WHO press conference on coronavirus disease (COVID-19) - 11 January
COVID-19
Virtual Press conference
11 January 2021
00:00:12
FC Hello,
all. I am Fadela Chaib, speaking to you from WHO headquarters in Geneva and I
welcome you to our global COVID-19 press conference today, Monday January 11th.
Present in the room are Who Director-General, Dr Tedros, Dr Mike Ryan,
Executive Director, health Emergencies, Dr Maria Van Kerkhove, Dr Mariangela
Simao, Assistant Director-General, Access to Medicines and Health Products, Dr
Soumya Swaminathan, our Chief Scientist, Dr Bruce Aylward, Special Advisor to
the Director-General and Lead on the ACT Accelerator, and Dr Kate O'Brien,
Director, Immunisation, Vaccines and Biologicals. Welcome, all.
We have simultaneous interpretation in the six
UN languages plus Portuguese and Hindi. Now without further ado I will hand
over to the Director-General, Dr Tedros, for his opening remarks. Dr Tedros,
the floor is yours.
TAG Thank
you. Thank you so much, Fadela. Shukran. Good morning, good afternoon and good
evening. One year ago the first death from COVID-19 was reported and WHO issued
its first tranche of technical guidance. The comprehensive package included
guidance on surveillance, lab testing, infection prevention and control, a
readiness checklist and risk communication and community engagement.
00:01:52
A year on there have been almost two million
deaths from the COVID-19 virus and while we're hopeful about the safe and
effective vaccines that are being rolled out we want to see this sped up and
vaccines allocated equitably in the coming weeks.
Next week at the WHO executive board I will be
encouraging all countries to fulfil their pledge to COVAX. I call for a
collective commitment so that within the next 100 days vaccination for health
workers and those at high risk in all countries is underway.
Governments, manufacturers, civil society,
religious and community leaders must come together to create the greatest mass
mobilisation in history for equitable vaccination. WHO continues to ask vaccine
manufacturers from around the world to move swiftly to provide the necessary
data that will allow us to consider them for emergency use listings.
I am pleased that the WHO team is in China
currently working with the producers of the Sinovac and Sinopharm vaccines to
assist with compliance with international quality manufacturing practice ahead
of potential emergency use listing by WHO. To clarify, this is separate from
the WHO origins mission.
00:03:25
We also look forward to Serum Institute of India
submitting full data sets for rapid assessment so WHO can determine whether we
can recommend their AstraZeneca vaccine for international use. These are just a
couple of examples of work underway by WHO, GAVI, CEPI and other partners aimed
at safe, rapid, equitable and wise allocation of vaccines.
As I have said before and will say again, saving
lives, livelihoods and economies depends on a global agreement to avoid vaccine
nationalism. Over the weekend WHO was notified by Japan about a new variant of
the virus. The more the virus spreads the higher the chance of new change to
the virus.
Most notably transmissibility of some variants
of the virus appears to be increasing. This can drive a surge of cases and
hospitalisations which is highly problematic for health workers and hospitals
already closed to breaking point. This is especially true where public health
and social measures have already broken down.
00:04:53
This can have a knock-on effect on other
essential health services. At present the variants do not seem to show
increased severity of disease. With new treatments coming down the pipeline
we're hopeful that more lives of those with serious cases of COVID-19 can be
saved.
But we need to follow the public health basics
now more than ever. Keep as much physical distance as you can from other
people, keep rooms well-ventilated, wear a mask, keep your hands clean and
cough away from others into your elbow.
You might get fed up of hearing it but the virus
is not fed up with us. Limiting transmission limits the chance of dangerous new
variants developing. What's most critical is that we sequence the virus
effectively so we know how it's changing and how to respond.
For example while diagnostics and vaccines still
seem to be effective against the current virus we may need to tweak them in the
future. Last week WHO released a comprehensive implementation guide and risk
monitoring framework to help countries set up high-impact sequencing
programmes.
00:06:29
We call on all countries to increase the
sequencing of the virus to supplement ongoing surveillance, monitoring and
testing efforts and to share that data internationally. This helps us better
understand when variants of concern are identified. We're aware that sequencing
requires specialist equipment, a trained workforce and close collaboration
between experts.
Building upon our existing lab networks WHO is
working with countries to enhance sequencing capacity and we extend our support
to all countries who need it. We achieve much of this through our international
network of labs for SARS-CoV2 and influenza flu lab network, both of which have
been a beacon of science, solutions and solidarity in the last year.
Tomorrow WHO's R&D blueprint group is
convening scientists from around the world to set global research priorities
for the year ahead including on virus variants and sequencing. This builds on a
year's worth of work defining and delivering on an R&D roadmap for
COVID-19.
Just as we look forward on research and rolling
out vaccines we continue work on the origins. We're pleased that an
international team of scientists, distinguished experts from ten institutions
and countries are commencing their travel to China to engage in and review
scientific research with their Chinese counterparts on the origins of the
virus.
00:08:30
I want to thank all GOARN partners and the
countries supporting this mission. These include Australia, Denmark, Germany,
Kenya, Japan, Netherlands, Qatar, Russia, Sudan, the United Kingdom, the United
States of America and Vietnam and our colleagues from China.
The studies will begin in Wuhan to identify the
potential source of infection of the early cases. Scientific evidence will
drive hypothesis, which will then be the basis for further long-term studies.
This is important not just for COVID-19 but for the future of global health
security and to manage emerging disease threats with pandemic potential.
We will share more news as we have it but let's
give this team of scientists the space to work with their Chinese counterparts
effectively and let's wish them all well and express our respect and
appreciation to these distinguished scientists and experts. I thank you.
Fadela, back to you.
00:09:49
FC Thank
you, Dr Tedros. I will now open the floor to questions from members of the
media. I remind you that you will need to raise your hand using the function
raise your hand in order to get in the queue. I would like now to invite Bayram
Aturk from Anadolu news agency to ask the first question. Bayram, are you with
us?
BM Hi.
Thank you, Fadela, for taking my question. I had a short question; as WHO have
you set up a concrete date or timeline for delivering vaccines to the 92 low
and middle-income countries through the COVAX facility? And if you answer yes
which countries or regions are primary on your emergency list? What are your
plans on this issue? Thank you.
FC Thank
you, Bayram. I would like to invite Dr Bruce Aylward to answer this question.
Dr Aylward.
BA Thank
you very much for the question. As I think everyone on the call is aware, over
40 countries have now begun vaccinating against COVID-19 using five different
COVID vaccines. However all of that vaccination or virtually all of it, as the
Director-General has emphasised, was in the high-income and upper middle-income
countries so far.
00:11:27
We're working very hard, as we discussed at last
week's press conference, to try and accelerate now the roll-out of vaccines
through the COVAX facility and especially for the AMC countries. We expect and
we have strong confidence that we should be able to be vaccinating in February
in these countries.
We're doing everything possible to make sure in
as many countries as possible but we cannot do that on our own. We require the
co-operation of vaccine manufacturers to prioritise deliveries to the COVAX
facility. We require the co-operation of our financiers to see through the
financing necessary and we require the co-operation, as Dr Tedros said, of key
suppliers to make sure that we have the necessary data to ensure these vaccines
meet all of the criteria necessary in terms of efficacy, safety and quality.
We are also looking at some extraordinary things
we could do to even bring that timeline a little bit further ahead and we have
a great ambition actually to try and do something even in January but again it
requires the co-operation of a lot of other players, particularly the suppliers
to prioritise the COVAX facility and not the COVAX facility but really the AMC
countries to be receiving vaccines.
00:12:54
Because right now we have an inequitable
situation where vaccines are going to high-income countries, upper
middle-income countries and not yet to the lowest-income countries. This is not
something that COVAX facility fully controls. We're doing everything possible
to advance that.
In terms of the specific countries, countries
are at different levels of preparedness and readiness to roll out COVAX
vaccines so we are in the process of working across all members of COVAX,
especially the 92 what we call AMC countries. That's the advance market
commitment countries or, for those of you who don't know, the countries who are
eligible for support through COVAX for the vaccines.
So we're working through all of those - and I'm
going to ask Kate to say a word about that - to ensure their readiness. As we
go out to countries they come back and they tell us when they would like to
introduce their vaccines, when they will be ready to do that, what kind of
vaccines and how many they might like to use, etc. So we have to take all of
that information together to look at the scale of how the vaccines roll out.
00:14:03
Then we have to match that against the supply
side, as I just mentioned. Just last week the COVAX facility wrote out to all
of the countries again on 6th January asking for updates on their
readiness plans and their ambition in this regard so we hope to actually have
that roll-out plan of what countries and when later this month so all of these
things are moving fast.
The critical piece we need now is to work with
the manufacturers to make sure we have the vaccines for these countries. Kate,
you may wish to add on the readiness piece.
KOB Thank
you, Bruce. The country readiness; I think it's not lost on anybody how
critical the country readiness is. We've been hearing about high-income
countries that are working really hard but struggling to actually deploy the
vaccines that they have and to deploy them with speed and with prioritisation
that the countries have made.
So I think we really cannot underestimate the
task that it is for a country to be ready to start to deploy any of these
vaccines, in particular vaccines like the Pfizer vaccine that does require
special cold-chain processes and ultra-cold chain so keeping it at between -60
and -90 degrees so this is not for the faint of heart.
00:15:24
The areas of country readiness that we're
working directly with countries on have to do with their regulatory process.
Not only will products need to have this review by WHO but countries also need
to have a way to authorise the importation of the products.
We're working with countries on training of
healthcare workers so that the dosing requirements, the engagement with
patients is appropriate for the vaccines that we have. Countries do also need
to choose what the priority groups will be. With these limited number of doses
that will come initially there does have to be a decision in the country about
what that prioritisation will be and we are of course very strongly
recommending that it is health workers who are at high and very high risk of
COVID disease and older age groups who are also at high and very high risk of
serious disease or even of death.
I mentioned the cold chain so every country does
have to make a plan and start to execute the plan for assuring that there is
capacity within the cold chain to handle the influx of the vaccines and safety
monitoring of the administration of the vaccines, as we've assured and continue
to emphasise that every vaccine programme has a safety monitoring system and
doing everything that can be done in order to ensure from the very beginning
that there is the monitoring of the doses that are administered and should
there be an event that there is the capacity at the site to deal with that
health issue.
00:17:14
Finally it sounds like a bit of a boring thing
but the data system is really critical. Because these are two-dose regimens
there does need to be a way for these adults to be recalled back for them to
know when they need to get their second dose and for the whole programme to
know whether those second doses are being given in the time frame they're
supposed to be given and to make sure that the people who are being vaccinated
are getting the full benefit of the vaccine programme.
So these are all areas for which WHO is working
very closely with UNICEF, with GAVI and other partners. We've developed
guidance and training materials and frankly simulation exercises for countries
to start to practice and to rehearse and to identify whether or not the systems
are in place to be able to deliver these vaccines which are critical for the
highest-priority groups to receive in the time and in the way that they need to
be received. Those are the areas we're working on.
00:18:22
BA Thanks,
Fadela. If I can just come back on one point, it sounds complicated but the
reality is we are ready to start vaccinating in the AMC countries. The
challenge is threefold; one, the manufacturers prioritising supply to the COVAX
facility and also prioritising that they get the information to WHO to be able
to ensure the safety, efficacy and quality of the vaccines.
So far, as I think most of you are aware,
there's only one manufacturer that had submitted those data early enough that
we could make a decision on it. That was the Pfizer vaccine. We're delighted
that others have now submitted full data. As the Director-General said,
Sinopharm has submitted its full data and we're looking at others, we hope, in
the near future so that's one piece.
Second, the countries that do have access to and
are controlling the supply of the products that we know are safe and
efficacious, etc; they can be sharing doses or they can be donating doses
through the COVAX facility so that we can roll out to other parts of the world.
00:19:36
Then the third piece is that the countries, as
Kate would say, who will be using these products can actually put them to good
use immediately and that's complicated because our motto is no dose lies idle
anywhere in the world. But frankly the best measure of the world's commitment
to the equitable roll-out of these products and our common commitment to this
battle against COVID will be how quickly the COVAX facility can vaccinated
because we need a world committed to that to make it happen.
FC Thank
you. I would like now to invite Corinne Gretler from Bloomberg to ask the next
question. Corinne, the floor is yours.
CO Thanks
for taking my question. I have one for Mike today. In August you said Sweden
did a good job in its fight against COVID. I just wanted to check if your views
have changed in any way during the second wave, as in, was Sweden maybe too
slow to implement non-voluntary measures?
And what would you say are the lessons to be
learned from the Swedish approach? Thank you.
00:20:55
MR August
seems like such a long time ago. I think if I recall my comments at that time I
was being asked about the Swedish approach and I was, I think, articulating at
the time that each country had to define its own control measures based on the
relationship and the social contract with its own population and that measures
that governments would put in place had to be acceptable to citizens.
I think at the time the Swedish Government in
the first wave very much relied on its own population to implement the basic
measures of physical distancing and hygiene and was relying too on the fact
that many people in Sweden lived in single-person households, there wasn't as
much mixing in that environment and to an extent was really relying on
individuals and communities to implement behaviours that would reduce the risk
of transmission.
I think at the time I did reflect on the fact
that that demonstrated the kind of relationship that governments needed with
populations in order to be successful in sustaining a long-term process of this
kind of new normal and I still stand by that.
I still think we need those kinds of contracts
where citizens implement without coercion and without being forced the kinds of
measures that are in the interests of their health, their community's health,
their family's health.
00:22:25
I think the Swedish Government themselves, the
Swedish officials did say, like many around the world, that a number of issues
were missed during those first and possibly second waves; protection of older
persons, particularly those living in long-term care facilities, the specific
issues related to migrant communities that lived in different social
circumstances; we saw this in Sweden; we saw this in the Emirates or in the
Gulf states; we saw this in Singapore where particular groups, particularly
migrant groups, were subject to higher levels of transmission because of the
environments in which they were living; dormitory-type conditions, multi-family
dwellings, etc.
So all countries missed some of the key elements
in a sense and learnt those lessons in the first and second waves and I do
believe that this time around Sweden has implemented further measures and some
of those measures have involved more government-mediated measures including the
Government advising and going beyond advice to more strict enforcement of
public health measures.
00:23:33
Again it still comes back to that idea of what a
government believes is the right way to behave with regard to its own population.
These are democratic states and they have to determine. Sweden has a very
particular contract with its population. They believe they're acting in good
faith and reflecting the will of their people.
That changes over time as the severity of this
pandemic has changed, as the implications of this pandemic have changed and I
believe the Government of Sweden and its population have made good decisions in
moving towards probably stricter measures because that is what the pandemic is
telling them and because it has been difficult to sustain those purely
voluntary measures at societal level, which would be true of every country.
I think it is an example of how difficult it is
to sustain public health and social measures that are purely determined by the
individual's willingness or determination to carry out those measures. It
somehow tells us, I think, at the beginning of 2021 how difficult and how
challenging that environment is but we have no other choice. Right now we are
faced with the prospect, as Kate and Bruce have so eloquently outlined; we have
a real prospect, if the right things are done by governments, if the right
things are done by companies, that we can begin to accelerate the delivery of
vaccines.
00:24:57
But regardless of the success of that there is a
period of time now in which older persons or people with underlying conditions
still remain extremely susceptible to the negative impacts of being infected
with this virus and can get very sick and die. We know that we can stop that,
we know that we can interrupt that transmission at one level or another.
We may not be able to eliminate transmission but
we have demonstrated two to three times in the last year that that is possible.
Many countries have had increases of incidence over the last couple of months.
We are still discussing how much of that has been due to new variants but the
fact remains that the vast majority of that increase in many countries has been
down to increased social mixing, down to people not abiding by the basic
measures to protect themselves, others and their communities and we need to
redouble our efforts on that.
00:25:48
We will say that Sweden, like all countries,
needs to redouble its efforts and its population but again it is not for WHO -
I repeat that - it is not for WHO to prescribe what nation states do in their
sovereign interests and in relation to the sovereign relationship that
governments have with their populations.
We fundamentally believe that the Swedish
Government is acting in the best interests of its population with regard to the
information that it has. All countries have to face this reality. We are there
to advise, we are there to support. We are not here to criticise.
FC Thank
you. I would like know to invite a journalist from El Meyadin television,
Moussa Asse, to ask the next question. Moussa, are you online?
TR Yes.
Can you hear me, Fadela?
FC Yes,
please go ahead.
TR I
will ask my question in Arabic. The question is as follows; currently we are
seeing high-income countries making a lot of orders for vaccines but we see
that poorer countries will not have enough access to the vaccines quickly
enough.
We have seen Lebanese doctors and nurses crying
because they couldn't take on any more patients. So my question goes to the
Director-General; has your call to share out the vaccines in an equitable
manner failed?
00:27:54
FC Thank
you, Moussa. Your question was on equitable access to vaccines and we'd like
maybe to start with Dr Aylward, if he can provide an answer.
BA Thank
you very much, Moussa. I'd first like to highlight the importance of the point
you made about health workers and indeed these people are at the front line,
they're highly exposed to this virus because they're trying to save lives and
take care of people with the disease.
Indeed our first priority is working across the
world with countries that have doses, with manufacturers to get initial doses
that we can get out to all countries, not just high-income but right across all
countries, for vaccination of that crucial group to ensure they are protected
as they continue their important work.
00:28:50
Indeed everybody is making high orders for
vaccines and I want to be very clear that the COVAX facility also has high
orders. When you say that they're making high orders from high-income countries,
we also are making high orders for the low-income and low middle-income
countries.
Through the COVAX facility we have contracted
now or we have deals in place for just over two billion doses of vaccine for
these countries and we actually have options and right of first refusal on over
a billion doses more so the issue is not the lack of vaccines that we are
ordering for the low and low middle-income countries.
The crucial thing is the timing to get at least
some of those doses early enough to protect, as you say, these healthcare
workers on the front lines in these countries as well as, remember, the older
populations and others who are at high risk of potentially dying of this
disease.
That's what's so important is as doses are now
going out around the world countries continue to ensure that they don't have to
be first in the queue for all of their population but rather for the crucial
populations and we need to make sure they get vaccinated around the world.
00:30:07
In terms of the Director-General's call for
equitable access I think it's been incredibly well heard. We've had multiple
countries talking to us about if they can donate or share doses, when they may
be able to do that once they get some initial crucial doses into their
populations.
We've had manufacturers now starting to speed up
their work with us, recognising that we've got to get more of these vaccines
properly assessed and quality-assured to get them out. So I think there has
been a very, very good response. There's a tremendous commitment but what we
need to see are vaccines going into people's arms in low-income, low
middle-income countries.
These vaccines have got to be efficacious,
they've got to be safe and they've got to be of the highest quality. That's our
commitment as the World Health Organization as a key part of the COVAX
facility, to make sure we can guarantee those vaccines are and those doses are
so that's part of what we're working toward.
00:31:06
So far there's been a lot of goodwill but
remember, goodwill isn't going to protect people alone. We need the actual
vaccine doses and we need them quickly to be able to make that work.
SS Just
to add, I think this is not the time to get disheartened. We've made incredible
progress and a year ago nobody would have predicted that there would have been
not one but several vaccines against this new virus that have been developed,
manufactured, produced and distributed.
This is testament to scientists around the world
both in the private sector and in the public sector who've worked together,
governments who've supported them, companies who've manufactured them but it
does take time. It takes time to scale the production of doses not just in the
millions but here we're talking about the billions.
So we have to be a little bit patient. The
vaccines are going to come; they're going to go to all countries but meanwhile
we mustn't forget that there are measures that work and, as Mike was saying, I
think it's really important to remind people, both governments as well as individuals,
on the responsibilities and the measures that we continue to need to practise
for the rest of this year at least because even as vaccines start protecting
the most vulnerable we're not going to achieve any levels of population
immunity or herd immunity in 2021 and even if it happens in a couple of
pockets, in a few countries it's not going to protect people across the world.
00:32:39
So the public health and social measures which
are tried, tested, known to work are important even as we start scaling
vaccines starting from the most vulnerable and then expanding to cover the
whole population.
FC Thank
you. I would like now to invite Jon Cohen from Science to ask the next
question. Jon, are you with us?
JO I
am. Thank you. I well understand that different countries want to test vaccines
to create confidence in them but can you point to any specific evidence that
different races or different ethnicities or different genetic backgrounds have
had different immune responses or side-effects to any vaccines against any
disease?
FC Thank
you, Jon. Dr Swaminathan.
00:33:39
SS Yes,
this is a really good question and I think it's something that should be
debated with the regulators around the world because, as you rightly point out,
this is a regulatory issue. Countries want to see data on their own subjects,
thinking that there might be differences.
I cannot think of any vaccine for that matter
which has had differences in response in different ethnic groups. One might
have a different side-effect profile but again this depends a lot on reporting
and that's why we're putting in place systems to ensure that there's good
adverse event reporting, especially from the countries where there's been early
roll-out of vaccines, both from countries that have well-established
pharmacovigilance systems but also from the others.
So this is an area - and the Director-General
mentioned a couple of meetings that will happen this week, the first one
tomorrow looking at research priorities on the variants but the one on 15th,
on Friday, will look at the research priorities around vaccines for 2021,
acknowledging that we're in a different position today than we were in 2020.
But there are lots of unanswered questions but I
think your particular question, Jon, on whether we need trials in all countries
is a good one and there isn't really a scientific basis for wanting that to
happen. Maybe Kate would want to add something to this.
00:35:16
KOB Just
to contribute to this; this is from a science perspective. As Soumya said, I
think you lumped in in your question a lot of different variables. There are
examples of vaccines that have variability in their vaccine effectiveness.
Rotavirus is one example; pneumococcal vaccine and hib [?] vaccine are two
others where we do see some variability of vaccine efficacy.
But you pointed to ethnicity or genetics and
where the variability has occurred is more likely to be around the burden of
disease and the underlying conditions in the population that have affected the
vaccine efficacy. For rotavirus of course this is a completely different
vaccine than what we're talking about for COVID and certainly has to do with
underlying gut immunity and those sorts of things.
So there are in fact examples where it is
important to evaluate vaccines especially for those populations that have the
highest burden because we absolutely want to make sure that the hurdle that the
vaccine has to jump is going to be that hurdle that is most impactful in the
populations that need those vaccines the most.
00:36:34
I think the question really is, is there an
underlying reason to believe for COVID vaccines that there would be variability
according to any of these criteria and certainly evaluating vaccines, whether
it's in the pre-licensure or pre-authorisation phase but certainly in the
post-use phase, the post-deployment phase where we're measuring and quantifying
the impact of those vaccines across a range of populations and across those
variables that could have an impact on them so that we can improve the
vaccines.
There's almost no vaccine that has stayed
static. We do always make an effort to improve all the characteristics of
vaccines to make them ever more impactful and so we shouldn't also see that
where we start from with a vaccine is necessarily the optimum vaccine either
from a delivery perspective or from its impact perspective.
So I think there is some reason but I really
want to support what Soumya said; we should not be going down the route of
requiring or expecting that each of these vaccines is going to be or needs to
be evaluated before they're used across a broad range of populations.
00:37:56
I think we want to know that they work, they
have the biologic effect that they're designed to have, that they're safe, that
they can be manufactured at scale and at quality and to deploy them while we
continue to learn about how to optimise.
FC Thank
you to both of you. I would like now to invite Dr Aylward to add.
BA I
just want to make one last point on this because it's so important. We look at
three characteristics of these vaccines; the quality, which is a function of
how these things are made and regulated, etc; then we look at the efficacy, as
Kate was talking about.
The third piece is the safety and what people
are often worried about; is there a difference in the safety of these vaccines
by the populations? There we have to be absolutely clear; no, we expect for
vaccines the safety profile does not change by the populations in which they're
used because that's what people are worried about.
00:38:53
Remember, you're giving these vaccines to
healthy people and and they want to know. Sometimes there can be side-effects
or problems that are related to other conditions that may be at different rates
in the population but again, as Kate said, you asked, was there a difference by
ethnicity or other and the bottom line is no.
So if these are safe somewhere then they're
going to be safe. If they have some sort of side-effect then you can expect
and, as Soumya said, you have to look for it in those other places to make sure
that you manage that as you roll it out.
FC Thank
you for this very comprehensive answer. I would like now to invite a journalist
from the Chinese news agency, Du Yong, to ask the next question. The floor is
yours.
DU Thank
you for the question. Can you hear me?
FC Yes,
very well. Go ahead, please.
DU As
COVID cases worldwide could be reaching 100 million within the next few days
how can we bring the pandemic under control and how worried should we be in
dealing with the new COVID variant? Thank you.
00:40:04
FC Thank
you. Dr Ryan.
MR Maria,
please. Maria will certainly follow up. That milestone is a grim and shocking
one as we do approach it. I think I said it in my previous comments; we have
the prospect of vaccines that we fundamentally believe will have a major impact
and relatively quickly once we have vulnerable populations vaccinated on severe
disease and on mortality. That's the first thing we need to deal with; those
who are getting severely ill and dying from this disease.
We then believe that obviously vaccination at
high enough levels can help us with controlling the disease but we have...
Again many countries in the world have demonstrated that this disease has a
high element of controllability and have actually gone on and done that.
Others have not been so lucky for different
reasons; the disease has come early, it has entered silently, they have been
caught unawares, they haven't been able to sustain a response over a long
period of time, surveillance systems have been weak, the populations have not
been willing or able to implement long-term behavioural measures or comply with
quarantine and isolation and the list goes on.
00:41:27
But again this disease can be significantly
controlled by the application of the measures that we have been outlining here
for a year, by the implementation of a comprehensive strategy that focuses on
reducing transmission, on reducing mortality and on developing the tools that
Bruce and so many others have been working on over the last year.
I'd love to be here with new answers for you. I
would love to be here saying, there are other things we can do. All we can do
is pick ourselves up and take the fight back to the virus. For those of you who
have the virus under control do not lose control, look at what other countries
are suffering as they have lost control of the virus.
So if you're in a low-incidence or
zero-incidence situation keep it up, it is worth the effort. If you're in, as
many countries are, a difficult transmission environment right now there are no
other options but to do what you've done before.
00:42:24
I see my own country, in Ireland, which has
suffered a massive increase in cases over the last number of weeks, has done
extremely well in surges of disease, has brought the disease under control and
has suffered one of the most acute increases in disease incidence of any
country in the world over the last number of months and not due to the variant,
let me add, but mainly due to increased social mixing and reduction in physical
distancing.
The Government and the authorities and the
community there have taken immediate action over the last two weeks and already
the disease number's starting to drop, the positivity rate's starting to drop
and we are seeing the National Reference Laboratory there doing superb
surveillance for the new variant strains which they are tracking.
They have not been the driver of new
transmission but new variants can and will emerge. Some will be not significant
in terms of transmission or in terms of severity. Some may be and that is why
we need a comprehensive monitoring framework, to keep an eye on those and
ensure that our measures are adapted as needed.
00:43:28
Right now there is no evidence that variants are
driving any element of severity. There is some evidence that variants may be
increasing or adding to transmission and in some sense giving some extra
transmissibility to the virus.
I was talking to my colleague, Tony Houlihan,
the Chief Medical Officer in Ireland, earlier and we were almost saying that
this was like adding a substitution in the second half of a football game; it
doesn't change the rules of the game, it doesn't change what you do but it
gives the virus some new energy, some new impetus, it adds to the challenge you
face because the opposition is bringing on some new players to the field.
It doesn't change the rules of the game. It
doesn't change what we need to do to win. It just changes the strength of the
opponent and in that sense we has to take from that that we just need to
redouble our efforts.
So thank you for the question. Maria, you may
wish to add.
MK I'm
just laughing at your sports analogy because I'm terrible at sports analogies.
I think the whole point is that this virus is controllable, even these variants
that we are seeing. Having variants become identified because we have good
sequencing that's happening globally and that's increasing globally, the fact
that we are identifying variants that have increased transmissibility in some
situations is not good.
00:44:53
It doesn't help the situation, it makes it that
much harder but we still have control over this virus. There were increases in
transmission in a number of countries before these variants were identified,
before these variants were circulating and that was due to increased mixing of
people.
There's no way around that. Variants don't help
these situations where they are now circulating and now are being identified in
other countries. That's going to make it that much harder but we have tools in our
toolbox that help us be able to break chains of transmission and we will
continue to say this.
What we do need are countries that are facing
incredibly intense transmission; we should also note that that's not universal
across the world. Transmission intensity is really concentrated in some
countries. Just look at our website and you can look at our dashboard and see
where transmission is most intense around the world and in many countries, some
of those countries have shown us over the summer months in the northern
hemisphere that they could bring transmission under control.
00:45:56
Transmission was down to single digits in most
countries across Europe over the summer and we lost the battle because we
changed our mixing patterns over the summer, into the fall and especially
around the Christmas and New Year holiday. The number of contacts that
individuals and their families had increased significantly over the Christmas
and New Year holiday and that has had a direct impact on the exponential growth
that you have seen in many countries.
Some of the exponential countries we've seen in
countries is almost vertical, it's not even at a slant, it's almost vertical
but that doesn't mean we've lost the battle. We have to make sure that we as
individuals do what we can to limit our contact with other families outside of
our immediate family.
The biggest thing that we can do right now is
keep a physical distance from others and I know that's really difficult but
it's true. We can increase our distance in some respects by wearing masks. We
can make sure that governments provide a supportive environment so that if we
are asked to stay home we can stay home, that our children can be looked after,
that we can still put food on the table; all of that needs to be supported.
00:47:11
The fundamental aspects of the public health and
social measures of active case finding, cluster investigation, isolation and
clinical care of cases, quarantine which is supportive of all contacts; this is
what breaks chains of transmission.
We can look for the next shiny bullet, we can
look for the next high that can help us but it all comes back to those public
health and social measures. Vaccines and vaccinations are an incredibly
powerful tool and, as you've heard all of us say, we don't just have one safe
and effective vaccine, we have many but it is going to take time for those to
come online.
In the meantime there is much that we can do. We
just have to do it and it will be hard and we're with you because we're in an
area right now that also has intense transmission but we need to put in the
work.
So please do what you can as individuals, as
communities, as leaders of your families, as religious leaders, government
leaders to put a system in place to help people limit their contact with others
while remaining socially connected with their loved ones.
00:48:15
But we can definitely do more to try to turn the
corner and bring transmission down because many countries have shown us that
they can do it already and, as Mike said, those countries that have brought
transmission down, keep it down, do everything that you can to keep it down
because many countries are showing us that they've found that balance of
adjusting the public health and social measures while opening up and keeping
transmission low.
If any cases are identified or any clusters are
identified really quick, rapid, aggressive investigation of those cases so that
those small numbers of cases do not become community transmission.
We have been shown over and over again that
countries can do this and so even countries with intense transmission can turn
it around. Vaccines will be another powerful tool but it will take some time so
hang in there, remain focused and determined to do what you can to be part of
the spike.
00:49:15
FC Thank
you. Let's move now to Italy, inviting Sondra Marzano, Italian television
channel 7, to ask the next question. Sondra, are you with us?
SO Yes.
Thank you for taking my question. My question concerns the issue of the report
written by some researchers from the Venice office of WHO Europe. This report
was published on 13th May and disappeared from the site of WHO after
24 hours. This paper has become very educated [?] [inaudible] Italy did not
have an undated influenza plan and that in part the Italian response to the
virus was chaotic, improvised.
FC Sondra,
can you just tell us, what is your question, please?
SO Yes.
I would like to ask you for a clear and definitive answer on what happened; was
the report from the Venice office withdrawn because it disappointed the Italian
Minister or because the Minister was not informed? In this case who should have
informed the Minister, Mr Rani Iguera [?], who was sent by the Director-General
to have direct relations with the Minister, or Francesco Zambon [?], who was
responsible for this report?
00:50:55
FC Thank
you, Sondra, for this question.
MR I
think we've dealt with these questions in the past and I'm not going to go back
over the specific issues around what was posted on what website on what dates
or not because I'll certainly get it wrong a month later.
I would refer you to our colleagues in the European
region, to Dr Hans Kluger's [?] staff who are dealing with this matter and I
don't want to cut across them. It's not that I don't want to give you
information. I just don't want to cut across what they have been doing to
analyse and to clarify on these issues.
So I'm sure we can follow up directly with you
in the aftermath of this conference. I know Gabi Stern, our Director of
Communications, has been dealing with colleagues in Euro and I'm sure Gabi and
her staff will get you the information that you need.
FC Thank
you. The next question is from NSK. Shoko, are you with us?
SH Hello,
Fadela. Can you hear me?
FC Yes,
very well. Go ahead, please.
00:51:57
SH Thank
you for taking my questions. Regarding the search for the origin of the virus,
is WHO planning to send experts to any other countries apart from China at this
stage? Thank you.
MK Hi.
Thank you for your question. We, our team - as you know, the Director-General
has said our team is commencing their travel to work with Chinese counterparts
on mainly looking at the initial cases and to find more information about those
initial cases that were identified in Wuhan.
There are a number of aspects that all of us
across the world are looking at to really better understand this pandemic. The research,
the studies begin in Wuhan. They begin where the first initial patients were
identified and then there will be many more studies that will follow on from
there.
In addition to that, not at the expense of that
but in addition to that we are also working with many different networks that
we have set up at the start of this pandemic, one of which is our laboratory
network that is following up on some studies that have been published that have
looked at waste water samples, that have looked at seroprevalence studies or
the studies of sera that were collected in 2019 and also tested for antibodies
against the SARS-CoV2 virus; any publications that are coming out that had some
results from 2019.
00:53:18
In each of those instances we have reached out
to the authors of those papers or pre-prints to find out more information about
the samples, more information about the tests that were done and in many cases
working with the researchers in those countries to set up further evaluations
of the samples that were tested in 2019.
So there's a lot of work that is ongoing. All of
us are working towards better understanding of this pandemic but again the
studies that are commencing in Wuhan, that have been ongoing in Wuhan,
especially looking at those initial patients that were first identified in
December are really, really critical to help us better understand the beginning
of this pandemic.
MR If
I just might add, the investigations in China may lead to hypotheses and may
lead to the need to make further enquiries or investigations in other countries
and again we as a member state organisation are there in the service, to serve
our member states and we have launched well over 100 technical, operational
support missions in country.
00:54:28
Our country offices are in 147 countries, 150
countries, I think, at this stage and we have been working very closely with
each and every member state regarding their technical, operational, scientific
and other needs and I know again the 100/100 initiative that Kate, Bruce and the
COVAX colleagues have been leading again has been around delivering direct
technical and operational support to countries to get ready for vaccination.
That is the essence of what WHO does.
With regard to international investigation and
response to epidemics, again over a given year we launch so many missions in
support of and in partnership with our member states, with our partners in the
global outbreak alert and response network and our emergency medical teams
networks around the world and our collaborating centre network.
So we will go anywhere and everywhere to gather
more information around the origins and impact of disease and stand ready if
any country has any issues regarding its current epidemic response and even
with all of the difficulties in terms of transport and moving people around the
world over the last year we've actually increased the levels of engagement we
have with our member states.
00:55:37
Obviously within that we've had previous
missions on MERS, previous missions on SARS, many other - Ebola, Lassa, so many
other emerging diseases and that is part of the day-to-day business of this
organisation and we thank all the countries and partners who understand the
importance of these kinds of mission.
Understanding the origin of disease is not about
finding somebody to blame. It is about finding the scientific answers about
that very important interface and the interface between the animal kingdom and
the human kingdom has now become and has been for many, many years - this is
not a new thing.
All of our influenza pandemics come from that
interface. We've just finished fighting two or three of the worst Ebola
outbreaks ever over the last three or four years. These are emerging disease
that breach the barrier between animals and humans and cause devastation in
human populations.
00:56:33
It is an absolute requirement that we understand
that interface and what is driving that dynamic and what specific issues
resulted in diseases breaching that barrier.
That is not so as to find blame. If that's the
case we can blame climate change, we can blame policy decisions made 30 years
ago regarding everything from urbanisation to the way we exploit the forest. So
if you're looking for someone to blame you can find people to blame in every
level of what we're doing on this planet.
So therefore the DG has said, let this mission
and let other missions be about the science, not about the politics. We are
looking for the answers here that may save us in future, not culprits and not
people to blame. I'm sorry for being very direct about this but sometimes I get
a sense that that is the drive.
That doesn't help science and that creates
barriers to WHO doing the work we need to do with member states because if the
perception of our member states is that we are an investigation outfit, that we
have some objective other than the science then it makes it very difficult for
us to operate in these situations.
00:57:45
When we have the trust of our member states,
when everyone believes that the objective is one of science and public health
then we can make huge progress and we would like to thank, as the DG has, all
of our partners and I mean all of our partners who've worked with us to ensure
the success of this mission over the next couple of weeks and months.
FC Thank
you, Dr Ryan. It has been one hour since we started this press conference so I
would like to hand over to Dr Tedros for any final comments. Over to you, DG.
TAG Thank
you so much, Fadela, and thank you to those who have joined us today. See you
in our upcoming presser. Thank you.
FC Thank
you. We will be sending you the DG's opening remarks and the audio file just
after this press conference. The full transcript will be posted tomorrow. Thank
you all and as usual, apologies to journalists who were not able to ask their
questions. Please be in contact with the WHO media team if you have any
follow-up questions. Thank you and have a nice evening.
00:58:55