COVID-19, Ukraine & Other Global Health Emergencies Virtual Press conference transcript - 16 March 2022
Overview
00:00:58
CL Hello
and welcome to WHO. It is Wednesday, 16 March 2022, and you’re joined for
today’s virtual press conference on COVID-19, the war in Ukraine, and other
global health emergencies. We have simultaneous interpretation available in six
official UN languages, Arabic, Chinese, French, English, Spanish and Russian,
as well as Portuguese and Hindi.
Now, let me introduce the quite strong panel
today. First and foremost, we have Dr Tedros Adhanom Ghebreyesus, WHO
Director-General, and Dr Mike Ryan, Executive Director for WHO’s Health
Emergencies Programme. On the more COVID side, we have Dr Maria Van Kerkhove,
Technical Lead on COVID-19. Dr Bruce Aylward will join us shortly. He’s Senior
Advisor to the Director-General and the Lead on the ACT Accelerator. We have Dr
Kate O’Brien, Director of Immunisation, Vaccines and Biologicals.
00:01:56
On the health emergencies for Ukraine we have Dr
Socé Fall, Assistant Director-General for the Emergencies Response, Dr Adelheid
Marschang, Senior Emergency Officer at the Emergencies Programme, and Dr Flavio
Salio, he’s the Network Lead for the Emergency Medical Teams, the EMT Network
Leader at WHO. Last but not least, joining us remotely is Dr Mariângela Simão,
Assistant Director-General for Access to Medicines and Health Products. With
this, again welcome, and let me hand to the Director-General for the opening
remarks.
TAG Thank
you. Thank you, Christian. Good morning, good afternoon and good evening. After
several weeks of declines, reported cases of COVID-19 are once again increasing
globally, especially in parts of Asia. These increases are occurring despite
reductions in testing in some countries, which means the cases we are seeing
are just the tip of the iceberg, and we know that when cases increase, so do
deaths.
Continued local outbreaks and surges are to be
expected, particularly in areas where measures to prevent transmission have
been lifted. However, there are unacceptably high levels of mortality in many
countries, especially where vaccination levels are low among susceptible
populations. Each country is facing a different situation with different
challenges but the pandemic is not over. I repeat, the pandemic is not over.
00:03:52
We call on all countries to remain vigilant, continue
to vaccinate, test, sequence, provide early care for patients, and apply
common-sense public health measures to protect health workers and the public. We continue to call on everyone to be
vaccinated, where vaccines are available, and we continue to work night and day
to expand access to vaccines everywhere.
Now, to Ukraine. WHO’s priority remains to
support health workers and the health system to continue to provide care to
meet immediate health needs. We have now
established supply lines to many cities of Ukraine but challenges with access
remain.
So far, we have sent about 100 metric tonnes of
supplies, including oxygen, insulin, surgical supplies, anaesthetics, and blood
transfusion kits. Other equipment,
including oxygen generators, electrical generators, defibrillators and more
have also been delivered and we are preparing to send a further 108 metric
tonnes.
We are coordinating the deployment of 20
Emergency Medical Teams of experts from many countries, pending a formal
request for assistance from Ukraine’s Ministry of Health, and we have opened a
field office in Poland to support our operations in Ukraine and to coordinate
the response to the health needs of refugees.
00:05:35
But, we are facing financial constraints in our
ability to deliver the support needed. So far, WHO has received just eight
million US dollars of our appeal for $57.5 million. Huge amounts of money are
being spent on weapons. We ask donors to invest in ensuring that civilians in
Ukraine and refugees receive the care they need.
And we continue to call for attacks on
healthcare to stop. More than 300 health facilities are along conflict lines or
in areas that Russia now controls and a further 600 facilities are within ten
kilometres of the conflict line. Since the beginning of the war in Ukraine, WHO
has verified 43 attacks on healthcare. WHO condemns all attacks on healthcare,
wherever they occur.
Tragically, Ukraine is not the only place where
patients, health workers, facilities, infrastructure and supply are under
attack. 2022 is only 75 days old but
already WHO has verified 89 attacks on healthcare around the world, in
Afghanistan, Burkina Faso, the Democratic Republic of the Congo, Libya,
Nigeria, the occupied Palestinian territory, Sudan, the Syrian Arab Republic,
and, of course, Ukraine.
Altogether, these attacks have injured 53 people
and killed 35, including health workers. That includes eight polio health
workers who were killed in Afghanistan last month. Attacks on healthcare not
only endanger lives, they deprive people of urgently needed care and break
already strained health systems.
Although Ukraine is the focus of the world’s
attention, it is far from the only crisis to which WHO is responding. In Yemen, roughly two-thirds of the
population, more than 20 million people, are estimated to be in need of health
assistance. In Afghanistan, more than half the population is in need, with
widespread malnutrition and a surge in measles, among many other challenges.
00:08:20
And, in Ethiopia, 6 million people in Tigray
have been under blockade by Ethiopian and Eritrean forces for almost 500 days,
sealed off from the outside world. There is almost no fuel, no cash and no
communications. No food aid has been delivered since the middle of December. 83%
of the population is food insecure. Our partners are running out of what little
food they have and the fuel to transport it.
About three-quarters of health facilities
assessed by WHO have been damaged or destroyed. In February, WHO airlifted more
than 33 metric tonnes of medicines and other supplies to Tigray, enough for 300,000
people, the first time we have been able to deliver supplies since July last
year.
In the past two weeks, WHO and our partners have
distributed supplies to 65 health facilities in Tigray, but much more is needed
and we are now preparing to send an additional 95 metric tonnes of supplies,
but no permission has been given yet.
We estimate that 2,200 metric tons of emergency
health supplies are needed to respond to urgent health needs in Tigray. Only
117 metric tonnes have been delivered, less than 1% of what is needed, but with
no fuel, even if we can get supplies in, getting them to where they need to go
is very difficult, or impossible.
00:10:02
The humanitarian situation in the neighbouring
Afar region also continues to deteriorate, with tens of thousands of people
displaced and in need of food, shelter and health services. But, while the
neighbouring regions of Afar and Amhara are also affected, we have had far better
access to those two regions than we have in Tigray.
What’s the impact of all this? People are dying.
There is no treatment for 46,000 people who need treatment for HIV and the
programme has been abandoned. People with tuberculosis, hypertension, diabetes
and cancer are also not being treated, and may have died.
As a result of the lack of fuel, some of our
partners are having to scale back their operations. The situation in Tigray is
catastrophic. The blockade on communications, including on journalists being
able to report from Tigray, means it remains a forgotten crisis, out of sight
and out of mind.
Yes, I am from Tigray, and this crisis affects
me, my family and my friends very personally but, as the Director-General of
WHO, I have a duty to protect and promote health wherever it is under threat
and there is nowhere on earth where the health of millions of people is more
under threat than in Tigray.
Just as we continue to call on Russia to make
peace in Ukraine, so we continue to call on Ethiopia and Eritrea to end the
blockade, the siege and allow safe access for humanitarian supplies and workers
to save lives. Peace is the only solution in Ukraine, Yemen, Afghanistan, and
Ethiopia. Christian, back to you.
00:12:21
CL Thank
you very much, Dr Tedros. Let me now open the floor to questions from the
media. To get into the queue to ask questions, you need to raise your hand
using the Raise your Hand icon on your screen, and do not forget to unmute
yourself when called upon. We’ll start with Corinne Gretler, from Bloomberg.
Corinne, please unmute yourself.
CG Hi.
Thank you. I’ve a question for Kate. I wanted to ask about Medicago’s COVID
vaccine, Covifenz. I see that its EOI has not been accepted. Would you be able
to help me understand what that means, exactly. Does that mean that Covifenz
will not be considered for EUL evaluation at all?
Then, also why? Is that perhaps because of the
tobacco link with Philip Morris, just because I know that there are some strict
rules around tobacco cooperation with the FCTC or if there is another reason? I
just want to understand what that means, basically, and whether Medicago can
appeal that decision at all. And, sorry, just a super quick add-on. Has the war
in Ukraine affected the WHO’s approval process of the Sputnik vaccine in any
way? Thank you so much.
CL Thank
you very much, Corinne. I think we’ll first go to Dr Mariângela Simão,
Assistant Director-General for Access to Medicines and Health Products. Mariângela,
please go ahead.
00:14:00
MS Thank
you, Corinne, for the two questions, actually. First, on the Medicago. You know
that Medicago has applied for an Emergency Use Listing by WHO but due to its
connections, it is partially owned by Philip Morris International, the process
is put on hold because it is well-known that WHO and UN have a very strict
policy regarding engagement with the tobacco and arms industries. So, the
process is put on hold. It is very likely that it won’t be accepted for
Emergency Use Listing by WHO.
On the Sputnik, yes, we were supposed to go do
inspections in Russia starting on 7 March and these inspections were postponed
for a later date. So, the assessment and local inspections have been affected
because of the situation and even the situation regarding flight options and
also the financial issues related to support of credit cards and some more
operational issues. This is being discussed with the Russian applicants and new
dates will be set as soon as possible. Thank you.
CL Thank
you very much, Mariângela. The next question goes to Isabel Saco, from EFE.
Isabel, please unmute yourself. Isabel, do you hear us? Please, unmute
yourself. Yes, you’re good. Please, go ahead.
IS Hello.
Do you hear me?
CL Yes,
we do.
IS Hello.
Sorry.
CL It
seems like Isabel doesn’t hear us. We’ll give it a second to see if we can fix
the connection. If not, then we’ll first go to Ashvin, from the Observer Times
of India, and we’ll come to Isabel in a moment when you have fixed that. So,
Ashvin, Observer Times, India. Please, unmute yourself.
00:16:36
AB Thank
you for considering my question. My question is, is cDNA microarray technology
useful to get ideal vaccine characteristics for COVID-19 disease? Thank you.
CL Ashvin,
can you please repeat? We’re not sure we got the full question.
AB Is
cDNA microarray technology useful to get ideal vaccine characteristics for
COVID-19 disease? Thank you.
CL Thank
you very much. I’ll go to Dr Kate O’Brien for a start, please.
KO The
question of the composition of vaccines and the technology to be able to
determine that composition is still really an open matter for research and
evaluation of vaccines. As you know, we have a number of different platforms of
vaccines. Some of them are based on the virus itself, some of them are based on
either RNA or DNA sequences of components of the virus. So, there’s no one
technology that is the ideal technology or the critical way forward.
I think the important part of this is this is an
area of science that has been evolving very, very quickly over the past year
and importantly contributing not only to the development of very effective
COVID vaccines but also deploying that technology towards other vaccines.
00:18:16
cDNA microarray technology is not something
specific that we’re focused on as that particular technology. I really want to
emphasise the range of options on vaccines. Those ones that have achieved WHO
EUL have all delivered on the protection against especially the severe end of
the disease spectrum. Thank you.
CL Thank
you very much, Dr O’Brien. We’ll try for a moment to come to Isabel Saco, from
EFE. Isabel, let’s try again. Isabel, if you hear us, please unmute yourself.
IS Yes.
Shall I do it again?
CL Yes,
please go ahead. Sorry, we’ll have to cut that again and maybe try again later.
In the meantime, we go to Manas Mishra, from Reuters. Manas, please unmute
yourself.
MM Thank
you for taking my question. I’m just wondering what is causing the rise in
infections again? Are we about to face a new wave?
CL What
is causing the rise in? We got it. Thank you very much. Dr Maria Van Kerkhove,
please.
MK Thanks
for the question. It’s a combination of factors for which we’re seeing an
increase in case detections again around the world. In the last week we saw an
8% increase in cases detected, with more than 11 million cases reported to WHO,
and this is despite a significant reduction in testing that’s occurring
worldwide.
00:20:01
So, it’s a combination of factors that is
resulting in this increase. First, is we still have Omicron, which is
transmitting at a very intense level around the world. We have sublineages of
Omicron, BA.1 and BA.2. BA.2 is more transmissible than BA.1 even and this is
the most transmissible variant we have seen of the SARS-CoV-2 virus to date.
In the context of lifting of public health and
social measures, lifting of the use of masks, lifting of physical distancing,
lifting of restrictions of limiting people’s movement, this will provide the
virus an opportunity to spread. We have also incomplete vaccination coverage in
many parts of the world and, in particular, among people who are at risk of
developing severe disease.
And we have huge amounts of misinformation out
there, the misinformation that Omicron is mild, misinformation that the
pandemic is over, misinformation that this is the last variant that we will
have to deal with. This is really causing a lot of confusion that’s out there.
So, we are seeing increases in case detection
around the world for a number of reasons. These are the same factors that have
been driving transmission of this virus since the beginning of the pandemic. We
completely understand that the world needs to move on from COVID-19, wants to
move on from COVID-19, but this virus spreads very efficiently between people
and if we don’t have the right interventions on place, the virus will take
opportunities to continue to spread, and the more the virus spreads, the more
opportunities it has to change. So, it’s
a number of factors.
00:21:48
The good news is that we have the tools that can
reduce the spread. We know that masking works. We know that physical distancing
works. We know that vaccination saves lives. So, we need to continue, as the DG
said in his speech just now and as the Director-General has been saying since
the beginning of this pandemic, it’s about a layered approach and using these
tools most effectively and making sure that we not only save lives with vaccination,
earlier clinical care, good testing, but we also take measures to reduce the
risk.
So, we are concerned that we’re starting to see
an increase in case detection again and, again, it is within our control. We do
have some power over being able to limit the spread and we really need to
remain vigilant and do what we can, where we can, to reduce the spread.
MR I
will just maybe add to that point because I think when we look at these data
and deep into them, when we look at the hospitalisations and deaths, again the
overwhelming majority of people who are getting very sick and dying are
vulnerable individuals, older individuals, people with underlying conditions
who have not been vaccinated or have not received a full course of effective
vaccines.
And we again need to restate the importance in
every country. This is not just a North-South issue. Every single country needs
to look again at vaccine levels in its most vulnerable, whether it’s using
booster policies or not, and ensure at the very minimum that every individual
who is vulnerable has two doses of effective vaccine and in situations where
boosters are available and policy is in place, as well.
00:23:29
Because I think we’ll see this virus is still,
as Maria said, very fit. It’s still moving around quite easily and, in the
context of waning immunity and the fact that vaccines don’t work perfectly
against infection, the likelihood is that this virus will echo around the
world. It’ll be high in some parts and in sometimes it’ll move and be higher
again. It’ll move to another area where immunity is waning.
The virus will pick up pockets of susceptibility
and will survive in those pockets for months and months until another pocket of
susceptibility opens up. This is how viruses work. They establish themselves
within a community and they’ll move quickly to the next community if it is
unprotected.
What can happen is if communities around a virus
are well-protected, the virus can sustain itself even in small communities. It
can stay there, it can rest there and then wait until susceptibility grows in
other communities. We’ve seen this, I’m looking at Bruce, in polio, in other
places.
So, I do think it’s very important that we
recognise that the transmission of this disease will occur. It will wax and it
will wane. It has not settled down into a purely seasonal or predictable
pattern yet.
00:24:46
The idea that we’re through in the Northern
Hemisphere now and we’ve got to wait till next winter, I think when we look at
increasing rates, for example, of cases and deaths in the likes of the UK, I
think we need to be very, very vigilant. We need to very cautious and we need
to watch this very carefully and we need to focus on getting the most
vulnerable appropriately vaccinated and we need to do that as quickly as possible
in every country.
CL Thank
you very much, Dr Ryan. The next question goes to Lizzy Davies, from The
Guardian. Lizzy, please unmute yourself.
LD Hi.
Thanks for taking my question. I’d like to know if you could give any more
detail about the 43 attacks on healthcare in Ukraine, specifically what kind of
establishments you’re talking about when you talk about healthcare? Where have
most of the attacks taken place? Are you able to give any geographic
information? And do you also have any information on how many healthcare
workers in Ukraine have been injured or even killed in the same time period?
Thank you.
CL Thank
you very much. We’ll start with Dr Socé Fall, Assistant Director-General for
the Emergencies Programme, in response.
SF Thank
you very much, Christian. I believe that the attacks on the healthcare
structures have been increasing day by day. It’s likely that by the end of
today or by tomorrow there will be more and larger ones. The geographic
distribution of them is varied. There are some of them occurring in zones that
are under Russian control already and some that are not yet under Russian
control.
00:26:43
The specific location matters less. The goal is
to protect the population and to protect the health institutions, as well as
the healthcare workers who must be protected. That is why we, without being
able to say specifically who is behind these attacks, we feel that it is very
important that all forces involved keep in mind the need to have working
healthcare, particularly for the populations, for elderly, for example, who
cannot travel or move about easily, and we must do everything we can to protect
those vulnerable populations, those vulnerable groups. All parties must respect
this international humanitarian law, which is to protect the healthcare workers
and protect life. Thank you.
MR Thank
you, Socé. I think it’s
imporant to reflect here and the DG referred to this, we’re only a very short
part into this year and we have never seen globally, never seen this rate of attacks
on healthcare. Health is becoming a target in these situaitons. It’s becoming
part of the strategy and tactics of war. It is entirely, entirely unaccepable.
It is against
international humanitarian law and, in fact, under international humanitarian
law conflicting parties are actually instructed to specifically take measures
to avoid attacking or inadvertently destroying or hurting health workers or
health facilities.
They don’t bear a
responsibiity to just not attack, they actually bear a responsibility to ensure
that they don’t attack, to identify those facilities, to deconflict those
facilities and to ensure that they do not, as part of their prosecution of war,
attack those facilities. So, it is not only against international humanitarian
law to carry out attacks like this, it is actually in the responsibility of all
parties, and I might weigh all parties in conflict, to do so.
00:28:50
We are, as the DG
again has said, working very hard with many partners to get emergency medical
teams on the ground but how can we put emergency medical teams on the ground if
the very facilities that they may want to go and support are going to be
attacked and going to be bombed and going to suffer catastrophic damage?
This crisis is
reaching a point where the health system in Ukraine is teetering on the brink.
It is doing exceptionally well. It needs to be supported. It needs to be shored
up. It needs to be given the basic tools to save lives. Part of that is
deploying teams in to support that. But, how can you do that in all conscience
if the very infrastructure that those people will go in to support is being
under direct attack?
Flavio Salio is back
from leading our EMT initiatives in Ukraine and maybe Flavio would like to
comment on this but this issue is more imporant than bricks and mortar. This
isn’t just about the destruction of buildings. This is about the destruction of
hope. This is about taking away the very thing that gives people the reason to
live, the fact that their families can be taken care of, that they can be cured
if tehy’re sick, that they can be treated if they’re injured.
This is the most basic
of human rights and it is being directly denied to people and we are then in a
position where we can’t send assistance to those people becasue the very act of
attacking those facilities or not taking care to avoid those facilities means
we can’t sent the appropriate help when it’s needed. Flavio.
00:30:25
FS Thanks, Dr Ryan. Yes, it becoming, for
sure, a challenge to ensure the right level of support reaches facilities. We
have been in touch with the hospitals requesting support, in particularly
specialised care, where basically an external medical team can bring the added
value and support the local sysem.
The challenge remains,
obviously, safety of the staff, safety as well of the patients themselves. It has
become, today, the most challenging point at this stage. There is, as well, a
signficant component that includes evacuation of patients from the areas which
are targeted, patients that obivously suffer from chronic conditions and do
require support.
So, there is an
ongoing evaluation of the system that can facilitate medical evacuation towards
the borders and then, obviously, across facilities in Europe that will
accommodate them. As a last point, I think maintaining the capacity through
temporary facilities could be other options but is challenged by the element
that Dr Ryan described in terms of the conflictions as well and ensuring that
if you bring such kind of capacity, it is recognised by, obviously, the parties
to the conflict. Thanks.
00:31:52
CL Thanks very much, all, for these
explanations. The next question goes to Sarah Newey, from The Telegraph. Sarah,
please unmute yourself.
SN Hi, there. Two quick questions, if
that’s okay. Firstly, you’ve talked a lot about the risk of COVID spreading in
Ukraine and other infectious diseases. Obviously, as Mike has just said, the
health system is struggling but do you have any evidence of increasing COVID
cases, or measles, or TB as people flee? Secondy, probably for Maria, could you
just tell us a bit more about the global spread of BA.2 and is there any
evidence that it is more severe or more likely to evade vaccines? Thank you.
CL We’ll start with the emergencies
question on Ukraine, on the diseases and the situation there. Dr Marschang,
please.
AM Thank you. We have stated prevoiusly
that the COVID-19 surveillance system in Ukraine is holding, is strong, is
detecting cases. We see at the same time that the testing has decreased. Still
we have captured now, I think, something like more than 30,000 new cases and
we’re trying to place that. If anything, it indicates an increase, this is
something that we have suspected, but we also need to say there is a decreasing
in access and capacity to deal with these cases.
We do understand that
between 23 February to 8 March, there was a 22% decrease in the number of beds
available with oxygen, for example, and a 20% decrease in the number of
intensive beds when they are most needed for some of those health risks that we
have pointed out previously, and that is trauma and injuries and an increase in
acute conditions due to non-communicable diseases that we have already pointed
out.
00:34:03
CL Thank you very much, Dr Marschang. Dr Socé
Fall, please.
SF Thank you, Christian. Just to add one
point on the risk of increased communicable diseases. It’s a real risk and
there’s a risk of COVID-19 due to the movement of population and a low level of
vaccination for two doses and the fact that people are gathering together, that
increases the risk of COVID. The level of testing is very low currently and we
will have to face that. If we combine that with the problem of providing oxygen
for serious cases, it is really a recipe for disaster.
There’s also a risk
for children, children who can’t receive their vaccinations for rubella or
measles. There’s a risk of outbreaks. There’s a lack of access to potable water
and then they face the risk of dysentery and other waterborne illnesses.
There’s already a high number of patients being treated for HIV and tuberculosis.
If their treatment is interrupted, it obviously worsens the risk of
transmission and the antimicrobial resistence of diseases themselves. Thank
you.
CL Thank you very much, Dr Fall. We turn
to the COVID part of the question from Dr Van Kerkhove.
MK Thanks, Sarah, for the question about
BA.2. In the last 30 days of the more than 400,000 sequences with sample dates,
in the last 30 days, 99.9% of those have been Omicron and, among those, about
75% of those are BA.2 compared to BA.1. About 25% are BA.1. Let me say that
again. Of the sequences that are available, about 75% are BA.2 and 25% of those
are BA.1. All of these are Omicron and all of these are variants of concern.
00:36:20
We are seeing an
increase in the proportion of BA.2 that is detected. However, the amount of
testing that is happening worldwide, as we have mentioned previously, is
dropping substantially. Our ability to track this virus, our ability to track
BA.2 is compromised because testing is reduced and you can’t sequence those who
you don’t test.
So, we need a very
strong surveillance system around the world for COVID-19. Despite all of the
challenges that we are facing, we still need to maintain testing, we still need
to maintain robust sequencing and making sure that we have good geographic
representation of the sequences that are shared so that we can really track
this virus in real time.
We, as WHO, are
working with literally thousands of public health professionals and scientists
around the world to be able to track virus evolution and look at what these
changes mean in terms of our ability to control the spread or reduce the
spread, our ability to use tools effectively and, of course, to look at the use
of vaccines.
We should say that
COVID-19 vaccines remain incredibly effective at preventing severe disease and
death, including against Omicron. You asked a question specifically about
severity. We do know that Omicron is less severe compared to Delta. We do not
see changes in severity of BA.2 compared to BA.1 at population levels.
00:37:51
However, with huge
numbers of cases you will see an increase in hospitalisations and we’ve seen
this in country after country. The sheer volume of cases that we have seen has
really translated into increased hospitalisations and that, in turn, has
translated into increased deaths.
What we can say when
we look at deaths in countries around the world, as Mike pointed out earlier,
as the DG has pointed out, the deaths are primarily occuring in people who are
not vaccinated or people who have only had one dose of vaccine. So, it is absolutely
critical that people receive vaccines around the world in all countries and, in
particular, people who are at risk of developing severe disease.
If you look at some
countries right now that are experiencing high amounts of mortality compared to
previous waves, look at the proportion of those populations that have actually
received the vaccines and look, in particular, how many above the age of 60,
those who have underlying conditions, who have received vaccines, in fact in a
lot of those countries that proportion is quite low.
So, it is really
critical not just to vaccinate but to ensure that those who are at most risk
receive the vaccines first because the vaccines are saving lives. We cannot
stress this enough. It is really important that we keep up the systems that
have been put in place for COVID for strong surveillance, strong testing,
getting the patients into the clinical pathway early, increase vaccination.
00:39:25
It’s this layered
approach that is really going to help us get a handle on COVID-19 and we have
the power right now to take the death and devastation out of COVID, but we have
to make sure that vaccines are received by all people and particularly those
who are most at risk in all countries.
CL Thank you very much, Dr Van Kerkhove.
We managed to reach Isabel Saco, from EFE, in writing. As we’re already talking
about BA.1 and BA.2, I’m going to read out the question she has on that. What
do you know about the new supposed varient combining BA.1 and BA.2? Where has
it been identified and is it a source of concern?
MK I’ll take a stab at that question. I’m
not aware of a combination of BA.1 and BA.2. You may be referring to the
recombinant that we mentioned last week, which was a combination of AY.4, which
is Delta, and BA.1, which is Omicron. That has been detected in three countries
and it is a very low level of circulation, as we are aware, but not aware of a
combination of BA.1 and BA.2. These are sublineages of Omicron. Again, BA.1 and
BA.2 are Omicron and they are already classified as variants of concern.
MR Can we we just add, so that is it not
misunderstood, as well. Those sublineages can co-circulate. It’s not that there
is a combined virus. What you have is multiple versions of the virus
circulating at the same time and, depending on the situation, one can gain the
upper hand over the other and it depends sometimes on just when it arrived.
00:41:06
So, for example, the
predominance of BA.2 in many Asian countries, it may be that BA.2 emerged
slightly later and has driven the ongoing
surge in Asia but there’s still BA.1, there’s still other variants and
lineages causing disease. So, it’s not a combination of both, as in one virus, but
a combined effect of both, when they’re both transmitting.
CL Thank you very much. Both very
important explanations. The next question goes to Bianca Rothier, from Globo,
Brazil. Bianca, please unmute yourself.
BR Hi, Christian. Thanks a lot for taking
my question. In fact, it’s a follow-up on Isabel Saco’s question because Brazil
said the country has now two cases of this Deltacron. They are calling it
Deltacron. So, I’m not sure if I understood the answer because there they are
saying that it is AY.4/BA.1. If you can explain better and if you have
information about this. Thanks a lot.
CL All right, let’s go and get an explanation
from Dr Van Kerkhove.
MK Thank you. This recombinant is a
combination of AY.4, which is Delta, a sublineage of Delta, and BA.1, which is
a sublineage of Omicron, and this redcombinant had been detected in a number of
countries. I mentioned three countries and you’ve just mentioned Brazil.
Now, as we look more,
as we do more sequencing, it is possible that his recombinant virus will be
detected in other countries but is circulating, as we understand, at very low
levels.
00:43:06
But, as I also mentioned,
given our lack of testing and reduced testing around the world, we are at a
disadvantage of being able to track this virus as effectively as we should,
given the amount of testing that is possible at a global level, given the
enhancements of sequencing that have occured in the last two years. So, it is
really imporant that we maintain this.
We’ve mentioned
prevoiusly that as this virus circulates, the more the virus circulates, the
more opportunities it has to change. The possibility of recombinants has always
been on the table and we are able to detect these recombinants now with good
sequencing around the world. So, what I’ve mentioned and what you’ve mentioned
is this recombinant of Delta and Omicron. We’re not calling this Deltacron,
that is not terminology that we are using, but we have detected this variant.
MR Maybe, just a way of explaining to
people, what we very often see with viruses is a form of what is known as antigenic
drift. In other words, a virus enters the human body and it effecively evolves.
The virus that is transmitted on is slightly different because as the virus
divides, as the virus reproduces itself, there are errors in reproducing its
code. Most of those errors result in a virus that is either not competent or
just dies away, and just occasionally that virus that’s passed on has an
advantage in transmission or an advantage.
It’s just evolution in
action. The same virus going into a body, coming out slightly different. That’s
called drift and over time that can generate new variants over a long number of
transmissions between hundreds and hundreds of different people.
00:44:52
Recombination occurs
when two viruses infect the same person or the same animal and what you then
have is not just errors in transcription, what you have is effectively two
viruses can exchange large amounts of genetic information and you effectively
get a new virus out the other end. Most of those viruses, because of the huge
change in the code, are not viable, they’re not competent, they’re not very good
at infecting the next human, but just occasionally they are.
That is how we
generate pandemics of influenza, it’s through viral recombination. It’s called
antigenic shift versus antigenic drift. Very often recombination is the way in
which we get pandemics of influenza. So, we have to be very cautious, as Maria
says.
We have to watch these
recombinant events very, very closely and, again, we’re back to the argument.
The best way to do that is to track the virus. The best way to do that is to
ensure that people, number one, are vaccinated, that people who get the disease
are treated and don’t have prolonged infections, and that we prevent and manage
the reverse infection of large animal groups to allow that kind of recombination
to happen. We can manage many of these risks but the risk will continue and
there needs to be monitoring of that risk and it needs to go on for a very long
time.
00:46:14
CL Fantastic. I think there’s a
clarification, maybe, on the question whether people can be infected with both
variants at the same time.
MK I think that was the clarification. It
was not whether or not there was a recombinant of BA.1 and BA.2, it was whether
or not people can be infected with two viruses at the same time. So, yes,
thanks for that clarification and Mike clarified that, as well. Yes, there are
viruses that are circulating, as we’ve said. We have BA.1 circulating, we have
BA.2 circulating and, if you remember, even in Europe, when Omicron was first
detected, we had huge amounts of Delta that were circulating. So, it is
possible.
But, again, this is
why we need to be able to test individuals. This is why we need to be able to
continue to do this sequencing. We are still learning about this virus. We do
not have all of the answers about this virus. What we do have answers to, we do
have tools that can actually limit the spread and this is what people out there
need to understand to be able to be empowered, to be able to do what they can
to prevent yourself getting infected and to spread the virus to someone else,
to get vaccinated when it is your turn and to fight for vaccine equity around
the world.
CL Thank you very much. Very important
clarfications and explanations. Now, with this, we reached the end of our time
today. I thank you all very much for your participation online and, of course,
here in the room. We will be sending the audio file and Dr Tedros’ remarks
right after the press conference, and the full transcript will again be posted
on the WHO website tomorrow morning. For any follow-ups please write to Media
Inquiries. Now, back to Dr Tedros for the closing remarks.
TAG Thank you. Thank you, Christian, and
thank you also to all members of the press who joined us today, and see you
next time.