COVID-19 : Europ Assistance International weekly medical update

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November 24th, 2021 - This weekly medical update on Covid-19 has been developed by Europ Assistance medical community and provides up-to-date public health information on Covid-19 from official sources. The aim of this bulletin is to share the most recent and relevant news on the pandemic with Europ Assistance employees and customers. It will be updated weekly until the situation stabilizes.

 

If you have any questions, comments or suggestions, please fell free to contact Aldiona KERRI,MD (Medical Project Manager) or Pr Thomas LESCOT (Group Chief Medical Officer).

 

COVID-19: GLOBAL OVERVIEW

 

Globally, as of 23 November 2021, there have been 257 469 528 confirmed cases  (+3 597 398  new cases in last 7 days) including  5 158 211 deaths (+ 51 373 new deaths in last 7 days) reported to WHO.  


 
As of 23 November 2021, a total 7.4 billion vaccine doses have been administrated  and  nearly 3.1 billion people have been fully vaccinated. 
(Source: World Health Organization)
 

 

  
Share of people vaccinated against COVID-19  


This bar chart shows the percentage of population in This bar chart shows the percentage of population in selected countries and territories worldwide that have received a COVID-19 vaccine as of November 23, 2021.
88% of the population of United Arab Emirates and Portugal has been fully vaccinated. Only 23% in South Africa and 13% in Egypt have received a single-dose vaccine or both doses of a two-dose vaccine.
 

Share of people vaccinated against covid-19

 

    
Vaccine booster doses 


As of November 23, 2021, Europe has administered the highest booster doses, around 6.9 per 100 people, an increase of 2 per 100 compared to last week. It is followed by North and South America with 6.7 and 5.5 vaccine booster doses respectively, administered per 100 people. Overall, there have been 2.7 booster doses administered per 100 people worldwide.

Covid -19 vaccine booster doses


 

ON THE GROUND

On the ground with Europ Assistance Medical Director in Hungary

Europ Assistance Medical Director in Hungary

Dr Sárosi Balázs

Europ Assistance Hungary

 

What is the current Covid-19 situation in Hungary and the region ?

 

As of 19 November 2021, the total number of covid-19 cases reported in Hungary is  998 488 since the start of the pandemic, including 32 780 cumulative deaths and 836 583 full recoveries. The current average daily number has been roughly 10 500 to   11 500 with a rapid increase recently. As of 19 November 2021, there have been 6 122 people hospitalized with COVID-19, 613 on ICU/respirator. The number of daily deaths increased from 131 to 135 in the days of 17 and 18 November. It is mainly the delta and the delta+ variant currently responsible for the cases. The current numbers are matching the peak numbers of the 3rd wave without seeing the plateau on the horizon. There are no clear numbers revealed of the percentage of vaccinated ratio amongst those critically ill. The only data available dates back to July.

 

Mitigation efforts only introduced on the 18 November, following weeks of alarming sounds from the entire health sector and scientists. Since last week, it is forbidden to resign from the public health sector and from the law enforcement. Using face masks on public transport is obligatory since last week. Obligatory face mask usage will be introduced from tomorrow for indoors like shopping malls, shops, museums, theatres, cinemas, etc. Schools are open but face mask is not obligatory. Same stands for sport centres, gyms. All event over 500 people require vaccination or recovery certificates.

 

The situation is similar in all countries in the region. Austria introduced major restrictions for 10 days for both vaccinated and non-vaccinated people in the urge of the peak of the 3rd wave, meanwhile Romania, Serbia and Bulgaria have seemingly just passed their plateau.
 

 

What are the main entry restrictions?

 

Currently Schengen borders are fully open with no check points. The land borders of Serbia and Ukraine and airport crossings are fully monitored. Hungary uses its own national classifications of risk areas, hence travel restrictions for Hungary are not based on the common EU traffic lights map.

 

Regardless of the passenger’s citizenship, the restrictions do not apply to travellers: recovered from COVID-19 within 6 months; holding an immunity certificate that is recognized by Hungary (24 countries at the moment: Albania, Bahrein, Cyprus, Czech, North Macedonia, Georgia, Croatia, India, Kazakhstan, Kyrgyzstan, Morocco, Moldova, Mongolia, Montenegro, Russian Federation, Romania, San Marino, Serbia, Slovakia, Slovenia, Turkey, Ukraine, Uzbekistan, Cape Verde); arriving via open land borders; crossing the border in relation to freight traffic, with diplomatic passport, foreign service passport, service passport and seaman’s passport; presenting a negative PCR result in English or in Hungarian performed within 72 hours from the time of entry in one of the following countries: EU, OECD, NATO, Russia, China, UAE, Bahrein, CCTSS.

 

Others who do not fall into the general exemption categories must have essential purpose of entry and must apply for entry permit issued by the Hungarian Police. Permit holders must go into isolation for 10 days, that can be shortened by performing 2 PCR tests in Hungary.

 

How is the vaccine booster campaign organized and what are the vaccination rates?

 

As of 19 November 2021, 6 013 007 people over the age of 12 are vaccinated in Hungary. Almost 60% of the population has received at least one dose. 5 784 958 are fully vaccinated. 1 714 000 received booster (2nd shot of Janssen, 3rd shot of Pfizer, Moderna, Astra-Zeneca). Currently there is no Sputnik vaccine available.

 

Obligatory vaccination was introduced for frontline workers in September. Booster shots are obligatory for all frontline workers since yesterday. The government made mandatory vaccination strategy legally available for all employers. Boosters are available to anyone above 12.

 

The government has introduced an extraordinary vaccination week last week. This will be the first time that anyone can ask for any kind of covid-19 vaccination (first, second, third shots – Pfizer, Moderna, Astra Zeneca, Janssen, Sinopharm) from Monday to Sunday 7-19 at all vaccination points without pre-registration on a walk-in basis.
 

 

COVID-19: REGIONAL OVERVIEWS 

(data as of 14 November 2021)


South-East-Asia 

South-East-Asia reported a total of  44 440 048 cases including  703 421 deaths since the start of the pandemic. Almost 136 000 new cases and over 2800 new deaths have been reported, representing a 11% and 19% decrease respectively. Countries that have reported the highest number of new cases last week include India (73 106 new cases, 11% decrease) and Thailand (46 171, 8% decrease).
Source: World Health Organization
 

Europ Assistance Health bulletin weekly confirmed COVID19 cases south east asia

 
Regions of the Americas

A total of 96 066 194 cases have been reported in Region of the Americas including 2 337 599 total deaths. Over 753 000 new cases and 13 000 new deaths have been reported as compared to the previous week, representing a 10% increase in new cases and new deaths. Countries that have reported the highest number of new cases were the United States of America (558 538 new cases, similar to the previous week's figures) and Brazil (64 121 new cases, 16% decrease).
Source: World Health Organization
 

Europ Assistance Health bulletin weekly confirmed COVID19 cases Americas


 

Eastern Mediterranean Region

Eastern Mediterranean Region has reported  16 684 015 cases and 307 833 deaths in total since the beginning of the pandemic. Over 92 000 new cases and over 1900 new deaths have been reported as compared to the previous week, representing a 9% decrease in cases and no change in deaths. Countries having reported the highest number of cases include the Islamic Republic of Iran (41 523 new cases, 19% decrease) and Jordan    (21 599, 35% increase).
Source: World Health Organization
 

Europ Assistance Health bulletin weekly confirmed COVID19 cases eastern mediterranean region


 

 European Region

A total of 84 082 216 cases including 1 518 516 deaths have been reported in the European Region. Over 2.4 million new cases and over 29 000 new deaths have been reported, resulting in a 11% increase in new cases and no change in deaths. Last week, the highest number of cases were reported from Germany (333 473 new cases, 31% increase), the United Kingdom (281 063 new cases, 11% increase) and the Russian Federation (260 484 new cases, similar to previous week).
Source: World Health Organization
 

Europ Assistance Health bulletin weekly confirmed COVID19 cases european region


 

African Region

A total of 6 202 079 total cases including 152 159 total deaths have been reported in Africa. Over the last week, the region reported over 13 000 new cases and over 385 new deaths, resulting in 10% increase in new cases and 30% decrease in deaths. The highest numbers of new cases were reported from South Africa (3498 new cases, 82% increase) and Ethiopia (1408 new cases, 11% decrease).
Source: World Health Organization
 

Europ Assistance Health bulletin weekly confirmed COVID19 cases african region

 

Western Pacific Region

The Western Pacific Region has reported 9 994 212 total cases and 138 670 deaths since the start of the pandemic. Over 175 000 new cases and over 3100 new deaths were reported, resulting in approximately a 10% increase and 29% increase respectively as compared to the previous week. The highest numbers of new cases were reported from Vietnam (66 279 new cases, 16% increase), Malaysia ( 40 600 new cases, similar to previous week) and Republic of Korea (19 965 new cases, 29% increase).
Source: World Health Organization
 

Europ Assistance Health bulletin weekly confirmed COVID19 cases western pacific region

 

SPECIAL FOCUS : COVID-19 booster and additional dose Q&A

 

What is the difference between booster doses and additional doses?


Booster doses are for people who have normal immune systems and responded adequately to primary vaccination, whereas additional doses are for those with weakened immune systems who did not respond adequately to primary vaccination. Booster doses are given to vaccinated people to restore protection after it would have waned. On the other hand, additional doses as part of a primary vaccination series may be given to people with severely weakened immune systems, as they may not achieve an adequate level of protection from the standard primary vaccination (1).


 
What current vaccines are approved as boosters or additional doses?


Current vaccines approved as boosters varies on your place of residence. In Europe, the
European Medicines Agency (EMA) recommended that an extra dose of Pfizer-BioNTech and Moderna may be given to people with severely weakened immune systems at least 28 days after their second dose and that booster doses of these two vaccines may be considered at least six months after the second dose for people aged 18 years and older (2,3). Recently, EMA is evaluating Janssen to be given as a booster dose two months after the first dose to people aged 18 years and older (4). In the USA, the U.S. Food and Drug Administration (FDA) has authorized three vaccine boosters — Pfizer-BioNTech, Moderna and Janssen/Johnson & Johnson (5).


 
Which target groups are prioritized ?

 
All EU countries recommend an additional dose as an extension of the primary series to those with weakened immune systems and are also recommending booster doses for waning immunity to different population groups. The majority of countries recommend a booster dose to those most vulnerable to severe disease and death i.e. residents in long-term care facilities and the elderly (6).


 
What are the benefits of a booster vaccine?

 

A booster dose increases your protection against (7):

  • infection with the virus that causes COVID-19
  • severe disease
  • dying from COVID-19

 

 
Is it safe to get a booster dose that is a different brand from my initial dose?

 
Current evidence suggests that it is safe to get a COVID-19 vaccine booster or additional dose that is a different brand than your initial dose or doses (8). The approved mix-and-match approach means that any of the vaccines approved by EMA or FDA can be taken as a booster shot, regardless of which vaccine a person had for their primary vaccination.

 
What about vaccine equity?

 
At present, approximately 54% of the global population has received at least one dose of a COVID-19 vaccine, but this number is about 5% in low-income countries (9). According to WHO, improving coverage of the primary vaccination series should be prioritized over booster vaccination to protect against severe disease.

 


Sources:
 

  1. World Health Organization. Interim statement on booster doses for COVID-19 vaccination. Accessed on: 24 November 2021. Available at: https://www.who.int/news/item/04-10-2021-interim-statement-on-booster-doses-for-covid-19-vaccination
  2. European Medicines Agency. Comirnaty and Spikevax: EMA recommendations on extra doses and boosters. 2021. Available at: https://www.ema.europa.eu/en/news/comirnatyspikevax-ema-recommendations-extra-doses-boosters
  3. European Medicines Agency. Spikevax: EMA recommendation on booster. 2021. Available at: https://www.ema.europa.eu/en/news/spikevax-ema-recommendation-booster
  4. European Medicines Agency (EMA). EMA evaluating data on booster dose of COVID-19 Vaccine Janssen. Accessed on: 24 November 2021. Available at: https://www.ema.europa.eu/en/news/ema-evaluatingdata-booster-dose-covid-19-vaccinejanssen#:~:text=EMA%20has%20started%20evaluating%20an,aged%2018%20years%20and%20older.
  5. U.S Food and Drug Administration. COVID-19 Vaccine Booster Shots. Accessed on: 24 November 2021. Available at: https://www.cdc.gov/coronavirus/2019ncov/vaccines/boostershot.htmls_cid=11705:who%20is%20eligible%20for%20covid%20booster%20shot:sem.ga:p:RG:GM:gen:PTN:FY22#choosing-booster
  6. European Centre for Disease Control and Prevention (ECDC). Overview of the implementation of COVID-19 vaccination strategies and deployment plans in the EU/EEA. Available at: https://www.ecdc.europa.eu/en/publications-data/overview-implementation-covid-19-vaccination-strategies-and-deployment-plans
  7. Australian Government, Department of Health. COVID-19 booster vaccine advice. Accessed on: 24 November 2021. Available at: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/getting-your-vaccination/booster-doses
  8. Deming, M.E., Lyke, K.E. A ‘mix and match’ approach to SARS-CoV-2 vaccination. Nat Med 27, 1510–1511 (2021). https://doi.org/10.1038/s41591-021-01463-x
  9. Statistics and Research: Coronavirus (COVID-19) Vaccinations. Accessed on: 23 November 2021. Available at: https://ourworldindata.org/covid-vaccination

 

 

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Today's updated medical information and action recommendations regarding the Covid 19 epidemic
November 24th, 2021 - This weekly medical update on Covid-19 has been developed by Europ Assistance medical community and provides up-to-date public health information on Covid-19 from official sources. The aim of this bulletin is to share the most recent and relevant news on the pandemic with Europ Assistance employees and customers. It will be updated weekly until the situation stabilizes.
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