Coronavirus COVID-19 Outbreak – What's New

William M. Detmer, MD, supported by the Unbound Medicine Team

Updated: Friday, May 29, 2020 11:02 ET

Coronavirus Guidelines

What’s New Here

Recent updates

What’s New Elsewhere

COVID-19 Cases

Around the Globe

  • Cases of COVID-19 reported daily by European CDC have reached 5.77 million – an increase of ~119,000 since the last report.[1]
  • See maps and tables below for cases and death in different countries.
  • See Comparison of Epidemic Curves by Country for details.
COVID-19 Outbreak Map by Johns Hopkins CSSE – Updated Hourly
Coronavirus 2019 COVID-19 Outbreak Map

Click one of the links below to see the latest.
Desktop | Mobile
Source: Johns Hopkins Center for Systems Science and Engineering (CSSE).[2]

New Cases in Countries with Highest COVID-19 Activity
New Cases in Countries with Highest COVID-19 Activity

Recent Confirmed Cases in eight countries with the highest reported COVID-19 activity (United States, Brazil, Russia, India, Peru, UK, Canada and Italy). Note that the left axis is linear rather than logarithmic and represents the number of cases reportedto the European CDC by each country.

Click for Live Updates.

Data sources: European CDC. Our World in Data.

Total and New COVID-19 Cases — from European CDC

Cases

Deaths

May 29, 2020

Total

New

Total

New

Brazil

438,238

26,417

26,754

1,156

United States

1,721,750

21,817

101,617

1,175

Russia

379,051

8,371

4,142

174

India

165,799

7,466

4,706

175

Peru

141,779

5,874

4,099

116

France

149,071

3,325

28,662

66

Iran

143,849

2,258

7,627

63

Turkey

160,979

2,217

4,461

64

UK

269,127

1,887

37,837

377

Spain

237,906

1,137

27,119

1

Canada

88,501

993

6,877

112

Germany

180,458

741

8,450

39

Italy

231,732

593

33,142

70

South Korea

11,402

58

269

-

China

84,106

-

4,638

-

Other countries

1,373,186

36,028

59,689

1,145

TOTAL

5,776,934

119,182

360,089

4,733

European Centre for Disease Prevention and Control.[1]

Note: ECDC statistics are reported daily. See other sources for hour-by-hour updates.

Statistics may differ from other reporting agencies.

In the United States

  • As of May 28 at 17:00 ET
    • Total cases: more than 1.7 million in all 50 states
    • Deaths: more than 100,000 reported
U.S. Cases and Deaths by State and County
coronavirus curve by state

Aggregate data from the Centers for Disease Control and Prevention (CDC) and state- and local-level public health agencies. County-level data is confirmed by referencing state and local agencies directly. Confirmed cases and deaths reflect cumulative totals since January 22nd, 2020.

Click for Live Updates.

Source: USAFacts.org.[3]

U.S. States with the Most COVID-19 Activity

May 28, 2020

Total Cases

Total Deaths

Cases Last 7d

Rate per 100,000

California

98,980

3,884

17,185

250

Illinois

114,306

5,083

16,276

897

Virginia

41,401

1,338

8,493

486

Texas

57,921

1,562

8,009

202

New Jersey

156,628

11,339

7,615

1,758

Maryland

49,709

2,428

7,386

823

Massachusetts

94,220

6,547

6,295

1,365

Pennsylvania

70,042

5,373

6,106

547

New York

164,997

7,977

5,973

1,481

New York City

202,997

21,415

5,842

2,417

Georgia

44,447

1,909

5,694

423

Florida

52,634

2,319

5,690

247

North Carolina

24,628

794

4,928

237

Minnesota

22,464

942

4,794

400

Ohio

33,439

2,044

4,487

286

U.S. Centers for Disease Control.

Public Health

U.S. CDC Guidance

Phased Plan and Indicators for Reopening America

Gating Criteria

Threshold for entering Phase 1

Threshold for entering Phase 2

Threshold for entering Phase 3

Decreases in newly identified COVID-19 cases

Downward trajectory (or near-zero incidence) of documented cases over a 14-day period

Downward trajectory (or near-zero incidence) of documented cases for at least 14 days after entering Phase 1

Downward trajectory (or near-zero incidence) of documented cases for at least 14 days after entering Phase 2

Decreases in emergency department (ED) and/or outpatient visits for COVID-like illness (CLI)

Downward trajectory (or near-zero incidence) of CLI syndromic cases reported over a 14-day period

Downward trajectory (or near-zero incidence) of CLI syndromic cases reported for at least 14 days after entering Phase 1

Downward trajectory (or near-zero incidence) of CLI syndromic cases reported for at least an additional 14days after entering Phase 2

Decreases in ED and/or outpatient visits for influenza-like illness (ILI)

Downward trajectory (or near-zero incidence) of ILI reported over a 14-day period

Downward trajectory (or near-zero incidence) of ILI reported for at least 14 days after entering Phase 1

Downward trajectory (or near-zero incidence) of ILI reported for at least an additional 14 days after entering Phase 2

Decreases in percentage of SARS-CoV-2 tests positive

Downward trajectory (or near-zero percent positive) of positive tests as a percentage of total tests over a 14-day period (flat or increasing volume of tests)

Downward trajectory (or near-zero percent positive) of positive tests as a percentage of total tests for 14 days after entering Phase 1 (flat or increasing volume of tests)

Downward trajectory (or near-zero percent positive) of positive tests as a percentage of total tests for at least 14 days after entering Phase 2 (flat or increasing volume of tests)

Treat all patients without crisis care

Jurisdiction inpatient & ICU beds < 80% full Staff shortage in last week = no PPE supplies adequate for >4 days

Jurisdiction inpatient & ICU beds < 75% full Staff shortage in last week = no PPE supplies adequate for >4 days

Jurisdiction inpatient & ICU beds < 70% full Staff shortage in last week = no PPE supplies adequate for >15 days

Robust testing program

Test availability such that percentage of positive tests is < 20% for 14 days Median time from test order to result is < 4 days

Test availability such that percentage of positive tests is < 15% for 14 days Median time from test order to result is < 3 days

Test availability such that the percentage of positive tests is < 10% for 14 days Median time from test order to result is < 2 days

CDC Activities and Initiatives Supporting the COVID-19 Response. May 2020. Centers for Disease Control and Prevention (CDC). PDF Report (60 pages)

Other Resources

Medical

Clinical Care

Drugs

  • Remdesivir:
    • Preliminary results of an NIH-sponsored randomized clinical trial (ACTT; NCT04280705) published in NEJM showed remdesivir accelerated recovery from advanced COVID-19:[8]
      • Preliminary Results from ACTT trial

        Remdesivir

        Placebo

        Significance

        Median Time to Recovery (Days)

        11

        15

        p< 0.001

        Mortality

        7.1%

        11.9%

        HR 0.70
        95% CI, 0.47 to 1.04

        Serious Adverse Effects

        21.1%

        27.0%

        Preliminary Results from Adaptive COVID-19 Treatment Trial (ACTT).[8]

        HR = Hazard Ratio for Death

    • Lancet reported on a randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov NCT04257656) at ten hospitals in Hubei, China that showed treatment with remdesivir was not associated with statistically significant clinical benefits. There was a non-significant trend towards reduction in time to clinical improvement in those with symptom duration of 10 days or less.[9] Some authors have concluded that the study was underpowered to detect a statistical difference.[10]
    • Available in the U.S. by FDA emergency use authorization (EUA). Availability is limited – allocation within states controlled by state policies.
  • Hydroxychloroquine (HCQ):
    • Lancet reported a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. No benefit was found and these drugs were associated with decreased in-hospital survival and increased frequency of ventricular arrythmias.
    • Observational study published in JAMA showed amongst 1,438 hospitalized COVID-19 patients those receiving HCQ, azithromycin, or both had no significant differences in mortality from those not receiving these drugs.[11]
    • Observational study published in NEJM showed HCQ not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death.
  • Interferon beta-1b, lopinavir–ritonavir, and ribavirin combination reported in an open label, randomized trial (NCT04276688) to be safe and superior to lopinavir–ritonavir alone in alleviating symptoms and shortening hosptial stay and viral shedding in patients with mild to moderate COVID-19.[12]

Vaccines

Resources

For the Public

Feedback

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References

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Last updated: May 29, 2020