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1. Informing the pandemic response: the role of the WHO’s COVID-19 Weekly Epidemiological Update

Author

Maria D Van Kerkhove, Mahmoud Hassan, Ibrahima Socé Fall, Olivier Le Polain de Waroux, Boris Igor Pavlin, Sandra Adele, Kazuki Shimizu, Oliver Morgan, Daniel Feikin, Lorenzo Subissi, Richard G Pebody, Masaya Kato, Opeayo Ogundiran, Ana Riviere-Cinnamond, Tshewang Dorji, Ingrid Hammermeister Nezu, Friday Idoko, Tamano Matsui, Silviu Ciobanu, Juniorcaius Ikejezie, Blanche Johanna Greene-Cramer, Tondri Noe Guinko, Samuel Mesfin, Harsh Lata, Alessandro Miglietta, Yurie Izawa, Aura Rocio Escobar Corado Waeber, Anahi Rico Chinchilla, Adedoyin Awofisayo-Okuyelu, Esther Hamblion, Melissa M Higdon, Ayse Acma, Samuel Moro, Homa Attar Cohen, Mary Anissa Sinnathamby, James Richard Otieno, Yosef Temre, Brian Ngongheh Ajong, Bernadette Basuta Mirembe, Vaishali Sodagar, Craig Schultz, Joao Muianga, Stéphane De Barros, Yeowon Jin, Shagun Khare, Marcia Poole, Nyka Alexander, Manilay Phengxay, Emilie Peron, Brett Nicholas Archer, Zyleen Alnashir Kassamali, and Abdi Mahamud

Subjects
Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract

On 31 December 2019, the Municipal Health Commission of Wuhan, China, reported a cluster of atypical pneumonia cases. On 5 January 2020, the WHO publicly released a Disease Outbreak News (DON) report, providing information about the pneumonia cases, implemented response interventions, and WHO’s risk assessment and advice on public health and social measures. Following 9 additional DON reports and 209 daily situation reports, on 17 August 2020, WHO published the first edition of the COVID-19 Weekly Epidemiological Update (WEU). On 1 September 2023, the 158th edition of the WEU was published on WHO’s website, marking its final issue. Since then, the WEU has been replaced by comprehensive global epidemiological updates on COVID-19 released every 4 weeks. During the span of its publication, the webpage that hosts the WEU and the COVID-19 Operational Updates was accessed annually over 1.4 million times on average, with visits originating from more than 100 countries. This article provides an in-depth analysis of the WEU process, from data collection to publication, focusing on the scope, technical details, main features, underlying methods, impact and limitations. We also discuss WHO’s experience in disseminating epidemiological information on the COVID-19 pandemic at the global level and provide recommendations for enhancing collaboration and information sharing to support future health emergency responses.

Published
2024
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2. The World Health Organization COVID-19 surveillance database

Author

Maya Allan, Maja Lièvre, Henry Laurenson-Schafer, Stéphane de Barros, Yuka Jinnai, Sophie Andrews, Thomas Stricker, Jesus Perez Formigo, Craig Schultz, Anne Perrocheau, and Julia Fitzner

Subjects
SARS-CoV-2, COVID-19, Population-based surveillance, Pandemic, Repository, Public health, Public aspects of medicine, RA1-1270
Abstract

Abstract In January 2020, SARS-CoV-2 virus was identified as a cause of an outbreak in China. The disease quickly spread worldwide, and the World Health Organization (WHO) declared the pandemic in March 2020. From the first notifications of spread of the disease, the WHO’s Emergency Programme implemented a global COVID-19 surveillance system in coordination with all WHO regional offices. The system aimed to monitor the spread of the epidemic over countries and across population groups, severity of the disease and risk factors, and the impact of control measures. COVID-19 surveillance data reported to WHO is a combination of case-based data and weekly aggregated data, focusing on a minimum global dataset for cases and deaths including disaggregation by age, sex, occupation as a Health Care Worker, as well as number of cases tested, and number of cases newly admitted for hospitalization. These disaggregations aim to monitor inequities in COVID-19 distribution and risk factors among population groups. SARS-CoV-2 epidemic waves continue to sweep the world; as of March 2022, over 445 million cases and 6 million deaths have been reported worldwide. Of these, over 327 million cases (74%) have been reported in the WHO surveillance database, of which 255 million cases (57%) are disaggregated by age and sex. A public dashboard has been made available to visualize trends, age distributions, sex ratios, along with testing and hospitalization rates. It includes a feature to download the underlying dataset. This paper will describe the data flows, database, and frontend public dashboard, as well as the challenges experienced in data acquisition, curation and compilation and the lessons learnt in overcoming these. Two years after the pandemic was declared, COVID-19 continues to spread and is still considered a Public Health Emergency of International Concern (PHEIC). While WHO regional and country offices have demonstrated tremendous adaptability and commitment to process COVID-19 surveillance data, lessons learnt from this major event will serve to enhance capacity and preparedness at every level, as well as institutional empowerment that may lead to greater sharing of public health evidence during a PHEIC, with a focus on equity.

Published
2022
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4. Mortality from COVID-19 in 12 countries and 6 states of the United States

Author

Patrick Brown, Kamal Rai, Carlo La Vecchia, Peter S Rodriguez, Kathleen Qu, Mathew G Brown, Hwashin Hyun Shin, Xuyang Tang, Leslie Newcombe, Wilson Suraweera, Craig Schultz, Isaac Bogoch, Hellen Gelband, Nico Nagelkerke, and Prabhat Jha

Subjects
Excess mortality, education.field_of_study, Coronavirus disease 2019 (COVID-19), Mortality rate, Population, Psychological intervention, Outbreak, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Geography, 030220 oncology & carcinogenesis, Pandemic, 030212 general & internal medicine, China, education, Demography
Abstract

ImportanceReliable estimates of COVID-19 mortality are crucial to aid control strategies and to assess the effectiveness of interventions.ObjectiveProject COVID-19 mortality trends to October 1, 2020, in 12 countries or regions that constitute >90% of the global COVID-19 deaths reported as of April 12, 2020.Design, Setting, and ParticipantsThe Global COVID-19 Assessment of Mortality (GCAM) is an open, transparent, and continuously updated (www.cghr.org/covid) statistical model that combines actual COVID-19 mortality counts with Bayesian inference to forecast COVID-19 deaths, the date of peak deaths, and the duration of excess mortality. The analyses covered a total of 700 million population above age 20 in 12 countries or regions: USA; Italy; Spain; France; UK; Iran; Belgium; a province of China (Hubei, which accounted for 90% of reported Chinese deaths); Germany; the Netherlands; Switzerland; and Canada; and six US states: New York, New Jersey, Michigan, Louisiana, California, and Washington.ResultsForecasted deaths across the 12 current high-burden countries sum 167,000 to 593,000 (median 253,000). The trajectory of US deaths (49,000-249,000 deaths; median 86,000)—over half of which are expected in states beyond the initial six states analysed in this study—will have the greatest impact on the eventual total. Mortality ranges are 25,000-109,000 (median 46,000) in the UK; 23,000-31,000 (median 26,000) in Italy; 21,000-37,000 (median 26,000) in France and 21,000-32,000 (median 25,000) in Spain. Estimates are most precise for Hubei, China—where the epidemic curve is complete—and least precise in California, where it is ongoing. New York has the highest cumulative median mortality rate per million (1135), about 12-fold that of Germany. Mortality trajectories are notably flatter in Germany, California, and Washington State, each of which took physical distancing and testing strategies seriously. Using past country-specific mortality as a guide, GCAM predicts surge capacity needs, reaching more than twice existing capacity in a number of places., In every setting, the results might be sensitive to undercounts of COVID-19 deaths, which are already apparent.Conclusion and RelevanceMortality from COVID-19 will be substantial across many settings, even in the best case scenario. GCAM will provide continually updated and increasingly precise estimates as the pandemic progresses.The coronavirus disease (COVID-19) pandemic has already caused over 115,000 deaths, with global deaths doubling every week.1-3Mortality is less biased than case reporting, which is affected by testing policies. However, the daily reporting of COVID-19 deaths is already known to undercount actual deaths, varying over time and place.4-6Reliable estimates of total COVID-19 mortality, the date of peak deaths, and of the duration of excess mortality are crucial to aid responses to the current and potential future pandemics. We have developed the Global COVID-19 Assessment of Mortality (GCAM), a statistical model to project COVID-19 mortality trends to October 1 2020 in 12 countries or regions that constitute >90% of the global COVID-19 deaths reported as of April 12th. We report also on six US states that account for 70% of the American totals to date (Supplementary Appendix).1We quantify the COVID-19 mortality trajectory ranges in each setting. A semi-automated website (www.cghr.org/covid) provides daily updates. GCAM is open, transparent, and uses a reasonably simple method that employs publicly reported mortality data to make plausible projections. The method is designed to improve as more mortality data become available over longer time periods.

Published
2020
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