In the last 28-day period (24 July to 20 August 2023), nearly 1.5 million new COVID-19 cases and over 2000 deaths were reported from WHO’s six regions,i an increase of 63% and a decrease of 48%, respectively, compared to the previous 28 days (Figure 1, Table 1). As of 20 August 2023, over 769 million confirmed cases and over 6.9 million deaths have been reported globally. Three WHO regions reported increases in the number of cases, while two regions reported decreases. While four WHO regions reported decreases in the number of deaths, the East Mediterranean Region reported an increase in deaths. In this WEU edition, we have included all available data from the Region of the Americas since the start of the pandemic up to 6 August 2023 in the global figures. However, 28-day comparisons for this Region and its Member States are not presented as the data for the reporting period were incomplete.
As countries discontinue COVID-19-specific reporting and integrate respiratory disease surveillance, WHO will use all available sources to continue monitoring the COVID-19 epidemiological situation, especially data on impact. COVID-19 remains a major threat and WHO urges Member States to maintain, not dismantle, their established COVID-19 infrastructure. It is crucial to sustain early warning, surveillance and reporting, variant tracking, early clinical care provision, administration of vaccine boosters to high-risk groups, improvements in ventilation, and regular communication.
Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. During this 28-day period, 44% (103 of 234) of countries reported at least one case to WHO – a proportion that has been declining since mid-2022. It is important to note that this statistic does not reflect the actual number of countries where cases exist. Additionally, data from previous weeks are continuously being updated to incorporate retrospective changes in reported COVID-19 cases and deaths made by countries. Data presented in this report are therefore incomplete and should be interpreted in light of these limitations. Some countries continue to report high burdens of COVID-19, including increases in newly reported cases and, more importantly, increases in hospitalizations and deaths – the latter of which are considered more reliable indicators given reductions in testing.
At the regional level, the number of newly reported cases within a 28-day period has increased across three of the five WHO regions assessed: the European Region (+11%), the Western Pacific Region (+88%), and the Eastern Mediterranean Region (+112%); while case numbers decreased in two WHO regions: the African Region (-84%), and the South-East Asia Region (-45%). The number of newly reported deaths within a 28-day period has decreased across four regions: the African Region (-75%), the South-East Asia Region (-55%), the European Region (-49%), and the Western Pacific Region (-14%); while newly reported deaths increased in the Eastern Mediterranean Region (+70%).
Hospitalizations and ICU admissions
At the global level, during the analysed 28-day period (17 July to 13 August 2023), 27 of 234 countries reported a total of 49 380 new hospitalizations, and 22 of 234 countries reported to WHO a total of 646 new intensive care unit (ICU) admissions (Figure 4). This represents a 21% increase and 44% decrease in hospitalizations and ICU admissions, respectively, compared to the previous 28 days (19 June to 16 July 2023). Note that the absence of reported data from other countries to the WHO does not imply that there are no COVID-19-related hospitalizations in those countries. The presented hospitalization data are preliminary and might change as new data become available. Furthermore, hospitalization data are subject to reporting delays. These data also likely include both hospitalizations with incidental cases of SARS-CoV-2 infection and those due to COVID-19 disease.
Globally, during the past 28 days, of the 27 (12%) countries that reported data to WHO on new hospitalizations at least once (Figure 5), the European Region had the highest proportion of countries reporting (16 countries; 26%), followed by the South-East Asia Region (two countries; 20%), the Western Pacific Region (three countries; 9%), the Region of the Americas (four countries; 7%), the Eastern Mediterranean Region (one country; 5%), and the African Region (one country; 2%). The proportion of countries that consistentlyii reported new hospitalizations for the period was 8% (19 countries) (Table 2).
Among the 19 out of 234 countries consistently reporting new hospitalizations to WHO, eight (42%) countries registered an increase of 20% or greater in hospitalizations during the past 28 days compared to the previous 28-day period: Bangladesh (1433 vs 340; +321%), Ireland (1077 vs 451; +139%), Greece (1659 vs 817; +103%), Kyrgyzstan (10 vs six; +67%), the United States of America (37 721 vs 24 785; +52%), Malta (165 vs 109; +51%), Mexico (882 vs 714; +24%), and the Netherlands (168 vs 137; +23%). The highest numbers of new hospitalizations were reported from the United States of America (37 721 vs 24 785; +52%), Malaysia (2743 vs 3418; -20%), and Greece (1659 vs 817; +103%).
Globally, in the past 28 days, 22 (9%) countries reported data to WHO on new ICU admissions at least once (Figure 5). Among them, the European Region had the highest proportion of reporting countries (14 countries; 23%), followed by the Western Pacific Region (five countries; 14%), the South-East Asia Region (one country; 10%), and the Region of the Americas (two countries; 4%). The African Region and the Eastern Mediterranean Region did not report ICU admission data during the period. The proportion of countries that consistently reported new ICU admissions for the period was 7% (17 countries) (Table 2).
Among the 17 countries consistently reporting new ICU admissions to WHO, six (35%) countries showed an increase of 20% or greater in new ICU admissions during the past 28 days compared to the previous 28-day period: Ireland (16 vs six; +167%), Malta (seven vs four; +75%), Singapore (10 vs six; +67%), Latvia (five vs three; +67%), Greece (27 vs 17; +59%), and Netherlands (12 vs 10; +20%). The highest numbers of new ICU admissions were reported from Brazil (375 vs 627; -40%), Australia (82 vs 148; -45%), and Italy (57 vs 61; -7%).
SARS-CoV-2 variants of interest and variants under monitoring
Geographic spread and prevalence
Globally, from 24 July to 20 August 2023 (28 days), 11 310 SARS-CoV-2 sequences were shared through GISAID. This is a decrease in comparison to the 34 064 SARS-CoV-2 sequences shared in the previous 28-day period (26 June to 23 July 2023). This should be interpreted with caution as the number of sequences is continuously updated retrospectively in GISAID and in the context of a decline in the submission of sequences since May 2023, coinciding with the discontinuation of the PHEIC for COVID-19.
WHO is currently tracking several SARS-CoV-2 variants, including:
- Three variants of interest (VOIs); XBB.1.5, XBB.1.16 and EG.5.
- Seven variants under monitoring (VUMs); BA.2.75, BA.2.86, CH.1.1, XBB, XBB.1.9.1, XBB.1.9.2 and XBB.2.3.
BA.2.86 was designated as a new variant under monitoring on 17 August 2023. As of 23 August 2023 (17:00 CET), there have been nine sequences of the BA.2.86 variant reported from five countries (three in the European Region, one from the African Region and one from the Region of the Americas) that were uploaded on GISAID (Table 3). The nine BA.2.86 cases have no epidemiological link and only one case had a travel history from a WHO Region country where BA.2.86 has not been reported (the Western Pacific Region). To date, no deaths have been reported to WHO among the cases detected with BA.2.86. In addition, one country (Switzerland) has reported detection of BA.2.86 in wastewater samples. The potential impact of the BA.2.86 mutations are presently unknown and are currently undergoing careful assessment. WHO continues to call for enhanced surveillance, sequencing, and reporting of SARS-CoV-2 variants as the virus continues to circulate and evolve.
At the country level, the highest numbers of new cases reported within the 28-day period were from the
Republic of Korea (1 286 028 new cases; +117%), Australia (22 836 new cases; -53%), the United Kingdom (21 866 new cases; +92%), Italy (19 777 new cases; +32%), and Singapore (18 125 new cases; -40%). The highest numbers of new 28-day deaths were reported from the Republic of Korea (398 new deaths; +100%), the Russian Federation (166 new deaths; -51%), Italy (165 new deaths; -9%), Australia (148 new deaths; -58%), and the Philippines (136 new deaths; +386%).
WHO regional overviews Data for 24 July to 20 August 2023
African Region The African Region reported over 600 new cases, an 84% decrease as compared to the previous 28-day period. Two (4%) of the 50 countries for which data are available reported increases in new cases of 20% or greater: Ethiopia (45 vs 26 new cases; +73%) and Senegal (six vs five new cases; +20%). The highest numbers of new cases were reported from Mauritius (390 new cases; 30.7 new cases per 100 000; -33%), Cabo Verde (58 new cases; 10.4 new cases per 100 000; -59%), and Botswana (53 new cases; 2.3 new cases per 100 000; -46%).
The number of new 28-day deaths in the Region decreased by 75% as compared to the previous 28-day period, with four new deaths reported. The new deaths were reported from Zimbabwe (two new deaths; <1 new death per 100 000; -50%), Botswana (one new death; <1 new death per 100 000; -50%), and Cabo Verde (one new death; <1 new death per 100 000; no deaths reported the previous 28-day period).
The Eastern Mediterranean Region reported over 3000 new cases, a 112% increase as compared to the previous 28-day period. Three (14%) of the 22 countries for which data are available reported increases in new cases of 20% or greater: Kuwait (70 vs 37 new cases; +89%), the Islamic Republic of Iran (640 vs 414 new cases; +55%), and Morocco (149 vs 109 new cases; +37%). The highest numbers of new cases were reported from Lebanon (1352 new cases; 19.8 new cases per 100 000; no cases reported the previous 28-day period), Afghanistan (823 new cases; 2.1 new cases per 100 000; -6%), and the Islamic Republic of Iran (640 new cases; <1 new case per 100 000; +55%).
The number of new 28-day deaths in the Region increased by 70% as compared to the previous 28-day period, with 34 new deaths reported. The highest numbers of new deaths were reported from the Islamic Republic of Iran (15 new deaths; <1 new death per 100 000; +7%), Lebanon (11 new deaths; <1 new death per 100 000; no deaths reported the previous 28-day period), and Afghanistan (eight new deaths; <1 new death per 100 000;
The European Region reported over 85 000 new cases, an 11% increase as compared to the previous 28-day period. Fifteen (25%) of the 61 countries for which data are available reported increases in new cases of 20% or greater, with the highest proportional increases observed in Belgium (2081 vs 758 new cases; +175%), Ireland (2122 vs 775 new cases; +174%), and Czechia (657 vs 267 new cases; +146%). The highest numbers of new cases were reported from the United Kingdom (21 866 new cases; 32.2 new cases per 100 000; +92%), Italy (19 777 new cases; 33.2 new cases per 100 000; +32%), and the Russian Federation (12 043 new cases; 8.3 new cases per 100 000; -32%).
The number of new 28-day deaths in the Region decreased by 49% as compared to the previous 28-day period, with 699 new deaths reported. The highest numbers of new deaths were reported from the Russian Federation (166 new deaths; <1 new death per 100 000; -51%), Italy (165 new deaths; <1 new death per 100 000; -9%), and Portugal (81 new deaths; <1 new death per
The South-East Asia Region reported over 4300 new cases, a 45% decrease as compared to the previous 28-day period. Two (20%) of the 10 countries for which data are available reported increases in new cases of 20% or greater, with the highest proportional increases observed in Nepal (38 vs 12 new cases; +217%), and the Maldives (seven vs four new cases; +75%). The highest numbers of new cases were reported from Thailand (1366 new cases; 2.0 new cases per 100 000; -58%), India (1335 new cases; <1 new case per 100 000; +2%), and Bangladesh (1188 new cases; <1 new case per 100 000; -31%).
The number of new 28-day deaths in the Region decreased by 55% as compared to the previous 28-day period, with 68 new deaths reported. The highest numbers of new deaths were reported from Thailand (35 new deaths; <1 new death per 100 000; -61%), Indonesia (13 new deaths; <1 new death per 100 000; -66%), and India (10 new deaths; <1 new death per 100 000; -17%).
The Western Pacific Region reported over one million new cases, an 88% increase as compared to the previous 28-day period. Five (14%) of the 35 countries for which data are available reported increases in new cases of 20% or greater, with the highest proportional increases observed in Niue (nine vs two new cases; +350%), the Federated States of Micronesia (58 vs 13 new cases; +346%), and Kiribati (three vs one new cases; +200%). The highest numbers of new cases were reported from the Republic of Korea (1 286 028 new cases; 2508.4 new cases per 100 000; +117%), Australia (22 836 new cases; 89.6 new cases per 100 000; -53%), and Singapore (18 125 new cases; 309.8 new cases per 100 000; -40%).
The number of new 28-day deaths in the Region decreased by 14% as compared to the previous 28-day period, with 856 new deaths reported.
The highest numbers of new deaths were reported from the Republic of Korea (398 new deaths; <1 new death per 100 000; +100%), Australia (148 new deaths; <1 new death per 100 000; -58%), and the Philippines (136 new deaths; <1 new death per 100 000; +386%).