Situation Report-51 SITUATION IN NUMBERS total and new cases in last 24 hours Globally 118 319 confirmed (4620 new) 4292 deaths (280 new) China 80 955 confirmed (31 new) 3162 deaths (22 new) Outside of China 37 364 confirmed (4589 new) 1130 deaths (258 new) 113 countries/territories/ areas (4 new) WHO RISK ASSESSMENT China Very High Regional Level Very High Global Level Very High HIGHLIGHTS • WHO Director-General in his regular media briefing today stated that WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction. WHO therefore have made the assessment that COVID-19 can be characterized as a pandemic. For detailed information, please see here. • Four new countries/territories/areas (Bolivia [Plurinational State of], Jamaica, Burkina Faso and Democratic Republic of the Congo) have reported cases of COVID-19 in the past 24 hours. • The COVID-19 virus infects people of all ages. However, evidence to date suggests that two groups of people are at a higher risk of getting severe COVID-19 disease. These are older people; and those with underlying medical conditions. WHO emphasizes that all must protect themselves from COVID-19 in order to protect others. For more information, please see 'subject in focus'. • On 10 March, the IFRC, UNICEF and WHO issued a new guidance to help protect children and schools from transmission of the COVID-19 virus. The guidance provides critical considerations and practical checklists to keep schools safe. More information can be found here. Figure 1. Countries, territories or areas with reported confirmed cases of COVID-19, 11 March 2020 Erratum: 'Total cases' and 'new cases' for Bulgaria and Paraguay have been corrected. SUBJECT IN FOCUS: Risk Communication guidance-COVID-19, older adults and people with underlying medical conditions The virus that causes COVID-19 infects people of all ages. However, evidence to date suggests that two groups of people are at a higher risk of getting severe COVID-19 disease. These are older people (that is people over 60 years old); and those with underlying medical conditions (such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer). The risk of severe disease gradually increases with age starting from around 40 years. It's important that adults in this age range protect themselves and in turn protect others that may be more vulnerable. WHO has issued advice for these two groups and for community support to ensure that they are protected from COVID-19 without being isolated, stigmatized, left in a position of increased vulnerability or unable to access basic provisions and social care. This advice covers the subject of receiving visitors, planning for supplies of medication and food, going out safely in public and staying connected with others through phone calls or other means. It is essential that these groups are supported by their communities during the COVID-19 outbreak. WHO emphasizes that all people must p...

Objective Information regarding the association of immune‐related factors with pneumonia in children with coronavirus disease 2019 (COVID‐19) is scarce. This study aims to summarize the immune‐related factors and their association with pneumonia in children with COVID‐19. Methods Children with COVID‐19 at Wuhan Children's Hospital from 28 January to 12 March 2020 were enrolled. Pneumonia due to causes other than COVID‐19 were excluded. The clinical and laboratory information including routine blood tests, blood biochemistry, lymphocyte subsets, immunoglobulins, cytokines, and inflammatory factors were analyzed retrospectively in 127 patients. Normal ranges and mean values of laboratory markers were applied as parameters for logistic regression analyses of their association with pneumonia. Results In nonintensive care unit patients, 48.8% and 22.4% of patients had increased levels of procalcitonin and hypersensitive C‐reactive protein (hs‐CRP) respectively. A total 12.6% and 18.1% of patients had decreased levels of immunoglobulin A (IgA) and interleukin 10 (IL‐10), respectively. Approximately 65.8% of patients had pneumonia. These patients had decreased levels of globulin (odds ratio [OR], 3.13; 95% confidence interval [CI] 1.41‐6.93; P = .005), IgA (OR, 4.00; 95% CI, 1.13‐14.18; P = .032), and increased levels of hs‐CRP (OR, 3.14; 95% CI, 1.34‐7.36; P = .008), procalcitonin (OR, 3.83; 95% CI, 2.03‐7.24; P < .001), IL‐10 (OR, 7.0; 95% CI, 1.59‐30.80; P = .010), and CD4+ CD25+ T lymphocyte less than 5.0% (OR, 1.93; 95% CI, 1.04‐3.61; P = 0.038). Conclusion Decreased IgA and CD4+ CD25+ T lymphocyte percentage, and increased hs‐CRP, procalcitonin, and IL‐10 were associated with pneumonia, suggesting that the immune‐related factors may participate in the pathogenesis of pneumonia in children with COVID‐19.