Thread by @AliHMokdad

There are five distinct #COVID19 trends globally. 1) In Brazil and some neighboring countries, a P1-driven surge is unfolding with potentially huge impacts on health systems and deaths. 1/10

2) B.1.1.7 surge is unfolding in the northern states of the US and Canada. The rapid increases in cases seen in Michigan may be a marker of what may unfold in other parts of the US and Canada. 2/10

3) Cases and deaths are increasing in Europe despite extensive social distancing mandates, slowly increasing vaccination rates, and reduced mobility. 3/10

4) Bangladesh, Pakistan, and many states in India have rapid increases in cases and deaths. 5) A surge in many African countries after the detection of B.1.351 in South Africa. 4/10

Many countries in the Middle East appear to be following the same pattern as in Europe, with likely a B.1.1.7-driven epidemic. The rapid increases in Turkey are particularly concerning. 5/10

Given much lower sequencing rates, it is harder to be sure which variant is accounting for this increase in these locations. 6/10

Rising cases in settings where seroprevalence data suggest more than 60% have been infected suggest that the surge may be related to an escape variant. 7/10

Overly rapid reopening, well documented in the rapid increases in mobility in the US, increases the risk of an April/May surge despite rapid scale-up of vaccination. 8/10

Currently, sustained mask use in the US is one important brake on the surge; if mask use starts to drop then we may see increasing death numbers in the US through until May. 9/10

The trajectory of the pandemic requires stronger preventive measures and depends on the behavioral response in terms of vaccine confidence, mask wearing, and avoidance of situations that pose a high risk for transmission. 10/10