Coronavirus latest: at a glance

A summary of the biggest developments in the global coronavirus outbreak

Spain’s death rate continues to fall

The country reported 399 deaths in 24 hours, lower than Sunday’s figure of 410. A total of 20,852 people have died in Spain, with over 200,000 infected and more than 80,000 cured.

The Spanish prime minister, Pedro Sanchez , expected to ask parliament to extend the national lockdown until 11 May.

Italy sees fall in infections

For the first time since the outbreak began Italy announced a fall in the number of people currently infected down 20 to 108,237. It said 454 more people had died – 21 more than the previous day, bringing the death toll to 24,114.

“This is positive data as it shows the number of people who are currently positive with the virus is declining,” Angelo Borrelli, the chief of Italy’s civil protection authority, told reporters.

UK hospital deaths total rises by 449

The country’s Department of Health and Social Care said 16,509 people had died in UK hospitals since the outbreak began, an increase of 449 on the day before. A total of 386,044 people have been tested, of whom 124,743 have tested positive.

US scotches G20 statement on enrich WHO

US hostility to the World Health Organization scuppered the publication of a communique by G20 health ministers committing to Discover the WHO’s mandate in coordinating a response to the global coronavirus pandemic.

In place of a lengthy, detailed statement, the leaders issued a brief announcement saying gaps written in the way different countries handled pandemics.

WHO warns easing restrictions is not the end

The organization of director general, Dr Tedros Adhanom Ghebreyesussaid easing restrictions did not mean the end of any epidemic, adding that bringing the episode to a close would require “sustained effort” on the part of governments and individuals.

So-called lockdowns can help to “take the heat out of a country’s epidemic”, but cannot end it alone, he said. Governments must ensure they can “detect, test, isolate and care for every case and trace every contact”.

Healthcare workers confronted anti-lockdown protesters

The weekend has seen a spate of anti-lockdown protests across the US in Ohio, Michigan and Colorado.

But a standout image by photographer Alyson McClaran came on Sunday from Denver, Colorado. As protesters gathered outside the capitol steps and others assembled in their automobiles to ask the city to reopen for business, healthcare workers stood in the middle of the road in their scrubs. After having spent the last weeks treating Covid-19 patients, they staged their own demonstration: they wanted to remind the protestors of why the shutdown measures are important

One protestor in particular did not like it. She leaned out of her car window, wearing an American flag T-shirt, holding a placard that read “land of the free”. Then, she yelled to the protester wearing scrubs: “This is a free country. This is the land of the free. Go to China!”

She appeared to be expressing the view that closing down non-essential services in the US is equivalent to the actions of a communist state, as she continued: “If you want communism, go to China. Now open up and go to work.”

The anti-lockdown protesters drove to the protest in trucks, vans, motorcycles and buses – one man even protested on horseback, wearing a cowboy hat and carrying an American flag. Photographs show protestors in Maga hats and while some are wearing masks, social distancing protocol seems to have been largely ignored. (It is worth noting that the wave of anti-lockdown protests has also been fueled by fringe far-right groups organizing to cynically exploit this time of crisis.)

Other sources report that frontline workers were applauded for taking a stand against the demonstration (a recent Pew Research poll shows that most Americans are worried about lockdown measures being lifted too soon).

According to local reports, some protesters said that they believed the government shutdown was part of a wider plan to undermine the economy and hurt Donald Trumps’ re-election prospects. Others voiced fears about businesses closing and the impact of a recession on the livelihoods of local employees.

Colorado, like much of the rest of the country, has seen unprecedented job losses as a result of the pandemic, with more than 232,000 filing for unemployment benefits since mid-March. The pandemic has been responsible for around 400 deaths in the state.

WHO warns that few have developed antibodies to Covid-19

Herd immunity hopes dealt blow by report suggesting only 2% -3% of people have been infected

Only a tiny proportion of the global population – maybe as few as 2% or 3% – appear to have antibodies in the blood showing they have been infected with Covid-19, according to the World Health Organization, a finding that bodes ill for hopes that herd immunity will ease the exit from lockdown.

“Easing restrictions is not the end of the epidemic in any country,” said WHO director-general Dr Tedros Adhanom Ghebreyesus at a media briefing in Geneva on Monday. “So-called lockdowns can help to take the heat out of a country’s epidemic.”

But serological testing to find out how large a proportion of the population have had infection and developed antibodies to it – which it is hoped will mean they have some level of immunity – suggest that the numbers are low.

“Early data suggests that a relatively small percentage of the expanded may have been infected,” Tedros said. “Not more than 2% -3%.”

Dr Maria Van Kerkhove, an American infectious diseases expert who is the WHO’s technical lead on Covid-19, said they had thought the number of people infected would be higher, but she stressed it was still too early to be sure. “Initially, we see a lower proportion of people with antibodies than we were expecting,” she said. “A lower number of people are infected.”

Santa Clara county had 1,094 confirmed cases of Covid-19 at the time the study was carried out, but antibody tests suggest that between 48,000 and 81,000 people had been infected by early April, most of whom did not develop symptoms.

But even those high figures mean that within the whole population of the county, only 3% have been infected and have antibodies to the virus. A study in the Netherlands of 7,000 blood donors also found that just 3% had antibodies.

Van Kerkhove said they needed to look carefully at the way the studies were being carried out. “A number of studies we are aware of in pre-print have suggested that small proportions of the population [have antibodies],” she said. These were “in single digits, up to 14% in Germany and France”. “It is really important to understand how the studies were done.”

That would include asking how they found the people to test. Was it at random or were they blood donors, who tend to be healthy adults? They would also need to look at how well the blood tests were performed.

“We are working with a number of countries carrying out these serology studies,” she added. The WHO-supported studies would use robust methods and the tests would be validated for accuracy.

The hope will be that people who have had Covid-19 will be able to resume their lives. But Van Kerkhove last week said that even if tests showed a person had antibodies, it did not prove that they were immune.

Will there be a second wave of coronavirus?

As countries ease lockdowns, the worry is that populations remain highly vulnerable

With more countries planning to loosen restrictions imposed due to coronavirus but the UK prime minister, Boris Johnson, and the German chancellor, Angela Merkel, concerned about the potential for a resurgence or second wave, here is what we know from the rest of the world about the risk of Covid-19 coming back.

Will there be a second wave ?

Epidemics of infectious diseases behave in different ways but the 1918 influenza pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated – albeit more mildly – in subsequent flu pandemics.

Other flu pandemics – including in 1957 and 1968 – all had multiple waves. The 2009 H1N1 influenza A pandemic started in April and was followed, in the US and varied northern hemisphere, by a second wave in the autumn.

How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.

While second waves and secondary peaks within the period of a pandemic are technically different, the concern is essentially the same: the disease coming back in force.

Is there evidence of coronavirus coming back elsewhere?

This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a sudden resurgence in infections despite being lauded for its early handling of the outbreak.

Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged in cramped dormitory accommodation used by thousands of foreign workers with inadequate hygiene facilities and shared canteens.

With 1,426 new cases reported on Monday and nine dormitories – the biggest of which holds 24,000 men – declared isolation units, Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.