The CODE Update – 21 July

Priscilla Robinson

View the latest spreadsheet here

Well here we are again, lockdown #5 for us in Victoria, but release for folks in the UK after a mega-10-months of restrictions. People in New South Wales are only just finding out what it is like to  not be able to do precisely as you like, whilst the Netherlands is reimposing some restrictions after letting everyone out a few weeks ago along with an apology from their prime minister that the proverbial gates were opened too early. Canada has fully vaccinated enough people now to reopen the US border to fully vaccinated Americans. Meanwhile, everyone continues to ignore the success story that is Iceland (attack rate at 2% and under the global average, fatality rate 0.44, and 3/4 of its population now fully vaccinated).

The holiday (and for some weird reason sometimes quarantine stopover) destinations of the Seychelles and Maldives retain their spots as number one and three on the table of highest attack rates in the world (17.8% and 14%), with Czechia in the middle (15.6%). The other countries with attack rates over 10% – the US, Argentina, Netherlands and Sweden – have mostly got their immunisation programmes established and fully immunised around half of their populations (Argentina lags at 11% – still slightly ahead of Australia).

Worldwide, cases have risen in Europe by 37% compared with the week before, but with a drop in fatalities – this is probably the result of the vaccination programmes in almost all of Europe reaching around 2/3 of people with at least one dose and 40-50% having had two (not forgetting that the J&J vaccine only requires one dose). The other dramatic rise is in the Western Pacific with 29% more cases. The overall case fatality rate continues to fall, not down to 2.15 according using WHO figures, and 2.14 for Johns Hopkins data, which is a 0.3 drop from three weeks ago. So although case worldwide continue to rise, sometimes quickly, the overall fatality rate is dropping. Speaking of fatality rates, the very very high rates in Mexico and Peru suggest that there is an undercounting of cases, which also points to the disparities in case ascertainment from country to country. For readers new to this blog, this has been clear since the start of the pandemic, but at least the differences are consistent within and between countries – and individually, countries do change place on the Global Epidemiology spreadsheet ‘league table’, but not often and not by much.

The countries with big increases this week include Vietnam (which almost doubled last week for both cases and fatalities), Fiji is up 50% again, and also Laos and Cambodia, although things have slowed down a bit from the past couple of weeks. Indonesia has had an increase too, but not as large proportionally as other parts of SE Asia, as has Brunei Darussalam, and in Africa Mozambique, Rwanda, Malawi, Mauritius, Senegal, Zimbabwe, Botswana, and Namibia, although of course anywhere with a health care system where resources run short has problems, regardless of how much larger or smaller numbers of cases are compared with last week.

Which brings us to vaccines. No doubt sometime soon people will notice that highly vaccinated countries also have rising numbers of cases, so there are two things to say here. Firstly, the age of cases tends to fall but the proportion of fatal cases drops as outbreaks evolve, which is not to say it is not a serious problem for younger people but just a bit less of one. Secondly, it is the older age groups who have been vaccinated, and the vaccines definitely protect against serious disease and fatalities, although not 100% (almost no vaccines do that) so of course the younger unvaccinated groups are going to be the groups who become more obvious now. Plus, remove restrictions and observe the non-social-distancing socialising and you can observe transmission opportunities with your own eyes. Really it is now the younger age groups who need to be vaccinated now, and quickly – and several countries are onto that…

But not here in Australia. Sigh.

Here are some useful news links for this week. I am really pleased (especially with my ANZJPH editorial hat on) to see some more considered research emerging about the social effects of COVID, at least not using dodgy on-line opportunistic questionnaires circulated through social media using the weirdest and probably unanalysable questions (yes, I did investigate as many as I could find!) followed by an avalanche of results about how bad ‘we all’ felt.


Remote work offered ‘quiet deliverers’ who flew under the radar in the office a chance to really stand out.

Why introverts excelled at working from home

How effective are coronavirus vaccines against the Delta variant? | Financial Times

Majority of Covid misinformation came from 12 people, report finds


Now could we please have some much more solid epidemiology, with well-investigated risk factors for us to be able to use for better health promotion?  Not just age/sex/coexisting disease etc, none of which is a surprise, but much better information about crowding at home, income and income support, diet, smoking, alcohol, coincidental viral and other infections and illnesses, etc etc – there really must be enough cases by now to get this information which is sadly lacking. Plus it would be a welcome change from accidentally finding out a lot about what dodgy social influencers think about weird positive-energy-crystal-positive-thinking-extreme-yoga-dietary-additive-wild-exercise etc things to ward off The Virus. Just saying.


See you next week,




About Dr Priscilla Robinson and The CODE Update

Dr Robinson is a public health epidemiologist with particular interests in international health and communicable diseases, and public health competencies. She has worked in health departments in England and Australia, has managed public health teaching programmes, and taught and researched many aspects of public health epidemiology and policy in many countries. She is an adjunct Associate Professor at LaTrobe University, and to stop herself being bored is an editor of PHAA’s journal ANZJPH, and holds board positions (almost all unpaid) on various NGOs, journals, and at her local hospital. Otherwise, 10 acres of untamed bushland on a hill in South Gippsland makes weight-bearing gym exercise and strength training a bit redundant.

The CODE Update is a regular feature on the Intouch blog to keep readers informed of COVID-19 developments around the world.

The CODE update originally began at the start of the SARS CoV-2 pandemic as a way of explaining it to Priscilla’s friends and family who happen to live all over the world, and who were being bombarded with information and misinformation in their own countries. The CODE Update provides links to practical materials and papers written for people who are not versed in the language of outbreaks and epidemic curves. It is sent out every week, and includes a short commentary to provide context to the numbers included in the spreadsheets.

Note: Whilst every attempt is made to transcribe all data faithfully, every now and again mistakes are made and not noticed until the next update. Also, on occasion numbers are revised after posting at the source databases.

We hope you will find these updates to be a helpful tool, and the links to current information useful.

Leave a Reply