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For citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
June 04
2
COVID-19
Situation Report 466
Centre for Infectious Disease Epidemiology and Research (CIDER)For citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
i. Background
In December, China notified the World Health Organization (WHO) of several cases of human respiratory
illness, which appeared to be linked to an open seafood and livestock market in the city of Wuhan. The
infecting agent has since been identified as a novel coronavirus, previously known as 2019-nCoV and now
called SAR-CoV-2; The new name of the disease has also been termed COVID-19, as of 11th February 2020.
Although the virus is presumed zoonotic in origin, person-to-person spread is evident. Screening of
travellers, travel bans and quarantine measures are being implemented in many countries. Despite these
precautions, it is anticipated that more cases will be seen both inside China and internationally. The WHO
declared the outbreak of COVID-19 constitutes a Public Health Emergency of International Concern on 30
January. On 11 March, 2020, WHO declared the coronavirus outbreak a pandemic as the global death toll
rose above 4,600 and the number of confirmed cases topped 125,000. This report aims to update Global
Risk Assessment, Global Epidemiology, Quarantine Orders, Travel Ban/Advisory by countries, WHO’s and
CDC’s Guidance and Protocols and Scientific publication on a daily basis. New updates in the tables are
bolded.
1|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
ii. Global Risk Assessment
Table 1. Risk assessment of COVID-19 by WHO regions (Updated as of 4 June 2021, 1300H SGT)
Severity of Availability of Treatment/ Overall
Environmental Risk Transmissibility
Disease Vaccination# Risk
Global (n=198 countries)
High Moderate High Limited
Globally, 189 (95.4%) countries (excluding Based on CDC Case The number of countries that have
territories*) have reported the outbreak. data, median R0 fatality rate commenced mass vaccination in each
is estimated to is currently region are as follows: Combined WPRO
Using an incidence >20 cases/100,000 be 5.8 (95% CI at 2.15% and SEARO (33 countries), EURO (53
people over the past 14-days as cut-off for 4.4–7.7), but globally. countries), EMRO (20 countries),
a surge in cases, the number of countries the estimated Most cases Americas (33 countries), and Africa (41
reporting a surge in cases in each region effective present as countries).&
are as follows: Combined WPRO and reproduction flu-like
SEARO (15 countries), number in 174 illness. International clinical trials published on 2
EURO (45 countries), countries September confirm that cheap, widely
EMRO (14 countries), Americas (28 ranged from available steroid drugs can help seriously
countries), and Africa (6 countries). 0.19 to 1.7.$ ill patients survive Covid-19. The World
Health Organization issued new
Only 4 (2%) countries/territories have no treatment guidance, strongly
reported restrictions on inbound arrivals, recommending steroids to treat severely
while 146 (79%) countries/territories have and critically ill patients, but not to those
partially reopened their borders – require with mild disease. [4]
arrivals to produce a negative COVID-19
test result and/or undergo self-quarantine Researchers have found all regimens of
upon arrival. 49 (26%) anticoagulants to be far superior to no
countries/territories are totally closed to anticoagulants in COVID-19 patients.
international arrivals. [1] More specifically, patients on both a High
“therapeutic” or full dose and those on a
On October 7, the Centers for Disease “prophylactic” or lower dose, showed
Control and Prevention (CDC) confirmed about a 50% higher chance of survival
airborne transmission of SARS-CoV-2. [2] and roughly a 30% lower chance of
intubation, than those not on
The U.S. CDC has revised its guidance on anticoagulants. It was observed that
COVID-19 quarantine period from 14 days therapeutic and prophylactic
to 7-10 days, based one's test results and subcutaneous low-molecular weight
symptoms. Individuals without symptoms heparin and therapeutic oral apixaban
only need quarantine for 10 days without may lead to better results. [3]
testing; those tested negative can
quarantine for 7 days. [14] A new strain known as B.1.525
containing the same E484K mutation
The US Centers for Disease Control and found in the Brazilian and South African
Prevention (CDC) on 10 Feb announced variants has been detected in Britain
that fully vaccinated people did not need [18].
to quarantine if they received their last
dose within three months and 14 days
after their last shot, the time it takes to
develop immunity. [16]
2|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
Western Pacific Region and South-East Asia Region (n=41 countries)
Moderate Moderate Moderate High
33 (80.5%) countries have reported As of June 2, Case 33 countries have commenced
outbreaks; but only 15 (36.6%) countries the estimated fatality rate vaccination as of 4 June 2021. Coverage
are reporting a surge in cases. effective is 1.31%. was available for the following: i) at least
reproduction 1 dose was at 70% for 1 country
constant decreasing change in incidence countries ii) full vaccination was atFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
None of the countries have either a ranged from was atFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
Health Canada has approved
bamlanvimab, for the treatment of
COVID-19 in patients 12 years and older
with mild to moderate symptoms who
are at risk of severe disease progression.
[11]
FDA has allowed emergency use of Eli
Lilly & Co’s bamlanivimab for non-
hospitalized patients at risk of serious
illness due to age or other conditions.
[10]
FDA has issued emergency authorisation
for convalescent plasma to treat COVID-
19. [9]
RLF-100 (aviptadil) by NeuroRx and Relief
Therapeutics was approved for
emergency use in COVID-19 patients who
are too ill to participate in the trial. [8]
As of October 22, remdesivir is the first
and only FDA-approved COVID-19
treatment in the U.S. [7].
FDA has issued emergency authorisation
for sotrovimab to treat mild-to-moderate
Covid-19 adults and paediatric patients
(12 years old and older weighing at least
40kg) who are at risk of severe disease
progression. [23]
African Region (n=47 countries)
Moderate Moderate High High
47 (100%) countries have reported with As of June 2, Case 41 countries have commenced
outbreak; 6 (13.0%) countries are the estimated fatality rate vaccination as of 4 June 2021. Coverage
reporting a surge in cases. effective is 2.51%. was available for the following: i) at least
reproduction 1 dose was at 70% for 1 country ii) full vaccination was
decreasing change in incidence or no case countries atFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
*Only WHO member states are included. 30 territories that have reported cases (with the exception of Palestine)
are excluded from the tabulation of total countries affected/imported/local cases and case fatality rate. Refer to
WHO situation reports or table 4 for information.
$
https://epiforecasts.io/covid/posts/global/
^
Differences between R0 and effective R can be found here https://www.coronavirustoday.com/r-number-refers-
either-basic-or-effective-reproduction-number
&
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/; High vaccine coverage
defined as >70% population with full vaccination
6|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
iii. Global Epidemiology
Table 2. Summary of COVID-19 cases & fatalities globally (Updated as of 4 June 2021, 1300H SGT)
Case-
No. of Total Cases Case-
Fatality
Countries/ Total Global Outside Total Fatality
Rate (%) R0
Territories Cases Mainland Deaths Rate (%)
[outside
with Cases China [overall]
China]
5.8 (95% CI 4.4–
220 172,910,966 172,819,772 3,717,320 2.15% 2.15%
7.7)^
^Based on early release as of 10th April, 2020: https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
Table 3. Comparison with other viruses
Virus Incubation Period (Days) Case Fatality Rate (%) R0
Median = 5.1$
SARS-CoV-2 2.15 5.8 (95% CI 4.4–7.7) ^
(2-14) or up to 24*
SARS-CoV 2-7 9.6 2.0For citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
Figure 2. Growth Factor excluding mainland China
Figure 3. Growth Factor of Novel Coronavirus Daily Deaths (Mainland China + Other Countries)
Growth Factor = every day’s cases/cases on previous day. A growth factor above 1 indicates an increase, whereas one between 0 and 1 is a sign
of decline, with the quantity eventually becoming zero. A growth factor below 1 (or above 1 but trending downward) is a positive sign, whereas
a growth factor constantly above 1 is the sign of exponential growth.
Source: https://www.worldometers.info/coronavirus/coronavirus-cases/
8|Page Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
Case Breakdown by Countries
Live update of COVID-19 global cases can be found at
https://storymaps.arcgis.com/stories/a1746ada9bff48c09ef76e5a788b5910
Table 4. Breakdown of COVID-19 confirmed cases and deaths from 29 May – 4 June, 2021
(Updated as of 4 June 2021, 1300H SGT)
Country Total Cases Change Total DeathsChange Total Recovered Region
1 USA 34,174,752 +175072 611,611 +3885 28,025,575 Americas
2 India 28,574,350 +1018893 340,719 +21824 26,597,655 SEARO
3 Brazil 16,803,472 +461310 469,784 +13031 15,228,983 Americas
4 France 5,694,076 +58447 109,857 +692 5,378,299 EURO
5 Turkey 5,270,299 +49750 47,882 +912 5,139,993 EURO
6 Russia 5,099,182 +63975 122,660 +2658 4,711,982 EURO
7 UK 4,499,878 +26201 127,812 +54 4,296,244 EURO
8 Italy 4,225,163 +19193 126,342 +549 3,893,259 EURO
9 Argentina 3,884,447 +221232 79,873 +3738 3,438,437 Americas
10 Germany 3,701,690 +27721 89,605 +916 3,518,600 EURO
11 Spain 3,693,012 +29836 80,099 +211 3,464,896 EURO
12 Colombia 3,488,046 +168853 90,353 +3660 3,242,060 Americas
13 Iran 2,945,100 +69242 80,658 +1274 2,508,907 EMRO
14 Poland 2,874,092 +4440 74,075 +635 2,642,127 EURO
15 Mexico 2,426,822 +21100 228,362 +5705 1,934,541 Americas
16 Ukraine 2,209,417 +16050 50,959 +883 2,072,091 EURO
17 Peru 1,968,693 +26639 185,380 +116564 N/A Americas
18 Indonesia 1,837,126 +39627 51,095 +1188 1,691,593 SEARO
19 South Africa 1,680,373 +30396 56,765 +595 1,567,635 Africa
20 Czechia 1,662,608 +2628 30,136 +77 1,622,876 EURO
21 Netherlands 1,657,017 +19551 17,658 +66 1,506,869 EURO
22 Chile 1,403,101 +50378 29,598 +789 1,327,643 Americas
23 Canada 1,387,445 +16372 25,644 +233 1,334,011 Americas
24 Philippines 1,247,899 +47469 21,357 +978 1,170,752 WPRO
25 Iraq 1,214,367 +28058 16,462 +173 1,129,221 EMRO
26 Romania 1,078,338 +1498 30,499 +368 1,041,256 EURO
27 Sweden 1,076,993 +8520 14,474 +61 981,005 EURO
28 Belgium 1,066,957 +11414 24,995 +93 970,607 EURO
29 Pakistan 928,588 +14804 21,105 +498 856,005 EMRO
30 Portugal 851,031 +4025 17,029 +7 810,659 EURO
31 Israel 839,532 +112 6,416 +10 832,918 EURO
32 Bangladesh 805,980 +10995 12,724 +244 746,035 SEARO
33 Hungary 805,302 +2183 29,792 +138 708,198 EURO
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COVID-19 Situation Report 466. 4 June 2021
34 Japan 752,191 +22338 13,245 +644 690,623 WPRO
35 Jordan 738,521 +4482 9,500 +77 719,049 EMRO
36 Serbia 713,207 +1765 6,890 +67 699,009 EURO
37 Switzerland 696,801 +4690 10,828 +30 654,799 EURO
38 Austria 645,834 +2666 10,627 +54 630,731 EURO
39 Malaysia 595,374 +54150 3,096 +605 508,947 WPRO
40 UAE 576,947 +13732 1,689 +25 556,549 EMRO
41 Nepal 576,936 +34680 7,630 +679 467,467 SEARO
42 Lebanon 541,009 +1419 7,747 +42 521,458 EMRO
43 Morocco 520,423 +2301 9,165 +31 508,210 EMRO
44 Saudi Arabia 454,217 +8254 7,408 +99 436,884 EMRO
45 Ecuador 429,817 +7488 20,706 +349 375,151 Americas
46 Bulgaria 419,180 +1361 17,792 +155 385,271 EURO
47 Greece 406,751 +9781 12,184 +229 376,784 EURO
48 Belarus 396,869 +6666 2,882 +71 388,632 EURO
49 Kazakhstan 391,695 +9788 4,022 +119 363,604 EURO
50 Slovakia 390,129 +785 12,375 +55 376,016 EURO
51 Bolivia 380,457 +18877 14,832 +520 301,160 Americas
52 Panama 380,207 +3970 6,388 +27 367,007 Americas
53 Paraguay 364,702 +19345 9,498 +698 299,594 Americas
54 Croatia 357,109 +1813 8,056 +75 347,108 EURO
55 Tunisia 350,487 +10237 12,839 +388 307,778 EMRO
56 Georgia 346,983 +6145 4,853 +154 330,721 EURO
57 Azerbaijan 334,416 +1099 4,929 +38 325,863 EURO
58 Costa Rica 325,779 +13857 4,124 +195 246,686 Americas
59 Kuwait 313,289 +9090 1,783 +28 297,329 EMRO
60 Palestine 309,333 +2538 3,509 +26 301,443 EMRO
61 Uruguay 304,411 +24039 4,460 +394 263,733 Americas
62 Dominican Republic 297,119 +9085 3,642 +22 243,235 Americas
63 Denmark 284,117 +6718 2,517 +6 268,938 EURO
64 Lithuania 275,545 +2719 4,289 +60 257,675 EURO
65 Ethiopia 272,285 +1758 4,185 +58 243,378 Africa
66 Egypt 265,489 +7082 15,222 +318 194,291 EMRO
67 Ireland 263,191 +2892 4,941 0 245,731 EURO
68 Guatemala 258,633 +7297 8,238 +168 236,469 Americas
69 Moldova 255,354 +369 6,125 +32 247,830 EURO
70 Slovenia 254,692 +1844 4,383 +17 246,433 EURO
71 Bahrain 246,658 +17190 1,050 +148 219,108 EMRO
72 Honduras 240,382 +4783 6,415 +156 85,881 Americas
73 Venezuela 238,013 +9185 2,689 +113 218,956 Americas
74 Armenia 222,978 +569 4,448 +32 213,813 EURO
75 Oman 220,702 +6918 2,385 +82 202,021 EMRO
10 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
76 Qatar 218,080 +1397 563 +11 214,377 EMRO
77 Bosnia and Herzegovina 204,252 +490 9,332 +138 175,827 EURO
78 Sri Lanka 195,844 +20983 1,608 +310 162,397 SEARO
79 Libya 186,567 +2095 3,132 +17 172,637 EMRO
80 Thailand 171,979 +27003 1,177 +223 120,697 SEARO
81 Kenya 171,658 +1961 3,223 +115 117,345 Africa
82 Nigeria 166,682 +491 2,117 +46 162,521 Africa
83 North Macedonia 155,364 +195 5,435 +66 148,872 EURO
84 Cuba 145,567 +7837 985 +64 138,621 Americas
85 Myanmar 143,945 +531 3,221 +5 132,408 SEARO
86 S. Korea 142,852 +3954 1,969 +23 133,289 WPRO
87 Latvia 134,162 +1904 2,392 +37 126,999 EURO
88 Albania 132,360 +96 2,451 +4 129,566 EURO
89 Algeria 129,976 +2050 3,497 +49 90,517 Africa
90 Estonia 129,909 +751 1,260 +16 124,033 EURO
91 Norway 126,218 +2147 785 +2 88,952 EURO
92 Kyrgyzstan 105,840 +2257 1,830 +49 99,474 EURO
93 Uzbekistan 100,997 +1653 693 +8 96,889 EURO
94 Montenegro 99,717 +240 1,587 +9 97,429 EURO
95 Zambia 97,388 +3441 1,288 +13 92,320 Africa
96 Ghana 94,011 +288 785 +2 92,057 Africa
97 Finland 92,913 +851 959 +13 46,000 EURO
98 China 91,194 +149 4,636 0 86,187 WPRO
99 Cameroon 78,929 +947 1,275 +5 73,974 Africa
100 Afghanistan 76,628 +7482 3,068 +187 58,070 EMRO
101 El Salvador 74,141 +1320 2,260 +27 69,215 Americas
102 Cyprus 72,626 +392 362 +5 70,210 EURO
103 Mozambique 70,965 +292 837 +3 69,641 Africa
104 Luxembourg 70,088 +339 818 +5 68,484 EURO
105 Maldives 66,516 +5573 173 +22 43,959 SEARO
106 Mongolia 62,585 +6733 301 +38 52,812 WPRO
107 Singapore 62,145 +205 33 +1 61,557 WPRO
108 Namibia 56,981 +3078 877 +82 51,177 Africa
109 Botswana 56,217 +2446 866 +35 52,675 Africa
110 Uganda 49,759 +5165 365 +4 46,150 Africa
111 Jamaica 48,733 +553 951 +16 25,802 Americas
112 Ivory Coast 47,389 +243 306 +5 46,847 Africa
113 Senegal 41,539 +291 1,144 +8 40,165 Africa
114 Madagascar 41,488 +386 850 +28 40,774 Africa
115 Zimbabwe 39,092 +238 1,604 +12 36,680 Africa
116 Sudan 35,656 +367 2,662 +62 29,364 EMRO
117 Angola 35,140 +1533 784 +39 28,646 Africa
11 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
118 Malawi 34,365 +61 1,156 +2 32,641 Africa
119 Cambodia 32,189 +4551 236 +42 24,763 WPRO
120 DRC 32,177 +898 789 +8 27,727 Africa
121 Cabo Verde 30,774 +835 266 +7 29,125 Africa
122 Malta 30,557 +37 419 0 30,062 EURO
123 Australia 30,141 +67 910 0 29,105 WPRO
124 Rwanda 27,119 +276 358 +7 26,028 Africa
125 Trinidad and Tobago 25,272 +3285 537 +97 14,918 Americas
126 Réunion 24,901 0 189 0 22,796 Non
127 Syria 24,591 +226 1,782 +28 21,620 EMRO
128 French Guiana 24,534 +925 121 +5 9,995 Non
129 Gabon 24,429 +177 152 +2 22,118 Africa
130 Guinea 23,245 +135 162 +1 21,266 Africa
131 Mayotte 20,176 0 173 +2 2,964 Non
132 Mauritania 19,695 +351 464 +2 18,614 Africa
133 French Polynesia 18,884 +29 142 0 18,717 Non
134 Eswatini 18,623 +41 673 +1 17,886 Africa
135 Guyana 17,376 +722 400 +24 15,073 Americas
136 Guadeloupe 16,530 0 221 0 2,250 Non
137 Papua New Guinea 16,185 +770 162 0 15,408 WPRO
138 Suriname 15,676 +1664 325 +50 12,137 Americas
139 Haiti 15,058 +1021 321 +29 12,552 Americas
140 Somalia 14,699 +52 771 +3 6,891 EMRO
141 Mali 14,281 +22 517 +3 9,757 Africa
142 Andorra 13,752 +70 127 0 13,527 EURO
143 Togo 13,513 +93 125 0 13,105 Africa
144 Burkina Faso 13,446 +25 167 +1 13,260 Africa
145 Tajikistan 13,308 0 90 0 13,218 EURO
146 Belize 12,840 +51 325 +2 12,434 Americas
147 Curaçao 12,276 +5 122 0 12,132 Non
148 Martinique 12,040 +80 95 0 98 Non
149 Bahamas 11,930 +308 232 +6 10,932 Americas
150 Hong Kong 11,850 +13 210 0 11,577 WPRO
151 Congo 11,845 +187 154 +1 10,591 Africa
152 Seychelles 11,621 +476 42 +2 10,499 Africa
153 Djibouti 11,544 +21 154 +1 11,382 EMRO
154 Aruba 11,018 +61 107 0 10,857 Non
155 Lesotho 10,836 +12 326 0 6,437 Africa
156 South Sudan 10,688 0 115 0 10,514 Africa
157 Taiwan 9,974 +3213 166 +107 1,133 WPRO
158 Equatorial Guinea 8,572 +96 118 +5 8,189 Africa
159 Vietnam 8,115 +1759 49 +3 3,085 WPRO
12 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
160 Benin 8,082 +24 102 +1 7,893 Africa
161 Nicaragua 7,481 +157 187 +1 4,225 Americas
162 Timor-Leste 7,422 +963 16 +1 4,826 SEARO
163 CAR 7,091 +8 98 +1 6,859 Africa
164 Yemen 6,767 +71 1,325 +10 3,484 EMRO
165 Iceland 6,597 +26 30 0 6,522 EURO
166 Gambia 5,995 +5 179 +1 5,786 Africa
167 Niger 5,416 +10 192 0 5,096 Africa
168 Saint Lucia 5,102 +100 80 +3 4,867 Americas
169 San Marino 5,090 +1 90 0 4,998 EURO
170 Chad 4,935 +9 173 0 4,747 Africa
171 Burundi 4,844 +194 6 0 773 Africa
172 Gibraltar 4,299 +7 94 0 4,194 Non
173 Sierra Leone 4,162 +29 79 0 3,147 Africa
174 Eritrea 4,145 +135 14 0 3,855 Africa
175 Channel Islands 4,066 +1 86 0 3,956 Non
176 Barbados 4,026 +20 47 0 3,922 Americas
177 Comoros 3,882 +3 146 0 3,726 Africa
178 Guinea-Bissau 3,784 +28 68 0 3,525 Africa
179 Liechtenstein 3,017 +11 58 0 2,934 Non
180 New Zealand 2,682 +12 26 0 2,639 WPRO
181 Monaco 2,508 +5 33 +1 2,468 EURO
182 Bermuda 2,494 +3 33 +1 2,444 Non
183 Sint Maarten 2,448 +44 28 0 2,347 Non
184 Turks and Caicos 2,418 +7 17 0 2,386 Non
185 Sao Tome and Principe 2,349 +11 37 0 2,297 Africa
186 Liberia 2,219 +45 86 0 2,044 Africa
187 St. Vincent Grenadines 2,044 +38 12 0 1,832 Americas
188 Saint Martin 2,040 +125 12 0 1,399 Non
189 Laos 1,943 +38 3 0 1,654 WPRO
190 Bhutan 1,654 +163 1 0 1,327 SEARO
191 Caribbean Netherlands 1,615 +5 17 0 1,580 Non
192 Isle of Man 1,595 +4 29 0 1,562 Non
193 Mauritius 1,421 +80 18 +1 1,198 Africa
194 Antigua and Barbuda 1,262 +4 42 0 1,213 Americas
195 St. Barth 1,005 0 1 0 462 Non
196 Faeroe Islands 731 +30 1 0 687 Non
197 Diamond Princess 712 0 13 0 699 NA
198 Cayman Islands 584 +3 2 0 571 Non
199 Fiji 536 +222 4 0 183 WPRO
200 Tanzania 509 0 21 0 183 Africa
201 Wallis and Futuna 445 0 7 0 438 Non
13 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
202 British Virgin Islands 248 0 1 0 209 Non
203 Brunei 244 +3 3 0 231 WPRO
204 Dominica 188 +4 0 0 187 Americas
205 Grenada 161 0 1 0 160 Americas
206 New Caledonia 128 +2 0 0 58 Non
207 Anguilla 109 0 0 0 109 Non
208 Saint Kitts and Nevis 75 +11 0 0 48 Americas
209 Falkland Islands 63 0 0 0 63 Non
210 Macao 51 0 0 0 49 WPRO
211 Greenland 40 +4 0 0 34 Non
212 Vatican City 27 0 0 0 27 Non
213 Saint Pierre Miquelon 25 0 0 0 25 Non
214 Montserrat 20 0 1 0 19 Non
215 Solomon Islands 20 0 0 0 20 WPRO
216 Western Sahara 10 0 1 0 8 Non
217 MS Zaandam 9 0 2 0 7 NA
218 Vanuatu 4 0 1 0 3 WPRO
219 Marshall Islands 4 0 0 0 4 WPRO
220 Samoa 3 0 0 0 3 WPRO
221 Saint Helena 2 0 0 0 2 Non
222 Micronesia 1 0 0 0 1 WPRO
Total 172,910,966 +3267376 3,717,320 192,061 154,117,511
Figure 4. Areas with reported confirmed cases of COVID-19 (24 – 30 May 2021)
Source: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
14 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
Table 5. COVID-19 cases and deaths reported by states/UT in India between 29 May – 4 June, 2021
(Updated as of 4 June 2021, 1300H SGT)
Name of Total Change Total Change Total Change Total Change
State / UT Diagnosed from Active from Recovered from Deaths from
Cases previous Cases previous previous previous
week week week week
Andaman 7070 +153 131 -86 6820 +229 119 +10
and Nicobar
Islands
Andhra 1728577 +85020 138912 -47870 1578452 +132208 11213 +682
Pradesh
Arunachal 28382 +2562 3843 +151 24420 +2401 119 +10
Pradesh
Assam 424385 +31811 51881 -3187 368981 +34563 3523 +435
Bihar 710199 +9302 11431 -17017 693472 +25966 5296 +353
Chandigarh 60399 +983 1135 -1994 58502 +2944 762 +33
Chhattisgarh 976760 +14392 29378 -20042 934243 +34143 13139 +291
Dadra and 10345 +193 250 -120 10091 +313 4 0
Nagar Haveli
and Daman
and Diu
Delhi 1427926 +5377 8748 -7630 1394731 +12372 24447 +635
Goa 157847 +5446 9700 -5999 145437 +11273 2710 +172
Gujarat 813270 +12404 24404 -24678 778976 +36926 9890 +156
Haryana 760019 +9957 12688 -15501 738799 +24865 8532 +593
Himachal 193137 +7318 11057 -9127 178847 +16204 3233 +241
Pradesh
Jammu and 295879 +14251 30657 -11615 261230 +25613 3992 +253
Kashmir
Jharkhand 339930 +5200 7537 -5560 327372 +10665 5021 +95
Karnataka 2653446 +129448 286819 -115405 2336096 +241727 30531 +3126
Kerala 2584853 +136299 184699 -57657 2390779 +192644 9375 +1312
Ladakh 18954 +768 1505 -151 17256 +911 193 +8
Lakshadweep 8479 +1115 1355 -845 7089 +1953 35 +7
Madhya 782945 +9090 14186 -24141 760552 +32852 8207 +379
Pradesh
Maharashtra 5791413 +119233 207813 -95939 5486206 +210003 97394 +5169
Manipur 52899 +5788 8863 +1401 43187 +4286 849 +101
Meghalaya 37149 +4045 6352 -1903 30172 +5847 625 +101
Mizoram 13064 +1682 3415 +554 9602 +1115 47 +13
Nagaland 22240 +1217 4711 -230 17125 +1381 404 +66
Odisha 790970 +58231 75042 -31451 713055 +89427 2873 +255
Puducherry 107114 +6437 10015 -4458 95516 +10767 1583 +128
Punjab 574114 +18025 28673 -19558 530601 +36747 14840 +836
Rajasthan 943494 +12294 27408 -43691 907527 +55529 8559 +456
Sikkim 16165 +1951 4184 +580 11718 +1348 263 +23
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Tamil Nadu 2172751 +194130 280426 -32622 1866660 +223376 25665 +3376
Telangana 585489 +17972 32579 -5688 549579 +23536 3331 +124
Tripura 53872 +4582 6340 -875 46993 +5403 539 +54
Uttarakhand 332067 +8584 22530 -16707 302964 +24919 6573 +372
Uttar 1695212 +11347 25546 -32724 1648771 +43075 20895 +996
Pradesh
West Bengal 1403535 +72286 61780 -55374 1325834 +126714 15921 +946
Total 28574350 +1018893 1635993 -707159 26597655 +1704245 340702 +21807
Source: https://www.mohfw.gov.in/
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iv. Travel Bans/Advisories & Quarantine Orders
[1-2] Bangladesh
The closure of land borders with India has been extended until June 14, while the transportation
of goods through the land borders will continue.
Travelers from 11 countries have been banned with effect from June 4: Argentina, Bahrain,
Bolivia, Brazil, India, Malaysia, Maldives, Nepal, Paraguay, Uruguay, Trinidad and Tobago.
[3] Belarus
Belarus has temporarily banned all its citizens from traveling outside of the country. This applies
to all residents except for Belarusian civil servants on official trips, state transport staff and
residents with permanent residence in other countries. Foreigners may only leave the country
after a 10-day period of self-isolation.
[4] Canada
Ontario extended its ban on interprovincial travel until June 16. The ban applies to non-essential
travel affects Ontario's land boundaries with Manitoba and Quebec.
[5] France
Starting 31 May, compelling reasons will be required to enter France for non-EU foreigners who
are not residents in France and who come to France from the United Kingdom.
[6] Greece
An emergency notam on air travel restrictions has been extended until 6:00 on Monday, June 7.
This forbids the entry into Greece of third-country nationals arriving by air but not EU and
Schengen area nationals, their spouses or civil partners and their minor children. Exempted from
the ban are passengers travelling for essential reasons and the permanent residents of the
following 22 countries: Australia, North Macedonia, United Arab Emirates, United States, United
Kingdom, Israel, Canada, Belarus, Bahrain, New Zealand, South Korea, Qatar, China, Kuwait,
Ukraine, Rwanda, Russia, Saudi Arabia, Serbia, Singapore, Thailand and Bosnia-Herzegovina.
[7] Iceland
Travellers from defined high-risk areas are no longer required to complete their quarantine at
government-operated facilities. For those who present proof of vaccination or previous COVID-
19 infection are required to undergo a single test upon arrival and quarantine until they receive
a negative result. For those who do not present valid proof of vaccination or previous COVID-19
infection are required to undergo a test upon arrival to Iceland, quarantine for five days, and
undergo a follow-up test.
[8] India
The ban on international commercial flights has been extended till 30 June. However,
international scheduled flights will be allowed on selected routes on a case-to-case basis. Air
bubble pacts have been formed with around 27 countries, including Russia, Tanzania, USA,
Canada, Germany, and France and Seychelles and Uzbekistan have now been added.
[9-10] Israel
The ongoing travel ban has been extended until June 13 in seven countries: India, Ukraine,
Ethiopia, Brazil, South Africa, Mexico and Turkey. Israeli citizens and permanent residents who
want to travel to one of these countries must apply to an exceptions committee. Meanwhile, all
passengers arriving in Israel from these countries must go into quarantine, including those
vaccinated and recovered from the virus. The travel ban will now also apply to Argentina and
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Russia. A severe travel warning was also issued on May 31 for 10 additional countries:
Seychelles, Uruguay, Bolivia, Maldives, Nepal, Paraguay, Chile, Colombia, Costa Rica and Tunisia.
[11] Italy
Entry ban for people coming from India, Bangladesh and Sri Lanka was extended until June 21
and it does not apply to Italian citizens.
[12] Jamaica
The quarantine requirement for fully vaccinated persons has been reduced to eight days for a
four-week period from June 3 to 30 while, the travel restrictions for South American Countries –
Brazil, Chile, Peru, Colombia, Argentina and Paraguay, as well as for India and Trinidad &
Tobago, has been extended until June 30.
[13] Japan
Staring 4 June, a six-day quarantine period will be imposed on travelers who have recently been
to Vietnam and Malaysia and will be tested twice within 14 days of arrival. A quarantine period
of 10 days will be imposed on travelers who have recently been in Afghanistan and a 3-day
period of self-isolation for those recently in Thailand and 15 U.S. states including New York and
California. Travelers who have been to Israel or Slovakia within 14 days of arrival will no longer
be subject to a three-day quarantine period.
[14] Malta
Since June 1, all passengers travelling from and to the island require a vaccination certificate or
a negative PCR test result. The travel ban for all red zone countries remains in place, and only
Maltese citizens or people with a Superintendent of Public Health permission to visit Malta are
permitted to enter the country on presenting a double negative PCR test result before
departure and arrival and undergo 14 days of quarantine, and a repeated PCR test on day 11 or
12 of quarantine.
[15] Myanmar
The suspension period of international commercial flights has been extended to the end of June.
[16] Netherlands
On June 1, the flight ban imposed on arrivals from India, South Africa, and countries in South
and Central America was lifted and they will now only be subjected to a ten-day quarantine. This
period can be shortened if a negative test result is provided on the fifth day of self-isolation.
[17] New Zealand
Pause on the quarantine-free travel with Victoria has been extended until 9 June. However,
citizens and permanent residents, people with humanitarian exemptions and critical workers
who are stranded in Victoria will be able to fly to New Zealand from June 9.
[18] Oman
On 2 June, movement across its land borders for Omanis and citizens of other Gulf countries will
be allowed daily for work, while also loosening other pandemic-related restrictions imposed for
health reasons. Ban on entering the country from Sudan, Brazil, Nigeria, Tanzania, Sierra Leone,
Ethiopia, the United Kingdom, India, Pakistan, Bangladesh, Egypt and the Philippines has been
extended and entry for people coming from Thailand, Malaysia and Vietnam, as well as anyone
who has been in any of the banned countries in the prior 14 days will be banned, starting on
June 5.
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[19-20] Philippines
Workers from Philippines will now be allowed to go to work in Saudi Arabia after the kingdom
said they would not be charged for COVID-19 tests and quarantine upon arrival.
Ban on inbound travel from India, Pakistan, Sri Lanka, Bangladesh, Nepal, Oman, and the United
Arab Emirates has been extended until Jun 15.
[21] Russia
The ban on direct flights from the UK has been lifted starting 2 June however, the ban on flights
to Turkey and Tanzania will remain in place for at least another three weeks until June 21.
[22-23] Saudi Arabia
The travel ban has been lifted from 11 countries: United Arab Emirates, Germany, the United
States, Ireland, Italy, Portugal, the United Kingdom, Sweden, Switzerland, France and Japan
starting May 30. The institutional quarantine will be applied on those coming from the
aforementioned countries.
[24-25] Spain
Ban on International cruise ships will be lifted from June 7.
The entry restrictions on non-essential travel for arrivals from Morocco and Algeria as well as
other non-European Union/Schengen Area countries has been extended until 30 June.
[26-27] Sri Lanka
International airport was reopened on 1 June for all passengers excepts for those including
citizens, with a travel record to India and Vietnam over the last 14 days or who have used their
airports for transit.
The island wide travel restriction enforced in the country has been extended till 04 am on the
14th of June.
[28] Sweden
The entry restrictions for travellers from Denmark, Finland, Iceland and Norway has been lifted,
while the entry restrictions on travellers from the rest of the European Union and the European
Economic Area, and the entry ban on travellers from third countries have been extended to June
30.
[29] Thailand
Thailand has imposed stricter controls at its border with Malaysia which comprise of four Thai
provinces namely: Narathiwat, Yala, Songkhla and Satun.
[30] Turkey
As of 1 June, passengers departing from Afghanistan, Bangladesh, Brazil, South Africa, India,
Nepal, Pakistan, and Sri Lanka will be required to quarantine for 14 days in locations determined
by the governorships. Passengers who have been to these countries in the last 14 days will also
be requested to submit a negative result of the PCR test conducted a maximum of 72 hours
before entering Turkey.
[31-33] UAE
The suspension of passenger flights from India and a ban on travelers from Pakistan has been
extended till June 30.
The entry of passengers from Vietnam has temporarily been suspended from June 5 exempting,
transit flights coming to the UAE and flights departing to Vietnam, as well as cargo flights.
Travellers coming from Vietnam through other countries should stay no less than 14 days in
these countries to be allowed to enter the UAE.
19 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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[34] UK
Portugal has been removed from Britain’s quarantine-free travel list as of 3 June.
[35] USA
Travel restrictions at the Northern and Southern land and sea borders have been extended until
June 21, 2021. Individuals are not admitted for non-essential purposes but will be admitted for
“essential” purposes including travel for work, medical reasons, to attend educational
institutions, and diplomatic or military-related travel. Citizens and permanent residents are
exempted from the ban.
[36] Vietnam
Incoming international flights to Vietnamese capital Hanoi will be suspended for a week from
June 1.
v. Lockdowns
[1] Australia
Lockdown in Melbourne has been extended by another seven days as of June 2.
[2] Bangladesh
COVID-19 lockdown has been extended till June 6.
[3] Chile
Lockdown measures have been extended in 16 cities, including the capital Santiago starting 5
June.
[4] China
On 1 June, 38 zones in the provincial capital Guangzhou have been locked down, including the
entire
Zhongnan community in the city’s Liwan district. Residences and work areas of all infected
cases, as well as 37 other exposed venues have been sealed.
[5] Colombia
Several lockdown measures were relaxed as of 3 June which include; not requiring a negative
coronavirus test from travelers entering the country by air, students will return to classrooms on
completion of the teacher’s vaccination, concerts, large sporting events and nightclubs will be
allowed at 25% capacity in cities with less than 85% occupancy of ICU beds.
[6] Cyprus
More COVID-19 restrictions were lifted on 1 June with increase in house gatherings, wedding
parties and restaurants being able to use indoor facilities and night clubs reopening from 10
June.
[7] European Union
An entry ban for non-essential purposes on the residents of Japan has been abolished.
[8-25] India - Between 29 May and 4 June, following states have extended the lockdown with some
relaxations:
Andhra Pradesh - Restrictions in Tirupati and entire Chittoor district will be further intensified
and extended for a fortnight from June 1 to June 15.
Bihar - extended till June 8.
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Gujarat - The lockdown restrictions have been revised allowing, shops to remain open from June
4. Night curfew from 9 pm to 6 am will be imposed in the 36 cities between June 4 and June 11.
Haryana - extended till June 7.
Jammu and Kashmir - restrictions will be eased while the weekend and night curfew would
continue.
Jharkhand - extended the lockdown-like restrictions till June 10 with some easing in 15 of the 24
districts that witnessed lesser cases.
Karnataka - extended until June 14.
Kerala - extended until June 9.
Lakshadweep – complete lockdown has been extended for seven more days.
Maharashtra - extended until June 15. In Mumbai, the stricter lockdown-like curbs have been
relaxed in an order issued under the 'Break the Chain' initiative, which also permitted the
distribution of non-essential items along with essential ones under e-commerce.
Mizoram - The ongoing lockdown in the Aizawl Municipal Corporation (AMC) has been extended
by another seven days till 4 am of June 6.
New Delhi - extended until June 7 with restrictions for two sectors - manufacturing and
construction businesses being relaxed.
Odisha - extended until 5 a.m. on June 17.
Puducherry - extended until June 7.
South Andaman - extended until June 7.
Telangana - extended until June 9.
Uttar Pradesh - Easing of lockdown measures was announced, including allowing shops to open
on weekdays. Relaxation are not for cities and districts with over 600 cases. While shops outside
containment zones are allowed to open from Monday to Friday in a week, prevailing lockdown
measures will remain in place across the state during the weekends.
[26] Kenya
The nationwide night curfew which runs from 10pm and 4am has been extended for 60 days to
July 26 and a ban on public gatherings has been extended for another 30 days.
[27-28] Malaysia
A total lockdown has been imposed with Phase 1 beginning June 1 wherein only essential
economic and service sectors listed by the National Security Council will be allowed to operate.
These sectors include healthcare, telecommunications and media, food and beverage, utilities as
well as banking. The 12 manufacturing sectors such as food and drink manufacturing, medical
devices, textiles for producing personal protection equipment as well as oil and gas can continue
to operate at 60 per cent capacity.
[29] Nepal
On 2 June, lockdown in Kathmandu, Bhaktapur and Lalitpur districts was extended till June 14.
Under the new restrictions, grocery stores, which were asked to be shut down last time, are
allowed to open till 9 a.m. local time.
[30] Philippines
Five barangays- Barangays 2, Dalipe, San Fernando, Barangay 8 and Badiang, have been placed
under lockdown for 14 days effective May 31, 2021.
[31] Scotland
21 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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Restrictions in parts of Scotland will be eased on 5 June, with some parts of the country moving
from level 2 to level 1. Edinburgh and Midlothian, Dundee, East Dunbartonshire, Renfrewshire
and East Renfrewshire, the three Ayrshire areas, North and South Lanarkshire and
Clackmannanshire and Stirling will remain in level 2 while Glasgow will move to level 2. Those in
level 1 areas can meet outside and indoors in public places in larger groups.
[32] South Africa
From 31 May, the country will return to stricter lockdown with the nighttime curfew being
extended by an hour to start at 11pm until 4am. The lockdown level which has been level one
will now be raised to an adjusted level two.
[33] Spain
On 2 June, a traffic light system to determine coronavirus restrictions based on an area’s
epidemiological situation was approved. This set of common criteria is to be applied until 70% of
the population and all over-50s are vaccinated.
[34] Sri Lanka
Sri Lanka’s ongoing COVID-19 movement restrictions have been extended till 4am June 14.
[35] Suriname
A total lockdown of the country has been issued for the next 2.5 weeks starting Monday until
June 18th. During the lockdown, with the exception of essential services, all government offices
will be closed and citizens are only allowed to leave home for emergencies, such as for medical
reasons. Code Purple, the worst risk level for the pandemic, has been issues for the entire
country, and Code Black for the situation in hospitals.
vi. Military Surveillance
COVID-19 cases in Fiji military [1]
Of the 35 new cases reported in Fiji in the last week of May, there were seven soldiers from the military
barracks cluster in the capital Suva. No other information has been provided.
South Korea- COVID-19 cases in the South Korean military [2-6]
As of June 1, six army soldiers and two Air Force officer tested positive for COVID-19. The soldiers were
from border town of Cheorwon, southwestern county of Jangseon and central city of Cheonan and one
airman from the city of Osan. The remaining soldiers and one of the officer were confirmed to have
been infected following their recent vacations.
As of June 2, five service members and a civilian worker for the military tested positive. A soldier and an
Air Force officer were confirmed to have been infected after coming into contact with members of their
respective bases while, a Marine and the civilian worker tested positive following infections of their
family members.
As of June 3, five service members tested positive which include an Army soldier in Goyang, two from
the Army, one from the Air Force and one from a unit under the direct control of the ministry were
found to be infected either on or after vacation. The latest cases raised the total number of infections
reported among the military population to 972 with 52 under treatment.
22 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
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South Korea- COVID-19 cases in USFK [7-8]
As of 1 June, one American service member stationed at Camp Humphreys in Pyeongtaek and a South
Korean contractor who works at Yongsan Garrison in central Seoul for the U.S. Forces Korea (USFK)
tested positive for the new coronavirus.
As of 3 June, four American service members and three dependents tested positive upon their arrival via
Incheon International Airport, west of Seoul, between May 16-30. The latest cases raised the total
number of infections reported among the USFK-affiliated population to 884.
Japan - COVID-19 cases in USFJ [9-11]
On 27 May, the Yokota base reported that three people, all of them already quarantined, tested positive
between 26-28 May. One was a recent arrival from the United States; the remaining two were
previously identified as close contacts of another infected individual.
As of 29 May, American military bases on Okinawa tightened their restrictions while U.S. installations
across Japan reported four new coronavirus cases – three at Yokota Air Base in western Tokyo and one
at Kadena Air Base on Okinawa. The Marines have reported 45 cases of COVID-19 so far this month.
As of 2 June, US military in Japan reported four cases at the Yokosuka Naval Base and one cases at
Kadena Air Base on Okinawa.
As of 3 June, U.S. military in Japan reported nine new cases of COVID-19 with three each at Marine
Corps Air Station Futenma and Camp Hansen and two at Camp Foster. The Marines have reported 53
cases of COVID-19 since May 1.
Update: COVID-19 cases and deaths in the US military [12]
As of June 2, there have now been 295,794 total cases of COVID-19 within the DoD: 194,986 military,
29,804 dependents, 52,501 civilians and 18,503 Defense Department contractors. In addition, 190,647
military members, 29,436 dependents, 47,065 civilians and 17,507 contractors have recovered, and 352
DoD-connected personnel have died: 26 troops, 12 dependents, 234 civilians and 80 contractors. Of the
cases, 4,102 have required hospitalization: 1,734 service members, 1,487 civilians, 375 dependents and
506 contractors.
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vii. WHO Guidance & Other Protocols
The following update was published by the WHO from 29 May– 4 June 2021:
How to manage COVID-19 vaccines withoutVVM at vaccination service points?
Available at: https://www.who.int/publications/m/item/how-to-manage-covid-19-vaccines-
withoutvvm-at-vaccination-service-points
Critical preparedness, readiness and response actions for COVID-19
Available at: https://www.who.int/publications/i/item/critical-preparedness-readiness-and-
response-actions-for-covid-19
Operational guide for engaging communities in contact tracing
Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-Contact_tracing-
Community_engagement-2021.1-eng
Background document on the inactivated vaccine Sinovac-CoronaVac against COVID-19
Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-
SAGE_recommendation-Sinovac-CoronaVac-background-2021.1
Guidance on developing a national deployment and vaccination plan for COVID-19 vaccines
Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-Vaccine-deployment-
2021.1-eng
Annexes to the recommendations for use of the Sinovac-CoronaVac vaccine against COVID-19:
Grading of evidence, Evidence to recommendation tables
Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-
SAGE_recommendation-Sinovac-CoronaVac-annexes-2021.1
Interim recommendations for use of the inactivated COVID-19 vaccine, CoronaVac, developed
by Sinovac
Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-
SAGE_recommendation-Sinovac-CoronaVac-2021.1
viii. CDC Guidance & Protocols
US CDC
The following updates were published by the US CDC from 29 May– 4 June 2021:
Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with
Coronavirus Disease 2019 (COVID-19)
Available at: https://www.cdc.gov/coronavirus/2019-ncov/lab/lab-biosafety-guidelines.html
Discontinuation of Transmission-Based Precautions and Disposition of Patients with SARS-CoV-
2 Infection in Healthcare Settings
Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-
patients.html
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EU CDC
The following updates were published by the EU CDC from 29 May– 4 June 2021:
Suspected adverse reactions to COVID-19 vaccination and the safety of substances of human
origin
Available at: https://www.ecdc.europa.eu/en/publications-data/suspected-adverse-reactions-
covid-19-vaccination-and-safety-substances-human
Reducing COVID 19 transmission and strengthening vaccine uptake among migrant populations
in the EU/EEA
Available at: https://www.ecdc.europa.eu/en/publications-data/covid-19-migrants-reducing-
transmission-and-strengthening-vaccine-uptake
Interim public health considerations for COVID-19 vaccination of adolescents in the EU/EEA
Available at: https://www.ecdc.europa.eu/en/publications-data/interim-public-health-
considerations-covid-19-vaccination-adolescents-eueea
ix. Vaccines/Therapeutics Development
Noteworthy reports are included to inform main developments of COVID-19 pharmaceutics. Past updates
are available from situation report 211 onwards. A global map and registry of trials is also visualised &
accessible at: https://www.covid-nma.com/dataviz/ and trial results are available at: https://covid-
nma.com/living_data/index.php. A living systematic review of vaccine trials is also accessable at
https://covid-nma.com/vaccines/ or https://covid-nma.com/ .
Vaccines
[1] Global - The World Health Organization on June 1 approved Sinovac's two-dose vaccine
CoronaVac for emergency use.
[2] Canada - Canada’s National Advisory Committee on Immunization announced that people who
got the Oxford-AstraZeneca vaccine for the first dose can be offered either Pfizer-BioNTech or
Moderna for the second.
[3] Chile – On Jun 3, it was announced that the minimum age of men approved to receive the
AstraZeneca coronavirus vaccine will be raised to 45 from 18 until an investigation into a blood
clot report has been completed.
[4] China – As of 3 June, COVID-19 nasal spray vaccine which has been developed jointly by CanSino
Biologics Inc and vaccine developer Chen Wei, has applied for emergency use in China. The
vaccine only requires one-fifth of the amount of the injectable adenovirus vector COVID-19
vaccine and doesn't need cold-chain storage and transport.
[5] EU - The Pfizer-BioNTech vaccine has been authorized in 12- to 15-year-olds following the
European Medicines Agency's approval of administering the jabs to adolescents. This vaccine is
already approved for people aged 16 and over in the EU.
[6] Hong Kong – Pfizer BioNTech COVID-19 vaccine for children aged 12 and above has been
authorized on Jun 3.
[7] India - Zydus Cadila is planning to start the trials of its COVID-19 vaccine, ZyCoV-D, in children of
5-12 years. Benefits of the vaccine include needle-free administration. ZyCoV-D is a DNA plasmid
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vaccine, which uses a portion of the genetic code -- DNA or RNA -- in the virus to stimulate an
immune response.
[8] Netherlands - Use of Janssen Covid vaccine will be limited over side effects, effectiveness and
younger groups of people born after 1976, who have not yet received a Covid-19 vaccine will not
be given the Janssen Vaccine.
[9] Pakistan - On 1 June, homemade Covid-19 vaccine named “PakVac” which has been developed
with the help of China, was launched.
[10]Singapore – On 2 June, Sinovac's Covid-19 vaccine has been allowed under the Special Access
Route (SAR).
[11]South Korea – The phase-1 trial results for Genexine’s Covid-19 DNA vaccine candidate GX-19N
were released on 2 June. The vaccine showed excellent safety of GX-19N however, the vaccine
efficacy was too low and could not be proven.
[12]UK - Britain approved a single-shot COVID-19 vaccine developed by Johnson & Johnson on 28 May
in people aged 18 years and older.
[13]USA - The NIH has started a trial looking at what happens when an adult who is fully vaccinated
with one type of Covid vaccine, is boosted with a different shot about three to four months later.
The trial will include about 150 adults who have been fully vaccinated with the Johnson & Johnson,
Moderna or Pfizer Covid vaccines.
Therapeutics
[14]India - A combination of monoclonal antibodies, bamlanivimab and etesevimab has been given
approval for restricted use in emergency situations in hospital settings in adults.
[15]UAE - UAE authorised the emergency use of Sotrovimab, a kind of monoclonal antibody drug.
Vaccine Approval Status
Table 6: Number of approving countries per vaccine as of 1 June 2021
Number of countries
Developer Vaccine
approving
Anhui Zhifei Longcom RBD-Dimer 2
Bharat Biotech Covaxin 9
CanSino Ad5-nCoV 5
Chumakov Center Kovivac 1
FBRI EpiVacCorona 2
Gamaleya Sputnik V 68
Johnson & Johnson Ad26.COV2.S 42
Kazakhstan RIBSP QazCovid-in 1
Minhai Biotechnology Co SARS-CoV-2 Vaccine (Vero Cells) 1
Moderna mRNA-1273 49
Oxford/AstraZeneca AZD1222 99
BioNTech/Pfizer BNT162b2 85
Serum Institute of India Covishield 40
Sinopharm BBIBP-CorV 44
Sinopharm Inactivated 1
Sinovac CoronaVac 25
Takeda TAK-919 1
Source: https://covid19.trackvaccines.org/vaccines/
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Adverse Reactions & Effects
[1] Canada - Nova Scotia announced its first case of vaccine-induced immune thrombotic
thrombocytopenia on 2 June in a man in his 40s who received his first dose of AstraZeneca
vaccine in early May.
[2] China – On 29 may, data on adverse reactions following mass inoculation was released. A total
of 31,434 adverse reactions were reported among 265 million doses used between December
15, 2020 and April 30, 2021. Normal reactions like fever and swelling accounted for 82.96
percent while severe reactions such as acute allergies accounted for 17.04 percent. Among
severe adverse reaction cases, 0.07 cases in every 100,000 doses administered were termed as
“extremely rare”.
[3] Estonia – The following moderate to severe side effects have been reported last week after the
first dose: Pfizer/BioNTech - allergic reaction that caused swelling of the throat and face and
unilateral facial nerve palsy developing two days after the first dose of the vaccine; AstraZeneca
- onset of nerve damage one week after the first dose, long-term joint pain.
[4] Israel – As of June 1, a total of 275 cases of myocarditis were reported between December 2020
and May 2021 among more than five million vaccinated people. The study found a probable link
between receiving the second dose of Pfizer vaccine and the appearance of myocarditis among
men aged 16 to 30.
[5] Uruguay – Results from an analysis of 712,716 people who had passed the 14-day mark from
March 1 to May 25 after having received the final dose of the CoronaVac vaccine showed that
COVID-19-related deaths among Uruguayan adults aged 18-70 fell by 97%, hospitalizations in
intensive care units also decreased by over 95% and infection cases decreased by 57%.
[6] South Korea – The first case of very rare but serious side effect called thrombocytopenia in a
recipient of the AstraZeneca COVID-19 vaccine has been reported in a man in his 30s, working at
a medical facility who was inoculated on April 27.
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x. Scientific Publications with Epidemiology and Clinical Focus
Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with
COVID-19: Insights from the Cardio-COVID-Italy multicenter study [511]
Background: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized
patients with coronavirus disease 2019 (COVID-19). Our aim was to focus on the impact of relevant clinical
and laboratory factors on the protective effect of glucocorticoids on mortality.
Methods: We performed a sub-analysis of the multicenter Cardio-COVID-Italy registry, enrolling
consecutive patients with COVID-19 admitted to 13 Italian cardiology units between March 1st, 2020, and
April 9th, 2020. The primary endpoint was in-hospital mortality.
Results: A total of 706 COVID-19 patients were included (n = 349 treated with glucocorticoids, n = 357 not
treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was
associated with a lower risk of in-hospital mortality (adjusted HR 0.44, 95% CI 0.26-0.72, p = 0.001). A
significant interaction was observed between the protective effect of glucocorticoids on mortality and
PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP
(0.023). Such protective effect of glucocorticoids was mainly observed in patients with lower PaO2/FiO2
ratio ( 6
months) HCQ treatment prior to the COVID-19 outbreak were selected consecutively. The diagnosis of
COVID-19 was made based on the history of symptoms suggestive of the disease and/or serum IgG
positivity. During statistical analysis, the risk of COVID-19 infection was calculated in rheumatic patients
taking DMARDs versus controls, as well as in patients taking HCQ versus those who are not. The ORs and
95% CIs were also calculated. The participants in the control group were selected from individuals without
RD.
Results: A total of 800 patients with RD and 449 controls were analyzed. COVID-19 infection was detected
in 16.8% of rheumatic patients versus 17.6% of controls (OR 0.95; 95% CI 0.7-1.28). The proportions of
COVID-19 infection in HCQ users versus non-users were 15.3% and 18.1%, respectively (OR 0.87; 95% CI
0.61-1.26). These results remained unchanged after adjusting for all covariates using logistic regression
analysis.
28 | P a g e Centre for infectious disease epidemiology and researchFor citation: Centre for Infectious Disease Epidemiology and Research-NUS.
COVID-19 Situation Report 466. 4 June 2021
Conclusion: These findings indicate that rheumatic patients taking DMARDs are not at a higher risk of
COVID-19 infection, and that HCQ therapy has no influence on the risk of COVID-19 infection. Key points
• The risk of COVID-19 infection is not higher in patients with RD on DMARD therapy. • The prevalence of
COVID-19 infection in HCQ users has not significant difference relative to non-users. • Significant percent
of RD patients taking DMARDs had asymptomatic infection. • There was a positive association between
leflunamide therapy and the risk of COVID-19 infection.
Functional gastrointestinal and somatoform symptoms five months after SARS-CoV-2 infection: A
controlled cohort study [513]
Background: Gastrointestinal infections represent a risk factor for functional gastrointestinal and
somatoform extraintestinal disorders. We investigated the prevalence and relative risk (RR) of
gastrointestinal and somatoform symptoms 5 months after SARS-CoV-2 infection compared with a control
cohort.
Methods: One hundred and sixty-four SARS-CoV-2 infected patients and 183 controls responded to an
online questionnaire about symptoms and signs during the acute phase of the infection and after 4.8 ±
0.3 months. Presence and severity of gastrointestinal symptoms, somatization, anxiety, and depression
were recorded with standardized questionnaires. Stool form and presence of irritable bowel syndrome
(IBS) were also recorded. Any association between exposure to infection and symptoms was evaluated by
calculating crude and adjusted RR values and score differences with 95% confidence intervals (CI).
Key results: Fever, dyspnea, loss of smell/taste/weight, diarrhea, myalgia, arthralgia, and asthenia were
reported by more than 40% of patients during the acute phase. Compared with controls, adjusted RRs for
loose stools, chronic fatigue, and somatization were increased after infection: 1.88 (95% CI 0.99-3.54),
2.24 (95% CI 1.48-3.37), and 3.62 (95% CI 1.01-6.23), respectively. Gastrointestinal sequelae were greater
in patients with diarrhea during the acute phase.
Conclusions & inferences: Mild gastroenterological symptoms persist 5 months after SARS-CoV-2
infection, in particular in patients reporting diarrhea in the acute phase. Infected patients are at increased
risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional
gastrointestinal and somatoform disorders may have a common biological origin.
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