WHO press conference on coronavirus disease (COVID-19) - 15 February
00:00:31
FC Hello,
everyone. This is Fadela Chaib speaking to you from WHO headquarters in Geneva
and welcoming you to our global COVID-19 press conference today, Monday 15th
February. We have simultaneous interpretation in the six official UN languages
plus Portuguese and Hindi. Let me introduce to you the participants.
Present in the room are WHO Director-General, Dr
Tedros, Dr Mike Ryan, Executive Director, Health Emergencies, Dr Maria Van
Kerkhove, Technical Lead on COVID-19, Dr Mariangela Simao, Assistant
Director-General, Access to Medicines and Health Products. We are also joined
today by an expert, Deusdedit Mubangizi; he's the Head of the Pre-qualification
Unit at WHO; Dr Michelle Yao, Director, Strategic Health Operations, and Dr
Sylvie Briand, Global Infectious Hazard Preparedness.
Joining remotely are Dr Soumya Swaminathan,
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. Now without further delay I would like
to hand over to Dr Tedros for his opening remarks. You have the floor, Dr
Tedros.
TAG Thank
you. Thank you, Fadela. Good morning, good afternoon and good evening. The
number of reported cases of COVID-19 globally has now declined for the fifth
consecutive week. Last week saw the lowest number of reported weekly cases
since October.
00:02:28
So far this year the number of weekly reported
cases has fallen by almost half from more than five million cases in the week
of January 4th to 2.6 cases in the week starting February 8th,
just five weeks. This shows that simple public health measures work even in the
presence of variants.
What matters now is how we respond to this
trend. The fire is not out but we have reduced its size. If we stop fighting it
on any front it will come roaring back. Every day with fewer infections means
lives saved, suffering prevented and the burden on health systems eased just a
little bit.
Today we have even more reason to be hopeful of
bringing the pandemic under control. Today WHO gave emergency use listing to
two versions of the Oxford AstraZeneca vaccine, giving the green light for
these vaccines to be rolled out globally through COVAX.
00:03:48
One of the vaccines is produced by SKBio in the
Republic of Korea and the other is produced by the Serum Institute of India.
Although both companies are producing the same vaccine because they are made in
different production plants they required separate reviews and approvals.
WHO emergency use listing assesses and assures
the quality, safety and efficacy of COVID-19 vaccines and is a prerequisite for
vaccines to be distributed by COVAX. This listing was completed in just under
four weeks from the time WHO received the full dossiers from the manufacturers.
In addition to the Pfizer BioNTech vaccine these
are now the second and third vaccines to receive emergency use listing. We now
have all the pieces in place for the rapid distribution of vaccines but we
still need to scale up production and we continue to call for vaccine
developers to submit their dossiers to WHO for review at the same time as they
submit them to regulators in high-income countries.
On Friday I mentioned WHO's new declaration on
vaccine equity. Ensuring the rapid and equitable roll-out of vaccines globally
is essential for saving lives and stabilising health systems but it's also
essential for saving livelihoods and stabilising economies.
00:05:37
Fully funding COVAX represents the greatest
possible stimulus and is a rounding error compared with the trillions of
dollars that has been mobilised in G7 countries to support their economies. I
am pleased that the G7 under the United Kingdom's presidency is meeting this
Friday to discuss vaccine equity and I encourage all groups to sign WHO's
declaration.
We must continue to build the demand for
vaccines by ensuring people have the right information. A year ago I said that
we were not only fighting a pandemic, we were fighting an infodemic. In the
past year we have seen the real harm that can be caused when people are
overwhelmed by information, misinformation and disinformation.
The answer is not just to fight misinformation
and delete false or misleading statements. It is to listen to the real concerns
and questions people have and to answer those questions with good information.
That's part of the reason WHO holds these regular media briefings, publishes guidance,
communicates on its social media channels and website, holds seminars with
different community and professional groups and more.
00:07:15
Having the right information is essential in
every outbreak situation. As you know, last week an outbreak of Ebola was
detected in the Democratic Republic of the Congo. Four cases have now been
reported and two people have died. Yesterday authorities in Guinea declared a
separate outbreak of Ebola in the town of Goueke [?] in the south-east of the
country. So far three cases have been confirmed among six people who reported
Ebola-like symptoms after attending a funeral in late January. Two have since
died while the other four are being treated in hospital.
As you remember, Guinea was one of the three
countries affected by the West Africa Ebola outbreak of 2014 to 2016, the
largest Ebola outbreak on record. The outbreaks in Guinea and DRC are
completely unrelated but we face similar challenges in both.
Both outbreaks are occurring in areas that have
recent experience with Ebola and are benefiting from that experience in terms
of capacity for surveillance, rapid response, contact tracing, community
engagement, clinical care and more.
00:08:45
But both outbreaks are also in hard-to-reach,
insecure areas with some mistrust of outsiders. I'm pleased to say that
vaccination started today in DRC and so far 43 people have been vaccinated out
of 149 eligible contacts including 20 people who were vaccinated during the
previous outbreak in 2019.
WHO is working closely with health authorities
in both contribute to engage with the affected communities to enhance trust and
acceptance. Ebola and COVID-19 are two very different diseases. Both thrive on
misinformation and mistrust but both an be stopped with proven public health measures,
engaged communities, accurate information and vaccines. Fadela, back to you.
Shukran.
FC Thank
you, Dr Tedros. I'd like to inform the media that they may have received by now
a press statement on what Dr Tedros just announced in his opening remarks; WHO
listing two version of the AstraZeneca Oxford COVID-19 vaccine for emergency
use. It's also posted on our website.
I will now open the floor to questions from
members of the media. I remind you that you need to raise your hand using the
raise your hand function in order to get in the queue. I would like to start by
inviting Imogen Foulkes from the BBC to ask the first question. Imogen, you
have the floor.
00:10:34
IM Hi,
Fadela. Thanks for taking my question. This is about travel because traditionally
WHO has always somewhat counselled against travel restrictions. I know we're
well down the road in this pandemic but it's getting very confusing for people
with different countries introducing different things.
Your own WHO COVID-19 envoy this morning said he
could foresee vaccine passports. Is that something the WHO thinks would be a
good idea?
FC Dr
Ryan, you have the floor.
MR Thanks,
Imogen. The emergency committee made temporary recommendations in relation to a
number of issues to the Director-General and I think we're quite clear that at
this time - at the present time, I think they used specifically - they did not
advise for the use of immunity certification as a prerequisite of travel. That
is because, number one, vaccine is not widely available and it would actually
tend to restrict travel more than permit travel.
00:11:48
Secondly we don't have enough data right now to
understand to what extent vaccination will interrupt transmission and
especially the risk of an individual to continue transmitting disease.
So on that basis no but I think the envoy may
have been referring to a future situation in which we have widely available
vaccination and where we understand more about the impact of vaccination on
transmission dynamics or if we get the second and third-generation vaccines
where we may have more impact on transmission, at that point certainly.
We've seen this with yellow fever and other
diseases; vaccine can form part of a long-term strategy for disease control and
for the prevention of disease potentially moving from one place to another as
we've seen with yellow fever vaccination requirements, we have been in place
for a large number of decades now.
00:12:43
So I would believe that that is a discussion
that will be had in future. It will be based on emerging guidance from SAGE, on
continuing discussions of the emergency committee and the technical programmes
here.
So no, we don't foresee this as an immediate
requirement or need but certainly one that will have to be discussed in the
coming months.
FC Thank
you, Dr Ryan. I would like to invite Simon Ateba from Africa News Today,
Washington DC, to ask the next question. Simon, you have the floor.
SI Thank
you for taking my question. Can you hear me?
FC Very
well. Go ahead, please.
SI Thank
you for taking my question. This is Simon Ateba from Today News Africa in
Washington DC. I would like you to react to the statement at the weekend by the
Biden administration expressing concern over the first report that the WHO
issued on the origin of COVID-19 in China. Thank you.
FC Thank
you, Simon. I think...
00:14:08
MK Thank
you. Sorry, we were deciding who would start; apologies. The mission team from
China has not actually issued their report yet. They have recently returned
from China, arriving in their own countries and they are working on two
reports, the first of which is a summary report which is shorter, just
highlighting the work that has been done and some initial findings and
recommendations.
That will be followed by a longer report. The
initial, summary report has not actually been issued yet. They've only done a
press conference in Wuhan and they've answered some media questions but the
idea would be that they would issue the summary report and then have a full
press briefing themselves.
MR Maybe
I can also add that obviously there may be some misunderstandings here around
the origins and the purpose do this mission. I think this mission was envisaged
as a collaborative effort under the World Health Assembly Resolution where
obviously working with China, a sovereign state and a member state of the WHO
to better understand the origins of the virus so as to learn lessons for the
future.
00:15:26
It was not as such an investigation of supposed
wrongdoing or referring to any non-existent investigatory powers that WHO might
have. WHO does not possess the mandate to enter uninvited into any nation state
and must show due diplomatic respect to the process of engaging with
governments but also the scientific process of working together with our Chinese
counterparts to understand and make progress in the understanding of the
origins of this disease.
So as such this was and remains a collaborative
process of discovery between scientists. Clearly there's a political layer on
this that has been difficult for all parties to manage and it would be useful
at this point if we could step back from that and really focus on what progress
has been made scientifically in the understanding and to clearly identify where
further progress will need to be made in the future in terms of future studies.
So I think it is time that we look to the
science now and look at that and then do our best collectively to work with all
interested parties to identify further studies that will be needed to
fundamentally and finally understand the animal origins of this virus.
00:16:58
FC Thank
you, Dr Ryan. I would like now to call on Gabriela Sotomayor, a Mexican
journalist from Proceso. Gabriela, you have the floor.
GA Thank
you, Fadela, thank you very much. My question is on treatment. I know vaccines
are very important but my questions is on treatment. I would like to know, what
is your assessment on the use of Ivermectin in the early stages of the disease?
For example there is a group of specialists in
the USA saying that they recommend the use of this very cheap and old drug so I
don't know if you observed something on the use of this anti-parasite.
Then a quick clarification; I would like to know
if the hypothesis on the origin of the virus, the hypothesis of the laboratory
incident is still alive. Thank you.
FC Thank
you, Gabriela. Dr Van Kerkhove will take the first question.
MK I
can take the first part of that. We also have Peter Ben Embarek online, who can
answer the second part of that.
00:18:11
Yes, we have been asked the question about
Ivermectin before and the clinical team is looking at data right now on
different studies that have been evaluating Ivermectin. What they're doing is
they're synthesising the data from different studies. Some of those studies had
small sample sizes and the idea is to pool those together into a meta-analysis
and apply what they call a grade framework to assess the certainty and the
benefit or the risk based on each of those studies.
They're using the same methodology that they've
used for all of the living guidance that has been produced throughout this
pandemic and they are hoping that they will have guidance in the coming weeks,
in four to six weeks or so. They have a steering committee that are following
the different results of clinical trials around the world and that is being
used to trigger the development of the guidance by the WHO team so that has
been triggered and that is currently underway.
FC Thank
you. Peter, are you online? Dr Ben Embarek, you have the floor.
PBE Yes,
Fadela, I'm online.
00:19:17
FC Thank
you.
PBE The
question was with regard to the hypotheses we were looking at. It was a process
to organise our thoughts and our planning of future studies. As you know, this
mission was supposed to and did review all the work done under the phase-one
studies that were agreed last July and in that process we were also planning to
develop a series of hypotheses that we could explore further in the coming
weeks and months through a series of new studies that we would recommend and put
into motion and that's what we did.
With regard to the four hypotheses we worked on
and the hypothesis on the lab accident in particular, that one, based on the
data and the discussion we had with our counterparts and colleagues in the
different laboratories we visited in Wuhan and the amount of evidence that was
presented to us from elsewhere as well, was not seen as a high-priority
hypothesis for us, our joint China/WHO international team group, to move
forward with.
We decided to prioritise initially new studies
on the more likely scenarios that we could easily set in motion since these are
studies to enhance our understanding of the potential animal intermediate host,
the bat origin issues, the persistence of the virus on frozen products, the
entry into the Huanan market of farmed/wild animal products, etc.
00:21:14
Therefore the one on a laboratory accident was
more seen as a lesser priority for us and therefore was categorised as an
extremely unlikely scenario in our opinion based on what we had at hand.
We also decided and agreed that all the
hypotheses would be reviewed on a regular basis based on advance knowledge from
our new studies and from evidence that could come up in the coming weeks and
months. So that's the context under which this hypothesis and the others were
designed and used and of course they're still all under consideration. In
particular none of them were considered as impossible hypotheses otherwise we
wouldn't even have considered them so they are on the table, we considered
them. It's the first time we were able to put all these different hypotheses
next to each other on the table and consider them in a rational way.
So that's how we worked over the past months on
these hypotheses. Thank you.
00:22:27
FC Thank
you, Dr Ben Embarek. I would like to invite Dr Sylvie Briand to complement the
first question we got from Gabriela about treatment. You have the floor, Dr
Briand.
SB Thank
you very much, Fadela. Yes, just to complement on the issue of treatment. What
is clear is that we may need to have many different treatments for COVID-19.
The first studies were done on hospitalised patients, meaning patients with
quite severe disease and we found that for instance dexamethasone was very
useful for severe patients.
But now there are many studies ongoing to see if
we can treat patients that at out patients, not yet hospitalised, to prevent
them from going to severe disease. So this treatment needs to be administered
very early on in the disease and this is why those studies were more
complicated, especially at the early stage of the pandemic.
00:23:26
But now we start to have more information on
those treatments so Ivermectin is this type of treatment that is not specific.
It's an antiparasitic drug, as you rightly said and this drug has a
broad-spectrum activity and this is why it can be used at the early stage of
the disease, trying to prevent further severe disease.
So the studies are ongoing and we'll see if this
treatment can be useful to prevent severe disease in COVID-19 patients. Thank
you.
FC Thank
you, Dr Briand. I would like now to invite Esmir Milavich from Bosnian TV to
ask the next question. Esmir, can you hear me?
ES Hi,
Fadela. I can hear you. Can you hear me?
FC Very
well. Go ahead, please, Esmir.
ES My
question is for Dr Tedros. In this year or so you spoke so many times about
vaccine nationalism and big countries purchasing vaccines on their own and you
highlighted the importance of the COVAX system.
But even here in the region of the western
Balkans we are seeing that countries are not relying on COVAX but they're
purchasing vaccines on their own. How can you convince them to purchase and go
through the COVAX system but also what kind of message does this send, that
even countries like Bosnia are purchasing vaccines on their own? Thank you.
00:24:59
FC Thank
you, Esmir. Dr Simao will take this question.
MS Let
me start and maybe colleagues will want to complement. I think, Esmir, you're
raising a very important concern of many countries regarding access to vaccines
and let me say that we have the facility up and running to start distributing
vaccines this month, February and March and June and July. We have already
secured two billion doses through the facility and the good thing about the
COVAX facility is that actually countries don't need to go bilaterally. When we
say bilaterally, countries don't need to go one-by-one to different companies
trying to get the best price.
With the announcement today of the emergency use
listing of the two vaccines that are AstraZeneca vaccines that will be provided
through the facility it also triggers a lot of the purchase orders and
countries will be able to access, either through UNICEF or through the PAHO
revolving fund, the early doses for the AstraZeneca.
00:26:18
Also countries already have been informed about
indicative allocation from February to June this year so they can do the
preparedness as soon as possible. There are several things that need to be
ready at country level and these are two vaccines that have been approved today
for emergency use listing.
They are vaccines that are very easy to manage
from a logistic perspective because they're vaccines that use what we call the
cold chain, can use the usual refrigeration, two to eight degrees, in any
health centre.
So these are easy-to-use vaccines so the
vaccines through the COVAX facility start to be rolled out from the end of
February and there is the agreed number of doses that will be shipped to the
different countries until June this year. So I think there's no need to panic
and no need for countries to go buying in the market because they're going to
pay more and they will have all the difficulties of ensuring the different
contracts and that these vaccines will reach them in whatever time.
But the facility is up and running as we speak.
Thank you.
00:27:36
FC Thank
you, Dr Simao. I would like now to invite the next journalist, Ker Simons from
NBC. Ker, can you hear me?
KE Yes,
I can hear you. Can you hear me?
FC Very
well, Ker. You can go ahead.
KE A
question for the panel but also for Peter Ben Embarek. A couple of questions;
there appear to be some slight disagreements between the team. Can you help me
understand how you will reach a conclusive report or a report that everybody
agrees on? What will the process be and how much will the Chinese side of the
team have a say in what the final report says?
Then a detailed question if I may; some
confusion about the reporting referring to 13 sequences that were found, I
think, in the 174 cases. Peter, were those 13 different sequences with slight
differences or is it the case that eight of those sequences were the same and
the others show slight genetic variations? Can you help unpick that piece of
reporting and explain exactly what you found?
00:28:59
FC Thank
you. Dr Ben Embarek, you have the floor.
PBE Thank
you. First responding to the last part of your question on the sequences, we
identified 13 sequences in December 2019. These were mostly from cases but also
from the market environment, as you probably know.
These were mostly from different individuals but
a few sequences were repeats from the same cases; we have in some instances
several sequences from the same cases so it was not in total 13 different
individuals.
Some of them were very similar; these were the
ones coming from cases who had a link with the Huanan market, indicating that
the virus was circulating closely in that market environment and that's in line
with the conclusions from the epidemiological studies.
Some were slightly different and these were from
cases with no link to the market. That suggested that the virus was circulating
in Wuhan both in the close environment of the Huanan market but also in other
parts of the city with some individual chains of transmission. That's again in
line with the findings of the epidemiological investigations.
00:30:49
All that gave us the picture of a substantial
circulation already in December, particularly in the second half of December 19
in Wuhan.
With regard to the report the process is that
the international team and the Chinese counterparts have already agreed on the
summary report when we were in Wuhan on the last day of the mission and in
particular on the key elements of that report in terms of key conclusions, key
findings and key recommendations.
Of course we will over the coming days and weeks
finalise the technical parts, the background parts, the methodological parts of
these reports, which are just descriptive material. The process is that the
international team in the coming days together with our Chinese counterparts
will finalise the interim report first and then work on the full report
afterwards.
It's a joint report. It will be two groups. We
have worked on this together and therefore it's not a question of one side
having a say on what the other side is concluding but more having a consensus
document on our joint key findings, conclusions and recommendations because
this is reflecting the nature of the work, as we discussed earlier today.
00:32:27
The mission was there to review a series of
studies that were done in China over the past weeks and months as part of the
phase-one studies we had agreed in July and make recommendations for future
studies, more long-term studies to explore some of the hypotheses and advance
our understanding of the origin of the virus.
So it's a consensus document reflecting the
joint activities. Of course the fact that we have different scientists from
different backgrounds and different fields of experience means that everybody
has their specific views, specific recommendations, specific interest in moving
some studies forward in one direction or repeating some studies, etc.
That's why we brought together a broad group of
scientists with diverse backgrounds, diverse experience, diverse expertise,
precisely to make sure that we have the best possible consensus, scientific and
robust conclusions around this work. Thank you.
FC Thank
you, Dr Peter Ben Embarek. We are sorry, we had a small technical problem and
we lost the video link to Dr Ben Embarek. Dr Ryan would like to add something.
00:33:59
MR I
really congratulate the team and Peter's leadership and the work the whole team
have done. In my experience particularly in field investigation or any
scientific endeavour achieving an absolute consensus around every point is almost
an impossibility in science.
What we can do is reach a conclusion based on
the evidence before us. We may not agree on whether there's enough data to make
a decision. There may be differences in our understanding of the methodologies
used to collect that data and even if we have enough data and we agree on
methodologies we may differ in our interpretation of what that data means in
the real world.
So it is a difficult pursuit to achieve
consensus between two scientists, never mind between 20 or 25 scientists around
the same issue and again remembering there were different components to this;
components around the environment, around animals, around labs, around the
clinical, around the epidemiologic so it's a complex interweaving so a finding
or a set of data in one area can affect how you look at information, at data in
the other areas.
00:35:07
So I think this is a complex puzzle to put
together. The team need the time to finalise that. They obviously are just
tidying up that preliminary report. There will be a longer and deeper report
but I think it's important for us to reflect on that fact.
Again when we look at evidence for anything in
public health or in science we have to make findings and conclusions but then
we have to determine how strong the evidence is supporting that conclusion and
what further data or evidence would help in further bringing certainty to that
conclusion or to that finding.
That's what we do all the time in science; we
say, yes, we think the data tells us this but we'd be certainly happier to
gather more data in this area to make us firmer in that conclusion. So I think
we have to get away from the land of absolutes here; that's not how science
works. Everything is relative; if the possibility of one hypothesis goes up the
possibility of another hypotheses explaining the same set of facts actually
goes down.
So everything is moving dynamically and I think
we need to give the team the space to be able to determine what their findings
and conclusions actually are and then to determine what further data and what
further studies would be helpful in further bringing certainty to those
findings or conclusions or where conclusions cannot be reached what studies are
needed to be able to generate the evidence needed.
00:36:36
I think we've always said that such a journey of
discovery, certainly on the animal-human side, is difficult and it's fraught
with obstacles in terms of being able to understand the true origins of any
disease and I do believe it will take further studies for us to be able to
fully understand that.
I did say the last day that we certainly are
making great progress thanks to the team and again recognising the scientists
on both sides in that team and, Peter, your leadership in that group we've
certainly made tremendous progress but we have to be very careful on the
absolutes of declaring successes or missions accomplished. Mission accomplished
is not a term we tend to use in public health.
00:37:27
TAG Yes,
thank you so much, Mike. I just want to add a bit. As Mike said, reaching a
consensus on everything may be difficult and it will not be possible,
especially when you're just starting. So we would expect that, as Mike said,
that there may not be consensus on all issues and there should not be consensus
on all issues actually.
So when the team faces that the solution is they
can represent or indicate their differences in the report and that can help in
proposing also future studies so that's what should be done. A joint report
doesn't mean that we will have consensus on everything. A joint report can have
a consensus on some issues but at the same time can have differences on other
issues and the report can accommodate what was suggested by one group or one
individual or another group or another individual.
So that could be the solution and that, as I
said earlier, can help in even proposing future studies so that's what we
expect the team will do. But I think once the report is ready we will make sure
that the team has the opportunity to have its own press conference either full,
all experts, or as many experts as possible that they want to delegate if they
want to but it will be up to them.
00:39:38
The last thing I would like to say is whatever
conclusions come these are independent experts. Except two in the group the
rest, ten of the members or experts are from different institutions, not even
from WHO so they come from different institutions representing different
countries actually; ten countries, ten institutions and they're independent and
we don't tell them what to do. They will present their own independent report
and that's what I think will of course make this study dependent on independent
experts' opinion.
Many times I hear that this is a WHO study or
investigation. It's not. It's an independent study, a study which is composed
of independent individuals from ten institutions and WHO's role here is
co-ordination and that's what we should take into consideration too so that
will be really helpful to understand. Thank you, Fadela.
FC Thank
you, Dr Tedros. I would like to invite Kate Kellan from Reuters to ask the next
question. Kate, you have the floor.
KA Thank
you. I wonder whether you could give a more specific estimation of when the
first vaccines that are being delivered via COVAX will get to countries and
into the arms of people that are getting them through COVAX.
00:41:45
Also have you had any one of the countries that
are due to receive AstraZeneca vaccines saying that they're not so keen now
after the South Africa situation last week where they paused the roll-out?
FC Thank
you, Kate. Dr Simao.
MS Let
me start and then I'll ask Kate O'Brien or Dr Soumya to complement. Thank you,
Kate, because this is a very important question right now. We don't have the
exact date because at the moment there are purchase orders that are being put
to the two manufacturers. For the Serum Institute of India I believe that there
are seven or eight purchase orders that were already issued through the Serum
Institute of India for some countries to receive that have been assessed as
ready by WHO.
Then there are the orders that will be placed
for the Korean manufacturers, SKBio so we will publish the number of doses that
will go now on the first round to the allocation quite soon, probably mid next
week but the exact date each country will receive depends a lot on how the
shipments will be made and the contracts that are being arranged through UNICEF
and PAHO. Maybe Kate can address the second question.
00:43:13
FC Yes,
Kate or Dr Swaminathan.
KOB Sure,
I can address the second question and then I'm happy for others to come in as
well on this. We've spent quite a bit of time and effort both in this convening
and with member states and in other convenings with them to clarify the
recommendations from SAGE about the use of the AstraZeneca vaccine
notwithstanding the very preliminary evidence that has started to come out
about this product and a variety of the variants.
Countries remain enthusiastic about receiving
the AstraZeneca product while at the same time asking very relevant questions
about what the evidence shows and what the evidence doesn't show. I'll just
reinforce that three is no evidence on whether or not the AstraZeneca product
against the B1351 variant has any change or that the change in that vaccine
efficacy is a substantial change.
00:44:26
There are plausible reasons why we think that
they will retain activity against severe disease. This is evidence that SAGE
looked through and made that recommendation so in fact the engagement with
countries has been with a lot of questions that they have had and I think what
has been shared with them about what the evidence shows has reassured countries
about moving forward and enthusiasm from countries to go ahead with the
vaccination programmes with AstraZeneca vaccine.
We are also working closely with the South
African Government as they consider how they will accrue additional evidence on
the AstraZeneca product in the setting of very wide distribution of the variant
in South Africa.
Remember that countries that have the variant in
the countries; that does not mean that the majority of the strains that are
circulating are from that variant. I'll end there and see if there's anybody
who would like to add to that; Soumya or others perhaps. Thank you.
FC I
think you covered it fully. I would like now to invite a Chinese journalist
from China Daily, Chen Wihua, to ask the next question. Chen, can you hear me?
00:45:57
CH Yes,
thank you very much. Dr Tedros, you again mentioned misinformation and
disinformation today. I don't know; are you actually referring to the war of
words in the media? You have the US Government, a State Department official
spokesman saying they're not going to accept the independent expert team report
even before it comes out.
You also have the other Peter, Peter Dazak from
the expert team saying on Twitter, don't rely on US intel. Also he said,
experts' words are being selectively used and also very angrily commented on
the New York Times article, saying, shame on the New York Times.
So I'm wondering what's the WHO's stance on the
US' not going to accept the report and Peter here, Peter Ben Embarek, are you
feeling [overtalking]?
FC Can
you just...? It's a very long question and comments.
TAG Yes,
okay. I will start. What I said today about misinformation and disinformation
has nothing to do with any specific things that we heard yesterday or the day
before yesterday. The reason we included it in our presser today is that it's
the first anniversary since we started to advocate for the public to fight
misinformation and disinformation and that's why also Dr Sylvie Briand is with
us.
00:47:44
So we're actually celebrating the first
anniversary of the initiative that we started. Sylvie can give you more
background. Sylvie, please.
SB Yes,
thanks a lot, Dr Tedros. In fact it's because we have seen that every epidemic
is accompanied by an infodemic which is a tsunami of information, accurate or
not and that can be of course harmful if it's not accurate information.
So WHO has done a lot of activities to make sure
that people can access accurate information at any time during the outbreak and
as you have seen, the difficulty with such a pandemic is that there's a lot of
uncertainty. Science is moving very fast. Every day we have new findings and
it's very hard for the public to understand what is going on and sometimes they
are confused.
Some people also use this confusion to send out
information that is not completely accurate so what we try to do is really to
listen to people and this listening is very important. We have developed not
only tools to listen to people offline but also online and see what are their
concerns and try to really answer their concerns and questions in real time and
fill the void because we know that when there is a vacuum, when there is no
information people will try to find this information wherever it comes from and
sometimes it's not the right information.
00:49:28
This is why we wanted to celebrate somehow this
one year because during this year a lot of organisations, UN organisation
partners have been contributing to ensure that everyone on Earth has access to
accurate information at any time. Thank you.
FC Thank
you, Dr Briand. I would like now to invite Helen Branswell to ask the next
question. Helen, you have the floor.
HE Hi.
Thank you very much, Fadela. I'm wondering if we could have some information
about the Ebola cases in DRC and Guinea. In particular is it known yet whether
the virus in Guinea is Ebola Zaire and is there any thought that this is - is
it known if it's a new spillover or if there might be an incidence of viral
persistence? Thank you.
00:50:32
FC Dr
Yao, you have the floor.
MY Thank
you very much. The first cases were confirmed and, as you know, the outbreak
was declared yesterday by the national authorities so it's Ebola Zaire but the
genotype has to be analysed and a sample has been sent to reference labs mainly
in Senegal to do the sequencing so that at least we can know if it is the same
virus that affected a few years ago or if it's a totally new one.
So it's a bit early to answer precisely about
this point but it's in process.
MR If
I can just add - thanks, Michel - again we would like to thank the Government
in Guinea, the Governments in Sierra Leone, Liberia, Cote d'Ivoire and others
who are taking immediate action both in terms of response and readiness. We saw
similar responses in Congo before and the 14 and mainly in the nine really
at-risk countries.
This disease represents a regional risk and we
very much welcome the regional and subregional response to that. I know our
regional director, Dr Tshidi Moeti is already in touch with senior officials in
many ministries and with the West African Health Organisation and many others
in the region.
00:52:08
We do need a very coherent, co-ordinated
response led by governments in country with the UN, other partners, NGOs
supporting that response and WHO will do its part to support the Government.
We already have, Michel, I think, I believe we
have a team en route to Ensakore [?] right now to provide support. We are
moving vaccines in country from both Geneva and US stockpiles. Those vaccines
are still the investigational use doses. They will have to be used under
investigational use protocol.
We have previously approved protocols in the
three countries. We're working with the Governments to have those updated.
Currently vaccinators will be trained. We already have experienced vaccinators
in all three countries but we have vaccinators and supervisors who've been
working with us in Congo from Guinea and they're in Guinea already and will be
working on this.
00:53:12
We also will be shipping therapeutics, both
MAB114 and the Regeneron product, to the field and are working with ALINA and
other colleagues and other NGOs, IMC and others, MSF, to see how best we can
provide the higher standards of care that were achieved in Congo and transfer
them to the management of patients in Guinea.
We're not in the same situation we were a number
of years ago. The disease is very much in the same area as before. It does
threaten at least the three countries and therefore we have to be exceptionally
vigilant, highly alert and we have to get surveillance, laboratory diagnostics,
clinical management and all of the other things in place, much as we've had to
do with COVID.
WHO is ready to do its part and our systems are
fully geared now to providing the absolute highest level of support to both the
government of Guinea and Akri and to the surrounding countries so we've
launched a comprehensive response. Michel Yao is our lead on that here but he
is surrounded by a very competent team and Dr Socé Fall, our Assistant
Director-General for Response, will also provide oversight to the response on
behalf of Dr Tedros.
FC Thank
you, Dr Yao and Dr Ryan. I would like to give the floor for last question to
Kai Kupferschmidt from Nature. Kai, you have the floor.
00:54:43
KI Hi,
thanks for taking my question. I was wondering, given that we've seen five
weeks of falling case numbers, whether you can give an idea, maybe Mike, how
you think of this. Clearly there's a lot we don't understand about the virus
but we are seeing a drop in a lot of places where fundamentally the public
health measures haven't changed all that much.
Could you just give us an idea of how you think
about this drop and how you see the future also given the faster-spreading
variants we're all concerned about?
FC Thank
you, Kai. Dr Ryan.
MR Yes,
I think the real expert on this will be Maria but, Kai, yes, thank you. I think
we have to be very, very careful. When things go bad with an epidemic it's
never all our fault and when things go well it's never all our doing because
viruses have a natural cycle. They're ruled by seasonality, our behaviour and
other things.
00:55:45
I think there has been a significant and global
drop in disease week-on-week for the last four or five weeks. We haven't seen
levels as low as this since last October. I do think a good proportion of that
has been down to the huge efforts made by communities. There've been very
swingeing lock-downs and stay-at-home orders and other things but also as part
of that seroprevalence is rising, people are taking better care.
We need to understand what is driving those
transmission dynamics. Is it the natural seasonality and wave-like pattern of
the disease, are we building up a level of immunity in the population that's
preventing the disease finding the next case and are control measures having an
impact on that?
I think all of the above to an extent are true.
I think the thing we have to remember is that this virus still has a high force
of infection, a very high kinetic energy. There still are a large number of
susceptible individuals out there and transmission will continue.
I think as we look collectively at lifting some
of the measures that are currently in place we're going to need to be
exceptionally careful that we don't do the same thing as last autumn where we
allow the disease to re-establish itself, reignite and re-accelerate.
00:57:08
I think it's the accelerations in this disease
that have been the most worrying. The disease can move along at fairly low
levels and then you see this really fast acceleration and spread. We need to
avoid that the next time.
We do believe that vaccines offer us an
opportunity to reduce the hospitalisations and death and that's going to offer
a different set of decisions in a number of months' time. If we can distribute
vaccines equitable and the most vulnerable and the highest-risk people are
protected then the decisions we make around this disease will understandably change
because the consequence of transmission is different when we don't have death
or hospitalisation as an endpoint and that's going to be a very important
consideration going forward.
So I think it's difficult to understand the
dynamics but I would hate to think as these numbers drop that we're in any way
about to declare some kind of victory. We've done that twice before. I don't
think anyone has put up a victory flag but we collectively have taken a sigh of
relief, moved on from a wave and then been very surprised two or three months
later when we're in the middle of the next wave.
00:58:16
What we need to do - we said this many times
last year; we need to avoid lurching from lock-down to lock-down, from peak to
peak and get into a more stable relationship with this virus unfortunately. We
need to get control on the virus. The virus still very much has control over
us. We need to get to low, sustainable levels of transmission. We need to get
to no deaths and minimal hospital admissions.
If we achieve that then we will have other
choices to move forward, possibly with second and third-generation vaccines and
other opportunities to potentially eliminate or eradicate this virus. That is
not on the immediate horizon. We need to take the heat out of this pandemic. We
need to take the death out of this pandemic. We need to take the suffering out
of this pandemic and I believe we can do that if we're really smart about
continuing our own personal measures, continuing to reduce our own chances of
being infected, if governments support people in being able to do that and if
we can roll out vaccines in an equitable fashion so our most vulnerable and our
most at risk are vaccinated as the highest priority. Maria.
00:59:25
MK Thanks,
Mike, and thanks, Kai, for the question. I think the downward trend in cases
and deaths is definitely a hopeful sign and there's likely a combination of
factors that are pushing and driving transmission down and it comes down to
individual-level measures, measures taken at the family level, the community
level and by governments.
We have reasons to be hopeful and I hope
everyone is taking some comfort in the fact that we can drive transmission
down, we do have the possibility to control transmission with our
individual-level actions if we are enabled to do so.
We do see that the public health and social
measures are working across a number of countries including countries where the
virus variants are circulating, where they are predominant, where they're being
identified and that is good because we know what works and it's that
combination of factors.
01:00:16
Getting down to the level of detail of which
combination works where is what we're trying to better understand in terms of
all of these public health and social measures but I think we have some
challenges ahead.
These virus variants and the changes, the
natural evolution of the virus pose some uncertainty in terms of what is this
virus going to do, how much is it going to change, are we in a position
globally to rapidly detect these mutations, these virus variants and assess
what they mean in terms of transmission, severity, impacts on diagnostics,
therapeutics and vaccines.
You know we are working with partners all over
the world to set up this global risk assessment framework to be able to monitor
them and study them in real time and that poses a challenge.
The other challenge I think we have is while
vaccines and vaccination is incredibly hopeful and an incredible achievement
they will take time to roll out and they will take time to reach those who are
most vulnerable and those most at risk in all countries.
The third thing that I think is a big challenge
that we have now is fatigue. The world is tired. All of us up here are tired as
well and we want this to be over and we cannot become complacent. Even with
downward trends we need to really stay the course and we need to hold on to
what works and have some feeling of control, empowerment over what we can do.
01:01:46
There's a lot of work that is happening in this
area and Sylvie may want to comment on this but working with communities,
talking to communities, with communities, listening to communities, making sure
that they are part of the solution, that they are informed, engaged and
empowered, most importantly empowered and enabled to carry out the actions that
are necessary.
It's no good for us to lay out ten different
things to do if a community is not enabled to do so so I think there're a
number of reasons why we should be hopeful but it is no time to let down our
guard. We need to really hold on to everything that we can do, take all of the
measures at our own level to keep ourselves and our loved ones safe.
FC Thank
you. I would like to invite Mr Deusdedit Mubangizi, who's the Head of the
Pre-qualification Unit, to say a few words about the important announcement
made today. You have the floor.
01:02:51
DM Thank
you, Fadela. Indeed today is a great day especially for COVAX. We started
assessing these two vaccines hardly four weeks ago but when you look at the map
that has been shown in various fora where you have continents that have access
to vaccines and then other continents that don't have, I think any movement
that increases capacity on the manufacturing and supply of vaccine is a great
milestone for this world.
If we are going to be safe, as the
Director-General says, nobody will be safe unless everybody is safe and today's
announcement of two vaccines, versions of AstraZeneca allows everybody to
access vaccines.
I would like to first of all use this
opportunity to thank the experts that have been behind the assessment of these
vaccines. I was excited yesterday; it was Valentine's Day but all the experts
were around the table and assessing to make sure that today a final decision
was made and people could access these vaccines.
I want to assure people out there that experts
have looked at this vaccine and it is safe, it's of good quality and it is
effective.
01:04:42
Secondly we put a system in place that has
assessors from every WHO geographical region to make sure that there is input
not only from one part of the universe but all parts of the globe, to make sure
that the input, the decision that goes into this decision that we've made today
has a global input, has considered all the specificities of the different parts
and and markets and health systems.
We are confident that one of the concerns and
the interests of the different populations have been considered but also that
the aspects or ability to deliver this vaccine in the different health systems
of the world has been considered.
Therefore we now call upon our colleagues first
of all in the national regulatory authorities. We have put in place a report
that has had input from all parts of the world. Let's now make the quick
decisions so that people can access these vaccines as quickly as possible.
We will work with all of you to make sure that
any questions that you have to facilitate quick authorisation at the national
level are done and hopefully by the time we enter March the map will be
different and everybody will have an opportunity to access this vaccine. Thank
you very much.
01:06:19
FC Thank
you. I would like to hand over to Dr Tedros for any final comment. You have the
floor, Dr Tedros.
TAG Thank
you so much. I think Deus has said it very, very well on the vaccines and
Valentine's. My colleagues didn't have a break even on Valentine's Day and it
was also Sunday. Thank you so much for your hard work and for making it happen
in a very short period, the approval of the AstraZeneca. This will help us to
roll out quickly so thank you, Mariangela, for your leadership, Deus, Parwar
[?] and...
[Inaudible]
TAG Carmen;
okay. Thank you so much and I would like also to thank the media colleagues who
have joined today. See you in our next presser. Thank you.
FC Thank
you, Dr Tedros. I would just like to let journalists know that we will be
sending them the DG's opening remarks and the audio file of this press
conference just after we close here. The full transcript will be available to
you tomorrow morning. Thank you all. See you next time.
01:07:39