Coronavirus COVID-19 Outbreak – What's New

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

Updated: Monday, June 01, 2020 09:33 ET

How to:

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 6.14 million – an increase of ~107,000 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

June 1, 2020

Total

⇓ New

Total

New

United States

1,790,191

19,807

104,383

602

Brazil

514,849

16,409

29,314

480

Russia

405,843

9,268

4,693

138

Peru

164,476

8,805

4,506

135

India

190,535

8,392

5,394

230

Iran

151,466

2,516

7,797

63

UK

274,762

1,936

38,489

113

Turkey

163,942

839

4,540

25

Canada

90,936

757

7,295

222

Italy

233,019

355

33,415

75

Germany

181,815

333

8,511

11

France

151,753

257

28,802

31

Spain

239,429

201

27,127

2

South_Korea

11,503

35

271

1

China

84,147

19

4,638

-

Other countries

1,487,419

37,830

62,682

783

TOTAL

6,136,085

107,759

371,857

2,911

†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 31 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

106,878

4,156

18,434

270

Illinois

118,917

5,330

13,473

933

Texas

62,338

1,648

8,889

217

Virginia

44,607

1,375

8,858

524

Maryland

52,778

2,532

7,283

873

New Jersey

159,608

11,634

6,889

1,792

North Carolina

27,673

877

6,055

267

New York City

199,893

21,512

5,942

2,380

Massachusetts

96,301

6,768

5,402

1,395

New York

166,909

8,100

5,239

1,498

Minnesota

24,850

1,050

5,005

443

Pennsylvania

71,926

5,555

4,943

562

Georgia

46,301

2,003

4,819

440

Florida

54,029

2,447

4,578

254

Ohio

35,034

2,149

4,240

300

†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:
    • ⇒ NEJM study in patients with severe COVID-19 not requiring mechanical ventilation did not show a significant difference between a 5-day and 10-day course of remdesivir. With no placebo control, the magnitude of benefit of treatment could not be determined.[7]
    • 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

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References

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Last updated: June 1, 2020