally has more than doubled in the past week.

March 31 — WHO Western Pacific Regional Director Dr. Takeshi Kasai expresses concerns about how travel restrictions are impacting Pacific island countries’ ability to diagnose COVID-19 cases. Lacking laboratory capacity, most countries need to ship specimen samples outside their territories. He calls on the international community to prioritize test kits that can run on GeneXpert machines, as these are available in many Pacific countries.

An International Rescue Committee international staff member who is working on the Ebola response in the Democratic Republic of the Congo tests positive for COVID-19.

The U.S. government places a moratorium on USAID’s global shipments of personal protective gear, asking it to instead be sent to the U.S., reports Politico.

COVID-19 claims the life of professor Gita Ramjee, a world-renowned HIV scientist, in South Africa.

A 13-year-old in Nairobi dies after he is shot by police enforcing a national curfew aimed at preventing the spread of COVID-19. The boy had been standing on a balcony at his home at the time of the incident.

UNICEF tells The Telegraph it has halted routine and emergency vaccinations due to worries that these activities could further the spread of COVID-19, prompting concerns of a resurgence of diseases such as measles and polio.

Burundi and Sierra Leone report first cases of COVID-19.

Mark Dybul calls for global task force on COVID-19, Via YouTube.

March 30 — Johnson & Johnson announces the selection of a lead COVID-19 vaccine candidate. The company expects to start human trials by September, at the latest, and anticipates the first batches of a vaccine could be available for U.S. Food and Drug Administration "emergency use authorization" in early 2021.

The University of Washington, University of Oxford, and La Jolla Institute for Immunology receive $20 million to fund clinical trials to identify highly potent immunotherapies to combat the COVID-19 pandemic. The grants come from the COVID-19 Therapeutics Accelerator, an initiative of the Bill & Melinda Gates Foundation, Wellcome, and Mastercard.

According to the U.N. Development Programme, income losses are expected to surpass $220 billion in low- and middle-income countries. Almost half of jobs in Africa could be lost.

"For vast swathes of the globe, the pandemic will leave deep, deep scars,” says Achim Steiner, administrator of UNDP. “Without support from the international community, we risk a massive reversal of gains made over the last two decades, and an entire generation lost, if not in lives then in rights, opportunities, and dignity.”

Botswana reports its first cases of COVID-19.

March 29 — Global death toll from COVID-19 surpasses 30,000.

March 28 — Cases of COVID-19 worldwide surpass 600,000.

Portugal announces that all foreigners will be treated as residents during the COVID-19 crisis, to ensure they have access to public services.

Quarantine measures in the Chinese city of Wuhan, where the outbreak began, begin to ease after more than two months of lockdown, including restarting rail service in and out of the city.

Health officials in Illinois, U.S., announce the death of a baby from COVID-19. This is the first death of an infant in the country.

Spain and Italy hit new records for the number of dead in one day. Spain records 832 dead and Italy records 889.

March 27 —The African Development Bank launches a $3 billion social bond to help the continent manage the economic and social impact of COVID-19. It is the largest social bond ever launched in international capital markets and the largest U.S. dollar benchmark ever issued by the bank.

WHO announces that the first patients will shortly be enrolled in Norway and Spain in a trial called the Solidarity Trial, comparing the effectiveness of four different drugs or drug combinations against COVID-19. "This is a historic trial that will dramatically cut the time needed to generate robust evidence about what drugs work," says WHO Director-General Tedros Adhanom Ghebreyesu during a press conference. More than 45 countries are contributing to the trial.

In a conference call focused on how COVID-19 is impacting sexual and reproductive health, Chris Purdy, president and CEO at DKT International, says he wants to "ring the alarm bell" about what is coming. "In every single link of the supply chain we are seeing disruption. This disruption, I fear, is going to result, if things aren't addressed quickly, in more stock outs, shortages and a lack of access in coming months," he says.

U.K. Prime Minister Boris Johnson tests positive for COVID-19.

How Jan Egeland sees the COVID-19 crisis developing. Via Youtube.

In a scientific brief, WHO reiterates respiratory droplets and indirect contact with surfaces or objects used by an infected person are still the main routes of transmission for SARS-CoV-2. The agency says a recent experimental study detailing virus persistence in the air does not reflect normal human cough conditions.

Airborne transmission may be possible in procedures that generate aerosols including endotracheal intubation, bronchoscopy, open suctioning, administration of nebulized treatment, manual ventilation before intubation, turning the patient to the prone position, disconnecting the patient from the ventilator, noninvasive positive-pressure ventilation, tracheostomy, and cardiopulmonary resuscitation.

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March 26 — The African continent does not have the manufacturing capacity to produce health machines such as ventilators and respirators, says Dr. Matshidiso Moeti, WHO regional director for Africa, during a press conference, noting that the continent is dependent on Western countries and countries in Asia, including China and India.

"We would need to rely very much on these types of countries that have really strong industrialization and production capacity immediately, urgently, and see if they can manufacture in sufficient numbers," she says. "We need global solidarity so that those countries that don't have the production capacity can also be enabled to import, working with partners, some of these key items that are needed to support their own response to the outbreak."

There is also a need for conversations with African countries on repurposing existing manufacturing facilities to produce these machines, says Dr. John Nkengasong, director of the Africa Centres for Disease Control and Prevention, during the press conference. This could include manufacturing facilities in South Africa, Egypt, Morocco, and Tunisia

"It's a conversation that needs to start now, and start urgently," he says.

G-20 country leaders, after their virtual summit, release a statement outlining commitments in fighting the pandemic, such as sharing timely and transparent information, strengthening health systems globally, and protecting front-line health workers. The countries call upon WHO to assess gaps in pandemic preparedness and report to a meeting of finance and health ministers in the coming months, aimed at establishing a global initiative on pandemic preparedness and response.

“COVID-19 is menacing the whole of humanity — and so the whole of humanity must fight back. Individual country responses are not going to be enough.”

— António Guterres, secretary-general, United Nations

Cases in the U.S. surpass those in China and Italy — making it the new epicenter of the pandemic. 

Anguilla reports first cases of COVID-19.

March 25 — The United Nations launches a $2 billion global humanitarian response plan appeal to assist vulnerable countries in fighting the COVID-19 pandemic. Funds would go to laboratory equipment, medical supplies, handwashing stations, public information campaigns, and the creation of air bridges and hubs in Africa, Asia, and Latin America to move humanitarian workers and supplies.

“COVID-19 is menacing the whole of humanity — and so the whole of humanity must fight back. Individual country responses are not going to be enough,” says U.N. Secretary-General António Guterres when announcing the appeal.

During a press conference, Tedros lists six steps countries should take as they are in lockdown mode: expand, train, and deploy health care workforce; create systems to find all suspected case at community levels; increase production and availability of testing; identify and equip facilities needed to treat and isolate patients; develop plans on how to quarantine contacts; and focus the whole government on the suppression and control of the pandemic.

"These measures are the best way to suppress and stop transmission, so that when restrictions are lifted, the virus doesn’t resurge. The last thing any country needs is to open schools and businesses, only to be forced to close them again because of a resurgence," he says.

Saint Kitts and Nevis, Guinea-Bissau, British Virgin Islands, and Mali report first cases of COVID-19.

March 24 — Cases of COVID-19 surpass 400,000. It took over three months to reach the first 100,000 confirmed cases, 12 days to reach 200,000, three days to reach 300,000, and two days to reach 400,000.

India's Prime Minister Narendra Modi announces a lockdown of 21 days for the country's 1.3 billion residents. This is the largest lockdown announced since the beginning of the outbreak.

The Chinese government announces it will lift the lockdown on Wuhan, the city at the center of the outbreak, on April 8.

An Asian Development Bank employee tests positive for COVID-19.

Libya and Laos report first cases of COVID-19.

March 23 — World Bank Group President David Malpass calls on bilateral creditors of the lowest-income countries to provide debt relief so these countries can focus resources on the COVID-19 pandemic, during a G-20 finance ministers conference call. He also calls on countries to implement structural reforms including removing “obstacles” such as “excessive regulations, subsidies, licensing regimes, trade protection or litigiousness.”

African finance ministers call for $100 billion in funding for economic stimulus and a suspension of interest payments on public debt and sovereign bonds.

U.N. Secretary-General António Guterres calls for a global ceasefire to "help create corridors for life-saving aid, open windows for diplomacy and bring hope to places among the most vulnerable to COVID-19."

Norway creates a multidonor fund with the United Nations to assist low- and middle-income countries respond to the COVID-19 crisis.

“Asking people to stay at home and other physical distancing measures are an important way of slowing down the spread of the virus and buying time — but they are defensive measures. To win, we need to attack the virus with aggressive and targeted tactics — testing every suspected case, isolating and caring for every confirmed case, and tracing and quarantining every close contact,” WHO Director-General Tedros Adhanom Ghebreyesu says at a press conference.

Hacking attempts against WHO have doubled, Reuters reports.

Myanmar and Belize report first cases of COVID-19.

March 22 — Global cases of COVID-19 surpass 300,000. It took over three months to reach the first 100,000 confirmed cases, 12 days to reach 200,000 and three days to reach 300,000.

A cargo flight lands in Addis Ababa, Ethiopia, with 5.4 million face masks, 1.08 million COVID-19 diagnostic tests, 40,000 sets of protective clothing, and 60,000 sets of protective face shields for distribution throughout the African continent. The medical supplies were donated by the Jack Ma Foundation and Alibaba Foundation. Ma also announced that his foundation would donate emergency supplies to 17 countries in Asia and Latin America.

WHO says there is "a rise in criminals disguising themselves as WHO to steal money or sensitive information."

Palestinian health officials report the first two cases of COVID-19 in the Gaza Strip.

Uganda, Grenada, Mozambique, Dominica, and Syria report first cases of COVID-19.

March 21 — Ecuador’s health and labor ministers resign after cases in the country surpass 500.

East Timor, Angola, and Eritrea report first cases of COVID-19.

March 20 — The Asian Development Bank is making adjustments to its annual meeting this year. The bank is moving its full annual meeting to Sept. 18-21, in Incheon, South Korea. Meanwhile, its board of governors will meet on May 22 in Manila, Philippines, to consider the bank’s financial statements and net income allocation.

WHO says it’s identified some producers in China that have agreed to supply WHO with personal protective equipment. The agency is now finalizing arrangements and coordinating shipments in order to refill its warehouse in Dubai and make global shipments.

WHO launches a health alert messaging service through WhatsApp and Facebook. People can access this service by sending "hi" to this WhatsApp number: +41 798 931 892.

"One of the things we are learning is that although older people are the hardest hit, younger people are not spared. Data from many countries clearly show that people under 50 make up a significant proportion of patients requiring hospitalization," WHO Director-General Tedros Adhanom Ghebreyesu says at a press conference.

Papua New Guinea, Cape Verde, Zimbabwe, and Madagascar report first cases of COVID-19.

People walk out of a public market wearing protective masks during the national quarantine in response to the spread of COVID-19 in Caracas, Venezuela. Photo by: REUTERS / Manaure Quintero

March 19 — Cases of COVID-19 surpass 200,000 globally. It took over three months to reach the first 100,000 confirmed cases and just 12 days to reach the next 100,000.

We’ve lifted our paywall on all COVID-19 coverage. Looking for more in-depth global development coverage? Please consider supporting our journalism with a Pro subscription.

World Food Programme Executive Director David Beasley tests positive for COVID-19 after returning to the U.S. following a visit to Canada.

The Rockefeller Foundation commits $20 million to the COVID-19 response, with a particular focus in Bellagio, Italy; New York, NY; Washington, DC; Nairobi, Kenya; and Bangkok, Thailand.

"For the younger patients the bigger risk is developing pulmonary fibrosis after surviving the disease," says Dr. Frank Minja, associate professor of radiology and biomedical imaging at Yale University School of Medicine during a conference call hosted by the Africa CDC. "This may be something as radiologists we may be diagnosing for years to come as more and more patients are being exposed to this disease,” Minja says.

For the first time since the outbreak began, Wuhan reports no new cases.

Mauritius, Fiji, Chad, Niger, and Haiti report first cases of COVID-19.

March 18 — Two Washington, D.C.-based employees of the World Bank Group have tested positive for COVID-19, World Bank President David Malpass has said in a memo obtained by Devex. In the memo, Malpass says it is likely that more cases will be diagnosed among the bank’s employees in the coming days and weeks. World Bank Group staff members at the Washington headquarters were advised last week to work from home after an International Monetary Fund employee tested positive for the virus.

The Coalition for Epidemic Preparedness Innovations provides $620,000 to The University of Hong Kong to support preclinical testing of another vaccine candidate against COVID-19. This is the seventh vaccine development project against COVID-19 CEPI has invested in since January.

WHO launches a study to compare untested treatments of COVID-19 against one another called the Solidarity Trial. Countries currently included are Argentina, Bahrain, Canada, France, Iran, Norway, South Africa, Spain, Switzerland, and Thailand.

"Multiple small trials with different methodologies may not give us the clear, strong evidence we need about which treatments help to save lives," WHO Director-General Tedros Adhanom Ghebreyesu says at a press conference.

The African Development Bank announces that staff will work through telecommuting and video conferencing, while visits to buildings will be suspended along with the cancelation of all travel, meetings, and conferences.

Kyrgyzstan, Djibouti, Zambia, El Salvador, and Nicaragua report first cases of COVID-19.

March 17 — Bloomberg Philanthropies announces $40 million for a COVID-19 global response initiative to prevent and slow the spread in low- and middle-income countries. This includes funding rapid response teams, training health care workers, increasing lab capacity, measuring acceptance of social distancing activities through phone surveys, providing communications support for public education campaigns, and providing expertise for health organizations. It will have a “strong focus” on African nations.

WHO confirms two staff members at its Geneva headquarters tested positive with COVID-19.

Cases of COVID-19 surpass 480 in Southeast Asia. WHO calls on countries in the region "to urgently scale-up aggressive measures” to combat its spread.

The International Organization for Migration and The UN Refugee Agency temporarily suspend refugee resettlement departures to reduce the spread of the virus.

The World Bank Group announces an additional $2 billion in funding to help with the COVID-19 pandemic.

Montenegro, Barbados, Gambia, and Montserrat report first cases of COVID-19.

March 16 — For the first time since the beginning of the outbreak, infections and deaths outside China surpass those within China.

The Jack Ma Foundation and the Alibaba Foundation are sending 500,000 testing kits and 1 million masks in donations to the U.S.

"We have also seen a rapid escalation in social distancing measures, like closing schools and cancelling sporting events and other gatherings. But we have not seen an urgent enough escalation in testing, isolation and contact tracing — which is the backbone of the response," WHO Director-General Tedros Adhanom Ghebreyesu says during a press conference.

“This is the defining global health crisis of our time,” he said.

WHO announces its staff is now working through “teleworking arrangements,” except for workers whose position requires them to access the agency’s facilities.

Somalia, Benin, Liberia, and Tanzania report first cases of COVID-19.

March 15 — Cases in Africa are on the rise. A week ago there were 27 cases on the continent.

Now, there are 273 confirmed cases in 26 countries and 6 deaths. Countries respond with travel restrictions.

German government sources tell Reuters that the U.S. is trying to convince German firm CureVac to move research on a potential vaccine to the United States.

The European Commission implements restrictions on export of personal protective equipment supplies, such as masks, face shields, and protective garments, outside the European Union. Any exports of this equipment require authorization by EU member states.

Uzbekistan and the Bahamas report first cases of COVID-19.

March 14 — Namibia, Central African Republic, Republic of Congo, Equatorial Guinea, Rwanda, Seychelles, and Eswatini confirm first cases of COVID-19.

Read: Will the private sector unite to fight COVID-19?

March 13 — “Europe has now become the epicenter of the pandemic, with more reported cases and deaths than the rest of the world combined, apart from China,” WHO Director-General Tedros Adhanom Ghebreyesu says during a press conference. “More cases are now being reported every day than were reported in China at the height of its epidemic.”

Maria Van Kerkhove, technical lead of the WHO Health Emergencies Programme, speaks during a press conference about the need to support countries as they expand the number of people tested for the virus.

Watch the full conference call on how NGOs can help prepare Africa for a coronavirus spread. We’ve removed our paywall for this conference call — previously for Pro subscribers only — to provide access to accurate information and resources during the COVID-19 outbreak.

“If there are countries that are starting to identify cases and starting to identify large numbers of cases because they are looking, because they are doing aggressive case and contact finding, they shouldn’t be punished for that. It’s really important that we support countries in doing the right measures, and sometimes that’s going to mean the numbers are going to increase,” she says.

WHO, the United Nations Foundation, and partners launch the COVID-19 Solidarity Response Fund to support at-risk countries with weak health systems in preparing for and responding to the COVID-19 pandemic.

The European Bank for Reconstruction and Development approves a €1 billion ($1.1 billion) package to help companies in the region with the impact of the COVID-19 pandemic.

The International Monetary Fund and World Bank Group advise employees at their Washington, D.C. headquarters to work from home after an IMF employee is confirmed positive for the virus.

Kazakhstan, Sudan, Puerto Rico, Venezuela, Antigua and Barbuda, Ethiopia, Guinea, Kenya, Uruguay, Guatemala, St. Lucia, Suriname, and Mauritania confirm first cases of COVID-19. 

March 12 — The Pacific confirms its first case of COVID-19. The patient is Maina Sage, a French Polynesian politician who recently returned from Paris.

The Asian Development Bank asks its staff at its Manila headquarters to work from home temporarily after a visitor tested positive for COVID-19. But bank operations continue. ADB announces $200 million will be made available to companies in the supply chain critical in combating the COVID-19 outbreak. The money will be made available through its Supply Chain Finance Program.

A diplomat from the Philippines tests positive for COVID-19, marking the first case at the United Nations headquarters in New York City.

Trinidad and Tobago, Ghana, and Gabon confirm first cases of COVID-19.

March 11  WHO Director-General Tedros Adhanom Ghebreyesus declares the global COVID-19 outbreak a pandemic. “We are deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,” he says, adding that “we have called every day for countries to take urgent and aggressive action.” The decision has been made based on input from experts both internally and externally.

While only eight countries in Africa have reported cases of COVID-19, there is concern that weak surveillance systems are not identifying existing cases, says Ryan, during a press conference. "We believe there may be an element of underdiagnosis in some countries and we are chasing that and trying to activate surveillance on the whole continent," he says.

After the first case of COVID-19 was detected in DRC this week, WHO is redirecting some of its Ebola response capacity toward the potential isolation and treatment of cases, Ryan says. Last week, the last Ebola patient was discharged from a treatment center. Responders say that resources are still needed to ensure there is not a resurgence of the virus.

The U.K. announces up to $192.4 million (£150 million) in aid funding from the nation's budget to "mitigate the impact of coronavirus on the world’s most vulnerable countries."

Turkey, Côte d’Ivoire, Cuba, Guyana, Honduras, Saint Vincent and the Grenadines confirm first cases of COVID-19.

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In places such as Iran, North Korea, and Syria, sanctions are hindering the response to the outbreak, impacting countries’ ability to purchase test kits, medicines, equipment, and other necessary items.

Read: Iran, NKorea, Syria: How sanctions are hindering coronavirus response

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March 10 — The Coalition for Epidemic Preparedness Innovations, or CEPI, is investing a further $4.4 million for vaccine development efforts against COVID-19, bringing the organization’s total investments to $23.7 million. The money will be used to help Novavax and the University of Oxford in their vaccine development work.

The Bill & Melinda Gates Foundation, Wellcome, and Mastercard commit up to $125 million to speed up the response to the COVID-19 epidemic by developing and scaling up treatments, with a focus on making products broadly available and affordable.

UK health minister Nadine Dorries tests positive for COVID-19.

Brunei Darussalam, Democratic Republic of Congo, Bolivia, Jamaica, and Mongolia report first cases of COVID-19.

March 9 — WHO moves closer to declaring the COVID-19 outbreak a pandemic.

“Now that the virus has a foothold in so many countries, the threat of a pandemic has become very real,” Tedros says during a press conference.

WHO experts say they are concerned about how the world will respond to that declaration — potentially causing an abandonment of efforts to control the spread of the virus.

“Will the reaction to the word [pandemic] be: Let’s fight? Let’s push this disease back? Or will the reaction to the word be: Let’s give up,” asks Dr. Michael Ryan, executive director of the WHO Health Emergencies Programme.

Albania, Cyprus, Burkina Faso, and Panama report first cases of COVID-19.

March 8 — Over 100 countries report cases of COVID-19.

Bulgaria and Bangladesh report first cases of COVID-19.

March 7 — The number of COVID-19 cases surpasses 100,000.

Malta, Moldova, Paraguay, and the Maldives report first cases of COVID-19.

March 6 — The U.K. announces a £46 million ($59.9 million) package for the COVID-19 response, funded by the country's international development budget. It includes funding for the development of a vaccine and a rapid diagnostic test. 

WHO says there are more than 200 clinical trials registered that look at different therapeutics to treat COVID-19, as well as traditional Chinese medicine, according to Dr. Maria Van Kerkhove, technical lead of the WHO Health Emergencies Programme.

Slovakia, Bhutan, Peru, Costa Rica, Columbia, Cameroon, and Togo report first cases of COVID-19.

March 5 — The International Monetary Fund chief, Kristalina Georgieva, says emerging market and low-income countries dealing with, or at-risk of, COVID-19 will have access to $50 billion through IMF’s rapid-disbursing emergency financing facilities. Twenty percent of this, or $10 billion, is available at 0% interest for lowest-income countries.

“Under any scenario, global growth in 2020 will drop below last year’s level. How far it will fall, and for how long, is difficult to predict, and would depend on the epidemic, but also on the timeliness and effectiveness of our actions,” Georgieva writes in the IMF blog.

As the global health community tries to fast-track the development of a vaccine, it is looking for answers from lessons learned — or not learned — from past outbreaks.

Australia’s support to the Indo-Pacific region to prepare for a COVID-19 outbreak is being partly paid for from existing official development assistance funding, but its impact on other existing or planned projects is unknown.

U.S. Congress approves an emergency spending package to fund efforts to prevent, prepare for, and respond to COVID-19. About $1.25 billion will be spent internationally.

Bosnia and Herzegovina, Slovenia, South Africa, and Palestine report their first cases of COVID-19.

March 4 — The Global Fund to Fight AIDS, Tuberculosis and Malaria says countries may use savings from their existing grants for COVID-19 response, with a limit of up to 5% of the grant’s total value. Eligible activities under this guidance include epidemic preparedness assessment, laboratory testing, transporting of samples, use of surveillance infrastructure, infection control in health facilities, and information campaigns.

In exceptional cases, countries may also be able to reprogram funding from existing grants for the same purposes. All are subject for approval, but the Global Fund says it will fast-track the process by responding within five working days.

The United Nations Educational, Scientific and Cultural Organization says COVID-19 has disrupted the education of 290.5 million students globally, which is an “unprecedented” figure. This includes school closures in 13 countries.

Poland reports its first case of COVID-19.

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March 3 — The World Bank Group commits $12 billion in immediate support to help countries strengthen health systems and to help cope with economic impacts of the COVID-19 outbreak.

To meet global demand for personal protective equipment, WHO estimates that industry needs to increase manufacturing by 40%. An estimated 89 million medical masks, 76 million examination gloves, and 1.6 million goggles are required each month for the COVID-19 response. 

Ukraine, Argentina, and Chile report their first cases of COVID-19.

March 2 — The United States commits $37 million from the Emergency Reserve Fund for Contagious Infectious Diseases at the U.S. Agency for International Development for countries affected by COVID-19 or at high risk of its spread. These are the first of the funds committed from the pledge of up to $100 million announced on Feb. 7. Countries include Afghanistan, Angola, Bangladesh, Burma, Cambodia, Ethiopia, Indonesia, Iraq, Kazakhstan, Kenya, Kyrgyzstan, Laos, Mongolia, Nepal, Nigeria, Pakistan, South Africa, Tajikistan, Thailand, the Philippines, Turkmenistan, Uzbekistan, Vietnam, Zambia, and Zimbabwe.

A team of WHO experts lands in Iran to support the outbreak response with technical assistance, bringing medical supplies and protective equipment for over 15,000 health care workers and enough laboratory kits to test nearly 100,000 people. A WHO staff member in Iran tests positive for COVID-19.

Over the past 24 hours, there were nearly nine times more new cases reported outside China than within China.

Influenza is different than COVID-19 because there are treatments, vaccines, and there is an understanding of its transmission and patterns, says Dr. Michael Ryan, executive director at the WHO Health Emergencies Programme, during a press conference. "Here we have a disease in which we have no vaccine, no treatment, we don't fully understand transmission, we don't really understand case fatality. What we have been genuinely heartened by is that unlike influenza, where countries have fought back, where they've put in place strong measures, we've remarkably seen that the virus is suppressed.”

Indonesia, Senegal, Portugal, Andora, Latvia, Jordan, Morocco, Saudi Arabia, and Tunisia report their first cases of COVID-19.

March 1 — The United Nations releases $15 million from its Central Emergency Response Fund to WHO and UNICEF to support vulnerable countries in areas including monitoring the spread of COVID-19, investigating cases, and operating national laboratories. 

The number of new cases of COVID-19 in Hubei province, China — the epicenter of the outbreak — increased for two successive days following a period of decline in the number of new cases.

Countries should work to increase the availability of pulse oximeters and medical oxygen systems, according to WHO.

South Korea, with 3,736 cases, and Italy, with 1,128 cases, have the most cases outside of China.

Czech Republic, Iceland, and Armenia report their first cases of COVID-19. The Dominican Republic also reports the first confirmed case of COVID-19 — a 62-year-old Italian man who arrived in the country on Feb. 22. This is the first confirmed case in the Caribbean.

Feb. 29 — WHO updates its guidance on travel restrictions. While it continues to advise against travel or trade restrictions, it notes that in certain circumstances countries can use travel restrictions temporarily, such as in settings with few international connections and limited response capacities. It says that countries can only justify significant travel restrictions at the beginning of an outbreak to give a country time to implement preparedness measures for an outbreak.

"Travel bans to affected areas or denial of entry to passengers coming from affected areas are usually not effective in preventing the importation of cases but may have a significant economic and social impact," according to the guidance.

WHO also says that temperature screening alone at airports and borders is not an effective way to stop international spread because people may be in an incubation period and not showing symptoms or be using antipyretics to reduce fever.

"Such measures require substantial investments for what may bear little benefits. It is more effective to provide prevention recommendation messages to travellers and to collect health declarations at arrival, with travellers’ contact details, to allow for a proper risk assessment and a possible contact tracing of incoming travellers," WHO says.

WHO also recommends that countries intensify surveillance for "unusual outbreaks of influenza-like illness and severe pneumonia and monitor carefully the evolution of COVID-19 outbreaks, reinforcing epidemiological surveillance."

Ecuador, Qatar, Monaco, and Luxembourg report first cases of COVID-19.

Feb. 28 — WHO raises the global risk of spread of COVID-19 from “high” to “very high.”

“This is a reality check for every government on the planet. Wake up. Get ready. This virus may be on its way, and you need to be ready,” says Dr. Michael Ryan, executive director of the WHO Health Emergencies Programme, during a press conference.

In recent days, 24 new cases originating from Italy have been reported in 14 countries, and 97 cases originating in Iran have been reported in 11 countries.

More than 20 vaccines are in development globally, and several therapeutics are in clinical trials, with results from those trials expected in a few weeks, WHO Director-General Tedros Adhanom Ghebreyesus says during a press conference.

A WHO delegation for assisting with the outbreak in Iran has experienced delays because of “severe issues with getting flights and access to Iran right now,” Ryan says. The team is expected to arrive by March 1 at the earliest.

WHO officials say it is not yet time to declare a pandemic, adding that once one is declared, efforts will move away from containment to mitigation.

“To declare a pandemic — it’s unhelpful to do that when you are still trying to contain a disease,” Ryan says. “China has clearly shown that this is not necessarily the natural outcome of this event if we take action, if we move quickly, if we do the things we need to do.”

According to Tedros, of the 46 countries that have reported cases, eight have not reported new cases over the past two weeks, 23 have reported only one case each, and a “good number” of those 23 countries have reported fewer than 10 cases.

“What containment is also doing is slowing down the virus. We’ve already seen in countries and quite sophisticated countries — who’ve had a rapid rise in cases in the last week — are having trouble coping with the clinical caseloads. And we need to keep this virus slowed down. Health systems around the world — and I mean North and South — are just not ready,” Ryan says.

Research has shown that some people have recovered from COVID-19, tested negative for the virus, and then tested positive again. Further study is needed on whether there is a viable virus present in these individuals and whether these people are actually shedding live virus, says Kerkhove, during a press conference.

There are 36,117 people in China that have recovered from the disease, according to WHO.

Thirty-eight countries reported to WHO they’ve instituted travel restrictions, including travel bans of visitors from China or other countries reporting transmission of COVID-19, quarantine of foreigners, self-isolation of returning citizens and visa restrictions. There have been no trade restrictions.

Nigeria, New Zealand, Belarus, Mexico, Lithuania, Azerbaijan, Ireland, and Iceland report their first COVID-19 cases.

Feb. 27 — The number of infections globally continues to grow. There are 3,474 cases of COVID-19 — including 54 deaths — outside of China in 44 countries.

Denmark, Estonia, San Marino, and the Netherlands report first cases of the virus.

“We are at a decisive point,” says Tedros during a press conference. “My message to each of these countries is: This is your window of opportunity. If you act aggressively now, you can contain this virus. You can prevent people getting sick. You can save lives. So my advice to these countries is to move swiftly.”

Belgium, Cambodia, India, Nepal, Philippines, Russia, Sri Lanka, and Vietnam have not reported new cases in more than two weeks, according to Tedros.

One of Iran’s vice presidents, Masoumeh Ebtekar, is infected with COVID-19. She’s one of several Iranian officials who has tested positive for the virus. Others include members of parliament Mojtaba Zolnour and Mahmoud Sadeghi; Morteza Rahmanzadeh, mayor of Tehran; and Iraj Harirchi, Iran’s deputy health minister.

Feb. 26 — Brazil confirms its first case of COVID-19, marking the first case in South America. Cases of the virus have now been confirmed on every continent except Antarctica.

Greece, Georgia, North Macedonia, Norway, Romania and Pakistan report their first cases of COVID-19.

For the first time since the outbreak began, there are more new cases reported outside China, 459, than in China, 412.

The Asian Development Bank approves another $2 million to help countries in Asia and the Pacific prepare for, respond to, and boost their resilience against COVID-19 and other communicable diseases.

The European Commission requests member states to review pandemic preparedness plans, and inform the commission of how they plan to implement them. The commission also announces an initiative to launch a joint procurement procedure to support its member states in accessing personal protective equipment as COVID-19 cases rise in the region, Stella Kyriakides, European commissioner for health and food safety, says during a press conference in Italy.

Read: Conferences canceled: Coronavirus' impact on development efforts

Feb. 25 — Algeria reports its first case of COVID-19 — an Italian adult, who arrived in the country on Feb. 17. This is the second confirmed case on the African continent.

Switzerland, Croatia, and Austria report their first cases.

Iran’s deputy health minister, Iraj Harirchi, who is leading the nation's COVID-19 task force, has contracted the virus.

The U.S. Centers for Disease Control and Prevention warns about the likely spread of COVID-19 in the United States, urging the population to “prepare for the expectation that this might be bad.” Dr. Nancy Messonnier, director at the National Center for Immunization and Respiratory Diseases, cautioned during a press briefing: “It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen.”

Feb. 24 — "We must focus on containment, while doing everything we can to prepare for a potential pandemic," says WHO Director-General Tedros Adhanom Ghebreyesus during a press conference.

The Asian Development Bank advises delegates planning to attend its annual meeting that it is monitoring the situation in South Korea, where the number of confirmed COVID-19 cases is now over 700, according to the latest situation report by WHO. The bank’s 53rd annual meeting is scheduled to take place from May 2-5 in Incheon, South Korea.

The European Commission announces a new aid package of €232 million ($252 million) for global preparedness and response to COVID-19. The bulk of the money is for WHO’s work and for a public-private partnership supporting the pharmaceutical industry’s search for a vaccine against the disease. A small percentage — €3 million — is for the repatriation of EU citizens from Wuhan, China.

Cases in China are falling, according to Dr. Bruce Aylward, who led the external experts on a mission in China for the past two weeks — from an average of 2,500 cases two weeks ago to 400 cases today. But he warned against complacency.

Aylward says the world needs to prioritize studies that can stop the outbreak faster and can reduce morbidity and mortality. He said at the moment, only one drug, remdesivir, seems to be showing real efficacy against the disease.

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In addition, countries that serve as a second line of defense for low-income countries, should think about what measures they can take to ensure the virus doesn’t reach those with less capacity to handle an outbreak, Aylward said.

The host of COVID-19 remains unclear, says Liang Wannian, leader of the National Health Commission Expert Team for the epidemic response in China. But according to currently available data, bats may be the host and pangolins intermediate hosts of the virus. Some evidence also points to virus transmission through oral-fecal route and aerosol transmission, but this needs further confirmation. It’s also still unclear whether asymptomatic carriers of the virus can spread the disease.

The case fatality rate in China is between 3% and 4%, but less than 1% in cities and provinces outside Wuhan.

US biotech firm Moderna sends an experimental COVID-19 vaccine to the U.S. National Institute of Allergy and Infectious Diseases for a planned phase one study in the U.S.

Kuwait, Bahrain, Afghanistan, Iraq, and Oman report first cases of COVID-19.

Feb. 23 — South Korean President Moon Jae-in announces the highest level of alert after the country surpasses 340 cases of COVID-19, the majority of which were discovered in the past few days. This empowers the government to take measures such as restricting public transportation and banning visitors from certain countries.

Cases of COVID-19 in Italy continue to rise in what has become the largest outbreak outside of Asia.

Neighboring countries close their borders with Iran, fearing a spread of the outbreak.

Feb. 22 — WHO conducts a survey of African countries to assess their overall readiness for COVID-19 and finds the regional readiness level is at about 66%. "We need urgently to prioritize strengthening the capacities for countries to investigate alerts, treat patients in isolation facilities and improve infection, prevention and control in health facilities and in communities," says Dr. Matshidiso Moeti, WHO regional director for Africa, in a press release.

The African Union Commission hosts an emergency meeting on the COVID-19 outbreak with health ministers from across the continent.

Feb. 21 — WHO says it is concerned about the rapid spread of COVID-19 in Iran, which has 18 cases and has seen four deaths in the past two days. The country reported its first cases on Feb. 19.

WHO appoints six special envoys on COVID-19 to "provide strategic advice and high-level political advocacy and engagement in different parts of the world."

Lebanon confirms its first case of COVID-19: A woman who arrived from Iran and is now quarantined at a hospital in Beirut.

Israel confirms its first case of COVID-19: A person who had been quarantined on the Diamond Princess cruise ship off Japan’s coast.

“We are concerned about the number of cases with no clear epidemiological link, such as travel history to China or contact with a confirmed case,” says WHO Director-General Tedros Adhanom Ghebreyesus during a press conference. He says that the window of opportunity to contain the outbreak is “narrowing.”

While the number of cases in China’s Hubei province — the epicenter of the outbreak — continues to decline, WHO says it is concerned about an increase in the number of cases in Shandong province.

Over 500 new cases of COVID-19 are traced to four prisons in China.

Feb. 20 — Peng Yinhua, a 29-year-old respiratory doctor in Wuhan, dies from COVID-19.

Iran reports five cases of COVID-19 in two days, two of which have resulted in death. These are the first deaths from COVID-19 in the Middle East.

South Korea sees a spike in cases, bringing its count to 104. The country now has the second-highest number of cases outside of mainland China. The new cases are concentrated in the city of Daegu and the surrounding North Gyeongsang province.

Outside of China, there are 1,076 cases in 26 countries, with seven deaths.

China has again changed the way that it classifies confirmed cases, removing the category of "clinically diagnosed,” which includes the use of chest exams. "Some previously reported ‘clinically diagnosed’ cases are thus expected to be discarded over the coming days as laboratory testing is conducted and some are found to be COVID-19-negative," according to WHO.

"This virus is very dangerous, and it’s public enemy No. 1. But it’s not being treated as such, and one important indicator is the response, especially to financing the response," says WHO Director-General Tedros Adhanom Ghebreyesus during a press conference.

Feb. 19 — The death toll from COVID-19 surpasses 2,000.

The Joint United Nations Programme on HIV/AIDS reports that, in a survey, nearly one-third of respondents living with HIV in China say they are at risk of running out of their HIV treatment in the coming days due to lockdowns and restrictions on movement amid the COVID-19 outbreak.

China revokes the press credentials of three Wall Street Journal reporters. The government’s Foreign Ministry says the move was retribution for a recent opinion piece published by the media outlet.

Iran reports first COVID-19 cases.

Feb. 18 — There are currently 92 documented cases in 12 countries other than China in which human-to-human transmission of the virus has occurred.

Liu Zhiming, director of the Wuchang Hospital in Wuhan, dies from COVID-19.

Countries work to evacuate their citizens from the Diamond Princess cruise ship, which is quarantined in Japan, as the number of COVID-19 cases on the ship surpasses 450. “Clearly there has been more transmission than expected on the ship, and I think the authorities in Japan are adjusting to that reality now and taking the necessary public health measures with other countries to evacuate people and deal with their follow up in a different way,” says Ryan, during a press conference.

Feb. 17 — China publishes a paper with detailed information on more than 44,000 confirmed cases of COVID-19. The data appears to show that COVID-19 is not as deadly as other types of coronaviruses, including severe acute respiratory syndrome and Middle East respiratory syndrome. The data shows that more than 80% of patients have mild disease; about 14% of cases lead to severe diseases, including pneumonia; about 5% of cases lead to critical diseases including respiratory failure, septic shock and multiorgan failure; and about 2% of reported cases lead to death. Mortality rates increase in older patients, with few cases among children.

"This new data addresses some of the gaps in our understanding, but others remain," WHO Director-General Tedros Adhanom Ghebreyesus said during a press conference.

WHO switches methods for reporting confirmed COVID-19 cases, now aligning with how the Chinese government has reported cases since Feb. 13. WHO previously reported only laboratory-confirmed cases but now includes cases that are clinically confirmed via chest imaging.

Feb. 16 — An American woman who had been on a cruise ship that docked in Cambodia, tests positive for COVID-19 after flying to Malaysia. The ship originally set sail from Hong Kong on Feb.1, with 1,455 passengers and 802 members of its crew.

Taiwan reports its first death from COVID-19, marking the fifth death from the virus outside of mainland China.

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Feb. 15 — France reports the first death from COVID-19 outside of Asia — an 80-year-old tourist from Hubei province.

In a speech at the Munich Security Conference, WHO Director-General Tedros Adhanom Ghebreyesus called for an increase in funding to the response. “We’re concerned by the lack of urgency in funding the response from the international community,” he said.

Feb. 14 — China reports that 1,716 health workers have contracted COVID-19 and that six of them have died. "We've seen this before with MERS, we've seen this before with SARS, we've certainly seen this with hemorrhagic fevers," says Dr. Michael Ryan, executive director of WHO Health Emergencies Programme, during a press conference. "Our understanding is that the cases amongst health workers peaked in the third and fourth week of January and that there has been a rapid fall-off in the number of cases that have occurred in health workers in the last two weeks."

Overall, the percentage of health workers infected with COVID-19 is lower than what has occurred historically in outbreaks of other kinds of coronaviruses, he says.

Egypt reports its first case of COVID-19. This is the first case confirmed on the African continent and the first new country to see a case since Feb. 4.

Feb. 13 — Overnight, China reports a spike in cases, with 14,840 cases in Hubei province. This is due to the fact that the Chinese government changed its reporting to include both laboratory-confirmed cases and clinically diagnosed cases. This includes a medical professional classifying a confirmed case on the basis of chest imaging. "We understand that most of these cases relate to a period going back over days and weeks and are retrospectively reported as cases, since some time back to the beginning of the outbreak itself," says Dr. Michael Ryan, executive director of WHO Health Emergencies Programme, during a press conference.

WHO is still only reporting laboratory-confirmed cases. The rest of the world is also only reporting laboratory-confirmed cases.

The third death from the virus outside of mainland China is confirmed in Japan. The previous deaths took place in Hong Kong and the Philippines.

There could be information in a matter of weeks about the impact of drugs currently in trial to treat the virus, according to WHO.

A successful vaccine will require huge investments, according to WHO. "Making a decision to advance a vaccine to phase one, phase two, phase three trials, requires hundreds of millions of dollars to be invested. We may have to invest in multiple candidates, without any certainty that one of them will work," WHO’s Ryan says.

WHO says 17 countries in Africa now have the capacity to test for COVID-19. This is a clarification from Feb. 7, when WHO had said 28 countries in Africa have the capacity.

Feb. 12 — The number of countries outside China reporting cases has not changed since Feb. 4.

A total of 175 people test positive for COVID-19 on the Diamond Princess cruise ship, which is quarantined in Japan.

Cambodia agrees to accept a cruise ship that had been turned away from five ports, over fears that passengers might have COVID-19.

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A global research and innovation forum on COVID-19 concludes. Top research priorities identified include finding simpler diagnostic tools, best approaches for infection prevention, optimal treatment for patients, and acceleration of the development of vaccines and therapeutics.

Feb. 11 — WHO assigns the novel coronavirus its official name: COVID-19.

A United Nations Crisis Management Team is activated, led by Dr. Michael Ryan, executive director at WHO’s Health Emergencies Programme.

A global research and innovation forum starts in Geneva, aimed at creating a roadmap for identifying research priorities on COVID-19.

WHO Director-General Tedros Adhanom Ghebreyesus calls the outbreak a “very grave threat for the rest of the world.”

WHO says a vaccine could be available in an estimated 18 months.

Death toll from the outbreak reaches over 1,000.

Feb. 10 — An advance team for the WHO-led 2019-nCoV international mission leaves for China.

WHO chief Tedros says instances of onward transmission from people with no travel history to China are concerning, and that “the detection of this small number of cases could be the spark that becomes a bigger fire." 

WHO and the Foundation for Innovative New Diagnostics announce that a memorandum of understanding was signed focused on strengthening diagnostic systems in resource-limited countries, saying that the ongoing 2019-nCoV outbreak has highlighted the need to close these gaps.

The U.K.'s health department declares 2019-nCoV an “imminent threat” to public health, allowing the government to forcibly quarantine individuals.

168 labs around the world now have the capacity to diagnose the virus.

The death count — at 909 — surpasses that associated with Middle East respiratory syndrome, which has claimed the lives of 858 people.

Feb. 9 — The death toll of victims of the 2019-nCoV is now over 800, surpassing the death toll of the SARS epidemic in 2002 and 2003, which killed 773 people.

Feb. 8 — At a press conference, WHO Director-General Tedros Adhanom Ghebreyesus criticizes the levels of misinformation spreading around the virus, saying "we’re not just battling the virus; we’re also battling the trolls and conspiracy theorists that push misinformation and undermine the outbreak response." He says WHO is engaging with Facebook, Google, Tencent, Baidu, Twitter, TikTok, Weibo, Pinterest, and others to promote accurate information about 2019-nCoV. 

Five British citizens test positive for the virus at a ski resort in eastern France.

Feb. 7 — The Asian Development Bank approves $2 million to support response capacity efforts against the 2019-nCoV outbreak in the Asia-Pacific region. The fund will supplement the bank’s technical assistance work in several Southeast Asian countries as well as China. The bank is working with WHO to identify areas for further possible financial assistance.

Confirmed cases in Japan jump to 86, as the number of infected rises to 61 inside a cruise ship docked in Yokohama. Patients include non-Japanese citizens.

Meanwhile, a local doctor in Wuhan, Li Wenliang, who tried to raise the alarm on the 2019-nCoV in December, dies. His death causes further angry sentiments in China, where he has been hailed a hero, with some calling for “freedom of speech” in the country where communication is tightly controlled by the government.

South Korea news daily JoongAng Ilbo reports of confirmed 2019-nCoV in North Korea, but this has yet to be confirmed by WHO. WHO representative to North Korea Edwin Ceniza Salvador tells Devex the U.N. agency has not received any report of coronavirus cases from North Korea’s public health ministry.

WHO announces that 28 countries in Africa now have the capacity to diagnose coronavirus — up from an initial two. By the end of the weekend, all other African nations should have the capacity to do so as well, according to the agency. This was later revised on Feb. 13 to 17 countries.

WHO tells reporters on a press call that there is a “severe global disruption” in the market for personal protective equipment, impacting access for front-line health workers. Demand is up to 100 times higher than normal and prices are 20 times higher, resulting in “depleted stockpiles and backlogs of four to six months.”

The United States pledges $100 million to the 2019-nCoV response.

Feb. 6 — Japan announces a $10 million contribution for WHO’s 2019-nCoV outbreak response fund to support countries with weak health systems as they prepare for the potential spread of the virus.

WHO unveils plans to host a global research and innovation forum from Feb. 11-12 in Geneva to bring together leading scientists, public health agencies, ministries of health, and research funders. The forum is aimed at setting the research agenda for 2019-nCoV.

Total cases in China now at 31,161, and 636 deaths. Outside mainland China, cases at 310, with 2 deaths.

Feb. 5 — Ten passengers from a cruise ship currently docked in Yokohama, Japan, test positive for 2019-nCoV, bringing the total cases in Japan to 35, now the highest among countries with confirmed cases outside mainland China. Global cases total over 28,000, with 565 deaths, and a majority of cases in China. China state media Xinhua also reports a newborn has been infected with the virus, but the route of transmission is still unknown.

Meanwhile in China, the central government has started penalizing officials found to be neglectful in performing their duties in relation to infection prevention and control of the outbreak, amid increasing anecdotal reports of government officials’ slow response to the early days of the outbreak.

The Bill & Melinda Gates Foundation announces $100 million in funding in support of 2019-nCoV response and preparedness efforts. WHO estimates resources required from February to April 2020 to amount to $675 million, as per its newly launched Strategic Preparedness and Response Plan.

Feb. 4 — Hong Kong reports its first death of a patient with 2019-nCoV. The 39-year-old man had travel history from Wuhan, the outbreak’s epicenter. This is the second death linked to the 2019-nCoV reported outside mainland China, after the Philippines. The total number of deaths from 2019-nCoV stands at 492, and confirmed cases globally over 24,000.

Belgium reports its first case of 2019-nCoV. The patient was one of the nine people repatriated from Wuhan over the weekend.

Feb. 3 — China launches a clinical trial of Gilead’s antiviral drug remdesivir, previously tested in patients with Ebola, against the 2019-nCoV, just as China’s Huoshenshan Hospital in Wuhan starts operations. The hospital was built in 10 days and is dedicated to treating 2019-nCoV patients.

In Hong Kong, hospital workers go on strike to demand that the government impose total border closure with mainland China, where cases total 20,438, bringing total confirmed cases globally to 20,625, and 426 deaths. Chinese officials call on the U.S. not to overreact and cause panic over 2019-nCoV.

The World Bank releases a statement saying it is reviewing financial and technical resources that can be mobilized to support countries affected by the 2019-nCoV outbreak. WHO meanwhile launches its own dashboard of 2019-nCoV confirmed cases in China and globally.

Feb. 2 — The first 2019-nCoV death outside China is reported in the Philippines. The patient was a 44-year-old Chinese male, and known companion of the 38-year-old woman who tested positive for 2019-nCoV on Jan. 30 and the first case in the Philippines. It also imposes travel ban for travelers coming from China, Hong Kong, and Macao, and a 14-day quarantine period for Philippine residents.

Overseas donations flood into China, while citizens scrutinize organizations receiving donations for the response. The local Red Cross in Hubei province faces criticisms over the slow delivery of donated medical supplies, as cases in Hubei, the epicenter, reach over 11,000. Confirmed cases now at 17,205, bringing total global cases to 17,386, with 362 deaths.

Feb. 1 — In China, confirmed cases now total 14,380 and the death toll rises above 300.

Jan. 31 — More countries are applying border control measures against foreign nationals with recent travel history from China, just as confirmed cases in China reach 11,791, with 259 deaths. The U.S. declares the 2019-nCoV outbreak a public health emergency domestically. The U.K., Russia, Sweden, and Spain also confirm their first 2019-nCoV cases.

Jan. 30 — WHO Director-General Tedros Adhanom Ghebreyesus declares the 2019-nCoV outbreak a public health emergency of international concern, noting the potential spread of the virus to countries with weak health systems. The decision comes as more countries outside China report cases of infection, including the Philippines and India. Both confirm their first 2019-nCoV cases. Total confirmed cases in China reach 9,692, with 213 deaths. WHO recommends “2019-nCoV acute respiratory disease” as interim name for the disease.

Jan. 29 — Tedros decides to reconvene the International Health Regulations Emergency Committee on Thursday for advice on whether to declare the 2019-nCoV outbreak a public health emergency of international concern. The announcement comes just a week after Tedros initially refrained from declaring the outbreak an emergency. As 2019-nCoV cases grow in number and spread to more countries, the virus reaches the Middle East for the first time, with the United Arab Emirates reporting imported cases in a family of four. Finland also reports its first confirmed case.

Meanwhile, several countries prepare to repatriate people from Wuhan, and multiple airlines suspend or restrict flights to and from Chinese cities, just as confirmed cases in China continue to rise, now at 7,711. Globally, total confirmed cases are now at 7,816, with 170 deaths.

There are, however, some positive developments, as Australian scientists announce they have successfully grown 2019-nCoV in the laboratory, which can be helpful in improving diagnosis of the virus. Through his foundation, Alibaba Founder Jack Ma also donates 100 million Chinese yuan ($14.4 million) to help fund the development of a vaccine for the 2019-nCoV.

Jan. 28 — WHO’s Tedros meets with Chinese President Xi Jinping in Beijing to discuss the latest developments in the 2019-nCoV outbreak. China agrees for WHO to send in international experts to help increase global understanding of the outbreak and guide response efforts.

Africa prepares for the potential spread of 2019-nCoV as the number of confirmed cases in China rises to 5,974 with 132 deaths. Confirmed cases globally now total over 6,000.

Jan. 27 — WHO chief Tedros travels to Beijing to meet with government and health experts on 2019-nCoV outbreak response. Hong Kong denies entry to visitors with travel history from Hubei Province, China, in the past 14 days. Authorities in Hubei suspend passport application and the provision of exit and entry permits in efforts to contain the spread of the virus.

The Bill & Melinda Gates Foundation commits $10 million for the 2019-nCoV outbreak response in China, and screening and outbreak preparedness in Africa.

Cambodia, Germany and Sri Lanka each confirm their first 2019-nCoV cases.

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In its latest update, China’s National Health Commission reports 1,771 new confirmed cases, more than double the cases on Jan. 26. This brings total confirmed cases in China to 4,515, with 976 severe cases and 106 deaths, and 4,580 total cases globally.

Jan. 26 — China reports 769 new confirmed cases of 2019-nCoV, significantly raising the total number of cases globally to 2,801. This includes 461 severe cases and 80 deaths.

China’s National Health Commission starts recommending use of HIV drugs as treatment against 2019-nCoV, as scientists globally start efforts to look for effective treatment and preventive therapy. The Chinese Center for Disease Control and Prevention also starts developing a vaccine against 2019-nCoV.

In a circular, China’s Ministry of Civil Affairs tells charities and volunteer organizations not to send staff and volunteers to Hubei province amid the ongoing novel coronavirus epidemic.

Jan. 25 — The 2019-nCoV reaches more countries. Australia confirms the first case of 2019-nCoV in the continent, with health authorities announcing three more cases later in the day. France confirms three cases, the first in Europe. Malaysia also reports the first four cases, Canada reports its first case.

Several infected countries also confirm new cases, such as Thailand and Japan. In China meanwhile, Chinese government reports 688 new cases, bringing the total to 1,975. Cases with severe conditions rise to 324, and deaths to 56 in total.

Hong Kong meanwhile raises response to 2019-nCoV to the highest level, suspending all flights to and from Wuhan.

Jan. 24 — Japan and U.S. each confirm second 2019-nCoV cases, while Nepal confirms the first case of 2019-nCoV in the country. Total confirmed cases in China rise to 830, with 177 in severe condition and 25 deaths.

Later in the day, China’s National Health Commission reports 444 new confirmed cases and 16 new deaths in China, bringing total confirmed cases in the country to 1,287. This includes 237 cases in severe condition and a total of 41 deaths.

Jan. 23 — WHO’s director-general decides to not declare the 2019-nCoV outbreak a public health emergency of international concern yet, as per recommendations by the emergency committee.

The city of Wuhan shuts down public transportation, closing the airport and railway stations as of Thursday morning, in efforts to curb the spread of the 2019-nCoV. The suspension is in effect “until further notice.” Later in the day, another city is on lockdown: Ezhou. Beijing cancels plans for Chinese new year festivities and closes the Forbidden City. Another city, Huanggang, announces it will go into lockdown Friday. Singapore also confirms its first imported case, while Vietnam confirms two cases.

Jan. 22 — The emergency committee defers its decision on whether to advise WHO Director-General Tedros Adhanom Ghebreyesus to declare 2019-nCoV outbreak a public health emergency of international concern. The meeting takes place amid a significant rise in confirmed cases of individuals infected with 2019-nCoV, at 580, according to China’s National Health Commission. The death toll has now risen to 17, with all cases reported from Hubei province.

Jan. 21 — WHO confirms human-to-human transmission of the virus. The total number of cases is now 222, including infections among health-care workers. Chinese authorities have also reported a fourth death. WHO Director-General Tedros Adhanom Ghebreyesus has convened an emergency committee on Jan. 22 to decide whether this constitutes a public health emergency of international concern.

Jan. 20 — South Korea confirms its first case of 2019-nCoV. The patient did not report visiting markets in Wuhan.

Jan. 18-19 — Chinese authorities report a spike in 2019-nCoV cases, including first confirmed cases in Shenzhen (1 case) and Beijing (2 cases), bringing the total to 204 confirmed cases. They also report a third death linked to the new coronavirus.

Jan. 17 — Thailand confirms the second imported case of 2019-nCoV in the country, bringing the total exported cases from China to three.

Jan. 16 — Japan reports another imported case of 2019-nCoV. The Chinese national, a man in his 30s, also did not report visiting the Huanan seafood market.

Jan. 15 — China reports second death linked to 2019-nCoV. The patient was a 69-year-old male with severe myocarditis, abnormal renal function, and severe damage to multiple organ functions.

Jan. 13 — Thailand reports first imported case of 2019-nCoV. The patient, a 61-year-old woman from Wuhan, did not report visiting the Huanan seafood market.

Jan. 12 — China shares the genetic sequence of the novel coronavirus, helping countries in testing and tracing any potentially infected people.

Jan. 9 — China reports first death linked to the new coronavirus, 2019-nCoV. A 61-year-old male admitted to hospital in Wuhan with several underlying medical conditions. Apart from respiratory failure and severe pneumonia, the patient also suffered from abdominal tumors and chronic liver disease.

Jan. 7 — China identifies new coronavirus as cause of the outbreak. Coronaviruses are a large family of viruses that can cause varying levels of disease, from common colds to severe fatal diseases. Usually found in animals, some can infect humans and transmit between humans. Both SARS and MERS are caused by a coronavirus.

Jan. 3 — China reports a total of 44 suspected patients with the mystery disease.

Jan. 1 — Officials close the Huanan seafood market, suspected to be the source of the mystery disease, as some of the patients presenting with the pneumonia-like illness were dealers or vendors at the market.

Dec. 31, 2019 — Chinese authorities inform WHO’s China office of pneumonia cases in Wuhan City, Hubei province, China, with unknown cause.

This article was last updated on 30 October 2020

About the authors

  • Jenny Lei Ravelo

    Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
  • Sara Jerving

    Sara Jerving is Devex's East Africa Correspondent based in Nairobi. She is a reporter and producer, whose work has appeared in The Wall Street Journal, the Los Angeles Times, Vice News, Bloomberg Businessweek, The Nation magazine, among others. Sara holds a master's degree in business and economic reporting from Columbia University Graduate School of Journalism where she was a Lorana Sullivan fellow.