In the past 7 days (April 2 to 8), the COVID-19 pandemic continued its rapid spread and 1.71-fold more cases were reported on April 8 when compared with to April 2. The USA is the most severely affected country where 9 states have reported more than 10,000 confirmed cases. The rapid increase of COVID-19 in some European countries appear to be slightly slowing. The daily number of new reported cases in Italy, Germany, Spain, Belgium, Norway, Switzerland, and Austria declined, but the numbers in France and the Netherlands fluctuated but remained high. On the contrary, daily new cases in the UK, Ireland, Portugal, and Sweden still increased. Moreover, the daily number of new reported cases in many Eastern European in the past week show clear increases such as Russia, Ukraine, Romania, and Poland. Large numbers of ongoing COVID-19 cases in the USA and Europe make them continuing epicenters of the pandemic worldwide.

By April 8, 9 states in the USA reported more than 10,000 cases. More importantly, 6 states showed higher numbers of cumulative cases and mortalities than Hubei Province, which was the worst affected province of China. Although more than 2.2 million COVID-19 tests have been conducted in the USA by April 8, high positive rates nationwide suggest that the epidemic is still in the stage of rapid increase, particularly in the states of NY, NJ, MA, LA, CT, and MI. The testing percentage in NY has already reached to 1.2%, while the positive rate has continuously increased in the past week reaching 40%. This situation is even more severe than that of Lombardy, the epicenter of Italy’s epidemic, at the most critical stage.

From the COVID Tracking Project website (5), we have also collected data on the numbers of the hospitalized COVID-19 cases on April 8 in the 6 most affected states. In general, the ratios of hospitalized cases to total confirmed cases are low, i.e., 23.1% in NY, 9.4% in MA, 14.8% in NJ, 11.6% in LA, 16.8% in CT, and 17.8% in MI. The relatively low hospitalization ratio of COVID-19 cases will make patient isolation and management more difficult. On the other hand, rapid increases in COVID-19 cases over a short period of time will cause a shortage of medical resources in a specific regions. Such phenomena have likely already appeared in some states in the USA, where the Institute of Health Metrics and Evaluation (IHME) has estimated shortages of 5,000 and 2,000 critical care beds in NY and NJ (6).

We have also noticed that the COVID-19 pandemic in Russia, India, Brazil, and Turkey with large populations became more severe in the past week with rapid increases in numbers of daily new cases and fatalities. The growth of the pandemic beyond control in many countries with large populations will definitely increase the difficulty of COVID-19 containment globally. More cases have been reported in African countries last week, especially Sub-Saharan countries. Compared with improvements in clinical treatment capacity, quick and efficient implementation of non-pharmaceutical measures in African countries is more pivotal.

The implementations of air travel restrictions and other relevant measures seemed to be effective and led to a reduction in imported cases via airports in China over the last week. However, more imported cases emerged via land ports last week, mostly from Russia. As a large country, there are dozens of land ports connecting China with 14 other countries as well as with Hong Kong SAR and Macau SAR, most of which are already temporarily closed. When compared to cities with international airports, most cities with land ports have relatively limited medical resources and medical service capacities. Careful assessment and rapid improvement in the capacities of surveillance, quarantine, isolation, clinical treatment, and transportation are still largely required.

Similar to our previous reports, relevant data presented here was collected from the websites of governments, mainstream media, relevant professional websites, and published literature, which may affect the accuracy and real-time performance. Deviations of the predictions and assessments from reality are probably inevitable.

Acknowledgements: The authors would like to thank George F. Gao, Zunyou Wu, Xiaoming Shi, Jiaqi Ma, Jingjing Xi, Lei Zhou, Luzhao Feng, Wenxiao Tu, Xiang Ren, Qiulan Chen, and Wei Chen from China CDC, as well as Yidu Cloud (Beijing) Technology Co., Ltd. for their contributions to the article.

Funding: This study was supported by the foundation of the Science and Technology Department of “Evaluation and Analysis of the 2019-nCoV Transmission Epidemiology and Control Strategies” Project, “Public Security Risk Control & Emergency Technical Equipment” Key Program, National Key R&D Program of China (No.2012C33002).