WHO press conference on COVID-19 and other global health issues - 12 July 2022

00:00:28

TJ           Warm greetings from warm Geneva to everyone. My name is Tarik and I welcome you to a WHO press briefing on COVID-19 and other health issues. As we have put in our media advisory, we have a special privilege today to host members of WHO’s Science Council, who will present to you their first report that is focusing on accelerating access to genomics for global health. Dr Tedros, in his opening remarks will introduce the chair, who will say more about that and we hope that we will be getting questions on that topic as well.

Before giving the floor to Dr Tedros, let me just tell you who is with us here in the room. We have Dr Soumya Swaminathan, our Chief Scientist, Dr Maria Van Kerkhove, Technical Lead on COVID-19, Dr Mike Ryan, our Executive Director for Health Emergencies, and online we have Dr Rosamund Lewis, Technical Lead on monkeypox, and we also have Dr Bruce Aylward, who is a Special Advisor to the Director-General and who leads on ACT-Accelerator. We may be joined by other colleagues, as well.

00:01:48

Just before giving the floor to Dr Tedros, journalists who have questions on WHO Science Council and their report please, beside raising hand, drop quick words in a Q&A so we can prioritise you, as the chair will have to leave us soon. So, with this, I’ll give the floor to Dr Tedros for his opening remarks.

TAG        Thank you. Thank you, Tarik. Good morning, good afternoon and good evening. I’m concerned that cases of COVID-19 continue to rise, putting further pressure on stretched health systems and health workers. I’m also concerned about the increasing trend of deaths.

The Emergency Committee on COVID-19 met on Friday last week and concluded that the virus remains a Public Health Emergency of International Concern. The Committee noted their concern about several interlinked challenges. First, subvariants of Omicron, like BA.4 and BA.5, continue to drive waves of cases, hospitalisation and death around the world.

Second, surveillance has reduced significantly, including testing and sequencing, making it increasingly difficult to assess the impact of variants on transmission, disease characteristics, and the effectiveness of countermeasures. Third, diagnostics, treatments and vaccines are not being deployed effectively.

The virus is running freely and countries are not effectively managing the disease burden based on their capacity, in terms of both hospitalisation for acute cases and the expanding number of people with post COVID-19 condition, often referred to as long COVID.

00:03:48

Finally, there is a major disconnect in COVID-19 risk perception between scientific communities, political leaders and the general public. This is a dual challenge of communicating risk and building community trust in health tools and public health social measures like masking, distancing, and ventilation.

The Committee made a series of recommendations with several that I want to focus on. New waves of the virus demonstrate again that the COVID-19 is nowhere near over. As the virus pushes at us, we must push back. We’re in a much better position than at the beginning of the pandemic. Of course, we have made good progress. We have safe and effective tools that prevent infections, hospitalisations and deaths. However, we should not take them for granted.

As G-20 finance ministers meet next week, it is critical that governments around the world finance WHO and the ACT-Accelerator to ensure the equitable distribution of health tools. As transmission and hospitalisations rise, governments must also deploy tried and tested measures like masking, improved ventilation and test and treat protocols.

I urge governments to regularly review and adjust their COVID-19 response plans based on the current epidemiology and also the potential for new variants to appear. Governments should also work to reverse the reduction in surveillance, testing and sequencing, and share antivirals effectively.

00:05:39

Vaccines have saved millions of lives and it’s important for governments to focus on boosting those most at risk communities, finding the unvaccinated so as to build up the wall of immunity toward the 70% vaccination target. Planning and tackling COVID-19 should also go hand-in-hand with vaccinating for killer diseases like measles, pneumonia and diarrhoea. It’s not a question of either/or, it’s possible to do both, and new vaccines, including HPV and malaria, should continue to be introduced.

Today, WHO released the first-ever report on vaccines in development to prevent infections caused by antimicrobial-resistant bacterial pathogens. The report examines some of the challenges facing vaccine development and proposes disruptive approaches to nurture innovation in a space that has been severely neglected.

I am glad to be joined today by WHO’s Science Council, which I set up just over a year ago to provide advice on advances in science and technology that impact global health. Led by Dr Harold Varmus, the group just had their first in-person meeting and has been focused on genomics, given its implications for public health, and the challenges of scaling it up in low and middle-income countries.

During COVID-19, genomics has been essential to detecting the virus initially and new variants subsequently, and also integral to the development of tests, treatments and vaccines. As laid out in WHO’s new ten-year global genomic surveillance strategy, genomic surveillance covers disease detection, strengthening lab systems, developing tests, data sharing and analysis, so that together new health tools can be developed and deployed.

00:07:47

Further, genomics has massive potential beyond pathogen surveillance, for human health. It is timely for countries to invest in infrastructure and human resources in this area. To tell us more about the work of the Science Council, I’m happy to hand over to Dr Harold Varmus. Dr Varmus, you have the floor.

HV          Thank you, Dr Tedros, and we appreciate your invitation to ask us to service WHO in this capacity and we’re very proud to be releasing our first report, as you say, on the expansion of the use of genomics. We are a small group but we’ve been guided by the scientific community, by three workshops held in the fall that assembled hundreds of people who work in genomics and who are interested in their application, to give us advice.

We recognise a variety of issues, some of which you’ve already alluded to, the growing influence and the benefits of genomics in medicine and actually many other fields beyond health, and those benefits have been illustrated, as you’ve pointed out, in the COVID pandemic, namely on the development of vaccines and tests and the identification of variants that continue to pose serious problems for the wider public.

We, as a small group, have assembled a set of recommendations to the WHO, to Member States, to organisations and academic institutions and they fall into four thematic areas, and I’m going to review them extremely briefly to save time for questions.

00:09:29

First, we argue that WHO and Member States can do more to promote the adoption of the use of genomics and that the WHO should assemble a genomics committee that oversees and assists with the implementation of genomics. The second board area addresses implementation. We’re encouraged by evidence that we heard in our workshops that genomics has been adopted in many relatively poor countries.

Costs are coming down. There are incentives to encourage that commercial providers of the essential ingredients, machines, reagents, software, use a variety of economic incentives to further the expansion of the use of genomics, even in poor countries, because we are concerned that the already widespread use of genomics in advanced countries should not leave lower and middle-income countries behind, as has occurred in many other contexts.

The third issue is collaboration. We’ve seen evidence already of collaborations between scientific disciplines, between countries, and we encourage in many aspects of our recommendations the usefulness of collaborating among scientific groups and among nations. And, fourth, we address a number of recommendations to ethical, legal and social issues that have been associated for several years with genomics and we would like to see WHO become the authoritative source for mediation and guidance about these issues.

We are optimistic about the future applications of genomics. We believe that many indicators and the economic and scientific sectors argue that adoption of widespread use is feasible and, with the encouragement of WHO and its leaders, can be achieved. I look forward to taking some questions, accompanied by several of my colleagues from the Council who have met here today for the first time in person, and we welcome any attention that press organisations can give to the release of our report. Thank you very much.

00:11:54

TAG        Thank you. Thank you, Dr Varmus for that deep dive into the work of the Science Council and genomics and for the recommendations. I couldn’t agree more about the importance of scaling up genomic sequencing capacity globally and also ensuring that enough bioanalysts are trained to act on the sequencing.

On monkeypox, there are now 9,200 cases in 63 countries. The Emergency Committee for Monkeypox will reconvene next week and look at trends, how effective the countermeasures are, and make recommendations for what countries and communities should do to tackle the outbreak.

In the meantime, the multipronged approach continues. First, WHO is working closely with civil society and LGBTIQ community, especially to tackle the stigma around the virus and spread information so people can stay safe. Second, WHO continues to work with countries and vaccine manufacturers to coordinate the sharing of vaccines, which are currently scarce. Third, WHO continues to work with countries and experts to drive forward research and development.

00:13:21

On Sunday and Monday, the National Institute for Biomedical Research in the Democratic Republic of Congo, the National Institute of Health and Medical Research, and the National Institute of Allergy and Infectious Diseases, in collaboration with WHO, convened researchers and experts in trials worldwide to develop consensus on a global CORE protocol for the evaluation of treatments for monkeypox.

I again stress that we must work to stop onward transmission and advise governments to implement contact tracing to help track and stem the virus, as well as to assist people in isolation.

In Ghana there are currently two suspected cases of Marburg. Ghana is currently dispatching samples to the Institute Pasteur of Dakar in Senegal for verification. In the meantime, the Ministry of Health has set up precautionary contact tracing, case investigations and preparedness in health facilities with the support of WHO.

Finally on Syria, the renewal of the United Nations Security Council resolution on cross-border operations in northwest Syria is very good news for the nearly 4.5 million Syrians whose lives and health depend on this humanitarian access.

WHO and partners will continue to deliver life-saving supplies and healthcare to this vulnerable population, 80% of whom are women and children. We thank the Security Council for protecting and ensuring this vital operation serving civilians and avoiding an almost complete cut of vital aid. Tarik, back to you.

00:15:20

TJ           Many thanks, Dr Tedros and Dr Varmus for these opening remarks. We have shared with our global list the report and accompanying press release on WHO’s Science Council, as Dr Varmus has said, council members would be happy to speak to media any time it is needed. Now, we will open the floor to questions. We will go first to Erin Prater, from Forbes. Fortune, sorry. Erin is from Fortune. Erin, can you please unmute yourself.

EP          Thank you so much. Just curious about the COVID-19 subvariant BA.2.75. Curious about tracking of this variant. What kind of levels have you all seen and what are the implications or what do we know about the implication of the mutations? Thank you.

MK         Thanks very much for the question. BA.2.75 is one of the sublineages of Omicron that we are tracking. As you know, Omicron has several sublineages, dozens and dozens of them in fact that we are tracking at a global level. All of the sublineages of Omicron are characterised as a variant of concern. I just want to stress that for the moment.

Our ability to track and trace variants around the world depends on surveillance. It depends on the surveillance for the SARS-CoV-2 virus, the testing that is taking place, the sequences that are conducted and are shared, so that scientists around the world can assess those.

00:17:02

In particular, for BA.2.75 we have very few sequences available so far of this one. Less than 200 sequences or around 200 sequences are available from about 14 countries. Many of these sequences have been shared from India, reported from India, and the first collection date of these sequences is around May 2022. Our understanding of the behaviour of this virus is quite limited so far because we have few sequences that are available.

I just want to take the time to stress, given the topic of SARS-CoV-2, the Science Council and what they’ve been discussing, what we have been talking about over the course of several years now, the real importance of surveillance, the importance of testing, the importance of sequencing and the analysis of those sequences.

Our ability, as WHO, at a global level to assess these is reducing and the reason for that is because surveillance has reduced for SARS-CoV-2. So, it’s really important that we maintain surveillance activities and, in fact, enhance them, strengthen these activities, integrate SARS-CoV-2 surveillance with other respiratory pathogens that are circulating, so that we can track the known variants as well as to be able to detect new ones.

As more information become available of BA.2.75 we will make that available but, per usual, what we look for is characteristics of transmission, characteristics of severity and whether or not this variant or sublineage is more or less severe, and we look at properties of immune escape, as well as look at whether or not our interventions continue to work.

00:18:39

Our interventions continue to work against all of the sublineages of Omicron. It is really important that not only surveillance continues but we continue with vaccination because our vaccines are incredibly protective against severe disease and deaths. COVID-19 vaccines are safe and effective and prevent hospitalisations, as well as deaths.

So, it’s important that everyone receive those vaccines around the world and we particularly prioritise those who are most at risk of developing severe disease, those who are over 60, those with underlying conditions, and those who are more at risk for infection, for example our health workers, and that is true in every country around the world.

TJ           Thank you, Dr Van Kerkhove. Next question, Wall Street Journal, Denise. Denise, can you unmute yourself, please.

DR         Hello. Hi. Can you hear me?

TJ           Yes. Please, go ahead.

DR         Thank you. My question is about the distribution of monkeypox vaccine. I understand that although the Danish manufacturer, they can’t currently manufacture any more bulk vaccine, there is a good supply of ready-made bulk vaccine, most of which is owned by the US, that could be filled and finished at contract manufacturers.

I’m just curious to know some of the specifics, I suppose, of the actions that WHO is calling for to make that vaccine available. Are you, for instance, asking the US to share this bulk vaccine and are you taking any steps to speed up the fill and finish process of this material? Thank you.

00:20:16

TJ           Thank you, Denise. Let’s try with Dr Rosamund Lewis, who should be online and hopefully with a video connection. Dr Lewis.

RL          Thanks very much and thanks for the question. Yes, WHO is working with countries who have vaccine, working with manufacturers who produce vaccine, monitoring the vaccine production capacity and also working towards developing study protocols, different types of study protocols that will help countries and users of vaccines to monitor the vaccine effectiveness and safety, of course, in the field during this particular outbreak.

TJ           Thank you, Dr Lewis. We will move to the next question. We have Jennifer Rigby, from Reuters. Jennifer.

JR          Hello, and thank you for taking the question. It was two quick ones, actually, one on the genomics report and one just on BA.5. I’ll keep them short, though. BA.5 seems to be causing alarm in various countries, particularly the US, and I just wondered, from a WHO point of view, is there anything scientifically more concerning about this variant than anything else? There’s a lot of anecdotal stuff about reinfection, so I’m just asking for a scientific perspective on that.

Then, also on the genomics side of things, I saw in the report that the capacity has gone up from, I think, 54% of countries to 68% and I just wonder if there is any concern that that might slide back post-pandemic, if that’s kind of why you’re pushing for this now. Thanks.

00:21:53

TJ           Thank you. Let’s start with the first part of the question. Dr Van Kerkhove.

MK         Thanks. BA.5 is again one of the sublineages that we are tracking of Omicron. It is of concern for us because this illustrates the continued virus evolution of SARS-CoV-2. You’ve heard us say before, the more the virus circulates, the more opportunities it has to change and that fact has not changed.

The virus is spreading at a very intense level at a global level and, again, our ability to detect cases is reducing because surveillance strategies have changed. So, BA.5 is one of the sublineages. It is increasing in proportion in terms of the number of sequences that are BA.5 that have been reported to online platforms, open platforms like GISAID, and are being tracked by scientists around the world.

Our Technical Advisory Group for Virus Evolution, which has been meeting regularly throughout this pandemic, is also assessing BA.5 as well as all the other sublineages. BA.5 has a growth advantage over other sublineages of Omicron that are circulating and when we look at transmission, we look at properties of transmission, in terms of the ability of this virus to spread between people, but we also look at properties of immune escape, which we are seeing with BA.5.

00:23:09

We are seeing countries become concerned about this but we feel that countries should be concerned about SARS-CoV-2, whatever virus is circulating globally. We also not only need to focus on reducing severe disease and death, which is absolutely critical and we can do that with life-saving tools, we also have to take measures to reduce the spread, so that we reduce the possibility of further virus evolution.

You specifically asked about the risk of reinfection. We don’t have as many specifics as I would like to be able to report on reinfection but we are hearing of reports of reinfection. I’m sure all you anecdotally know of people who have been infected with Omicron. You may not know exactly what sublineage that is, that people are infected with, but the reporting of BA.5 is increasing in terms of the reports and it has increased substantially over the last four weeks alone.

We expect that trend to continue around the world but we will continue to assess this as we go forward. We need more data to be able to do that, to look again at transmissibility, immune escape severity. I should say, on the severity side, we have not seen an increase in severity over other sublineages of Omicron from the preliminary data that we have, from labs that are working on this and are sharing information with WHO and with others around the world, and we know that our diagnostics continue to work, our vaccines continue to work to prevent severe disease and death.

TJ           Thank you, Dr Van Kerkhove. Maybe we can address the second question Jen had on genomics? Dr Varmus had to leave us but we have with us, Salim Abdool Karim, who is Director of the Centre for the AIDS Programme of Research in South Africa, and he will try to take this question. Dr Abdool Karim, please.

00:25:03

SK          Thank you very much for that question. As we’ve looked at the capacity for countries to undertake research in genomics, we have seen systematically an expansion, driven in many poor countries initially by diseases like HIV, but now COVID-19 has also led to an expansion of capacity.

What’s important in genomics is that once you develop the generic capabilities they have very widespread application, so they have applications in COVID-19 to surveillance for different variants and subvariants, as we’ve already heard, but it could just as easily be expanded to include diseases like influenza and a variety of other conditions. So, we anticipate that genomics, instead of returning to pre-COVID-19 capacity, we’ll see it continuing to expand and its use also continuing to expand. Thank you.

TJ           Many thanks, Dr Abdool Karim, for this clarification. We will now go to the next question. We have Ari Daniel, from NPR. Ari, the floor is yours.

AD          Thank you so much. I was wondering about the upcoming Emergency Committee that is being convened on monkeypox. I know, Dr Tedros, you mentioned a little bit about that. I was wondering if you could say a bit more about what is going to be discussed, what you think has changed about the outbreak since the last meeting and whether this convening is happening sooner or later than was anticipated at the last gathering of the Emergency Committee. Thanks.

00:27:01

TJ           Thank you, Ari. We are also joined just now by Dr Sylvie Briand, who is Director of Epidemic and Pandemic Preparedness and Prevention Department here, at WHO. So, maybe Dr Briand can try to answer this question. Dr Briand.

SB          Thank you very much. Indeed, when the Emergency Committee met they assessed the situation that was the case when they met, but since then the situation has evolved. As Dr Tedros mentioned, we see an increasing number of cases. We have also seen new geographies affected. So, based on this new information, it is worth looking at it again and see if we need to reinforce certain advice or also revisit the strategy.

Basically, the Emergency Committee, they provided us with some criteria that need monitoring, nine criteria, and we will look at those criteria that are in the Emergency Committee report. Basically, the increasing number of cases, the deaths, if there are any deaths, if the disease is spreading outside the initial affected community, if we see changes in the virus and so on. So, we will rediscuss those criteria with the Emergency Committee and see if we need to then modify the strategy or declare a Public Health Emergency of International Concern at this stage. Thank you.

TJ           Thank you very much, Dr Briand. Let’s go to the next question. Laurent Sierro, from Swiss News. Laurent.

LS          Thank you, Tarik, for taking my question. A question on monkeypox. I think there was a study that tended to show that there might be some transmission through contaminated food. Have you any indication on that? Thank you.

00:29:22

TJ           Dr Ryan. Dr Lewis, maybe first.

RL          Thanks very much. I’m not sure to which study you may be referring. The possibility of transmission through contaminated food has always been a situation for zoonotic transmission, when there is infection through exposure to an infected animal, which is how monkeypox was originally described.

It was described as a zoonotic disease, where the virus circulates in certain rodent and also primate populations in forest settings in West and Central Africa. And in those settings, people go into the forest hunting and they may bring out wild game and then in preparation of that game, in cleaning of it, cooking of it, perhaps consuming not completely cooked food are all different ways of possibly being exposed if hunting and preparing and consuming wild game that may have this virus.

Of course, that is in the setting in West and Central Africa. We don’t yet have any reports of contamination of food in the current multi-country outbreak in other parts of the world.

MR         Just to emphasise what Rosamund has said, that the association with food is the food animal that may have the disease passing it on to the human. There is absolutely no evidence right now that normal consumption of normal food, normal food chains, going to the supermarket and buying your food is any way associated with any risk of getting monkeypox. That is very important.

00:31:08

But it’s also important that we look at all possible routes of transmission. Certainly, there is some data increasingly that suggests, and this was known before, that fomites or contamination of surfaces, particularly in a healthcare environment, could be associated with onward transmission. At least, virus can be cultured off those surfaces, which was rather difficult to do in COVID.

So, clearly the hygiene and infection prevention and control in a clinical setting is very, very important and also in the household settings where there is a case in terms of isolation and avoiding of contamination. Most of the transmission that has occurred in monkeypox historically between people occurs with very close, prolonged personal contact.

In this case prolonged and close sexual contact has been the main driver of transmission. That’s what is driving the transmission in this outbreak. We will continue to explore and be very clear that all routes of transmission will continue to be investigated. We thank scientists who are looking at the various avenues of transmission but we also need to be prudent and ensure that people don’t associate studies on the possible transmission routes with the actual transmission routes or the things that are driving transmission.

So, your food is safe. Always, it’s important to follow the instructions with food and food poisoning is a constant risk and therefore the proper handling, the proper cooking of food is very, very important and within that context monkeypox does not represent a risk.

00:32:43

TJ           Thank you, Dr Ryan and Dr Lewis. I think we have time for one more question, and we will go to Ashvin, from Observer Times, India. Ashvin, if you are with us, please unmute yourself.

AB          Thank you for considering my question. My question is how national animal disease control centres are essential in the countries to control monkeypox disease and other zoonotic disease research programmes. What are the present actions taken by WHO for capacity building of these national animal disease control centres? Thank you.

TJ           Thank you very much, Ashvin. Interesting question on animal disease control centres. Maybe, Dr Van Kerkhove.

MK         I could start and others can come in. I think you’re highlighting a really critical aspect of studying emerging diseases, zoonoses and this whole One Health approach, which is not a new concept, this comprehensive approach. Understanding how we, as humans, live with animals and live in the environments that we share with animals is really important to understanding not only safe handling of food and trading and raising of animals but also the potential spillover of these emerging pathogens from animals to humans and vice versa, back from humans into animals.

We work very closely with our partners in the animal sector, with the Food and Agriculture Organization of the United Nations and also OIE, which now has a new acronym, and with many partners around the world in the vet sector, in the animal sector, in the wildlife sector, environmental health as well, to improve surveillance activities in animals, in domesticated animals and wildlife along those trade routes, among people who are working and caring for these animals, raising them, selling them, trading them, and in human populations around the world.

00:34:43

There are many known pathogens that are zoonotic, that spill over from animals to humans, that have epidemic and pandemic potential that we are trying to improve surveillance on across the world so that we have better detection capacities, which include surveillance in communities and on farms. It includes improving lab detection capacities around the world, working, improving not only human labs but vet labs around the world and in partnership to ensure that the right samples from animals and humans go to the right labs, have the right types of laboratory assays to detect the known pathogens, as well as look for new ones.

It also links to sequencing, one of the earlier questions around sequencing and building that capacity. So much effort around the world has been focused on increasing sequencing capacities around the world and there is the threat that that will decline over time, which is why it is such a major focus for WHO and our partner agencies. We’ve launched a ten-year strategy to improve genomic sequencing for pathogens with epidemic and pandemic potential. This is in an effort to enhance the detection and assessment capabilities in animals and in humans.

So, for us it’s a partnership. We work with ministries of health, we work with ministries of agriculture, ministries of the environment across the different sectors so that we have a much more holistic, One Health approach to understanding these pathogens, but our work continues.

00:36:15

Any time that we detect a new pathogen or we have an outbreak or prevent an outbreak from happening our work doesn’t stop. It is something that is a constant and needs constant investment, constant nurturing over time. So, thank you very much for that question. I think it’s important that we highlight the work of our partners in the animal sector, that they also have the financing, that they have the structures in place, that they have the workforce.

There are many incredible village vet workers that are in countries, that are looking for changes in animal mortality, for example, and have those triggers to say this is a little bit unusual, let me trigger some action on our part to see if this is something, indeed, that’s unusual, but for us it is about partnership with that animal sector.

MR         Just to add, the partnership between the four agencies, WHO, FOA, OIE and United Nations Environment Programme is extremely important. It has been expanded recently to include UNEP. So, there’s a huge amount of work planned and underway by the four organisations as part of a One Health initiative in-house, but also over the years we’ve been working very closely.

The question you specifically asked us, what is WHO doing to work with those agencies? The International Health Regulations that you’ve probably heard ad nauseam here for the last 2.5 years, we speak about the IHR and the Emergency Committee. Under the IHR, that is the legal obligations of countries under the public health system.

00:37:49

There’s another system that the OIE, the Office of the World Organisation for Animal Health, have called the Performance of Veterinary Services pathway, which is a pathway for strengthening capacities in veterinary systems. We have been working with OIE and FAO on running what we call bridging workshops all over the world in all six regions in which we have multi-day workshops with the veterinary teams and the public health teams at the national and subnational level to work on exactly these issues.

How do we make these two systems work together? Because that’s the practical issue. We can talk about the importance of the issue, we can talk about the science needed and surveillance needed, but unless these two critical services at national level work together from the ground up with communities and all the way through to national policy, then we won’t make progress. So, we are working very hard. We understand the challenges, as Maria has so well outlined, but this is something that WHO is fiercely committed to, as are our partner agencies in this regard.

TJ           Thank you, Dr Ryan, and thank you, Dr Van Kerkhove, for answering this question from Observer Times, India. With this, we will conclude today’s press conference. Later tonight, we will send you audio and video material, and then we look forward to seeing you next time. Dr Tedros had to leave us, so I will wish you a very nice evening and we’ll see you next time for WHO regular press briefing.

00:39:22