train.csv

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"1 
 COVID -19 Epidemiological Update  
Edition  163 published  19 January  2024 
In this edition:   
• Key highlights   
• Global overview  
• Hospitalizations and ICU admissions  
• SARS -CoV-2 variants of interest and variants under monitoring  
• WHO regional overviews   
 
 
Key highlights  
 
• Globally, during the 28 -day period from 11  December 2023  to 7 January 2024 , 106 countries report ed COVID -
19 cases and 51 countries  report ed COVID -19 deaths. Note  that this does not reflect the actual number of 
countries where cases or deaths are occurring , as many  countries have stopped or changed frequency of 
reporting .  
• From the available data , the number of reported cases has increased while deaths have decreased during 
the 28 -day period , with over 1.1 million new cases and 8700  new deaths , an increase of 4% and a decrease 
of 26%, respectively, compared to the previous 28 days ( 13 November to 10 December 2023 ). Trends in the 
number of reported new cases and deaths should be interpreted with caution due to decreased testing  and 
sequencing, alongside reporting delays in many countries.   According  to estimates obtained from wastewater 
surveillance, clinical detection of cases underestimates  the real burden from 2 to 19 -fold.  
• SARS -CoV-2 PCR percent positivity , as detected in integrated sentinel  surveillance  as part of  the Global 
Influenza  Surveillance and Response System ( GISRS ) and reported to FluNet  was around 8 % as of 7 January 
2024. 
• During the 28 -day period  from 11 December 2023  to 7 January , 53 and 42 countries provided  data at least 
once on COVID -19"
"at least 
once on COVID -19 hospitalizations and admissions to an intensive care unit (ICU) , respectively . From the 
available data, over  173 000 new hospitalizations and over 1900 new ICU admissions were reported  during 
the 28 -day period .  Amongst  the countries reporting these data consistently over the current and past 
reporting period, there was an overall increase  of 40% and 13% in new hospitalizations  and new ICU 
admissions , respectively .  
•  Globally, JN.1 is the most reported VOI (now reported by 71 countries), accounting for 65.5% of sequences 
in week 52 compared to 24.8% in week 48 (Figure 10, Table 6). Its parent lineage, BA.2.86, is stable and 
accounted for 7.8% of sequences in week 52 c ompared to 7.0% in week 48 (Figure 10, Table 6). The initial 
risk evaluation for JN.1  was published on 19 December 2023, with an overall evaluation of low public health 
risk at the global level based on available evidence.  WHO is currently tracking several SARS -CoV-2 variants : 
five VOIs  – XBB.1.5, XBB.1.16 , EG.5  BA.2.86  and JN.1 ; and five VUMs : DV.7, XBB, XBB.1.9.1, XBB .1.9.2 and 
XBB.2.3   
• The Global WHO Coronavirus (COVID -19) Dashboard  has been updated and adapted with a new interface 
on 22 December 2023 to support WHO and Member States’ work to transition from COVID -19 as an 
emergency to longer -term disease management, as outlined in WHO’s 3 May 2023 COVID -19 2023"
"3 COVID -19 2023 -2025 
Updated Strategic Preparedness and Response Plan . The new dashboard will progressively incorporate more 
components throughout 2024.  The previous link of the Global WHO Coronavirus (COVID -19) Dashboard will 
still be active and redirect users  to the new one from 22 December onward. Please note that start time of 
the redirection can differ around the world by up to 24 hours.  
 
 2 
  
For t he latest data and other updates on COVID -19, please see:  
• WHO Monthly Operational Update  and past editions of the Weekly  Epidemiological Update on COVID -19 
• WHO COVID -19 detailed surveillance data dashboard   
• WHO COVID -19 policy briefs   
• COVID -19 surveillance reporting requirements update for Member States  
• Summary  Tables  of COVID -19 vaccine effectiveness (VE) studies and results (last updated 11 January 
2024)  
• Forest Plots  displaying results of COVID -19 VE studies (last updated 15 January 2024)  
• Special focus WEU on interpreting relative VE  (29 June 2022, pages 6 -8) 
• Neutralizat ion p lots (last updated 15 January 2024)  
• WHO COVID -19 VE Resources  
 
 
Global overview  
 
Data  as of 7 January  2024 
Globally, the number of new weekly cases remained stable during the 28 -day period of 11 December 2023 to 7 
January 2024 as compared to the previous 28 -day period, with over 1.1 million new cases reported (Figure 1, 
Table 1). The number of new weekly deaths  decreased by 26% as compared to the previous 28 -day period, with 
8700  new fatalities"
"
8700  new fatalities reported. As of 7 January 2024, over 774 million confirmed cases and over 7 million deaths 
have been reported globally.  According to estimates obtained from viral loads in wastewater surveillance, clinical 
detection of cases underestimated the real burden 2 to 19 -fold1,2,3 
Reported cases do not accurately represent infection rates due to the r eduction in testing and reporting globally . 
During this 28 -day period, only 45% (10 6 of 234) of countries reported at least one case to WHO. It is important 
to note that this statistic does not reflect the actual number of countries where cases exist. Additionally, data 
from the previous 28 -day period are continuously being updated to inc orporate retrospective changes made by 
countries regarding reported COVID -19 cases and deaths. Data presented in this report are therefore incomplete 
and should be interpreted considering these limitations. Some countries continue to r eport 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. Global and 
national data on SARS -CoV-2 PCR percent positivity are available on WHO’s integrated influenza and other 
respiratory viruses surveillance dashboard . Recent data (epidemiological week one, 1 to 7 January  2024) from 
sentinel sites show that the SARS -CoV-2 PCR percent positivity from reporting countries averages approximately 
8% (Figure 2).   
As many countries discontinue COVID -19-specific reporting and integrate it into respiratory disease surveillance, 
WHO will use all available sources to continue monitoring the COVID -19 epidemiological situation, especially 
data on morbidity and impact on h ealth systems. COVID -19 remains a major threat, and WHO urges Member 
States to maintain, not dism"
"
States to maintain, not dismantle, their established COVID -19 infrastructure. It is crucial to sustain, inter alia , 
early warning, surveillance and reporting, variant tracking, early clin ical care provision, administration of vaccine 
to high -risk groups, improvements in ventilation, and regular communication.  
 
1  Show us the data: global COVID -19 wastewater monitoring effectors, equity,  and gaps   
 
2.  Capturing the SARS -CoV-2 infection pyramid within the municipality of Rotterdam using longitudinal sewage surveillance   
 
3. Omicron COVID -19 Case Estimates Based on Previous SARS -CoV-2 Wastewater Load, Regional Municipality of Peel, Ontario, Canada   
 3 
 Current trends in reported COVID -19 cases and deaths should be interpreted with caution as several countries 
have been progressively changing COVID -19 testing strategies, resulting in lower overall numbers of tests 
performed and consequently lower numbers o f cases detected. Additionally, data from previous weeks are 
continuously updated to retrospectively incorporate changes in reported COVID -19 cases and deaths made by 
countries.  
 
 
Figure 1. COVID -19 cases and global deaths by 28 -day intervals reported by WHO Region,  as of 7 January 2024 ( A); 26 
June  to 17 January 2024 (B)** 
 
 
 
 
**See Annex 1: Data, table, and figure note  
 
A 
B 4 
 At the regional level, the number of newly reported 28 -day cases decreased across four of the six WHO regions: 
the African Region ( -63%), the Region of the Americas ( -18%), the Eastern Mediterranean Region ( -13%), and 
the European Region ( -13%); while case  numbers increased in two WHO regions: the Western Pacific Region 
(+77%), and the South -East"
"77%), and the South -East Asia Region (+379%). The number of newly reported 28 -day deaths decreased or 
remained stable across five regions: the African Region ( -113%), the Eastern Mediterra nean Region ( -53%), the 
Western Pacific Region ( -45%), the Region of the Americas ( -41%), and the European Region ( -3%); while death 
numbers increased in the South -East Asia Region (+564%).  
At the country level, the highest numbers of new 28 -day cases were reported from the Russian Federation (235 
198 new cases; -30%), Singapore (174 643 new cases; +117%), Italy (163 599 new cases; -18%), Greece (68 590 
new cases; +81%), and Malaysia (67 206 n ew cases; +164%). The highest numbers of new 28 -day deaths were 
reported from Italy (1016 new deaths; -21%), the Russian Federation (679 new deaths; +45%), Poland (543 new 
deaths; +229%), Sweden (446 new deaths; -47%), and Greece (322 new deaths; +79%).  
 
Table 1. Newly reported and cumulative COVID -19 confirmed cases and deaths, by WHO Region, as of 7 January  2024** 
WHO 
Region  New cases in  
last 28 days 
(%) Change in 
new cases in 
last 28 days *  Cumulative 
cases (%)  New deaths 
in  last 28 
days (%)  Change in 
new deaths 
in last 28 
days *  Cumulative 
deaths (%)  Countries 
reporting 
cases in the 
last 28 days  Countries 
reporting 
deaths in 
the last 28 
"
"in 
the last 28 
days  
Europe  701 053  
  (63%)  -13%  278 615 
939 
  (36%)  4 194  
  (48%)  -3% 2 265 734  
  (32%)  34/61  
 (56%)  23/61  
 (38%)  
Western 
Pacific  338 056  
  (30%)  77%  208 014 
763 
  (27%)  416 
  (5%)  -45%  419 274  
  (6%)  17/35  
 (49%)  8/35  
(23%)  
America
s 42 330  
  (4%)  -18%  193 223 
732 
  (25%)  3 869  
  (44%)  -41%  2 992 342  
  (43%)  17/56  
(30%)  9/56  
(16%)  
South -
East 
Asia 26 469  
  (2%)  379%  61 241 866  
  (8%)  186 
  (2%)  564%  808 278  
  (12%)  6/10  
 (60%)  4/10  
(40%)  
Africa  3 354  
  (0%)  -63%  9 568 385  
  (1%)  -2 
  (0%)  -113%  175 473  
  (3%)  28/50  
 (56%)  4/50  
 (8%)"
" 4/50  
 (8%)  
Eastern 
Mediter
ranean  2 464  
  (0%)  -13%  23 409 749  
  (3%)  37 
  (0%)  -53%  351 870  
  (5%)  4/22  
(18%)  3/22  
 (14%)  
Global  1 113 726  
  (100%)  4%    774 075 
198 
  (100%)  8 700  
  (100%)  -26%  7 012 984  
  (100%)  106/234 
(45%)  51/234 
(22%)  
 
*Percent change in the number of newly confirmed cases/deaths in the past 28 days, compared to 28 days prior. Data from previous weeks are 
updated continuously with adjustments received from countries.  
**See Annex 1: Data, table, and figure notes                                                                                                                                                                     
 
 
 
 
 5 
 Figure 2. SARS -CoV-2 specimens tested and test positivity rates reported to FluNet  from sent inel sites ; 5 January 
2020 to 7 January  2024 
 
 
 
Source: Influenza and SARS -CoV-2 surveillance data from GISRS  reported to FluNet ; WHO Global Influenza Programme
 
6 
 Figure 3. Number of confirmed  COVID -19 cases  reported over  the last 28 days per 100 000 population , as of 7 January  2024** 
 
**See Annex 1: Data, table, and figure notes  
 
7 
 Figure 4. Percentage change in confirmed COVID -19 cases  over the last 2"
"-19 cases  over the last 28 days relative to the previous 28 days, as of 7 January  2024** 
 
**Se e Annex 1: Data, table, and figure notes  
 
8 
 Figure  5. Number  of COVID -19 deaths  reported over  the last 28 days per 100 000 population , as of 7 January   2024 ** 
 
**Se e Annex 1: Data, table, and figure notes  
 
9 
 Figure 6. Percentage change in confirmed COVID -19 deaths  over the last 28 days relative to the previous 28 days, as of 7 January  2024** 
 
**Se e Annex 1: Data, table, and figure notes  
 
10 
  
Hospitalizations and ICU admissions  
 
At the global level, during the past 28 days (11 December 2023  to 7 January 2024), a total of 173 547  new 
hospitalizations and 1 966 new intensive care unit (ICU) admissions were reported from 5 3 and 4 2 countries, 
respectively (Figure 7). This represents 32% increase and 3% decrease, respectively, compared to the previous 28 
days (13 November to 10 December 2023). Note that the absence of reported data from some countries to WHO 
does not imply that there are no COVID -19-related hospitalizations in those countries. The prese nted 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.   
  
 
New hospitalizations  
During the past 28 days, 5 3 (23%) countries reported data to WHO on new hospitalizations at least once (Figure 7)."
"izations at least once (Figure 7). 
The Region of the Americas had the highest proportion of countries reporting data on new hospitalizations (1 9 
countries; 3 4%), followed by the European Region (15 countries; 25%), the African Region (12 countries; 24%), the 
South -East Asia Region (two countries; 20%), and the Western Pacific Region (five countries; 14%). No country in the 
Eastern Mediterranean Region shared1. The number of countries that consistently reported new hospitalizations 
for the period was 9% (22  countries) (Table 2).  
 
Among the 22 countries consistently reporting new hospitalizations, 8 (36%) countries registered an increase of 20% 
or greater in hospitalizations during the past 28 days compared to the previous 28 -day period: Indonesia (1337 vs 
149; +797%), Malta (79 vs 21; +276%), Brunei Darussalam (588 vs 161; +265%),  Malaysia (9312 vs 4137; +125%), 
Greece (6366 vs 3792; +68%), Singapore (2619 vs 1719; +52%), United Sates of America (12 8 073 vs 84 98 1; +51%), 
and Ireland (1353 vs 967; +40%).  
The highest numbers of new hospital admissions were reported from the United States of America (12 8 073  vs 84 
981; +51%), Malaysia (9312 vs 4137; +125%), and Italy (8845 vs 13 857; -36%).  
 
 
 
 
 
 
 
 
 
  
11 
  
Table 2. Number of new hospitalization admissions"
"2. Number of new hospitalization admissions reported by WHO regions, 11 December 2023  to 7 January 2024  
compared to 16 October to 13  November to 10 December 2023  
Region  Countries reported at least once in 
the past 28 days  Countries reported consistently in the past and 
previous 28 days*  
Number of 
countries 
(percentage)**  Number of new 
hospitalizations  Number of 
countries 
(percentage)**  Number of new 
hospitalizations  Percent change in 
new hospitalizations  
Africa  12/50 (24%)  61 3/50 ( 6%)  6 -45%  
Americas  19/56 (3 4%)  134 789  5/56 ( 9%)  129 408  +48%  
Eastern   
Mediterranean  0/22 (<1%)  N/A***  0/22 (<1%)  N/A N/A 
Europe  15/61 (25%)  23 039  9/61 (15%)  22 574  -9%  
South -East  
Asia  2/10 (20%)  1358  2/10 (20%)  1358 +690%  
Western   
Pacific  5/35 (14%)  14 300  5/35 (14%)  14 300  +88%  
Global  53/234 (2 3%)  173 547  24/234 ( 10%)  167 646 +40% 
 
*Percent change is calculated for countries reporting consistently both in the past 28 days and the previous 28 days (compari son period).  
**Number of countries reported / total number of countries in the region ("
"reported / total number of countries in the region (percentage of reporting).  
*** N/A represents not available  or applicable .  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
12 
  
Table 3. Countries that consistently reported new hospitalizations by WHO region, 11  December 2023 to 7 January 2024 
compared to 13 November to 10 December 2023.  
WHO Region  Country  New Hospitalization in 
past 28 days  New Hospitalization in 
previous 28 -day period  % Change from 
previous 28 -day 
period  
Africa  Mauritania  0 0 N/A  
Africa  Mali  0 0 N/A  
Africa  Angola  6 11 -45%  
Americas  Turks and Caicos Islands  0 0 N/A  
Americas  United States of America  128073  84981  51%  
Americas  Canada  1335  2685  -50%  
Americas  Saint Lucia  0 7 -100%  
Americas  Honduras  0 5 -100%  
Europe  Malta  79 21 276%  
Europe  Greece  6366  3792  68%  
Europe  Ireland  1353  967  40%  
Europe  Netherlands  2474  2196  13%  
Europe  Slovakia  925  1015  -9% 
Europe  Czechia  2083  2317  -10%  
Europe  Estonia  420  474  -11%  
Europe  Italy  8845  13857  -36%  
Europe  Portugal  29 57 -49%  
South -East Asia  Indonesia  133"
"East Asia  Indonesia  1337  149  797%  
South -East Asia  Bangladesh  21 23 -9% 
Western Pacific  Brunei Darussalam  588  161  265%  
Western Pacific  Malaysia  9312  4137  125%  
Western Pacific  Singapore  2619  1719  52%  
Western Pacific  New Zealand  1726  1484  16%  
Western Pacific  Mongolia  55 106  -48%  
 
*N/A represents not applicable                                                                                                                                                                                                                   
 +WHO emphasizes the importance of maintaining reporting and encourages countries to report the absence of new admissions (“zero reporting”) if 
there are no new hospital or ICU admissions during the week.  
 
 
 
  
13 
 New ICU admissions  
Across the six WHO regions, in the past 28 days, a total of 4 2 (19%) countries reported data to WHO on new ICU 
admissions at least once (Figure 8). The African Region had the highest proportion of countries reporting data on 
new ICU admissions (13 countries; 26%), followed by the European Region (12 countries; 20%), the Region of the 
Americas (10 countries, 14%), the Western Pacific Region (six countries; 17%) , and the South -East Asia Region (one 
country; 10%). No country in the Eastern Mediterranean Region reported ICU data during the period. The 
proportion of coun tries that consistently reported new ICU admissions for the period was 8% (1 8 countries). 
Among the 1 8 countries consistently reporting new ICU admissions, eight ( 44%) countries showed an increase of 
20% or greater in new ICU admissions during the past 28 days compared to the previous 28 -day period: Indones"
"the previous 28 -day period: Indonesia 
(164 vs 18; +811%), Malaysia (135 vs 15; +800%), Singapore (77 vs38; +103%), Estonia (18 vs 10; +80%), Ireland  (20 
vs 13; +54%), Netherlands (120 vs 86; +40%), Greece (120 vs 88; +36%), and Czechia (18 2 vs 146; +25%)  
The highest numbers of new ICU admissions were reported from Italy (464 vs 492; -6%), Czechia (182 vs 146; 
+25%), and Indonesia (164 vs 18; +811%).  
 
Table 4. Number of new ICU admissions reported by WHO regions, 11 December 2023 to 7 January 2024 compared   to  
13 November  to 10 December  2023  
WHO Region  Countries reported at least once 
in the past 28 days  Countries reported consistently in the past and previous 28 
days*  
Number of 
countries 
(percentage)**  Number of 
new ICU 
admissions  Number of 
countries 
(percentage)**  Number of 
new ICU 
admissions  Percent change in 
new ICU admissions  
Africa  13/50 (26%)  6 1/50 ( 2%)  0 N/A  
Americas  10/56 (1 8%)  386 2/56 (16%)  99 -55%  
Eastern   
Mediterranean  0/22 (<1%)  N/A***  0/22 (<1%)  N/A N/A 
Europe  12/61 (20%)  1097  8/61 (1 3"
"7  8/61 (1 3%)  1032  +3%  
South -East  
Asia  1/10 (10%)  164 1/10 (10%)  164 +811%  
Western   
Pacific  6/35 (17%)  313 6/35 ( 14%)  256 +86%  
Global  42/235 (1 9%)  1966  18/235 ( 8%)  1551 +13% 
 
*Percent change is calculated for countries report ing consistently both in the past 28 days and the previous 28 days (comparison period).  
**Number of countries reported / total number of countries in the region (percentage of reporting).  
*** N/A represents data not available  or applicable .  
+ WHO emphasizes the importance of maintaining reporting and encourages countries to report the absence of new admissions (“zero re porting”) if 
there are no new hospital or ICU admissions during the week.  
  
14 
 Table 5. Countries that consistently reported new ICU admissions  by WHO regions, 11  December 2023 to 7 January 2024 
compared to 13 November to 10 December 2023.  
WHO Region   Country  New ICU admissions in 
past 28 days  New ICU admissions in 
previous 28 days  % Change in ICU 
admissions from 
previous 28 -day period  
Africa   Mauritania  0 0 N/A 
Americas   Canada  99 221 -55% 
Americas  Honduras  0 0 N/A 
Europe   Italy  464 492 -6% 
Europe   Czechia  182 146 25%  
Europe   Netherlands  120 86 40%  
Europe   Greece  120 88 36%"
"120 88 36%  
Europe   Sweden  101 158 -36%  
Europe   Ireland  20 13 54%  
Europe   Estonia  18 10 80%  
Europe   Slovakia  7 9 -22%  
South -East Asia   Indonesia  164 18 811%  
Western Pacific   Malaysia  135 15 800%  
Western Pacific   Singapore  77 38 103%  
Western Pacific   New Zealand  39 38 3% 
Western Pacific   Brunei Darussalam  5 5 0% 
Western Pacific   Mongolia  0 0 N/A 
Western Pacific  Australia  163 220 -26%  
 
* N/A represents not applicable + WHO emphasizes the importance of maintaining reporting and encourages countries to report the absence of new 
admissions (“zero reporting”) if there are no new hospital or ICU admissions during the week.  
 
 
 
 
 
 
 
 
  
15 
 Figure 7.  28 -day global COVID -19 new hospitalizations and ICU admissions, from 3 February 2020  to 7 January 
2024  (A); and  from 1 May  2023 to 7 January 2024  (B) 
   A 
 
 
B 
 
 
 
Note: Recent weeks are subject to reporting delays and data might not be complete, thus the data should be  interpret ed with caution. Cases included 
in grey bars are only from countries reporting hospitalizations or ICU admissions, respectively.  
 
 
16 
 Severity indicators  
 
The ICU -to-hospitalization ratio and death -to-hospitalization ratio have been key indicators for understanding 
COVID -19 severity throughout the pandemic. The ICU -to-hospitalization ratio is used"
"U -to-hospitalization ratio is used to assess the proportion of 
patients requiring ICU admission in relation to the total number of hospitalizations. The death -to-hospitalization ratio 
is used to assess the proportion of death s in relation to hospitalized patients.  
 
These indicators are subject to the same limitations mentioned above and their calculations are limited to the 
countries reporting all relevant data elements (hospitalizations , ICU admissions and deaths) in a given reporting 
period . It should be noted that there may be differences in reporting among countries. For instance, in some 
countries, hospitalization data may include ICU admissions, whereas in others, ICU admissions may be reported 
separately. Furthermore, it is important to  consider that some death s might have occurred outside of hospital 
facilities.  
 
Overall, the ICU -to-hospitalization ratio has been decreasing since the peak in July 2021 when the ratio was 0.2 6, 
dropping below 0.15 since the beginning of 2022, and around 0.05 since the start of 2023  (Figure 8) . The trend has 
been stable  in recent wee ks. This suggests that a decreasing proportion of new hospitalizations require intensive 
care.  
 
Similarly, the death -to-hospitalization ratio has been showing a general decline since July 2021. Since January 2023, 
it has remained under 0.15 , varying  between 0.06 to 0.14. This is an encouraging trend indicating a lower mortality 
risk among hospitalized individuals.  
 
Please n ote that the causes for these decreases cannot be directly interpreted from these data, but likely include a 
combination of increases in infection -derived or vaccine -derived immunity, improvements in early diagnosis and 
clinical care, reduced strain on hea lth systems, and other factors. It is not possible to infer a decreased intrinsic 
virulence amongst newer SARS -CoV-2 variants"
"newer SARS -CoV-2 variants from these data.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
17 
 Figure 8. COVID -19 ICU -to-hospitalization ratio and death -to-hospitalization ratio, from 27 April  2020 to  7 January 
2023  (A), and 22 May  to 7 January  2024 (B) 
 
A 
 
 
B 
 
 
 
 
 
Note: Recent weeks are subject to reporting delays and should not be interpreted as a declining trend. The ICU ratio figure is created from the data of the countries 
reported both new hospitalizations and new ICU admissions. The d eath ratio figure is created from the data of the countries that reported both new hospitalization 
and new deaths.  
Source : WHO COVID -19 Detailed Surveillance Dashboard  
 
18 
 SARS -CoV-2 variants of interest  and variants under monitoring  
 
Geographic spread and prevalence  
Globally, during the 28 -day period from 11 December 2023 to 7 January 2024, 33 659 SARS -CoV-2 sequences were 
shared through GISAID. In comparison, in the two previous 28 -day periods, there were 112 909 and 192 222 
sequences shared, respectively. The data are periodically retrospectively updated to include sequences w ith earlier 
collection dates, so the number of submissions in a given time period may change.  
 
WHO is currently tracking several SARS -CoV-2 variants, including:  
•  Five variants of interest (VOIs): XBB.1.5, XBB.1.16, EG.5, BA.2.86 and JN.1  
•  Five variants under monitoring (V"
" 
•  Five variants under monitoring (VUMs): DV.7, XBB, XBB.1.9.1, XBB.1.9.2 and XBB.2.3  
 
Table 6 shows the number of countries reporting VOIs and VUMs, and their prevalence from epidemiological week 
48 (27 November to 3 December 2023) to week 52 (25 December to 31 December 2023). The VOIs and VUMs 
exhibiting increasing trends are highlighted i n yellow, those that have remained stable are highlighted in blue, and 
those with decreasing trends are highlighted in green.  
 
Globally, JN.1 is currently the dominant circulating  VOI (reported by 71 countries), accounting for 65.5% of sequences 
in week 52 compared to 24.8% in week 48 (Figure 10, Table 6). Its parent lineage, BA.2.86, is stable and accounted 
for 7.8% of sequences in week 52 compared to 7.0% in week 48 (Figure 10, Table 6 ). The initial risk evaluation for 
JN.1  was published on 19 December 2023, with an overall evaluation of low public health risk at the global level 
based on available evidence.  
 
The other VOIs, XBB.1.5, XBB.1.16 and EG.5, have decreased in global prevalence during the same period: XBB.1.5 
accounted for 3.3% of sequences in week 52, a decrease from 8.3% in week 48; XBB.1.6 accounted for 1.5% of 
sequences in week 52, a decrease from  6.3% in week 48; EG.5 accounted for 16.6% of sequences in week 52, a 
decrease from 43.6% in week 48 (Fig"
".6% in week 48 (Figure 10, Table 6).  
 
All VUMs have shown a decreasing trend over the reporting period (Table 6).  
 
Sufficient sequencing data to calculate variant prevalence at the regional level during weeks 48 to 52 were available 
from four WHO regions: the Region of the Americas, the Western Pacific Region, the South -East Asia Region, and the 
European Region (Table 7). Among the VOIs, JN.1 was the most reported variant and showing an increasing trend in 
all the four regions. Except for XBB.1.16 that showed a small increase in the Western Pacific Region, the other VOIs 
and all the VUMs in all four regions observed dec reasing or stable trends.  
 
With declining rates of testing and sequencing globally (Figure 10), it is increasingly challenging to estimate the 
severity impact of emerging SARS -CoV-2 variants. There are currently no reported laboratory or epidemiological 
reports indicating any associ ation between VOIs/VUMs and increased disease severity. As shown in Figure 9 and 
Figure 10, low and unrepresentative levels of SARS -CoV-2 genomic surveillance continue to pose challenges in 
adequately assessing the variant landscape.  
 
 
 
 
 
 
 
 
 
  
19 
 Table 6. Weekly prevalence of SARS -CoV-2 VOIs and VUMs, week 48 to week 52 of 202 4 
 
 
 
§ Number of countries and sequences are since the emergence of the variants.  
* Includes descendant lineages, except those individually specified elsewhere in the table. For example, XBB* does not includ e 
XBB.1.5, XBB.1.16, EG.5, XBB.1.9.1, XBB.1.9.2, and XBB.2.3.  
 
 "
".2.3.  
 
 
Table 7. Weekly prevalence of SARS -CoV-2 VOIs and VUMs by WHO regions, week 48 to week 52 of 2023  
 
 
 
* Includes descendant lineages, except those individually specified elsewhere in the table. For example, XBB* does not includ e 
XBB.1.5, XBB.1.16, EG.5, XBB.1.9.1, XBB.1.9.2, and XBB.2.3.  
¥ due to the small numbers of sequences submitted in these regions, it has not been possible to determine trends for the VOIs  and 
VUMs in these regions; this is also represented by the shaded cells in the table .   
 
 
20 
 Figure 9. Global 28 -day prevalence of EG.5, XBB.1.5, XBB.1.16, BA.2.86, and JN.1, from 11 December 2023 to 7 January  
2024  *+     
 
 
* Reporting period to account for delay in sequence submission to GISAID.  
+ Historical presence indicates countries previously reporting sequences of VOIs but have not reported within the period from 4 
November  to 3 December  2023  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
21 
 Figure 10. The (A) number and (B) percentage of SARS -CoV-2 sequences, from 3 July to 31 December  2023  
 
 
 
 
 
 
   
Figure 10. Panel A  shows the number, and Panel B  the percentage, of all circulating variants since July to December 2023. The variants 
shown here include descendent lineages, except for the descendent lineage(s)"
"except for the descendent lineage(s) listed here. The Unassigned category includes lineages 
pending for a PANGO lineage name designation, whereas the Other category includes lineages that are assigned but not listed here. 
Source: SARS -CoV-2 sequence data and metadata from GISAID, from 3 July to 31 December 2023.  
 
 
 
 
A 
B  
22 
 Additional resources  
 
• Tracking SARS -CoV-2 Variants  
• WHO statement on updated tracking system on SARS -CoV-2 variants of concern and variants of interest   
• SARS -CoV-2 variant risk evaluation framework, 30 August 2023  
• WHO JN.1 Initial Risk Evaluation, 1 3 December 2023  
• WHO BA.2.86 Initial Risk Evaluation, 21 November 2023  
• WHO EG.5 Updated Risk Evaluation, 21 November 2023  
• WHO XBB.1.5 Updated Risk Assessment, 20 June 2023  
• WHO XBB.1.16 Updated Risk Assessment, 5 June 2023    
22 WHO  regional  overviews   
Data for 11 December  2023  to 7 January 2024  
 
African  Region 
The African Region reported over 3354 new cases, a 63% decrease as compared to the previous 28 -day period. Five (10%) of the 50 countries for which data are 
available reported increases in new cases of 20% or greater, with the highest proportional increases observed in Mauritania ( 30 vs six new cases; +400%), Senegal 
(17 vs six new cases ; +183%), Mali (two vs one new case; +100%), Burundi (78 vs 51 new cases; +53%), and Angola ("
"; +53%), and Angola (417 vs 316 new cases; +32%). The  highest 
numbers of new cases were reported from Mauritius (3228 new cases; 253.8 new cases per 100 000; -57%), Angola (417 new cas es; 1.3 new cases per 100 000; 
+32%), and Burundi (78 new cases; <1 new case per 100 000; +53%).  
The number of new 28 -day deaths in the Region decreased by 113% as compared to the previous 28 -day period, with no new deaths reported. The highest numbers 
of new deaths were reported from Mauritius (1 new death; <1 new death per 100 000; -50%), and Namibi a (1 new death; <1 new death per 100 000; -67%).  
 
 
Updates from the  African Region  
 
22 Region  of the Americas   
The Region of the Americas reported over 42 000 new cases, an 18% decrease as compared to the previous 28 -day period. Seven (12%) of the 56 countries for 
which data are available reported increases in new cases of 20% or greater, with the highest proportio nal increases observed in Panama (822 vs 180 new cases; 
+357%), Barbados (33 vs 14 new cases; +136%), Plurinational State of Bolivia  (1563 vs 670 new cases; +133%), Guyana (six vs three new cases; +100%), Colombia 
(1 680 vs 1 266 new cases; +33%), Paraguay (92 vs 73 new cases; +26%), and Jamaica (32 vs 26 new cases; +23%). The highest numbers of new cases were reported 
from"
"highest numbers of new cases were reported 
from Canada (18 947 new cases; 50.2 new cases per 100 000; -18%), Chile (9693 new cases; 50.7 new cases per 100 000; -25%), and Peru (4657 new cases; 14.1 
new cases per 100 000; -38%).  
The number of new 28 -day deaths in the Region decreased by 41% as compared to the previous 28 -day period, with 3869 new deaths reported. The highest 
numbers of new deaths were reported from the United States of America (3552 new deaths; 1.1 new deaths per 100 000; -40%), Canada (128 new deaths; <1 new 
death per 100 000; -60%), and Chile (114 new deaths; <1 new death per 100 000; -46%).  
 
 
 
 
Updates from the  Region of the Americas
 
  23 Eastern  Mediterranean  Region  
The Eastern Mediterranean Region reported over 2464 new cases, a 13% decrease as compared to the previous 28 -day period. One (5%) of the 22 countries for 
which data are available reported increases in new cases of 20% or greater, with the highest proportional increases observed in Kuwait (102 vs 39 new cases; 
+162%). The highest numbers of new cases were reported from Afghanistan (1256 new cas es; 3.2 new cases per 100 000; +14%), the Islamic Republic of Iran (663 
new cases; <1 new case per 100 000; -48%), and Morocco (443 new cases; 1.2 new cases per 100 000; +6%).  
The number of new 2"
"6%).  
The number of new 28 -day deaths in the Region decreased by 53% as compared to the previous 28 -day period, with 37 new deaths reported. The highest numbers 
of new deaths were reported from the Islamic Republic of Iran (27 new deaths; <1 new death per 100 00 0; -63%), Afghanistan (8 new deaths; <1 new death per 
100 000; +60%), and Morocco (2 new deaths; <1 new death per 100 000; +100%).  
 
Updates  from  the Eastern  Mediterranean  Region  
 
 
 
 
 
  23 European Region  
The European Region reported over 701 000 new cases, a 13% decrease as compared to the previous 28 -day period. 10 (16%) of the 62 countries for which data 
are available reported increases in new cases of 20% or greater, with the highest proportional increases observed in Malta (310 vs 75 new cases; +313%), Republic 
of Moldova (2 951 vs 1 485 new cases; +99%), Ireland (3 433 vs 1 856 new cases; +85%), Greece (68 590 vs 37 925 new cases; +81%), the United Kingdom (37 787 vs 
22 791 new cases; +66%), Romania (7 380 vs 4 916 new cases; +50%), Portugal (4 451 vs 3 103 new cases; +43%), Belgium (10 653 vs 8 623 new cases; +24%), 
Luxembourg (2 054 vs 1 696 new cases; +21%), and Netherlands (5 330 vs 4 442 new cases; +20%). The highest numbers of new"
"; +20%). The highest numbers of new cases were reported from the 
Russian Federation (235 198 new cases; 161.2 new cases per 100 000; -30%), Italy (163 599 new cases; 274.3 new cases per 100 000; -18%), and Greece (68 590 
new cases; 639.9 new c ases per 100 000; +81%).  
The number of new 28 -day deaths in the Region decreased by 3% as compared to the previous 28 -day period, with 4194 new deaths reported. The highest numbers 
of new deaths were reported from Italy (1016 new deaths; 1.7 new deaths per 100 000; -21%), the Russ ian Federation (679 new deaths; <1 new death per 100 
000; +45%), and Poland (543 new deaths; 1.4 new deaths per 100 000; +229%).  
 
 
 
 
Updates  from  the European  Region
 
25 
 South -East  Asia  Region  
The South -East Asia Region reported over 26 000 new cases, a 379% increase as compared to the previous 28 -day period. Five (45%) of the 11 countries for which 
data are available reported increases in new cases of 20% or greater, with the highest proportion al increases observed in India (15 079 vs 1 599 new cases; +843%), 
Myanmar (110 vs 20 new cases; +450%), Indonesia (8 610 vs 1 727 new cases; +399%), Bangladesh (276 vs 141 new cases; +96%), and Sri Lanka (67 vs 42 new 
cases; +"
"vs 42 new 
cases; +60%). The highest numbers of new cases were reported from India (15 079 new cases; 1.1 new cases per 100 000; +843%),  Indonesia (8610 new cases; 3.1 
new cas es per 100 000; +399%), and Thailand (2327 new cases; 3.3 new cases per 100 000; +17%).  
The number of new 28 -day deaths in the Region increased by 564% as compared to the previous 28 -day period, with 186 new deaths reported. The highest 
numbers of new deaths were reported from India (86 new deaths; <1 new death per 100 000; +682%), Indonesia (72 new deaths; <1 new death per 100 000; 
+1340%), and Thailand (21 new deaths; <1 new death per 100 000; +91%).  
 
 
 
Updates from the South -East Asia Region  
 
26 
 Western  Pacific  Region  
The Western Pacific Region reported over 338 000 new cases, a 77% increase as compared to the previous 28 -day period. Ten (29%) 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 Niu e (98 vs six new cases; +1533%), Palau 
(16 vs two new cases; +700%), Tonga (62 vs 12 new cases ; +417%), Cook Islands (29 vs six new cases; +383%), Cambodia (76 vs 16 new cases; +375%), Brunei 
Darussalam (16 648 vs 4 207 new cases; +296%), Malaysia (67"
"296%), Malaysia (67 206 vs 25 484 new cases; +164%), the Philippines (10 262 vs 4 672 new cases; +120%), Singapore 
(174 643 vs 80 296 new cases; +117%), and China (2 514 vs 1 674 new cases; +50%). The highest numbers of new cases were repor ted from Singapore (174 643 
new cases; 2985.2 new cases per 100 000; +117%), Malaysia (67 206 new cases; 207.6 new cases per 100 000; +164%), and Australia (41 965 new cases; 164.6 
new cases per 100 000; -18%).  
The number of new 28 -day deaths in the Region decreased by 45% as compared to the previous 28 -day period, with 416 new deaths reported. The highest numbers 
of new deaths were reported from Australia (185 new deaths; <1 new death per 100 000; -67%), Malaysi a (97 new deaths; <1 new death per 100 000; +259%), 
and New Zealand (54 new deaths; 1.1 new deaths per 100 000; -49%).  
 
 
Updates from the Western Pacific Region  
 
25 
 Annex 1. Data, table, and figure notes  
Data presented are based on official laboratory -confirmed COVID -19 cases and deaths reported to WHO by 
coun try/territories/areas, largely based upon WHO case definitions  and surveillance guidance . While steps are taken to 
ensure accuracy and reliability, all data are subject to continuous verification and change, and caution must be taken when 
interpreting these"
"must be taken when 
interpreting these data as several factors influence the counts presented, with variable underestimation o f true case and 
death incidences, and variable delays to reflecting these data at the global level. Case detection, inclusion criteria, testi ng 
strategies, reporting practices, and data cut -off and lag times differ between countries/territories/areas.  Dif ferences are 
to be expected between information products published by WHO, national public health authorities, and other sources.  
A record of historic data adjustment is available upon request by emailing epi-data [email protected] . Please specify the 
countries of interest, time period, and purpose of the request/intended usage. Prior situation reports will not be edited; 
see covid19.who.int  for the most up -to-date data.  
‘Countries’ may refer to countries, territories, areas or other jurisdictions of similar status. The  designations employed, 
and the presentation of these materials , do not imply the expression of any opinion whatsoever on the part of WHO 
concerning the legal status of any country, territory, or area or of its authorities, or concerning the delimitation of its 
frontiers or boundaries. Dotted and dashed lines on maps r epresent approximate border lines for which there may not 
yet be full agreement. Countries, territories, and areas are arranged under the administering WHO region. The mention 
of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by 
WHO in preference to others of a similar nature that are not mentioned. Errors and omissions  excepted;  the names of 
proprietary products are distinguished by initial capital letters.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
26 
 Annex 2. SARS -CoV-2 variants assessment and classification  
 
WHO, in collaboration with national authorities, institutions and researchers, routinely assesses if variants of S"