The purpose of this report is to provide a concise overview of the epidemiological situation of the COVID-19 pandemic and vaccine uptake by country. It presents trends over time of selected epidemiological indicators for COVID-19 based on multiple sources of data. For all countries globally that have reported COVID-19 cases to date, the main indicator shown is the 14-day notification rate of reported COVID-19 cases per 100 000 population, which provides an estimate of the prevalence of active cases in the population. A 14-day notification rate of reported deaths per 1 000 000 population is also plotted on the time-series for each country to show trends in deaths compared to cases.
A more nuanced assessment of the epidemiological situation in EU/EEA Member States is made possible by surveillance data routinely collected by ECDC.
COVID-19 vaccine uptake in EU/EEA countries is presented for at least one vaccine dose, primary course and subsequent booster doses in the total population, by age groups and other target populations (e.g. healthcare workers).
This report complements the presentation of data in ECDC’s COVID-19 vaccine tracker.
Interpretation of COVID-19 data presented on this report
The 14-day notification rate of new COVID-19 cases, along with the 14-day death rate are the main indicators displayed. These rates are calculated based on data collected by the ECDC Epidemic Intelligence from various sources and are affected by the local testing strategy, laboratory capacity and the effectiveness of surveillance systems. Comparing the epidemiological situation regarding COVID-19 between countries should therefore not be based on these rates alone. At individual country level, this indicator may however be useful for monitoring the national situation over time.
Testing policies and the number of tests performed per 100 000 persons, vary markedly across the EU/EEA and presumably even more so among third countries. More extensive testing will inevitably lead to more cases being detected.
The 14-day notification rate of new COVID-19 cases should be used in combination with other factors including testing policies, number of tests performed, test positivity, excess mortality and rates of hospital and Intensive Care Unit (ICU) admissions, when analysing the epidemiological situation in a country. Most of these indicators are presented for EU/EEA Member States in this report.
Data on vaccine uptake are updated every two weeks based on the current schedule of data submission from EU/EEA countries to TESSy. Details on the definitions of vaccine uptake indicators may be found in the ‘COVID-19 vaccine data’ section in the COVID-19 vaccine tracker.
Even when using several indicators in combination, comparisons between countries should be done with caution and relevant epidemiological expertise.
The data behind many of the plots are available to download from ECDC’s website.
The report is arranged into chapters, the first of which covers all countries globally, the second focuses on EU/EEA Member States overall, and subsequent chapters present information for each Member State. Data on new cases and deaths in all countries globally are collected weekly by ECDC’s epidemic intelligence team and made available to download on ECDC’s website and COVID-19 vaccine tracker.
Sources of data used for the EU/EEA figures are shown under each plot. All data are shown for the calendar week ending the previous Sunday. Starting in week 44 in 2020, data from France for some indicators (testing rate and test positivity) have been provided for a week that runs from Saturday to Friday (i.e. two days earlier than calendar week). Data for all other indicators from France are for the calendar week.
Figures displaying 14-day age-specific COVID-19 case notification rate are based on data provided directly by Member States to ECDC via The European Surveillance System (TESSy).
The figures in this report are based on several data sources, labeled as follows:
‘TESSy COVID-19’: data provided directly by Member States to ECDC via TESSy.
‘ECDC database compiled from public online sources’: the data displayed have been automatically or manually retrieved (‘web-scraped’) daily from national/official public online sources from EU/EEA Member States. It should be noted that there are several limitations to this type of data. Scraped data are not available for all variables and/or countries due to content variability on national websites. Additionally, the data collection process requires constant adaptation to avoid to interrupted time series (i.e. due to modification of website pages, types of data). Hospital and ICU admission criteria, and policies to report these data differ between countries and over time, which may result biased estimates derived from such data.
The data on COVID-19 vaccine doses are periodically submitted to TESSy by EU/EEA countries.
In order to improve data quality, ECDC is continuously monitoring the data available in the public domain and updating the datasets accordingly.
Long-term care facility data
Definitions used for the long-term care facility (LCTF) data reported at the national level can be found in the related ECDC surveillance protocol. The data sources for the denominator ‘number of LTCF beds’ are presented on ECDC’s website.
Description of data collected through the LTCF surveillance activity each week including the contextual information for the weekly trends that are collected by the associated ‘Periodic Survey’ and caveats provided by the EU/EEA countries that participated in weekly aggregated LTCF COVID-19 reporting is available in the technical report published by ECDC.
Definition of trends
14-day (2-week) notification rates for cases per 100 000 and deaths per million population. Trend for week W compares rate on week W with that on week W-1. Countries with low rates (cases: <10, deaths: <5) or which do not meet the criteria below are classified as stable trend. Increasing/decreasing trend: relative rate change (cases: >10%, deaths: >10%) OR absolute rate change (cases: >10, deaths: >5).
Testing rate per 100 000 population. Trend for week W compares rate on week W with that on week W-1. Stable: relative change =<10% or absolute rate change =<50. Increase/decrease: relative rate change >10% and absolute rate change >50.
Positivity (%) = number of confirmed cases/number of tests done per week. Trend for week W compares positivity on week W with that on week W-1. Stable: relative change =<10% or absolute change =<0.5 percentage points. Increase/decrease: relative positivity change >10% and absolute positivity change >0.5 percentage points.
Hospital or ICU admission rate: Trend for week W compares the admission rate per 100 000 population on week W with that on week W-1. Countries with low rates (<5% of the maximum weekly rate during the pandemic) or which do not meet the criteria below are classified as stable trend. Increasing/decreasing trend: relative rate change >10%
Hospital or ICU occupancy. Trend for day D compares mean 7-day mean occupancy rate per 100 000 popultion on day D with that on day D-7. Countries with low occupancy (<5% of the maximum 7-day rate during the pandemic) or which do not meet the criteria below are classified as stable trend. Increasing/decreasing trend: relative rate change >10%.
This section contains disclaimers relating to the data displayed in this report. Those listed under each country header are usually provided by the national contact points responsible for submitting national surveillance data to TESSy. Additional country-specific data disclaimers can be found in the ECDC COVID-19 vaccine tracker.
[Testing and cases] Starting in week 49 of 2020, the following changes have occurred in COVID-19 surveillance in France: a) the case definition has been updated to include antigen tests as a laboratory method to confirm a case; b) test positivity is calculated as the number of patients testing positive for SARS-CoV-2 (by RT-PCR or AT) divided by the number of patients testing positive for SARS-CoV-2 and the number of individuals testing negative; c) the number of individuals tested during a certain period corresponds to the number of people who had at least one test during this period and who have never tested positive in the previous 60 days; d) the number of individuals tested positive corresponds to a person who tested positive either for the first time or after more than 60 days after a previous positive test (in this event the person will be counted as a new case). As a result of these changes, surveillance artefacts are present in the values for week 49 compared to week 48 for test positivity (decrease, due to an increase in the denominator of number of people tested) and the testing rate (increase, approximately doubled). An increase in the case notification rate is also expected to occur due to an increased number of detections by antigen tests. As of 28 October 2022, the number of new confirmed COVID-19 cases is underestimated following a suspension of COVID-19 test results transfers from private laboratories to the central database between 21 to 24 October, 14 to 16 November and 1-3 December 2022. Similarly, the incidence and the testing rates are underestimated for those time periods. Sequencing results as of week 44 2022 may also be impacted.
[Testing] Starting in week 44 of 2020, data for some indicators displayed in ECDC’s surveillance outputs (testing rate, test positivity) are provided for a week that runs from Saturday to Friday (i.e. two days earlier than calendar week). Data for all other indicators are for the calendar week.
[Hospital admissions] Affecting week 33 2021, a data entry catch-up in the database for hospitalisation data (SIVIC) has been carried out since 21 August 2021 by facilities in Martinique and Guadeloupe. The increase in these hospital indicators must be interpreted with caution, taking into account the data retrieval.
[Testing, cases, sequencing] As of 28 October, the number of new confirmed COVID-19 cases is underestimated following a suspension of COVID-19 test results transfers from private laboratories to the central database between 21 to 24 October, 14 to 16 November and 1-3 December. Similarly, the incidence and the testing rates are underestimated for those time periods. Sequencing results as of week 44 may also be impacted.
[Testing, cases, hospital data, vaccinations] Due to changes to the legal framework of COVID-19 surveillance in France, the surveillance systems for laboratory testing, hospitalisations and vaccination are evolving and Covid-19 data submission was ceased. Week 24, 2023 was the final week of data submission to TESSy. Submission of respiratory virus surveillance data will commence again in the next winter season 2023/23.
[Long-term care facility data] The rates that use ‘number of beds’ as a denominator are an overestimate, because currently the denominator does not include all facility types.
[ICU occupancy] Since week 26 2022, ICU occupancy data refers to all COVID-19 positive patients admitted to ICU due to COVID-19.
[Testing, cases and deaths] From week 13, 2023 and onwards only number of tests and test positivity of virological laboratories participating in the virological weekly reporting system are reported. As testing for the general public is no longer offered since 18 March 2023 the RIVM stopped reporting of (age specific) notification rates. From January 1st 2023, the RIVM is not reporting deaths anymore. Moreover, there is an underreporting in the number of deaths in data up and till 31st December 2022. Statistics Netherlands is monitoring deaths attributed to COVID-19. From week 38 of 2020 up and including week 12, 2023, the number of tests reported were corrected for underreporting. The estimated number of tests was obtained by multiplying the weekly total number of tests reported from virological laboratories by the weekly ratio of COVID-19 notifications by municipal health services to positive tests reported from virological laboratories. From week 12 of 2021 up until week 12 of 2022, the number of entry tests for events and activities, as reported by ‘Stichting Open Nederland’, were being collected and were added to this data. From week 29 up to and including week 39 of 2021, the number of tests for commercial testing of outbound travellers, sourced from the various commercial testing organizations as reported by ‘the Ministry of Infrastructure and Water Management’, were added to these data.
[Hospital and ICU admissions] Since January 25th 2022, hospitals report the reason for hospital/ICU admission of patients who tested positive for SARS-CoV-2. Therefore, from January 25th 2022 patients from the TESSy RESPISEVERE data file that were admitted due to other reasons than their SARS-CoV-2 infection, have been excluded. It should be noted that for a relatively large amount of patients (approximately one third), it is unknown or not reported whether SARS-CoV-2 was the reason for admission. These admissions are not excluded and remain in the reported dataset. In addition, there is a change in identification method to determine the hospital and ICU occupancy by COVID-19 cases. The data has been updated retrospectively since January 1st 2021, resulting in a lower number of hospital and ICU occupancy from then on.
[Vaccination] In the Netherlands a person is also registered as having completed the primary vaccination course when this person had one dose of vaccine (with exclusion of Janssen) within six months after a COVID-19 infection. Excluded from this are persons aged 80 years and older. This group always needs two doses of vaccine to be registered as having completed the primary vaccination course. In the Netherlands, an immune compromised person is registered as having completed the primary vaccination course when this person had three doses of mRNA vaccine. This group of persons is already invited to get their fifth dose of vaccine. Because of this, these persons could already have 5 doses of vaccine of which only the first four are passed on to ECDC when these persons are tested positive for SARS-CoV-2.
[LTCF surveillance] From January 1st 2023, the RIVM is collecting less additional information from people that have tested positive for SARS-CoV-2. As a result, we will not report any deaths among LTCF residents anymore from January 1st 2023 and onwards. Moreover, there is an underreporting in the number of deaths among LTCF residents in data up and till 31st December 2022. This is due to the fact that it has never been obligatory to report deaths due to COVID-19. Because of this, PHS and RIVM do not have a complete overview of all deaths related to COVID-19 in LTCFs in the Netherlands. In addition, there is a change in identification method to determine if a positive COVID-19 case is an LTCF resident. This will lead to lower numbers of confirmed COVID-19 cases among LTCF residents and COVID-19 clusters in LTCFs, but will not affect the total COVID-19 case count.
[Testing] Since week 40 of 2020, the number of tests reported has been the number of tested individuals per week. From weeks 27–39 this related to the number of analysed tests per week. Where testing data are not available in advance of the reporting deadline the number of tests for the most recent week are estimated using the previous week’s data.
[Cases and testing] As of week 6 of 2022, testing for COVID-19 is no longer offered to the general public. The Swedish Public Health Agency recommends to focus testing for patients, care users and health and elderly care staff with symptoms of COVID-19. From January 2022, one laboratory in Sweden has experienced problems in reporting to the national notification system for notifiable communicable diseases. From week 23 up to week 39, cases from January and onwards were reported retrospectively. In week 39, the remaining 9,496 cases tested in January and early February was reported. The post-registration is thus completed.
ECDC’s legal notice and disclaimer can be found at https://www.ecdc.europa.eu/en/legal-notice.