Coronavirus World Map: 2,471,136 Confirmed Cases; 207 Countries; 169,006 Deaths

WHO Novel Coronavirus (COVID-19) Situation Report 93

• WHO is deeply saddened at the death of a member of personnel during a security incident in Rakhine district of Myanmar, who was transporting COVID-19 surveillance samples in support of the Ministry of Health and Sports. WHO condemns targeting of health workers involved in the COVID-19 response.
• As of April 22, Japan changed the method of reporting deaths, which now includes both the number of (i) deceased cases with complete data matching and verification; and (ii) deceased cases whose data matching and verification are in progress. The notable increase in the number of deaths reported from Japan can be attributed to this change.
• A WHO mission to Belarus has recommended the introduction of community-wide steps to increase physical distancing.
• OpenWHO has launched a new online course on Standard precautions: Hand hygiene. The module has been prepared to help summarize the WHO guidelines on hand hygiene, associated tools and ideas for effective implementation. To date, there has been more than 1.5 million enrollments in the platform’s courses to support the COVID-19 response.
• The WHO Information Network for Epidemics (EPI-WIN) was launched at the beginning of the COVID-19 outbreak, specifically for infodemic management. For updates and more information, see the ‘Subject in Focus’ below.
• WHO issued guidance on Safe Ramadan practices in the context of COVID-19, which is available in Arabic, English, French, Russian and Spanish. For details, see the ‘Subject in Focus’ below.

Risk Assessment

Global Level: Very High

Coronavirus Situation in Numbers

Globally

• 2,471,136 confirmed cases (73,920 new)
• 169,006 deaths (6,058 new)

European Region

• 1,219,486 confirmed cases (32,302 new)
• 109,952 deaths (3,618 new)

Regions of the Americas

• 925,291 confirmed cases (32,172 new)
• 44,775 deaths (2,089 new)

Western Pacific Region

• 139,349 confirmed cases (4,879 new)
• 6,326 deaths (141 new)

Eastern Mediterranean Region

• 136,271 confirmed cases (1,765 new)
• 5,793 deaths (108 new)

South-East Asia

• 33,912 confirmed cases (2,242 new)
• 1,427 deaths (86 new)

African Region

• 16,115 confirmed cases (560 new)
• 720 deaths (16 new)

SUBJECT IN FOCUS:Infodemic management: the right information at the right time

The ongoing COVID-19 pandemic response requires rapid action from multiple sectors of society and government. Individuals need to adopt new behaviors; societies need to implement new public health measures; businesses need to develop new services to operate differently; faith leaders need to change practices to protect their communities; and the sports and entertainment sectors need to make difficult decisions to protect the public’s health. For this to happen, people need answers to their questions and advice designed for their needs and contexts. The WHO Information Network for Epidemics (EPI-WIN) was launched at the beginning of the COVID-19 outbreak, specifically to meet these information demands and those of future pandemics and emergencies.

Since January 2020, EPI-WIN has been engaging with some of the most vital sectors involved in the COVID-19 response through amplification webinars. The partnerships with the healthcare, business, faith, travel and tourism, food and agriculture and high-visibility events (sports and entertainment) sectors have helped EPI-WIN broaden the global reach of WHO’s life-saving risk communication messages significantly.

The Network has reached more than 160 health organizations or professional associations that bring together millions of frontline healthcare workers–the backbone of a country’s defenses to save lives and limit the spread of disease. It also provided illustrated guidance to caretakers at home who play a vital role when health systems become overstretched.

In addition to engaging the health community, EPI-WIN has connected with the world’s employers and employees. With over 3 billion people in paid employment globally, the business sector serves as a major amplifier of information. EPI-WIN has directly connected with more than 400 businesses in food, agriculture, travel and tourism.

Approximately 84% of the world’s population identifies with a religious group and sadly many outbreaks of COVID-19 have been linked to faith gatherings. Faith-based organizations can and need to mobilize and inform millions of people through their churches, mosques, synagogues and temples. EPI-WIN has worked directly with more than 60 faith organizations to recommend critically important health behaviors for faith settings.

TheNetworkalsocombatsmisinformationbyprovidingtransparent, evidence-based guidance as events unfold. The COVID-19 pandemic continues to evolve rapidly, making the need for updated, accurate and trusted information even more critical. EPI-WIN meets this information need, through behavior change and myth-busting messages. EPI-WIN’s science-based information has supported WHO’s website and social media channels. The EPI-WIN messaging is used on WHO’s COVID-19 website which has received 147 million page views since 22 January 2020. This information also fed the Google coronavirus page which received hundreds of millions of visitors every day, as well as a record of over 14.5 million users on WhatsApp and Viber.

EPI-WIN will continue to adapt and grow to meet the information needs of specific audiences as COVID-19 continues and as the world faces other future public health threats.

SUBJECT IN FOCUS: Safe Ramadan practices in the context of the COVID-19

Ramadan is the ninth month of the Islamic calendar and is observed by Muslims worldwide as a month of fasting from sunrise to sunset, prayer and reflection. It is marked by numerous religious and social gatherings, as families and friends unite to break their fast together, after sunset during iftar or before dawn during suhour.

As this year Ramadan is expected to start on April 23 and end on May 23, thus falling during the ongoing pandemic of COVID-19, WHO has issued dedicated guidance on Safe Ramadan practices in the context of COVID-19. The purpose is to provide advice on gatherings occurring during the month of Ramadan, or immediately preceding and following it. Guidance was released on April 15 and is available in Arabic, English, French, Russian and Spanish. The document is addressed to national health authorities with the aim of facilitating their role in establishing policies for events. Early involvement of religious leaders in the decision-making process is also recommended, so that they may disseminate information to the faithful community. In general, a strong communication strategy should ensure that decisions taken are explained to all those concerned in a timely and consistent manner.

As a first step, WHO recommends that decisions to restrict, modify, postpone, cancel or proceed with holding a mass gathering during Ramadan should be based on a rigorous and standardized assessment of the risks associated with such events in terms of contributing to the spread of COVID-19. Detailed guidance on risk-assessment protocols is included in Practical considerations and recommendations for Religious Leaders and Faith-based Communities in the context of COVID-19, with a risk-assessment tool and decision tree. Canceling in-person events and holding them virtually, using platforms such as television, radio, digital and social media is therefore an option to be considered, especially if risk of transmission is significant.

The decision-making process can be facilitated by some overarching considerations related to physical distancing: for example, a distance of at least one meter (three feet) between people should be strictly maintained at all times during the event. People who are feeling unwell or have any symptoms of COVID-19 –as they may transmit the infection, and older people and anyone with pre-existing medical conditions should be discouraged from attending, as they have higher likelihood of developing severe illness.

If it is decided that physical gatherings shall go ahead, WHO recommends that mitigation measures be applied to further decrease risk of COVID-19 transmission during the planned event. Mitigation measures include: improving the venue’s facilities and arrangements (e.g. holding the event outdoors rather than indoors, or ensuring adequate ventilation), encouraging healthy practices by attendees (e.g. handwashing or taking safety steps in mosques, such as using personal prayer rugs), and ensuring that premises and often-touched objects are thoroughly and regularly cleaned.

The document also provides recommendations tailored to many social activities typical of Ramadan, such as the practice of charity (sadaqat or zakah), or the traditional iftar banquets, suggesting ways to safely live in full the spirit of Ramadan as the COVID-19 pandemic continues. Additional considerations pertaining to fasting, physical activity, healthy diet and nutrition, and tobacco use, as well as to mental and psycho-social health and response to domestic violence are also proposed with the aim of clarifying misconceptions, and providing advice that may help make the most out of the holy month of Ramadan and its myriad of celebrations.

Countries, territories or areas with reported laboratory-confirmed COVID-19 cases and deaths, April 22, 2020

Country/Territory/Area	Confirmed Cases
United States of America	776907
Spain	204178
Italy	183957
Germany	145694
United Kingdom	129048
France	116151
Turkey	95591
Iran	84802
China	84287
Russian Federation	57999
Belgium	40956
Brazil	40581
Canada	37374
Netherlands	34134
Switzerland	27981
Portugal	21379
India	19984
Peru	16325
Ireland	16040
Sweden	15322
Austria	14833
Israel	13942
Saudi Arabia	11631
Japan	11496
Chile	10832
Republic of Korea	10694
Ecuador	10398
Poland	9856
Pakistan	9749
Romania	9242
Singapore	9125
Mexico	8772
United Arab Emirates	7755
Denmark	7695
Norway	7166
Indonesia	7135
Czechia	7041
Serbia	6890
Belarus	6723
Australia	6647
Philippines	6599
Ukraine	6592
Qatar	6533
Malaysia	5482
Dominican Republic	5044
Panama	4658
Finland	4014
Colombia	3977
Luxembourg	3618
Egypt	3490
South Africa	3465
Bangladesh	3382
Morocco	3209
Argentina	3073
Thailand	2826
Algeria	2811
Republic of Moldova	2641
Greece	2401
Hungary	2168
Kuwait	2080
Kazakhstan	1995
Bahrain	1973
Croatia	1908
Iceland	1778
Uzbekistan	1657
Oman	1614
Iraq	1602
Estonia	1552
Azerbaijan	1480
Armenia	1377
Lithuania	1370
Bosnia and Herzegovina	1340
Slovenia	1340
Puerto Rico	1298
North Macedonia	1231
Slovakia	1199
Cameroon	1163
Cuba	1137
New Zealand	1113
Afghanistan	1092
Ghana	1042
Bulgaria	975
Djibouti	945
Côte d’Ivoire	916
Tunisia	901
Cyprus	784
Latvia	748
Andorra	723
International (Diamond Princess Cruise Ship)	712
Guinea	688
Lebanon	682
Costa Rica	662
Niger	657
Albania	634
Kyrgyzstan	612
Kosovo	604
Bolivia	598
Burkina Faso	581
Nigeria	541
Uruguay	535
Honduras	494
San Marino	476
Malta	443
Jordan	428
Senegal	412
Georgia	411
Réunion	410
Democratic Republic of the Congo	359
Palestinian Territory	335
Mauritius	328
Montenegro	313
Mayotte	311
Sri Lanka	310
Isle of Man	307
Kenya	296
Guatemala	294
Somalia	286
Venezuela	285
Vietnam	268
Mali	258
United Republic of Tanzania	255
Jersey	250
Guernsey	239
El Salvador	225
Paraguay	208
Jamaica	223
Faroe Islands	185
Congo	165
Martinique	163
Gabon	156
Rwanda	150
Guadeloupe	148
Sudan	140
Brunei Darussalam	138
Guam	136
Gibraltar	133
Cambodia	122
Madagascar	121
Myanmar	121
Ethiopia	114
Trinidad and Tobago	114
Liberia	101
Monaco	98
Aruba	97
French Guiana	97
Bermuda	86
Togo	86
Maldives	83
Liechtenstein	82
Equatorial Guinea	79
Barbados	75
Zambia	70
Sint Maarten	68
Cabo Verde	67
Cayman Islands	66
Guyana	66
Bahamas	64
Libya	59
French Polynesia	57
Haiti	57
Uganda	56
Benin	54
United States Virgin Islands	54
Guinea-Bissau	50
Sierra Leone	50
Nepal	42
Syrian Arab Republic	42
Eritrea	39
Mozambique	39
Saint Martin	37
Chad	34
Mongolia	34
Zimbabwe	28
Angola	24
Eswatini	24
Antigua and Barbuda	23
Timor-Leste	23
Botswana	20
Lao People’s Democratic Republic	19
Belize	18
Fiji	18
Malawi	18
New Caledonia	18
Dominica	16
Namibia	16
Saint Kitts and Nevis	15
Saint Lucia	15
Central African Republic	14
Curaçao	14
Grenada	14
Northern Mariana Islands	14
Saint Vincent and the Grenadines	12
Burundi	11
Falkland Islands (Malvinas)	11
Greenland	11
Montserrat	11
Seychelles	11
Turks and Caicos	11
Gambia	10
Nicaragua	10
Suriname	10
Holy See	9
Mauritania	7
Papua New Guinea	7
Bhutan	6
Saint Barthelemy	6
Bonaire, Sint Eustatius and Saba	5
British Virgin Islands	4
São Tomé and Príncipe	4
South Sudan	4
Anguilla	3
Saint Pierre and Miquelon	1
Yemen	1
Total	2471136

Recommendations and Advice for the Public

If you are not in an area where COVID-19 is spreading or have not traveled from an area where COVID-19 is spreading or have not been in contact with an infected patient, your risk of infection is low. It is understandable that you may feel anxious about the outbreak. Get the facts from reliable sources to help you accurately determine your risks so that you can take reasonable precautions (see Frequently Asked Questions). Seek guidance from WHO, your healthcare provider, your national public health authority or your employer for accurate information on COVID-19 and whether COVID-19 is circulating where you live. It is important to be informed of the situation and take appropriate measures to protect yourself and your family (see Protection measures for everyone).

If you are in an area where there are cases of COVID-19 you need to take the risk of infection seriously. Follow the advice of WHO and guidance issued by national and local health authorities. For most people, COVID-19 infection will cause mild illness however, it can make some people very ill and, in some people, it can be fatal. Older people, and those with pre-existing medical conditions (such as cardiovascular disease, chronic respiratory disease or diabetes) are at risk for severe disease (See Protection measures for persons who are in or have recently visited (past 14 days) areas where COVID-19 is spreading).