WHO press conference on coronavirus disease (COVID-19) - 15 January
00:00:00
FC Hello,
all. I am Fadela Chaib, speaking to you from WHO headquarters in Geneva and
welcoming you to our global COVID-19 press conference today, Friday 15th
January. We will update you about COVID-19 but also about the recommendation of
the sixth emergency committee meeting regarding the outbreak of COVID-19 that
took place virtually yesterday. The emergency committee statement and a press
release were sent to the media an hour ago and are also posted on the WHO
website.
I will let Dr Tedros introduce our guest, the
Chair of the emergency committee, later on. Present in the room are Dr Tedros,
Director-General of WHO, Dr Mike Ryan, Executive Director, Health Emergencies
and Dr Maria Van Kerkhove, Technical Lead for COVID-19. Joining also are Dr
Jaouad Mahjour, Assistant Director-General, Emergency Preparedness, and Dr
Carmen Dolea, Unit Head, International Health Regulation. Both can talk about
the emergency committee recommendation.
We have also Dr Mariângela Simão, Assistant
Director-General, Access to Medicine and Health products, Dr Soumya
Swaminathan, Chief Scientist, Dr Bruce Aylward, Special Advisor to the
Director-General and Lead on the ACT Accelerator.
Joining online is Dr Kate O'Brien, Director,
Immunisation, Vaccines and Biologicals. Welcome, all. Simultaneous
interpretation is provided in the six UN languages plus Portuguese and Hindi.
Now without further delay I would like to invite Dr Tedros for his opening
remarks. Dr Tedros, the floor is yours.
00:02:15
TAG Merci
beaucoup, Fadela. Shukran. Good morning, good afternoon and good evening. The
emergency committee met this week and made a series of recommendations about
the COVID-19 outbreak. It will come as no surprise to you that variants and
vaccines were heavily discussed as well as the current epidemiological
situation.
Some countries in Europe, Africa and the
Americas are seeing spikes in cases with multiple factors driving transmission
risk. This is because we're collectively not succeeding at breaking the chains
of transmission at the community level or within households.
We need to close the gap between intent and
implementation at the country and individual level because at present there is
immense pressure on hospitals and health workers.
00:03:15
With almost two million deaths and new variants
appearing in multiple countries the emergency committee emphasised the need for
governments to do all they can to curb infections through tried and tested
public health measures. The more the virus is suppressed the less opportunity
it has to mutate.
We need to be more efficient than the virus and
reach excellence in everything we do. There is only one way out of this storm
and that's to share the tools we have and commit to use them together. The
committee called for upgrading national sequencing capacity so that as the
virus changes we can effectively monitor and respond to new challenges.
This is a defining moment in the pandemic and I
was pleased that the emergency committee put a major emphasis on rolling out
COVID-19 vaccines equitably. Health workers are exhausted. Health systems are
stretched and we're seeing supplies of oxygen run dangerously low in some
countries.
Now is the time we must pull together as common
humanity and roll out vaccines to health workers and those at highest risk.
This is key to saving lives, protecting health systems and driving a fair
recovery.
00:04:51
We have also developed updated guidance about
how to best protect people in long-term care facilities and recognise that if they
are isolated it has a profoundly negative impact physically and mentally. The
guidance aims to prevent the COVID-19 virus from entering the facilities and
ensure our loved ones remain safe.
I was really pleased to see refugees in Jordan
start to be vaccinated this week. I truly appreciate the approach taken by the
Jordanian Government to ensure that refugees are not left behind. It's critical
this momentum on equitable vaccine roll-out continues in the weeks ahead.
I came into public health because I wanted to
ensure that everyone everywhere has access to quality health services. I know
what it's like to come from a continent where not all health services are
available. When AIDS drugs first rolled out they were only available in rich
countries until a historic movement of health advocates, civil society and
manufacturers provided a roll-out of low-cost antiretroviral drugs.
00:06:21
In the H1N1 pandemic by the time low-income
countries received vaccine supply the pandemic was over. We don't want this to
be repeated. COVID-19 vaccines are a major scientific breakthrough and I know
through COVAX that we will distribute them a lot more effectively than in the
past.
We're working hard but we must also do more to
ensure that vaccines reach those that need them most. I will keep repeating
this over and over again during the coming weeks because, as I said on Monday,
I want to see vaccination underway in every country in the next 100 days so
that health workers and those at high risk are protected first.
I'm looking forward to the executive board next
week and working with manufacturers and countries to ensure that vaccine supply
is available and distributed equitably around the world. I now want to turn to
the Chair of the emergency committee, Professor Didier Houssin, to discuss the
recommendations from the committee. Professor, you have the floor.
DH Thank
you very much, Dr Tedros, and good morning, good afternoon, good evening to you
all. The Emergency Committee met yesterday and I want to thank first the members
of the committee for their work and contribution to these recommendations.
00:08:07
It's a sad anniversary because nearly one year
ago the emergency recommended - and it was followed - in considering
[inaudible] be even considered a public health emergency of international
concern.
Since that time, as Dr Tedros said, 19 million
people contaminated, nearly two million people have died and the committee
focused on two things. The first is a worry, a worry about the variant which
starts circulating in some places in the world. This variant requires a strong
and quick effort in research in collaboration between research teams in sharing
of information as suggested and mentioned by Dr Tedros and also about data
sharing.
I think we are in a race between the virus which
is going to continue trying to mutate in order to spread more easily and
humanity which has to try to stop its spreading. This effort of research needs
to be very, very quick and very intense.
00:09:30
Fortunately there is also good news. The good
news is about the vaccine but this good news should not be transformed into bad
news and we should remember the objective for 2021 is 20% of the population
vaccinated not only in rich countries but also in low and middle-income
countries. It's extremely important not to transform this good news into bad
news.
For the vaccine of course some of the
recommendations of the emergency committee are about trying to know more about
the efficacy of the vaccine, the efficacy against the new variants, etc. I will
not go into the detail.
I would like to add a final point about the
situation in which the world is presently. We are a little bit paralysed, we
are a little bit confused and clearly the question of travel inside the world,
around the world by air, by road, by sea needs to be perhaps better possible
and organised.
This is why one of the recommendations of the
committee to WHO was to take a strong lead in order to produce clear and
scientifically based guidance about how best to facilitate and permit the circulation
of people in a safe manner by air, by sea and by [inaudible]. I thank you for
your attention.
00:11:13
TAG Thank
you. Thank you so much, Professor. These recommendations are very important as
the world fights COVID-19. The greater the solidarity we have the more lives we
will save and the quicker we will end this pandemic. Thank you so much again,
Professor. I thank you and back to you, Fadela.
FC Thank
you, DG; thank you, Professor Houssin. I would like now to open the floor to
questions from journalists. I remind you that you need to raise your hand under
the raise your hand icon in order to get in the queue. I would like to start
with Christophe Vogt from Agence France Press. Christophe, can you hear me?
Christophe. Can you please unmute yourself, Christophe? We cannot hear you.
CH Okay,
it should be done now. Can you hear me now?
FC Very
well. Go ahead, please, Christophe.
CH Okay,
I'm really sorry about that. I have a question about what Dr Houssin just said
and what has been said in the last few weeks since the vaccines arrived and now
with the variant. It's a bit confusing. We had a light at the end of the tunnel
at the end of the year and then two or three days ago Dr Ryan talked about how
this year could be even worse than last year was.
00:12:56
So how can we reconcile the fact that now we
have efficient vaccines and still have this idea that things could get still
worse?
FC Dr
Ryan will start.
MR Thanks
for your question. I think this is a matter of deciding the future. We have an
element to control of the future we want to have and we did also warn in 2020
that if we were to rely entirely on vaccines as the only solution we could lose
the very control measures that we had at our disposal at the time.
I think to some extent that has come true for
different reasons; because people are more inside in the northern hemisphere,
because the holiday season pushed and brought people together and people mixed
in a way that they might not otherwise have done.
We've seen northern and southern hemisphere
increases; it's not just in the northern hemisphere. If you go to the southern
cone of the Americas, in Argentina, in Chile, in Paraguay and Uruguay and in
Brazil we're seeing difficulties there. This phenomenon of rapid acceleration
of cases is in the Americas, it is in Europe, it is in some countries in Africa
and it is in some countries in every region.
00:14:22
That is the reality and that's happening for a
reason. A small proportion of that may be due to the emergence of variants that
are fitter but the large proportion of that transmission has occurred because
we are reducing our social, physical distancing, our behaviour is...
As the DG said in his speech, we're not breaking
the chains of transmission. The virus is exploiting our lack of tactical commitment,
our fatigue, the breaking down of our behaviours. The vaccine is light at the
end of the tunnel, it is a massive advance but it doesn't answer and it won't
address every question that we have. We have to continue doing the other
measures and even with that - and Bruce will speak to this - if vaccination is
going to be successful people have got to be vaccinated and for people to get
vaccinated countries have to get vaccine.
Therefore it's not just an equity issue about
countries getting vaccine. It's about protecting those around the world who are
most vulnerable; our front-line workers.
00:15:29
So we want to start the year on a hopeful note.
I think what the Director-General is trying to do is start the year on a
realistic note. We need to be real with ourselves, we need to be honest. We're
not doing as well as we could. We've learnt so much about the virus, we know
more than we've ever known before, we have more tools, we have to sustain the
effort.
It's tough. We've got to pick ourselves back up.
Many of us in the northern hemisphere in the new year where people have been
celebrating holidays; many people in the southern hemisphere similarly; they're
confused because they think, oh, this disease is seasonal, it shouldn't the
here, we're in the middle of summer.
Again this idea that we've assigned seasonality
to a virus; we assign these values to the virus that were never proven
scientifically. We need to recommit ourselves to the basic measures. We need to
decide that this disease stops with me. Individuals need to protect... let the
disease stop with them. Communities need to ensure that the disease stops with
them in clusters.
Governments need to support communities and
individuals to do that and I've said it before; we're expecting our communities
to do extraordinary things, to separate themselves in extraordinary ways, to
make huge sacrifices.
00:16:50
In order for that to be successful governments
need to support communities in extraordinary ways and within all of this none
of us are doing enough to make this all work. Everyone's go to recommit
themselves and increase the level of commitment. We're all working hard,
everyone's working hard. We're just not working hard enough. Bruce.
BA Thank
you, Mike, and thanks for the question. We do have efficient vaccines but
remember, we're in a situation with an escalating virus right now in terms of
numbers and transmission in many parts of the world. We have a virus that's
also evolving and we have against that background, as Mike said, we have a decrease
in what we call stringency in the application of the measures that we have.
When you put those three things together you're
making it easier for the virus and the virus is taking off so things can get
worse, numbers can go up and we're seeing that.
00:18:02
Against that we have vaccines, yes, but we have
limited supplies of vaccines that will be rolled out slowly across the world
and also vaccines are not perfect, they don't protect everyone in every
situation, as you know. So as a result the situation could definitely get worse
in the short term and we also have hesitancy against the vaccines in places.
So it is not the silver bullet, as the
Director-General and Mike have reaffirmed multiple times but there's very good
news of course because now we have three lines of defence but we have to use
them all. The first line of defence we're starting to roll out is the vaccine
that can protect people from getting infected.
Then we have diagnostics and we have new rapid
diagnostics that work well. They give a second line of defence so you can find
the ones who get infected, you can rapidly isolate, rapidly quarantine.
Then we have the third line of defence for those
people who are infected and get sick. We have dexamethasone, oxygen, as Maria
lays out all the time; very, very good clinical pathways and you can save lives
if all of that is applied. But no one part of this works; you have to use all
there lines of defence or the situation will continue to be very bad and that
middle line of defence is still about finding cases, getting them isolated very
rapidly, not just hospitalised but the mild and moderate cases at home.
00:19:26
We have to make it easier for people to isolate
so that they don't infect other people. You need all of that. Vaccine's such an
important part of the solution but this is a complex situation and we need all
pieces of this working together.
FC Thank
you. Maria.
MK Thank
you. I just wanted to highlight the point you made about the light at the end
of the tunnel. There is a light at the end of the tunnel but that tunnel is a
long tunnel right now and it's dark and it's dangerous and it's a challenging
one that we have to get through but we have the tools to help us get through
that and more and more and more are coming online.
But please don't forget about the tools we have
in hand. We're all in a challenging situation, we're tired, we're frustrated,
we want this to be done but we have to be part of the collective action towards
ending it, we have to be part of the collective action to prevent ourselves
from getting infected and if we do get infected the virus stops with us, we
don't allow this virus to pass from us to someone else.
00:20:34
We have the tools in hand to do that, whether
this is related to a virus variant; these variants will be detected and it's
confusing and it's scary but the virus itself is enough to scare us into
action. We need individual information to turn into action. We need knowledge
to turn into action. We need intent to turn into action and all of us have a
role to play but it's not just up to individual-level measures.
We need our families, we need our communities,
we need governments to provide supportive environments in which we can take
those actions. We need not only good testing with rapid turn-around results; we
need those tests to link to public health action so that we know where the
virus is circulating, we know...
If I'm infected or if I'm a contact of someone
who's been infected I need to know what to do and I need to know that I will be
supported in being in quarantine and that I can protect my loved ones.
00:21:34
We have a very different situation around the
world. Many countries have shown us the hope that by doing all of this
collective action, by putting in the hard work through a comprehensive
strategy, not one measure alone, many measures together, applying them in a
comprehensive way with strong national plans, implemented, adapted, agile at
the local levels, tailoring it to the specific needs of the local level.
They've shown us the way.
We have outlined guidance in support of all of
our member states, in support of everyone everywhere about what needs to be
done and we know it's hard but we have seen, we've had it demonstrated over and
over again that it works. This is why we sit up here and repeat that there are
many things that we can do. Vaccines and vaccination are another tool that will
help us get to that light at the end of the tunnel but it will take time.
So there is a frustration and I understand that
and all of us understand that because we feel it too but it will take some
time. But let's look at the hopeful angle here and that we are lucky in the
sense that we do have tools. We need to make sure that that luck and that hard
work and these vaccines reach all people all over the world and the COVAX
facility and the commitments that we have seen across the world to make sure
that that turns from just words into action, becomes a reality.
00:22:59
So there's a lot that we can do so I just wanted
to highlight your light at the end of the tunnel. There is a light at the end
of the tunnel and everyone that's listening to us today needs to know that
there's something they can do. They need to feel empowered and if you don't
know what it is you can do come to our website or reach out to find out, how
can I help, because all of us can be part of the solution to a very challenging
situation that all of us are in together.
FC Thank
you. I would like now to invite Toni Waterman from Asia News Channel to ask the
next question. Toni.
TO Thank
you very much for taking my question. It's on the WHO team of experts that has
now arrived in Wuhan. I believe the video meetings began today with Chinese
counterparts. I'm just wondering if there's any update on these initial
meetings or if you could provide any more specific information about what sort
of co-operation is going to be carried out and how the potential identification
of patient zero in Italy from November will play into this investigation into
the origins of the pandemic. Thank you.
00:24:13
FC Dr
Ryan.
MR Yes,
the team did immediately begin work and will be working with Chinese
counterparts to implement the terms of reference as we've agreed and getting
more specific on the specific data and the studies that we want to see and the
follow-up studies that need to be carried out.
But at this stage I think it's very important...
the team are going to have the need to be able to engage with their scientific counterparts
in China. We can't debate this every day; what did they do today; tomorrow;
what do they do the next day.
They have to have the space to be able to do the
work and therefore Maria can outline in more detail the overview of what we
want to achieve but this can't be paced on a daily basis and litigated in press
conferences. I'm sorry; this is not the way we would do outbreak response or
outbreak investigation or origins investigation in any situation.
00:25:13
However our team will be in touch with the media
in the field, there will be regular briefings and I'm sure that we will be able
to keep you updated on the day-to-day activities but forgive me for not getting
into the detail of what the team is achieving on a daily basis.
MK Thanks.
I'm not going to give you any very detailed response either because, as Mike
said, the team needs to do the work. The Chinese counterparts and the
international team have been meeting regularly and been talking by
teleconference and now the team is in Wuhan they're going through their
quarantine period but they're meeting again by videoconference. Once they
finish that quarantine period they'll be able to meet face-to-face.
Anyone who's ever been involved in visiting the
field or in these outbreak-type investigations knows these studies takes time.
Mainly what will happen is a series of studies - and this series of studies has
already begun - looking at some of these initial patients from December and
epidemiologic studies, seroepidemiologic studies, studies and review of past
work that has happened in the markets, that has happened with patients.
So it's a number of things but we won't be
giving a day-by-day update of what the team is doing. What we do need to do is
let them do the work and carry that out and put the information that all of
them are learning together into context in planning the next series of studies.
00:26:40
You mention a report from Italy and you refer to
this person as patient zero. We need to be very careful about the use of the
phrase patient zero, which many people indicate as the first initial case. We
may never find who the patient zero was. What we need to do is follow the
science, we need to follow the studies and make sure that they are done
comprehensively.
Any report of cases that were detected through
either looking at stored clinical samples or stored sera into 2019 we are
following up on. We are reaching out through our global networks, contacting
the researchers directly to find out more information and set up collaborations
for potential further work of any samples or studies that remain.
So we will continue to follow that and we will
report as much as we learn when we learn it to you but it will be put in a
collective understanding of the science.
00:27:42
So the team is there, they're very happy to be
there, they're very happy to be working with their Chinese counterparts and
we're thrilled for them to be able to have this time. But Bruce and I spent
some time in China and we are grateful for the opportunity to have worked
directly scientist-to-scientist to be able to have that level of interaction.
So let's let them do the work, let's let them
follow the science and we will report when we can.
MR Fadela,
can I just follow up again because I think it's important. The Director-General
in his mission to China in January 2020 - as early as that and before that in
terms of the various meetings here - the issue of the origin of the virus and
the animal/human interface was on the agenda.
The mission to China in February; the
animal/human interface and the origin of the virus was on the agenda. The World
Health Assembly in May formulated a resolution asking the Director-General to
deploy a team to follow up on that issue of designing studies that would allow
us to reach some better knowledge on this.
00:28:49
A team was deployed in June/July that went to
the field to do that preliminary discussion with Chinese colleagues on the
ground. Subsequently we've been planning that mission. That mission has now
been deployed and has arrived in Wuhan. That mission has ten of the finest
scientists I've ever worked with on it from different countries around the
world, covering a huge range of skills, supported by WHO team and in the
context of the Global Outbreak Alert and Response Network support.
The global scientific community has come
together in a network with GOARN at the request of the Director-General to
deploy a team to work with Chinese counterparts to find the scientific answers
we need so we can learn more about the origin of this virus.
They are in Wuhan today. I think we do need to
give them the time and the space to do that work. We do thank our colleagues in
China for working with us to achieve this. These things are not always easy to
achieve and we do thank them for that.
00:29:47
We thank our colleagues in Singapore for
facilitating the transit of our team and all of those who are working so hard
to ensure that we all get the scientific answers that we need so we can protect
public health now and into the future.
So in that regard we should see today as the
culmination of a lot of work to put together this process and, as Maria said,
there are no guarantees of answers. We've seen the same in previous epidemics
of emerging disease. It is a difficult task to fully establish the origins and
sometimes it can take two or three or four attempts to be able to do that in
different settings.
I wish the mission luck in the field. They're a
wonderful group of people and we trust with the co-operation and the
hospitality of the Chinese Government and the Chinese people and the
authorities in Hubei and Wuhan we will have a successful mission.
FC Thank
you both. I would like now to invite Jamie Keaton from Associated Press to ask
the next question.
JA Thank
you, Fadela. Can you hear me?
FC Yes,
very well. Go ahead, please.
JA Happy
New Year to you all; always nice to see you again. I'd just like to say that I
think that I speak for much of the Geneva press corps in saying that I hope
that we'll also see WHO spokespeople return to the UN briefings here.
00:31:10
My question is for Dr Houssin. I'd just like to
thank you for your recommendations. They're very illuminating. I just want to
ask you about the recently announced travel bans that we've seen in places like
the UK or in other places of particularly travellers coming from South Africa
or the UK in particular.
You mentioned in your recommendations that
countries should apply evidence-based approaches with regard to international
travel. Could you just elaborate a little bit on that and could you help us
understand if, in your view, these bans on travel are justified by the science?
Thanks so much.
FC Thank
you, Jamie. Professor Houssin.
DH Thank
you very much, Mr Keaton. This is not an easy question because we tend to live
with of course the lessons from the past with regard to travel in the context
of the International Health Regulations.
00:32:19
But with coronavirus things have changed and
it's necessary to reconsider perhaps some of the orientations which were
commonplace in the context of the IHR. This is where the science base can
perhaps modify some strategies. At the moment what we see is that there is a
great disparity in the behaviour of the member states about testing, about
quarantine, about bans, about suppression of visa, etc.
This is why we didn't go into the details of
what should be done but our recommendation to WHO was that it was really time
to reassess what could be recommended, what guidance could be provided with
regard to air travel, sea travel, land borders considering the new scientific
information provided with coronavirus.
This is our recommendation. Of course I cannot
give you a precise response about what should be recommended but the
recommendation was really to put a strong focus on this difficult topic, which
may lead us to see things a bit differently from the previous years, for
example at the time of the H1N1 influenza pandemic. Thank you.
FC Thank
you, Professor Houssin. I would like now to give the floor to Dr Carmen Dolea,
Unit Head, EHR, to complement the answer. Dr Dolea, you have the floor.
00:34:02
CD Thank
you very much, Fadela, and thank you very much for the question. To complement
what Professor Houssin said, the Chair of the emergency committee, we welcome
the continued advice and recommendations from the emergency committee that
build on the current work that we have been doing.
Just to let you know, we have published recently
updated guidance on considerations for implementing travel-related measures to
address transmission of SARS-CoV in the international context. This guidance is
promoting a risk management approach for countries whereby they take into
account when they issue the measures a number of elements that can influence
the suppression and the risk of transmission via travel of the disease.
So we propose that in this guidance there are
basic approaches that continue to be done in terms of self-monitoring, travel
advice. There are also additional approaches that can be done based on an
assessment of the risk in the arriving country, of the capacities of
destination countries and of the health system surveillance and response.
00:35:31
We will continue to refine this guidance and
these approaches based on what we begin to learn from countries on the effect
of these measures in actually suppressing or influencing the transmission of
the disease at the international level.
The recommendations of the... Again the review
[?] committee will continue to work with partners in the aviation and
transportation sector to calibrate better the measures and the advice that we
give to countries based on the assessment and the evidence that these measures
can have on reducing the international spread of the disease. I hope this
answers your question. I don't know if Mike can supplement.
MR Hi,
Jamie, and Happy New Year to you as well. Maybe let me give you one example
because you're asking specifically about the science-based approach and, as
Carmen has outlined quite correctly, a risk-based approach.
If you look at the recommendation made by the
committee around vaccination for travellers it says, at the present time the
committee does not recommend to include a requirement for proof of vaccination
for international travel - not because that won't be a good idea in future but
because we are lacking critical evidence regarding whether or not persons who
are vaccinated could be infected or continue to transmit disease and because
nobody in the world beyond health workers and very vulnerable people have
access to the vaccine.
00:37:06
The committee is not saying don't. What the
committee is saying is, at this present time scientific evidence is not
complete, there isn't enough vaccine and therefore we shouldn't do that now and
create an unnecessary restriction to travel, a barrier to travel that's
artificial until such a time as we have the evidence and the vaccine. I think
that's the way the committee has approached things.
This is about taking the principles of science
and precaution, using the best evidence one has, using a risk management
approach and we appreciate the recommendations of the committee at this time.
00:37:41
But that will change over time and there may be
different reasons in future to do that. So we're trying to protect the travel
space and ensure that economies are not entirely isolated but recognising that
a small island nation is very different to a nation that's land-locked in the
middle of a continent.
The consequences economically or socially of
preventing or stopping travel are different for each individual family,
community and country. It can only be made as a decision at that level.
There are attempts and very laudable attempts
amongst economic integration organisations like the European Union to try and
harmonise the rules around travel and I think that's a very positive thing and
we should encourage that.
Taking a regional and subregional risk
management approach is a very positive thing but we have to recognise that it
is very difficult to legislate risk management measures at a global level that
cover all types of travel in every situation between every country because
circumstances change.
So therefore taking this risk management approach,
applying science as best we can and working within and between governments to
ensure that we align those measures in the best possible way, we believe, is
the best way forward.
00:38:46
So we do thank the committee for their careful
recommendations related to travel and all of the other matters.
MK Thanks.
I just want to come in on the first part of your comments, Jamie, around the UN
press briefings. I just wanted to say I for one have been very proud to sit up
here next to Dr Tedros, Dr Ryan and so many other amazing colleagues here at
WHO.
My first press conference for this pandemic was
about a year ago as of yesterday and as of today we've done more than 130 press
conferences, we've done more than 50 live Q&As where we answer direct
questions. Our press conferences are translated by amazing translators who are
sitting in the room and I note, I try to speak more slowly for them as they try
to translate our answers to you; six different UN languages plus Hindi, plus
Portuguese and we have live captions that are ongoing as well.
00:39:46
It's a privilege for us to do these briefings,
to be able to answer these questions to all of you, to journalists, to people
in the general communities. We will continue to do so because these are
important ways in which - one of the ways in which we get information out so
thanks for mentioning that.
We will continue to find different ways in which
we can communicate but I for one am very proud to sit up here with this amazing
group of individuals day in and day out.
FC Thank
you. I would like now to invite Brazilian journalist, Bianca Rathier from
Globo, to ask the next question. Bianca. Can you unmute yourself, please?
Bianca, can you hear me? You are muted. Can you please unmute yourself? If not
I will move on to ask Sophie Mkwena from SABC, South Africa, to ask the next
question. Sophie, can you hear me?
SO Yes,
I can hear you loud and clear. The Director-General spoke about a need for
ensuring that all countries receive these visuals [?] where the front-line
workers and the vulnerable people are receiving the vaccine. But it looks like
it's doom and gloom to a continent like Africa unless the wealthy nations,
particularly the G20; their conscience tells them that, as you often say,
Director-General, no-one is free until all of us - no-one is safe until all of
us are safe.
00:41:59
It looks like there's no movement from
particularly the G7 and the G20 to really invest in COVID. And perhaps with the
new incoming President of the United States of America, Joe Biden, next week
are you hopeful as he has indicated that his priority will be to rejoin the
World Health Organization that perhaps world leaders with America back on board
will see a different approach?
FC Thank
you, Sophie; well understood. I would like to invite Dr Swaminathan to answer
your question.
SS Thank
you, Sophie, for that very important question. This is exactly what the
Director-General and the WHO have been saying from the beginning; it's a
question of solidarity, finding solutions and then sharing them equitably.
Science has played a major role. In the last year we've had amazing progress in
diagnostics, in a lot of clinical trials for drugs and of course for vaccines.
We are in a position where today a year after
the discovery of a new virus we have not one but we have several vaccines that
are in development, several the have been approved in certain countries and
deployed, one of course that has WHO emergency use listing.
00:43:30
But I was looking at the landscape document that
we have on our website and there are over 170 candidates still in preclinical
development and 65 in clinical development, 15 of them in phase three clinical
trials. That gives a lot of hope. There are more tools, more vaccines coming
down the pipeline.
In April the Director-General along with many
leaders around the world and several global health agencies set up the ACT
Accelerator exactly to address the issue of how to accelerate the development
of tools but equally, if not more important how to ensure equitable access.
So from the very beginning we have recognised
and advocated for equitable access and the COVAX facility which WHO runs
jointly with GAVI and CEPI was set up to ensure equitable access. As of now we
do have a guarantee of at least two billion doses and perhaps a lot more than
that at the moment, by the end of 2021 and that's going to go to the 190
countries that have signed up for COVAX.
92 of these are what we call the AMC countries;
the countries that are eligible for distribution of vaccines at either no cost
or very low cost by GAVI.
00:44:57
We anticipate that the first tranches of
vaccines will start going out in the first quarter of this year even though
they may be in small volume because we also need to recognise that vaccines do
need to go through the stages of testing, they need to complete trials, they
need to have data on efficacy and safety, they need to be manufactured in a
quality-assured facility.
Dr Simao's team has been working hard with a
number of manufacturers around the world, anticipating results from the trials,
already preparing for the regulatory processes and approvals that need to be
put in place.
We have at least 13 manufacturers who've
expressed an interest and five of them currently in conversation with WHO but
these things take time. We cannot rush the elements that need to be fulfilled
because billions of people are going to receive vaccine so on the one hand we
have to make sure that the vaccines we deploy are safe and efficacious and
quality-assured and on the other hand of course countries are preparing to
deploy this and WHO, UNICEF, partners, the World Bank have been working closely
with countries.
00:45:04
We had a goal of 100 countries to be ready for
deployment and that's been done by intense work over the last several months.
So we have to wait now for the supplies to get ramped up, to start coming into
the facility. We're very hopeful that that's going to start happening very
soon.
As I mentioned, several vaccines are currently
under assessment by our regulatory team and so in the second and third quarter
of this year is when we're really going to start seeing volumes but I think
people should continue to be hopeful. Vaccines are going to arrive in
countries, people are going to get vaccinated, starting with the most at risk
group, as Dr Tedros said; all health workers to start getting vaccines in the
next 100 days. That's the goal and that's what we are going to get to. Thanks.
Bruce might want to add or Mariangela.
MS May
I complement. I think this is a great question and it's really a moral issue at
the stage we live in because I think in an ideal world we would be seeing a
different scenario; we would be seeing a scenario where we're understanding
that we're living through a global crisis and that no-one's safe until everyone
is safe.
00:47:20
In an ideal world we would not be seeing what
we're seeing right now. WHO and partners worked for days and days and days to
ensure that we put a framework in place that would allow for timely access to
all countries, independent of income or availability of resources.
But the world we live in is not a fair world and
I'm saying this because the COVAX facility is a way for us to reach fairness.
We're going to get there and, as Dr Soumya was saying, there are vaccines that
are friendlier to the low and middle-income countries' environment. The
logistics that are needed to ensure coverage and to ensure that the countries
can actually use the vaccine in the priority populations and so on...
These vaccines are on the way so what we have is
a gap in time when we have now, I think, 46 countries which have started
vaccinations and out of these I think 38 are high-income countries. The COVAX
facility is there to ensure we can correct the course and make sure that all
countries have access to safe and effective vaccines.
00:48:50
This is not happening now in January but it's
happening quite soon and we hope to have good news for you on this in February
this year. Thank you.
FC Thank
you, Dr Simao. I would like to make a second attempt to reach Bianca Rathier
from Globo. Bianca.
BI Hi,
Fadela. Can you hear me?
FC Now
very well. Go ahead, please.
BI My
apologies; I had a technical problem here. Thanks a lot for trying again. My
question is about Brazil. As the UK suspended new arrivals from Brazil over
fears of a new coronavirus variant that was detected in Japan from travellers
from Amazonas, Brazil's largest state - because in the same state Amazonas
hospitals are overwhelmed, collapsing; we have reports of patients dying of
suffocation without oxygen.
So the state made an urgent call for help from
abroad. Is WHO aware and prepared to help? Does WHO believe that the new
variant could be contributing to the sharp rise in cases there and what do you
know about this new variant, is it more contagious than the UK variant for
example?
00:50:20
It seems like a lot of questions but they are
all related.
FC Thank
you, Bianca; very well understood. I'd like to ask Dr Ryan.
MR Hi,
Bianca. Yes, a lot of questions in there. Yes, we do have a WHO team on the
ground in Manaus and we have been working very closely with state-level and
federal-level authorities over the last number of months. Our Regional
Emergency Director, Sero Orgarte [?], our Incident Manager, Sylvan Aldigeri
[?], our Country Representative and others are working very, very closely with
our colleagues in Brazil at federal and state level.
You are correct; the situation in Amazonas and
particularly in Manaus has deteriorated significantly over the last couple of
weeks but that's not the only area. Other areas in association with the Amazon
have had big problems in terms of their ICU capacity; Rondonia, Amapa; very
high rates of positivity, in this case 54 and 46% respectively.
00:51:28
So this isn't just an issue in Amazonas; it's
not just an issue in Manaus. This is an issue in many areas of Brazil and in
many countries in Central and South America. Again a bit like some of the
countries in Europe like my own the holiday period has probably resulted in
many people mixing in ways they hadn't mixed before and certainly this is not
the winter period in these parts of the world so that's not the factor driving
things.
It remains to be seen to what extent variants
are driving that disease and Maria will speak to that in a minute. There has
been a rapid rise in hospitalisations reported in Amazonas since the middle of
December. Most of those cases are in Manaus, the capital of the state but
they're increasing in other municipalities as well.
Clearly if this continues we're going to see a
wave that is greater than what was a catastrophic wave in April and May in
Amazonas and particularly in Manaus, which is a tragedy in itself. The ICU
occupancy right now in Manaus is 100% over the full last two weeks. This is a
health system under extreme pressure.
More than 4,000 new COVID-19 cases and 50
confirmed COVID-19 deaths per day have been reported, over 2,000 people
hospitalised, both suspected and confirmed and over 400 people waiting to be
hospitalised who already have COVID.
00:52:54
There are many, many responses going on; the
local response team, the incident management team and many others are doing all
that they can to continue support but you are correct; there is a shortage in
supply of oxygen, there's a shortage in gloves and basic PPE and there's difficulty
in transporting oxygen from other states into Manaus.
Oxygen is not an easy thing to transport; it's
heavy, it's usually in these big cylinders, they're weighty and I'm sure other
states and the federal government will come to the assistance of Amazonas and
Manaus. Brazil is a country of great solidarity and I think we will see that
happen.
Another problem - and this is one thing that
happens; we've seen before front-line health workers being infected. Of note
here is that many, many surveillance officers are now affected by COVID-19;
many of the laboratory staff have been affected through community transmission.
00:53:49
This is a situation where your whole system
begins to implode because your hospital system, your public health system, your
laboratory system; those people are part of the community themselves and they
begin to become infected and you go into a negative spiral.
There's, I think, a backlog of 7,000 or more
samples. This is not a situation that other places didn't face. What I've described
there could have been described from New York or northern Italy or any number
of places on this planet over the last year.
The issue now is how do we get the necessary
support both within and outside Brazil to support but if you look at the epidemic
curves and, as I said, in Paraguay and Uruguay and Chile and in Argentine, the
whole southern cone and all the way up to the Mercosur countries in Central
America as well; we've seen a rapid, exponential increase in cases in a number
of countries in the Americas, again likely driven, as the DG said in his
speech, by that breaking down of basic behaviour, the increased social mixing,
the reduction in physical distancing, fatigue and exhaustion with having to
manage those measures is driving this.
We're going into waves where, as you can see in
the case of Manaus, the hospital and health system has already been weakened by
previous waves and therefore it's harder for them to suffer a second, third
punch.
00:55:12
So the situation is difficult and in this case,
in the case of the southern cone and Central and South America it is not new
variants driving this transmission. New variants may have an impact down the
line and they may be having some impact now and Maria can speak to what we know
about that but again it's too easy to just lay the blame on the variant and
say, it's the virus that did it.
Unfortunately it's also what we didn't do that
did it and we have to be able to accept our share individually and as
communities, as government, our share of the responsibility in this virus
getting out of control while recognising the variants in the virus make it
difficult.
I've said it before; the opposition has put
substitutes on the field, it has more energy. The virus has been energised by
the ability to evolve and become better, fitter and better adapted to infecting
us. We have got to get more efficient at fighting the virus. There are no easy
or other answers and again our solidarity is with the Government and the people
of Brazil.
00:56:20
It's entering - obviously with other countries
in the Americas - a very difficult phase. We will as an organisation, as
always, do everything to support our member states and everything to support
the people of Brazil. Maria.
MK Thanks,
Mike. Just some comments on the virus variants that are being reported. There
are some virus variants that have been reported from Brazil and we're working
directly with researchers and scientists and amazing public health
professionals in Brazil. They have very strong scientific work, sequencing
capacities and, as Mike said, we met with our colleagues in PAHO today to get
an overview of the current situation.
With regard to the virus variants, there is a
virus variant that has been reported. They're delineating this the P1 lineage.
I won't go into many different names but just to say there are several in
Brazil but also in other countries. This mutation, this variant has several
mutations that have some known biological importance; the ones you've heard us
talk about before; this 501Y mutation and the E484K mutation.
00:57:29
I think what we should do, Fadela, is we should
plan a specific live Q&A on these so that we can get into the details of
this and go point-by-point because it's a lot to cover in a very short answer.
But just to say that WHO and partners have been
monitoring these mutations so specific change, one change, or variants which
are a collection of mutations and deletions and setting up a monitoring
framework to evaluate these mutations and variants of interest and variants of
concern.
We've presented this to our strategic advisory
group, we've presented this to our R&D forum for epidemics. We had an
excellent meeting on Tuesday - I think it was Tuesday this week - where we
developed a research agenda specifically related to the studies that are
necessary to better understand each of these virus variants that are being
reported because more and more will be reported.
00:58:30
There's pressure on this virus to change; the
more it circulates the more opportunities it has to change so while we are
trying to get transmission under control we still have to monitor for new
variants. We presented this risk monitoring framework that we have outlined
also to the emergency committee where we are working to increase surveillance
for the SARS-CoV2 virus circulation using PCR tests, using antigen-based tests,
increasing capacity for sequencing.
There are a number of efforts that are ongoing
around the world to increase sequencing capacity. There's an excellent network
across PAHO to try to leverage existing systems. There's a system across Africa
as well and we're looking at different ways in which we can enhance sequencing
capacity around the world so that we can detect changes in the virus.
We're also working with our virus evolution
working group, which you've heard me mention many times, to set up a risk
assessment framework to say, okay, we see something of interest, what does this
mean, what are the studies that are needed to evaluate transmission, severity,
neutralisation and any potential impact on diagnostics, therapeutics and
vaccines, those that are available and those that will be available in the
future.
00:59:52
We had the R&D research meeting this week to
outline the suites of studies that are needed to be conducted and we're setting
up the collaborations to ensure that our partners that work in labs with good
biosafety and biosecurity can carry out the research that is needed to answer
these questions.
And lastly to make sure that all of this fits
into a risk assessment that WHO carries out regularly - we call these our rapid
risk assessments - just so that we can put into context what these variants
mean.
It's a lot of information for me to give in an
answer but I provide this because it's not just as simple as to say, we've
identified a mutation. There needs to be a system in place to understand what
each of these mutations mean, what these variants mean and how it impacts the
behaviour of the virus.
But as you've heard us say, this virus is
dangerous on its own, variant or not and even if it can provide increased
transmissibility - and some of them do - we still have tools that could break
chains of transmission.
01:00:58
The interventions that have been outlined by
WHO, that many countries are using, implementing at a local level based on the
local situation work at breaking chains of transmission. Variants and the
detection of variants and the emergence of variants makes it harder but we
still have some control over this virus.
The emergency committee reinforced what we
suggested in terms of monitoring this on a global level and said that this
needs to be strengthened and so we will work very hard to strengthen that
monitoring framework so that we have better eyes and ears on where these virus
variants are and we will also be working on a nomenclature so that we will be
able to describe these more eloquently to you as they emerge.
So it's a work in progress, there's a lot to do
but we all have to do as much as we can to prevent as many infections as we can
and reduce the pressure on this virus.
FC Thank
you. Dr Simao.
MS I
have a very short intervention because I think what's happening in Manaus and
Brazil is actually an alert for many countries because you have a resurgence
but at the same time you have an enormous break-down of the health system, the
structure.
01:02:19
We are seeing this, as Mike has mentioned, also
in developed countries so it's not just a matter of poor-resource settings.
Manaus had an infrastructure that was put in place for the emergency situation,
the horrible, horrific situation we went through in the first months of last
year.
Because of a false sense of security this was
let down and I think this is an important alert to all countries; don't let a
false sense of security bring your guard down. If you have built up
infrastructure - ICU beds and oxygen distribution points - don't shut it down
because it's not over yet.
I think we need to learn from what's happening,
the terrible situation that Manaus is facing right now. Let's say we can
prevent further damage if we take this further message forward and we take it
strongly; don't let your guard down, we're not over yet.
FC Thank
you all for your participation. I would like now to invite Dr Tedros for his
final words and also ask if Dr Houssin has any final comments to make; please
do. Dr Houssin, do you have any final comments?
01:03:50
DH No,
thank you very much, except to reinforce what Mike Ryan said; work, speed and
realism are what is necessary at the present time.
FC Thank
you, Professor Houssin. Over to you, Dr Tedros.
TAG Thank
you. Thank you so much, Fadela, and thank you to those journalists who have
joined us today and bon week-end. Thank you; until we see you in our next
presser.
FC Thank
you, Dr Tedros. Reminding you that you will receive the audio file and Dr
Tedros' opening remarks right after this press conference. The full transcript
will be posted on the WHO website as of tomorrow. Thank you and have a nice
weekend.
01:04:43