The head of the World Health Organization (WHO) today said global COVID-19 activity is at different stages in different parts of the world and warned of a long road ahead with the virus.

The global COVID-19 total today reached 2,623,231 cases from 185 countries, along with 182,359 deaths, according to the Johns Hopkins online dashboard.

Worrying upward trends in a susceptible world

At a media telebriefing today, Tedros Adhanom Ghebreysus, PhD, the WHO's director-general, said most of the epidemics in Western Europe have stabilized or are declining. However, there are worrying upward trends in Africa, Central and South America, and Eastern Europe, though numbers are still relatively low.

Most countries are still in the early stages of their epidemics, but some already-affected locations are seeing a resurgence. "Make no mistake: we have a long way to go. This virus will be with us for a long time," Tedros said.

He said social distancing steps have suppressed transmission in many countries, but the virus is still extremely dangerous, and early evidence suggests that most of the world is still susceptible. "That means epidemics can easily re-ignite," he said.

Communication key to weathering long lockdowns

Another danger is complacency, and he said people are understandably frustrated with stay-at-home orders and the threat to their livelihoods. Though the WHO understands and shares the desire to return to normal life, there must be a "new normal" that is healthier, safer, and better prepared, Tedros said.

Key steps in the response, such as finding and testing all suspected cases, should still be the backbone of the response, and it's also important to engage and empower people, he said.

When asked about protests against stay-at-home orders, Mike Ryan, MD, who leads the WHO's health emergencies program, said his work in different outbreak settings, including Ebola in the Democratic Republic of Congo, shows that a high level of trust between citizens and the government is key. "That's a valuable thing to have in the bank," he said. "They have to believe there's a plan, that there's a reason for doing this."

If plans and the rationale for response actions are murky, communications are vulnerable to be gamed and directed in counterproductive ways, Ryan said.

The process should be a two-way dialogue, which promotes transparency and ensures consistency so that people aren't hearing different messages, he said, adding that civil society should also play a role so that not all communications are purely governmental.

WHO flags response gaps

Tedros said one of the WHO's tasks is to track countries' outbreak response progress, and though many who reported have strong capabilities, no single country has everything in place. For example, of countries reporting data to the WHO, 91% have the lab capacity to test for COVID-19, while 78% have response plans in place, and 76% have surveillance systems.

However, he said only 66% have clinical referral systems to care for COVID-19 patients. Less than half have community engagement plans, and less than half have infection prevention and control programs and standards for water, sanitation, and hygiene in health facilities.

"In other words, there are still many gaps in the world's defenses," Tedros said. "WHO will continue working with countries and the international community to close these gaps and build sustainable capacities for now and the future."

PAHO head urges nations to step up testing

Countries in the WHO Americas region need to speed up and expand testing, Carissa Etienne, MBBS, MSc, director of the Pan American Health Organization (PAHO) said yesterday at a media briefing. "We need a clearer view of where the virus is circulating and how many people have been infected in order to guide our actions," she said.

Though countries have been ready to test and detect cases since before the pandemic was declared, with cases increasing, many countries are struggling to keeping up, Etienne said. PAHO has already sent 500,000 tests to 34 countries and territories, and it is sending 1.5 million more this week and another 3 million next week.

Brazil is South America's hardest-hit country, with more than 43,000 cases reported so far. Other countries battling large outbreaks include Peru, Chile, and Ecuador.

European, Asian developments

In Europe, Pedro Sanchez, Spain's prime minister, asked lawmakers to extend the country's emergency measures for a third time, the BBC reported. While Spain is the world's second hardest-hit country, cases are starting to decline there, as in neighboring countries. The prime minister told Parliament that restrictions can probably begin slowly easing in the last half of May.

Spain has some of Europe's tightest restrictions, including an order that children be kept inside. However, the government announced yesterday that beginning Apr 26, children ages 14 and younger can go outside for walks.

Meanwhile, German regulators approved a plan for clinical trials to proceed on COVID-19 vaccines developed by BioNTech and Pfizer, Reuters reported. And early results from a serology study by a Geneva-based research group show that 5.5% were positive for SARS-CoV-2 IgG antibodies.

In Asian developments, Harbin, the capital of Heilongjiang province, has restricted incoming travel today to slow the spread of the virus, after earlier ordering people from outside China or key epidemic areas to isolate, Reuters reported.

The province, on the Russian border, has been flagging infected residents coming from Russia, where virus activity is accelerating. China's National Health Commission today reported 30 new cases, 7 of them local cases from Heilongjiang province.

Singapore's health ministry today reported 1,106 new cases, part of a surge mainly linked to foreign workers living in tightly packed dorms. Of today's new cases, 967 were linked to the dorms.

In Taiwan, health officials reported an outbreak on a Navy supply ship that had recently visited Palau, Bloomberg News reported. Twenty-eight sailors tested positive for COVID-19.