COVID-19 Outbreak: Weekly Global Report for Friday, July 17, 2020

AdvaMed recognizes that its members, particularly those with global government affairs responsibilities, are tracking COVID-19 related developments around the world to assess the public health and economic impacts on their businesses. Knowing that companies are consuming information from a variety of sources, AdvaMed’s global team would like to provide members with a weekly snapshot of the key statistics, policy developments and advocacy initiatives underway in our priority markets.  If you have any suggestions, we welcome your feedback.

Global

• Weekly COVID-19 statistics- global cases reached 13.6 million, representing a 1.5 million increase over the previous week. Deaths around the world exceeded 586,369. The countries with the most reported cases are the U.S. (3.5 million), Brazil (2 million), India (968,000), and Russia (751,000).
• U.S. cases exceeded 3.5 million with deaths increasing to 138,000.

China

• Weekly COVID-19 statistics –China is reporting a few dozen new cases each day and are mostly linked to foreign arrivals. Total cases now stand at 85,314 and deaths stand at 4,644.
• The Chinese economy expanded by 3.2% in the second quarter, according to Chinese government figures. The economy had shrunk 6.8% in the first quarter when China was in the depths of its COVID emergency and economic shutdown. This represents the first recovery by a major economy following the fallout from the coronavirus pandemic. While production levels have returned to normal and even expanded, domestic consumption levels have yet to recover to pre-Covid levels.
• As part of its ongoing response to the Covid threat, the government is emphasizing the role of traditional Chinese medicine (TCM) as a therapeutic remedy. TCM clinics are to increase their supply of PPE and carry out nucleic acid tests.
• China is continuing to allow an increased number of inbound flights from overseas. The vast majority of passengers on these flights are returning Chinese nationals, as the Chinese government has not relaxed its entry ban on foreigners.
• Elective/regular surgeries and other medical services are back to normal.
• The WHO sent a team to China last week to investigate the origins of COVID-19.
• China is taking seriously its commitments under the Phase One trade deal, according to USTR. U.S. exports to China have noticeably increased since May as China’s economy has recovered. Most observers believe China will be unable to meet its additional purchase commitments for U.S. energy products and services, however.
• Staff Contact: Ralph Ives ([email protected]).

 India

• Weekly COVID-19 statistics – 331,146 active cases/24,915 deaths as compared to 269,789 active cases/21,129 deaths reported last week. 
• Prime Minister Narendra Modi reached out to the world for investing in India, while pointing out the country was already witnessing green shoots of economic recovery. Speaking during the inaugural address of the Global Week 2020, the PM tried to allay apprehensions that India could turn more protectionist with his call for an ‘Aatmanirbhar Bharat’ (“Self-Reliant India”).
• Pharmaceuticals major Zydus on Wednesday started human trials for its plasmid DNA vaccine ZyCovD-potential COVID-19 vaccine.
• The Union government continued to deny the onset of community transmission in India, even as the country is seeing increasing number of cases every day.
• Health Ministry said that India’s Covid-19 recovery rate has improved to 62.93 per cent.
• The Indian Council of Medical Research (ICMR) plans to launch a new pan India serological survey.
• ICMR’s Research Chief Balram Bhargava said human trials of vaccine had begun in different sites, and each of which will do clinical testing of vaccine on 1,000 volunteers.
• The Director General for Foreign Trade (DGFT) eased export restrictions on certain kinds of PPE to allow the export of certain non-woven materials.
• The Reserve Bank of India (RBI) may further cut interest rates as a monetary policy tool to perk up demand.
• Staff Contact:  Abby Pratt ([email protected]).

Japan

• Weekly COVID-19 statistics – 24,370 reported cases and 998 reported deaths compared to 21,476 reported cases and 995 reported deaths the previous week.      
• Tokyo deactivated its virus alert and moved to the third and final stage of its plan to reboot businesses and reopen society. Under Phase 3, nearly all business closures were lifted. Restaurants and bars can stay open until midnight, and public events will be limited to one thousand people.
• Following this reopening, Japan has experienced a sustained increase in reported cases. The majority of new cases are in Tokyo and are affecting people in their 20s and 30s. Despite this increase, the government continues to insist that re-imposing emergency measures is unnecessary.
• Japan lifted all domestic travel restrictions. Residents are free to visit any prefecture across the nation.
• The government released a national contact tracing app but was immediately confronted with bugs that forced the Ministry of Health, Labor, and Welfare (MHLW) to hastily pause the app’s operations.
• Japan and Vietnam announced an agreement to ease bilateral travel restrictions in stages. Vietnam will first accept 440 Japanese business travelers on three charter flights. The travelers will be required to undergo tests upon arrival and be quarantined for two weeks at hotels. Thailand will likely be next in line for eased restrictions, followed by Australia and New Zealand.
• Japan currently has an entry ban in place for 111 countries and regions, with foreign travelers who have been to any of those areas within the last two weeks being turned away.
• Japan’s Ministry of Health has adopted priority regulatory review procedures for new COVID-related medical devices.
• Japan will ban foreign companies from purchasing advanced medical device companies that are deemed essential to the national security in the fight against Covid-19. This measure is based on concerns about China but applies to companies from all countries.  The government aims to ensure stable supply of essential devices that are vulnerable to contamination by infection, such as implants and dialyzers.
• Staff Contact:  Phil Agress ([email protected]).

Korea

• Weekly COVID-19 statistics – South Korea’s new daily cases stand at 61 now, up from 50 a week ago, and double the number from two weeks ago. Authorities are continuing to monitor and do contact tracing. There are 13,612 cases, 925 active with 291 deaths and 2 deaths per day reported.    .      
• At the start of Parliamentary proceedings for Korea’s 21^st National Assembly, President Moon Jae-in on Thursday urged realization of the “politics of cooperation” and called on political parties to support his administration’s social and economic reforms, and peace drive. Moon said that the National Assembly remains far short of the public’s expectations despite its many achievements in the past. Moon urged the lawmakers to support the efforts to turn the country into a “leading nation” and support the so-called Korea New Deal.
• The deal is a massive government-led project that will see over 114 trillion won ($94.5 billion) investment from the central government by 2025 with the aim of creating 1.9 million jobs. The plan focuses on applying latest information technology and eco-friendly technologies to existing industries and infrastructure. The plans also include measures for strengthening social security, rolling out new vocational training programs and offering government subsidies and support to a larger range of jobs.
• According to the Ministry of Trade, Industry and Energy, Korea’s accumulated export volume as of end-June is down 11.2 percentage point from a year earlier. The Bank of Korea has continued to keep interest rates at record low rates, given bleak GDP growth projections.
• Korea continues to exhibit one of the lowest global death rates from COVID at just 2.4%. 
• South Korea has committed to inject over 4 trillion won (4.1 billion) in the materials, parts and equipment industries to ensure stable supplies for the nation’s key exports. Of this amount, 2 trillion won will be allocated for the nation’s three major industries, including semiconductor, biotech and future mobility sectors, according to the Minister of Industry.
• The government also plans to provide tax benefits and secure 110 billion won worth of venture capital funds to support SMEs developing future technologies. The government will separately invest 1.5 trillion won over the next 5 years to create industrial clusters that connect the major players with SMEs. It will also encourage foreign companies to join research and development projects, increasing the participation rate from 3 to 10 percent.
• Since Monday, the government has required those traveling from “high-risk” countries — Bangladesh, Pakistan, Kazakhstan and Kyrgyzstan — to submit certificates issued within 48 hours proving they tested negative for the coronavirus. Those without proof of the negative test result will not be allowed to board flights to Korea and could face deportation when they arrive. Even with the proof, they still need to self-quarantine for two weeks either at home or at designated facilities, depending on their visa status, and seek testing for the virus within three days of their arrival. On Thursday, Korea added Philippines and Uzbekistan to the list of high risk countries.
• South Korea maintains its 2-week quarantine for all other incoming international travelers and a requirement for all inbound flights to check passengers’ temperatures. Anyone with a temperature over 37.5 degrees Celsius (99.5 Fahrenheit) is denied entry. Korea has still not issued any guidance on an exemption that is supposedly available.  Korea has indicated all US inbound travelers will be tested for symptoms prior to being moved to quarantine.
• Korea is considering a proposal that would potentially reduce the price of certain cardiac stents. AdvaMed continues to be in touch with members and the medtech association in Korea and is prepared to engage at the appropriate time if necessary.
• Resources: http://ncov.mohw.go.kr/en/. 
• Staff Contact:  Joseph Gatewood ([email protected]).

 ASEAN

• Weekly COVID-19 statistics – ASEAN now has 203,067 reported cases and 5732 reported deaths compared to 180,785 reported cases and 4,919 reported deaths the previous week.
• The Philippines and Indonesia account for 96% of the deaths from COVID-19 in the region.
• Elective surgeries have resumed in Thailand and in most hospitals in Vietnam. Singapore now allows certain procedures including cancer screening, surgical operations for advanced cataracts, flu vaccinations, and dental procedures. Malaysia and the Philippines are beginning to plan for the resumption of elective surgery once recovery milestones are met. Provincial hospitals in Indonesia have resumed elective procedures but need approval from local government officials.
• Indonesia continues to see a substantial number of new cases. The Jakarta governor issued a stark warning that the continuing rise in cases could see the return of large-scale social distancing (PSBB) measures if health protocols are ignored.
• Indonesia has lifted the ban on export of medical devices for COVID-19 purposes. At the same time, President Jokowi has called for an end to PPE imports as the country is capable of manufacturing them locally. Indonesia has produced its own rapid test called RI-GHA COVID-19. 
• With new case growth below 20 per day for nearly a month and seven deaths recorded since June, Malaysia’s COVID-19 situation remains stable. Malaysia has experienced a less severe outbreak than many of its neighbors with 8,725 cases and 122 deaths, and is credited for quickly responding with lockdown measures to control the virus spread early on. 
• Malaysia and Singapore are expected to begin reopening their border on August 10. Both governments have agreed to implement a Reciprocal Green Lane (RGL) and Periodic Commuting Arrangement (PCA). The RGL will enable cross-border travel for essential business and official purposes between both countries and the PCA will allow residents of Singapore and Malaysia who hold long-term immigration passes for business and work purposes in the other country to enter the country for work.  
• Malaysia is also holding talks to create a “green zone” for travel with Brunei, Thailand, New Zealand, Australia, Japan, and South Korea. 
• With the continuous increase in confirmed COVID-19 cases in the country, Philippine President Rodrigo Duterte has extend the general community quarantine (GCQ) over Metro Manila until July 31. Surgeries will be for emergency cases only.
• The Philippines has resumed domestic flights. International flights remain suspended except repatriation flights to take foreigners home. 
• Singapore now allows small gatherings, and restaurants and shops can reopen. Social distancing requirements will remain, but this measure marks a major easing in COVID-19 restrictions and reflects a decline in worker dormitory cases and a stable level of other cases.
• Singapore and China began a “fast-lane” travel arrangement for official and business purposes between the two countries. Singapore is in discussion with other countries such New Zealand and South Korea on similar arrangements. 
• The Thai Government approved the fifth phase of lockdown easing, allowing most daily activities and businesses to resume. It has lifted the ban on international flights and allows certain categories of individuals from Japan, China, South Korea, Hong Kong, and Singapore to enter the country The Civil Aviation Authority will still apply stringent international travel restrictions preventing the entry of tourists.
• Vietnam will resume commercial flights to and from China, although details regarding the measures have yet to be confirmed. Beijing and Hanoi have yet to reach an agreement on the frequency of flights, and it also remains unclear whether the Vietnamese government’s 14-day quarantine measures might apply for overseas arrivals from China.
• Vietnam has gone three months without any newly reported cases of community-spread COVID-19. It is one of the few countries in the world whose economy grew in the second quarter.
• Staff Contact:  Phil Agress ([email protected])

Europe

Europe continues to improve overall. The WHO issued a public statement detailing how it believes the COVID pandemic is accelerating globally. WHO has appointed a committee to evaluate the global response to COVID and make recommendations for an enhanced system of global health governance. Conditions in some of the worst hit countries, such as Italy and Spain, have continued to improve, with new daily cases and total cases flattening. The UK leads the EU in the number of cases and deaths. Italy and France are second and third in the EU in the number of fatalities from COVID. Although not in the EU, Russia’s reported numbers on COVID are continuing to increase, and continue to be the worst in Europe. Russia remains the COVID hot spot in Europe, now reporting 746,369 cases, with just 11,770 reported deaths.  By comparison, Italy, with much fewer (243,506) cases, reports 34,997 deaths. Russia’s response and condition remain a concern for EU countries who are looking to reopen borders.

• The EU has issued a prohibition against inbound travelers from the US, Russia and Brazil based on COVID concerns when it reopens borders on July 1. They will permit inbound travel from any of 15 approved countries and will update the list every two weeks.
• New daily cases, which tends to show which countries are increasing in COVID incidence is as follows:  Spain 875; Italy 162; Germany 486; France 416; UK 538; Belgium 91, Russia 6,422.   
• New deaths per day are as follows:  Spain 4; Italy 13; Germany 4; France 20; UK 85; Belgium 1. Overall trends remain positive in the EU. Russia shows 156 deaths per day and Moscow residents are no longer required to wear masks outdoors. 
• On Friday, EU leaders begin a two-day summit to review and potentially approve an overall budget and recovery package spread over seven years estimated at around 1.75 trillion to 1.85 trillion euros. There are reservations from some of the more fiscally conservative members, such as the Netherlands, about the size and scope of the recovery package.      
• Apple and Ireland won an appeal and a major victory when the EU’s second highest court ruled that Apple did not have to pay 13 Billion Euro in Irish back taxes. Apple had been ordered to pay the back taxes by the EU based on purported benefits it had received from ‘illegal’ state aid under two Irish tax rulings. The EU has announced it plans to overhaul its corporate tax policy to secure ‘fair taxation.’
• The European Court of Justice has struck down the EU-US Privacy Shield law based on arguments from an EU plaintiff that the US security laws did not sufficiently protect EU citizens. Commerce Secretary Wilbur Ross expressed ‘deep disappointment’ in the ruling and said he would work with the EU to limit any negative consequences.  
• The negotiating team for the EU continues to indicate there are large differences between the EU and the UK on a post-Brexit trade deal. This despite efforts on both sides to intensify the talks and clarify issues.
• The UK has published its post-Brexit border guidance for the first time in the form of a 206 page document. It is reported that the process will involve more than 400 million annual customs forms for British and European businesses, and it is estimated the additional work could cost British businesses as much as 12 billion pounds per year.
• The UK records 649,000 fewer people are unemployed since the lockdown began. The total number of weekly work hours has plummeted by 175.3 million compared to the same time in 2019.   The UK government has worked to moderate the issue with 160 billion pounds of support to businesses and to furlough schemes designed to avoid layoffs.
• Infection rates in England are falling, and restrictions will continue to ease with outdoor pools and some other outdoor activities reopening from July 11 and indoor gyms, pools and sports facilities scheduled to reopen on July 25. The government has indicated that any of the scheduled easing is reversible depending upon local conditions or infection rates spiking.
• Following positive breakthroughs in vaccine development, the UK Health Secretary reiterated the government’s expectation that while “the best-case scenario” for a vaccine is this year, “the more likely is next year.” To improve the speed of an eventual vaccination program, he said he was planning to expand the range of health care professionals who can legally administer the vaccine, bringing on board “technicians” and “pharmacists.
• Recent reports indicate that the patients receiving necessary health treatment in NHS hospitals has dramatically declined due to hospital limitations from COVID. Concerns are that many health conditions have worsened due to people not receiving necessary treatment during the COVID pandemic. The NHS has committed to addressing this issue and in reducing what are now record waiting times for treatment. However, it cautions that it could be next year before waiting times come back within the normal range. Planned operations fell by 80% in May compared to the same time in 2019.
• The German Health Minister recently highlighted risks from a potential second wave of COVID-19, but indicated it was avoidable if people remain vigilant and avoid large gatherings. He also called for Germany to strengthen its role and financial contribution to the WHO. Germany has contributed 565 million euro to the WHO this year and has also urged the WHO to speed up its review of how it has handled the pandemic.  
• German Chancellor Angela Merkel has rejected the abolition of the corona-induced mask obligation in shops. She has broad support from the parties and the states to maintain rules favoring mask wearing in indoor spaces.
• Recent spikes in COVID-19 in Germany traced to meat packing plants have highlighted poor working conditions in Germany’s meat packing industry.
• Health ministers from Germany’s 16 states said this week that they were in favor of having future lockdowns over coronavirus outbreaks apply only to small local areas, adding that closing down large cities like Hamburg or Berlin was impossible.
• Siemens has announced it will implement in Germany a permanent policy to let employees work from home whenever they want for two or three days per week.
• France’s Prime Minister Castex accelerated by two weeks a rule to require mask wearing at public indoor areas after a small upswing in COVID cases in some parts of France. This will go into effect next week and primarily affect shops and other public indoor places. Overall hospitalizations for COVID in France remain on a downward trend.
• France has also indicated the government would commit an envelope of €7.5 billion to raise the wages of staff at hospitals badly strained by the coronavirus pandemic.
• If you are experiencing difficulties with exporting PPE from the EU, please let us know immediately. We have not seen any instances of this occurring since an initial incident was resolved.
• The proposed one-year suspension of implementation of the EU’s MDR is now final.  The measure extends until May 26, 2021 the date of application of the current regulation but does not extend every target deadline referenced in the law.  It also creates the possibility of EU-wide derogations for specific medical devices.
• https://ec.europa.eu/commission/presscorner/detail/en/IP_20_718;
• https://www.medtecheurope.org/news-and-events/press/medtech-europe-welcomes-the-amendment-of-the-medical-devices-regulation-and-urges-similar-action-for-the-ivd-regulation/.
• AdvaMed’s joint programs in Germany and the UK continue to provide COVID-19 updates and support on MDR implementation.
• Resources: https://www.ecdc.europa.eu/enlll;

• https://www.europarl.europa.eu/news/en/headlines/priorities/eu-response-to-coronavirus;
• https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public;
• https://www.ecdc.europa.eu/en;
• https://ec.europa.eu/info/live-work-travel-eu/health/coronavirus-response/economy_en;
• https://www.abhi.org.uk/what-we-do/abhi-covid-19-hub/;
• https://ec.europa.eu/commission/presscorner/detail/en/IP_20_582;
• https://www.bundesgesundheitsministerium.de/en/press/2020/coronavirus.html;
• https://www.medtecheurope.org/covid-19-information-hub;
• https://www.medtecheurope.org/resource-library/european-industry-trade-and-supply-chain-needs-to-respond-to-covid-19/;
• https://www.medtecheurope.org/wp-content/uploads/2020/03 European_Union_Emergency_Support_Instrument_for_the_healthcare_sector_-_questions_and_answers.pdf;
• https://www.medtecheurope.org/resource-library/eu-materials-covid-19/.
• Med Tech Europe White Paper on Companion Diagnostics under the IVDR:      https://www.medtecheurope.org/resource-library/joint-medtech-europe-efpia-white-paper-on-companion-diagnostics-under-the-ivdr/
• Staff Contact:  Joe Gatewood ([email protected])

Latin America

Regional

• Total COVID-19 cases up 16% and deaths up 14% over the previous week.

Other Highlights (Source: Prospectiva):

• Argentina: Country reaches 100K cases; political tensions outshine recent government’s measures.
• Bolivia: President Jeanine Añez tested positive, as new interim health minister takes office momentarily.
• Brazil: President Jair Bolsonaro tested positive for COVID-19
• Chile: As cases fell in recent weeks, some regions reopen gradually.
• Colombia: Quarantine extended with pilot plans for reopening moving forward simultaneously.
• Ecuador: The Ministry of Health in dialogues with the University of Oxford regarding a possible COVID vaccine.
• Mexico: Presidential visit to Washington marks the start of the USCMA and focuses on bringing back production to North America.
• Paraguay: Growing criticisms against Minister of Health for low expenditure amidst the emergency.
• Peru: President Vizcarra calls for general elections to be held in April 2021.
• Uruguay: Emergency law finally approved amid the pandemic
• Staff Contact:  Steven Bipes [email protected]