COVID-19 Virtual Press conference transcript - 19 October 2020
Overview
COVID-19
Virtual Press conference
19 October 2020
Speaker key:
FC Fadela Chaib
TAG Dr Tedros Adhanom Ghebreyesus
KS Kim Sledge
NM Natasha Mudhar
NA Naomi
SO Sophie
MR Dr Mike Ryan
MK Dr Maria Van Kerkhove
PE Peter
SH Shen
00:00:20
FC Hello, everybody. This is Fadela Chaib speaking to you from WHO headquarters in Geneva and welcoming you to our COVID-19 press conference today, Monday, 19th October and happy to moderate this press conference.
Today we have the privilege to welcome some very special guests remotely that Dr Tedros will introduce. In the room joining Dr Tedros we have Dr Mike Ryan, Executive Director, Health Emergencies, Dr Maria Van Kerkhove, Technical Lead, COVID-19, Dr Soumya Swaminathan, Chief Scientist, Dr Mariangela Simao, Assistant Director-General, Access to Medicines and Health Products. Now without further ado I would like to hand over to Dr Tedros to introduce our guest and give his opening speech. Dr Tedros, you have the floor.
Thank you. Thank you, Fadela. Good morning, good afternoon and good evening. I want to start the week off on a happy note. I'm delighted to announce that WHO has the honour of working with Kim Sledge of the legendary group Sister Sledge and Natasha Modhar, founder of The World We Want organisation.
Together we're ready, today announcing the start of a new We Are Family campaign to promote global solidarity and collaboration in the face of COVID. We Are Family is a global anthem that calls for what the world needs most right now, solidarity, unity and collaboration, working together as a global family for the future. I would like to thank Kim Sledge for her kind offer to donate proceeds from the sale of her special edition cover of We Are Family to the WHO Foundation.
00:02:25
This is in support of the COVID-19 response and strengthening health services around the world. I would also like to announce that we will have the honour of having Kim Sledge sing We Are Family at the opening of the 73rd World Health Assembly which resumes on 9th November.
I now would like to introduce Kim Sledge and Natasha Modhart to describe the motivation for the We Are Family campaign and how it will work. Kim, the floor is yours.
KS Hello, Dr Tedros. What an honour it is to be here and hello other wonderful, privileged listening guests. I am so honoured to be here today. I am so grateful to be a part of this very, very real and sincere desire for the world to unite, particularly those here, you; your heart and your ways and your voice and what I've heard you say about how the world needs to be united and this is a solidarity effort for a global concern.
00:04:11
We all, every tribe, every tongue, every nation, every people have the banner of love over us and desire to bring us together in this world to fight the kinds of things that come against who we are and lifting our generations.
So a very, very dear friend of mine, Mr Lou Weisbach from Chicago, called me one day and he said, listen, I have in my heart the desire to have us come together to begin to fight this pandemic that is attacking our world.
He'd been working for something for quite a long time with this and he felt that We Are Family is the perfect song to bring the world together for this. I called my dear friend, Natasha Ladarm [?] from The World We Want in London and she said, Kim, that's an incredible idea, let's come together on this.
So we've come together here today with that privilege and that challenge to come against this, fight against it and I know together we are really strong and we can do this as a family because we are one big global family.
I am so excited and I'm so honoured and I am so taken in my heart to do whatever I can as humankind to bring our hearts together and fight this. There's a verse that my mom used to always say; she said, where there is unity the Lord commands a blessing. There is unity here and the blessing will be fighting against this and eventually one day this being wiped off our planet because it has no right to take the lives that have been taken.
00:06:02
Together with what we've been given in our gifts and what God has given us in terms of our desire to live and to preserve life I know we will win against this so I'm thanking you today for the honour of being here. I'm thanking you for where your heart is.
I'm thanking my friend Lou Weisbach for his esteemed work towards this for my dear, precious friend Natasha Modhar, who has pulled this all together. That's why I'm here. It's time to go for it. The banner over us is love and together we are unity strong because we are family. That's why I'm here!
TAG Thank you so much, Kim. That was really wonderful and uplifting.
KS Thank you.
TAG To quote you again, we are one big global family. That's what you said so thank you so much and then you also said, I know we will win.
00:07:21
KS Yes, we will.
TAG That's it so thank you so much indeed. I will add to that, together we will do it, we will win. Thank you so much, Kim. Much gratitude from all of us here and from those listening.
KS Dr Tedros, I wanted to say something to you real quick. I don't want to interrupt you but I wanted to say this; We are family, I've got Dr Tedros with me.
TAG We have been trying here also. You will listen to our product in a few minutes. I hope we have done our bit... Yes, thank you again. Now I would like to hand over to Natasha Mudhar of The World We Want. Natasha, you have the floor.
NM Thank you, sir. It's an absolute honour; absolutely humbled, privileged to have this opportunity to be speaking to everybody here on this panel today and to share a little bit more about our story of what We Are Family means for us and for this particular project.
As Kim said, it's been in the making for a few months now and I was asked earlier actually in another interview that we were doing, why now are you releasing this and why not in March and why not in April?
00:08:54
The reason why now is because the pandemic that we're all facing is as relevant today as it was five, six months ago and with our music videos that we're producing, which will come out towards the end of the year, we want it to be a real clarion call that this beautiful, real, global world family is coming together in unity, in solidarity not just in 2020 but also looking towards 2021 as well, to address any global health challenge that we ever face including and beyond the COVID pandemic.
What I absolutely love about the project that we've incepted with We Are Family and the new cover edition that Kim has beautifully created is the fact that the mission with the song is to make it be the most globally inclusive and diverse anthem for unity and solidarity as best we can.
By that I mean, yes, we are encouraging all of the biggest, most high-profile individuals in our world such as celebrities, public figures, prime ministers, presidents, everybody to be involved but this is really for everyone everywhere and that's why we are really encouraging the global public to join our efforts in unity and solidarity, to come on board, to record their videos of them lip-syncing to We Are Family and sharing those videos with us on social media, even on our website unitystrong.com, so we can actually include that in this very cool music video that we're putting together and bringing the whole world together in one music video.
I think the other thing I'd like to add is the fact that music, we all know, is such a powerful source of energy, comfort, so many memories attached to it as well but what is so powerful about music and what we will will be so powerful about this particular campaign; the song in the video is that it will not only just entertain but inspire action; inspire action insofar as encouraging everybody to be a lot more empathetic and I believe that's something that we really need in the world in the here and now and just really bringing everybody together.
FC Thank you. Thank you so much, Natasha. That's really great and I hope this will inspire action, as you rightly said, and we're very honoured to partner with you. Now back to you, I think, for the in-house video.
TAG Yes, thanks so much to our very special guests. Now back to Dr Tedros for his opening remarks to continue his speech. No, before that I think I will hand over to Paul Garwood, my colleague. He has something to add. Thank you.
00:12:07
PG Thank you, Fadela. I just very quickly would like to play a video, the WHO version, the teaser video for the We Are Family campaign.
[Video plays]
FC This was very interesting. Dr Tedros.
TAG Thank you very much and I hope, Kim, you enjoyed our version and look forward to hearing you on November 9th. Thank you so much for your partnership again. To the rest, to those who have had a chance to follow our conversation, I would like you to join us, Kim Sledge and Natasha in the new We Are Family campaign.
Now moving into the next, on Friday we discussed the worrying phase that the COVID-19 pandemic has entered. As the northern hemisphere enters winter we're seeing cases accelerate, particularly in Europe and North America. It's encouraging to see many leaders communicating with their populations about targeted measures that are needed to slow down the spread of the virus and protect health workers and health systems.
00:14:27
As cases go up the number of people needing beds in hospitals and intensive care also increases. Nurses and doctors have a much better understanding of how best to treat people with the virus than they did in the early days of the pandemic.
However when hospital capacity is reached and exceeded it's a very difficult and dangerous situation for both patients and health workers alike so it's important that all governments focus on the fundamentals that help to break the chains of transmission and save both lives and livelihoods.
This means active case finding, cluster investigations, isolating all cases, quarantining contacts, ensuring good clinical care, supporting and protecting health workers and protecting the vulnerable. We're in this for the long haul but there is hope that if we make smart choices together we can keep cases down, ensure essential health services continue and children can still go to school.
We all have a part to play. Physical distancing, mask wearing, hand hygiene, coughing safely into your arm, avoiding crowds and meeting people outside where possible and when you have to be inside with others open windows and ensure good ventilation with non-recirculating air.
00:16:04
I know there is a fatigue but the virus has shown that when we let our guard down it can surge back at break-neck speed and threaten hospitals and health systems. On 9th October I shared that 171 countries and economies were part of the GAVI, CEPI and WHO-led COVAX initiative for vaccine access.
I am pleased to announce today that now 184 countries have now joined COVAX. The most recent countries joining over the weekend are Ecuador and Uruguay. COVAX represents the largest portfolio of potential COVID-19 vaccines and the most effective way to share safe and effective vaccines equitably across the world.
Equitably sharing vaccines is the fastest way to safeguard high-risk communities, stabilise health systems and drive a truly global economic recovery. As winter comes we know that the next few months will be tough but by working together today and sharing life-saving health supplies globally including personal protective equipment, supplies of oxygen, dexamethasone and vaccines when they are proven to be safe and effective we can save lives and get through this pandemic.
00:17:34
As Kim said, we are one big global family. I thank you.
FC Thank you, Dr Tedros. Just to inform you, this press conference is being translated into the official UN languages; Arabic, Chinese, French, English, Spanish but I apologise; today we do not have a Russian translation but we have Portuguese and Hindi.
Now I will open the floor to questions from journalists. I remind you that you need to raise your hand, use the raise your hand function in order to get in the queue to ask your question. We will start with Naomi Thomas from CNN. I think you have a question.
NA Hello, can you hear me?
FC Yes, very well. Go ahead please.
NA Hi. My question's actually for Kim if she's still available.
00:18:43
KS She is. Go ahead.
NA I was hoping that she could share with us what she thinks the messaging and the lyrics of the song mean during the pandemic.
FC Kim, did you hear the question?
KS Thank you for your question. I will say first what it means is very personal to me because I have two members of my family, my husband and my daughter, who are physicians, who are on the front line so We Are Family already, the family words are about family but the world is a family and those words are calling us together as a family to embrace one another through this time.
I feel that the song itself is one that has been about solidarity. It's about what families do when there are times of crisis and that is come together, look out for each other, find ways to solve solutions that make the whole family strong and this world family will be much stronger as a world family as we embrace those words, as we attack and bring about what needs to happen to resolve anything that conflicts and causes a problem with our world family. So that's why We Are Family.
00:20:13
FC Thank you, Kim Sledge, for these very powerful words. I would like now to pass the floor to Sophie Mokwena from SABC South Africa. Sophie, can you hear me?
SO Yes, I can hear you. Dr Tedros pointed out that the numbers are growing. There are reports in South Africa that we are likely to see a second wave of the pandemic. I just want to find out from WHO, are you sensing that we are heading towards a second wave of COVID-19 and at a time when our Minister of Health, Dr William Kize, announced yesterday that he tested positive for COVID-19?
FC Yes, thank you, Sophie. Dr Ryan will take this question. Dr Ryan, you have the floor.
MR Sure, and our sympathies regarding that positive case again. We're always troubled to learn of COVID-19 in leaders especially given their need to lead but also for them and their families.
With regard to South Africa, South Africa is in a steady state. South Africa has come down off a very high level of transmission down to levels approaching earlier parts of the year and currently is, I think, reporting about 11,000 cases weekly, about 189 new cases per million population and very little change in either the number of cases or the rate of deaths so in that steady state...
00:22:08
And you've seen other countries in the northern hemisphere reach that steady state and then start to track back upwards and I think this is what we really need to try and avoid if we can, avoid that inexorable move towards more transmission.
When you look across Africa as a whole there's a mixed pattern. In general in the Continent the overall situation for sub-Saharan Africa for the WHO regional office for Africa is about 31,473 cases for the week, about 1.3% of new global cases and just over 1,000 deaths in the countries in our Afro region, representing 2.9% of new global deaths.
So you can see there the cases may certainly be under-reported; we don't believe the deaths to be as grossly under-reported and therefore Africa as a whole is still very, very low down on the impact side of COVID but the impacts in Africa are being generated by other losses, socio-economic and healthcare losses as well so Africa is suffering, development is suffering, society is suffering and making lots of sacrifices to keep this disease under control.
00:23:29
So yes, there is a chance and we do know from the emerging - and Maria may speak to the availability of seroprevalance data in Africa; it's patchy enough but again we're not seeing huge numbers and percentage of the population having history of exposure so there is still a long way for this pandemic to go in South Africa, in the rest of Africa but we do believe that the young age profile, the community focus of the interventions so far and the ability to do good case finding and contact tracing has helped African countries in stemming the worst of this so far.
But again we've seen countries do okay in the first wave and many countries may have just received a glancing blow and we don't know to what extent in some cases countries got it right and then in other cases countries were just a little bit luckier than others.
But what we're seeing now is the second wave; even if you look at Asia and south-east Asia; we're seeing countries that were very little affected in the first wave being more affected now and again in Africa we're seeing some countries that had very few cases in the first wave seeing more activity now than they saw before.
00:24:41
Therefore it's really, really hard to predict what the next wave holds for any country but what South Africa has done - and to its great credit - it has crushed that curve, it has saved a lot of lives, as many other countries have.
The real question now is the extra effort it's going to take to keep that number low, to keep pushing that number down and down and down relentlessly until you reach enough control so that other measures and restrictions on people's lives and livelihoods can be released and that the public health action linked to the community action is enough to keep this disease under control.
FC Thank you. I think Dr Van Kerkhove would like to supplement.
MK Yes, very briefly just to say that there is no inevitable second wave that needs to happen and I think that many countries which have - as Mike has pointed out - using the systems that are in place - and many countries in Africa are in this position where they have either prevented an outbreak from happening or have crushed the curve.
00:25:44
So there is no inevitable second wave that needs to happen because all of the systems that you have in place and South Africa has put in place, many countries across Africa, all the diverse countries that are there, that are using the system for active case finding, for isolation of cases, for quarantining of contacts, for using the testing system, the facilities that are in place, for getting rapid turn-around tests back as quickly as possible, for using the hospital systems that have been established for providing optimal clinical care; all of that will help prevent a second wave.
I think if there's one thing that we can say to everyone - and we've said this many times over the summer in the northern hemisphere and others - is use your time wisely. In the time that you have brought these outbreaks under control stay ready, prepare for more because there could be another wave and there's the global interconnected world that we continue to have.
The virus needs people, it needs clusters to transmit in and you could be prepared for that and I think one of the things we need to emphasise as much as we possibly can is the importance of the isolation of cases and quarantining of contacts.
00:27:02
You hear us say this over and over again but it might be worth mentioning that quarantining of contacts means that individuals ideally could be quarantined outside of their home but we know that that's not possible all over the world.
Quarantining at home for 14 days; that means not going to work, it means not going to the grocery store, it means not socialising with friends, it means not having people over at your home and people who are in quarantine need to be supported through that because of course they still need to make a living, they still need to provide food for their families.
So it's really important that those who are in quarantine, those who are isolated as cases and those who are in quarantine are supported through that period. This will break chains of transmission and without isolation of cases, without quarantining of contacts it will be incredibly impossible to do.
00:27:54
So really I think we just need to emphasise what that means and I've had a lot of questions over the last few days from family and friends about what quarantine actually means and I think it's just worth emphasising what we mean there.
But I wanted to just highlight that there is no inevitable second wave or next peak. It's within our control, it's within our hands as individuals but also with strong government leadership, clear national plans implemented with targeted, controlled measures at local levels we can prevent additional subsequent waves of this happening.
FC Thank you. I would like now to invite Gabriela Sotomayor from Proceso to ask the next question. Gabriela, can you hear me?
GS Yes. Hola, Fadela. Thank you for giving me the opportunity. I have a question regarding Europe and the cases that we are seeing in Europe and the numbers. What has gone wrong, what happened especially to prevent the dramatic scenario that we saw in March from happening again?
For example in China there are 5,000 deaths and in Europe we have a quarter of a million. In the United States it's 200,000. The contrast in numbers is impressive so does it have to do with the treatment they are giving to patients in China or in Asia? How can we avoid being in a dramatic scenario again?
00:29:37
MR I think that's an interesting and complex question with, I think, complex answers but if I can be simple it's not just China. Many countries in East Asia and many territories and health authorities and the health authorities in Japan, in South Korea, the health authorities on the China mainland and in Taiwan, in Singapore and in Australia have made huge progress against the disease and have managed to really crush that curve and keep it down and managed to sustain that through a very long time of low numbers.
Each country has achieved that in a slightly different way; there hasn't been a one size fits all. Each country has had to adapt its strategy to what its social contract is with its population, what its powers are under public health law, what the expectations of communities are, what the trade-offs are on the socio-economic side.
So you will see countries though had some elements, I think, that were very, very common in terms of being able to both crush and sustain. One, I think, was a focus on case detection, case isolation and especially quarantining of contacts, the continued quarantining and supporting those contacts in their quarantine, not just sending people home but supporting them in that process, physically supporting them, providing them with accommodation, providing them with food, providing them with social support.
00:31:18
If you think in any one time in a community transmission environment between one in 400 and one in 500 people may be actively positive for COVID-19 and for SARS-CoV2; if you imagine that one person is a case and they have ten contacts, if I isolate that case and quarantine those contacts that's 11 people who are affected by the measure as opposed to a lock-down which has four to 500 people affected by the measure.
The success that countries had in Asia was their ability to find those 11 people, find that case and those contacts, maybe not all those cases but enough cases to start breaking the chains and to continue doing that.
Second thing obviously; there is an advantage in Asia and again I think people in Asia, communities in Asia do have higher levels of trust and compliance in government and they've tended to be able to implement for longer some of the measures that have been required of them in terms of their own behaviour.
00:32:25
Thirdly I think - and Maria may comment on this - many of these countries had serious follow-through; once they got the numbers down they followed through, they didn't start reducing testing centres, they increased testing centres; they didn't start reducing clinical capacity, they increased clinical capacity.
In other words they ran through the finish line and beyond and they kept running because they knew the race wasn't over. That finish line was false. Too many countries have put an imaginary finishing line and when they crossed it may have decelerated some of their activities.
The countries in south Asia and the western Pacific that have been successful to my mind have really continued to follow through on those key activities.
The other thing many countries have done, I think, is had multiple measures. If you look at testing in places like Korea it's been very intensive, very deep testing at community level.
00:33:24
In Japan it's not been quite as intense but they've really focused on cluster investigation; they're focused on really breaking clusters and learning from those clusters what's driving super-spreading events in Japan.
So again there's no right answer, there's no one size fits all. Each of those successful countries has taken the tools, all of the tools and seen how it can apply those tools within its territory, within its social - and then it's followed through on those activities even when the numbers have got low.
It's managed to sustain their community commitment to those measures but because those countries have been able to open up again, because those measures now only affect small numbers of people, the case and the contacts, and the rest of life has got back to normal those people now have an advantage of being able to sustain the effort.
It's very tough for countries right now in Europe and North America, going back into another phase of potential lock-downs. People are exhausted, they are tired and it's not an easy situation that Europe faces or that North America faces but, as Tedros always tells us here, there's always hope, there is always a chance to turn things around, there's always a chance to learn and I think as we move into the next few weeks and as Europe and others will experience high numbers of cases we must protect the vulnerable, we must protect the health system.
00:34:45
We must try if we can to keep our kids at school, we must also be prepared potentially to give up and continue to give up some of those things that we love to do but we must, must, must be able to test and trace and in the situation of intense transmission it may not be possible to trace every case.
We accept this and there are times when that is not the most efficient thing to do but you must be able to know where the virus is and as the numbers drop you must be able to re-engage in tracing, quarantine and isolation.
I think if there's one thing that differs in the responses in Asia and in Europe in general or the northern hemisphere in general it's been that ability to follow through on those activities in particular around quarantining contacts. Maria.
00:35:37
MK Yes, just to talk about the follow-through and I was looking back through some of the earlier peaks in other countries and looking at how long it actually took. We're not talking about days or weeks here; we're talking about outbreaks that took up to two months to resolve with incredible, intense effort, focusing on these cluster investigations.
I was asked recently about this idea of clusters and this idea of amplification events and this idea isn't penetrating many places and we're trying to figure out why. We talked a lot about how this virus operates in clusters, how it needs people to transmit between, how there are certain types of situations where the virus can be amplified.
This is a hallmark of coronaviruses and in all of our guidance materials we talk about these no cases, sporadic cases, clusters of cases and community transmission. What has happened in many parts of the world, in all the world and particularly in Asia, the way that the outbreaks have been tackled is doing cluster investigations.
So when the situation seemed overwhelming - I think of Korea and the example in Korea and the outbreak there in the beginning of the pandemic and the situation seemed overwhelming.
00:36:52
What they did - and this was based on their experience with MERS in 2015 so preparedness works, preparation works, experience in dealing with very similar pathogens works and you see this all throughout Asia - using the follow-through that Mike just mentioned of active...
They did incredible amounts of testing but it was smart, it was strategic, it wasn't everywhere all over the country, it was really focused on areas of intense transmission so that you could break down the fuzzy borders of where those outbreaks actually were.
I think what we can see in Europe now and in North America now where they're starting to see increases again is to do the same thing, is to look at... The virus is not uniformly spread all over. There are hot-spots of activity in certain cities and if we break that down, where is transmission actually occurring?
We know from other outbreaks that there are clues, that they can happen in places where you have enclosed settings, especially where you have poor ventilation. We've seen outbreaks in long-term living facilities, we've seen outbreaks in nightclubs and entertainment venues and restaurants.
00:38:00
We've seen outbreaks in hospitals so if we know this we can prepare our systems and actually do the types of cluster investigations in those areas that are necessary. But I think many parts of Europe are using the experience that they have; they didn't have experience with SARS previously, many cities didn't have experience with MERS.
Now they have experience with COVID-19 so I think the muscle memory that countries have now is being utilised in a strategic way so I think we're in a very different position than we were in the spring.
But the other part of your question was about mortality and looking at differences in mortality and all countries, everyone everywhere is better prepared at dealing with severe patients so we have better testing, we have more rapid turn-around of results so that patients can enter the clinical pathway sooner and if they can enter the clinical pathway sooner they can have their vitals checked and so we can check their oxygen levels, if they need to be administered oxygen that can happen faster and faster administration of oxygen saves lives.
00:39:05
There's dexamethasone, which is widely available all over the world. That can be administered to people who are severely or critically ill. That saves lives. There are many things that doctors and nurses and medical professionals who now have experience with this disease know that are saving lives.
So I think we're not in the same position; we're in this for the long haul together but we're not in the same position we were in a few months ago; we know a lot more and now is the time to be really strategic and smart about how we utilise all of these interventions where they are needed most.
FC Thank you. Now I would like to invite Peter Schilling from the European News Agency to ask the next question. Peter, can you hear me?
PE Yes, perfectly. Can you hear me?
FC Yes, very well. Go ahead, please.
00:39:56
PE Okay. I'd like to come back to the issue with vaccination, looking for a new vaccine as such because on the 13th October Eli Lilley posted the ongoing study for the treatment of COVID-19. That was only 24 hours before Johnson & Johnson did exactly the same. These are very large multinationals that should have the technology and, let's say, the knowledge available in their labs to do a good job.
On the COVAX facility I can't really find back how many people are really working on the development of this vaccine and I'd like to know to what extent does now WHO interpret these delays of the third-phase testing that is taking place. Does that really mean that vaccination will indeed be much delayed so well into next year?
Last but not least with vaccination one is aiming to, let's say, help out one of the most at-risk people, that being the older people, and it's known that vaccination really on older people doesn't work very well. So where do we really stand with the approach on vaccination?
FC Thank you, Peter. I would like to ask Dr Swaminathan to take those questions. Thank you, Dr Swaminathan.
00:41:26
SS Thank you. Those are all excellent questions. The first one is on the stoppage of the studies. You mentioned two trials; the Eli Lilley trial which is actually a trial of monoclonal antibodies so not a vaccine but a monoclonal antibody is now being tested in an approach to both prevent infection among people who are exposed, to prevent progression of disease among those who have the infection but very mild illness and also in a group of patients who are hospitalised with COVID.
So it's in this particular group of patients hospitalised with COVID where the antibody was being tested that it was halted by the data safety monitoring committee and we're still waiting for details of that. Obviously the data safety monitoring committee is a committee that looks at the blinded data so the investigators are not aware of what the issues are and I think we will hear something more later this week or next week about that particular study.
But there are other trials of monoclonal antibodies that are ongoing so this is a space that we need to watch and it's possible that these antibodies would also have a role to play in prevention, though we know that it's short-lived, it will be shorter-lived than a vaccine because antibodies have a half-life in the body which is about 20 days or so so if you give somebody an injection then over a period of time that protection will wane.
00:43:01
The other trial you mentioned is the Johnson & Johnson vaccine trial which an adenovirus 26 vaccine platform and this vaccine trial has been halted. Again we don't know the details of what has happened but we know a patient had a serious adverse event and this is a part of the conduct of clinical trials.
You mentioned that these are companies that know what they're doing so this is why the trials are set up in a way that safety is monitored and that if there's any signal then the trial is halted, the data safety monitoring committee looks into the details and then makes a decision based on whether or not this side-effect was related to the vaccine and whether or not it's serious enough to have a longer halt or whether the trial could resume.
So again we're waiting for further information but on the whole this is exactly what happens in clinical trials; it's just that now everything is under the spotlight and so we see all of these events as they're unfolding.
00:44:08
But this is not something to get unduly worried about, this is something that we have to watch and because there are so many vaccines in trial and will be going into phase three trials I think we need to stay hopeful and optimistic.
That brings me to your other question of what's happening with the whole space of vaccines and will we have a vaccine. This is something that we're tracking so WHO has a landscape document that gets updated on our website where we look at how many candidates at what stages of development and we know that there are over 45 candidates now in phase three studies so lots of data will be coming through.
We're looking at the beginning of next year really to start seeing data for many of the trials though we may see one or two before the end of the year but the majority will start reporting in early 2021 and that's when then we will be able to see the data, the regulators will see the data.
Many of these companies are already manufacturing several millions of doses so as soon as the results are out if it's promising companies will be able to start providing those doses to the COVAX facility which will then distribute based on the fair allocation framework that we have developed and that we have talked about which prioritises which group of people should get the vaccine but equitably across all countries so not a few people in a few countries but a few people in all countries, the most high-risk to be protected.
00:45:46
The timing of that is probably somewhere in the middle of 2021, that we will start seeing countries but again selected high-risk people getting vaccinated. On the older people your question is absolutely correct, that as you age your immune system is less robust in its response and therefore some vaccines don't work as well.
But again there is good news because some of the vaccines in development now are showing very good immunogeneicity in older people as well and that's data from the phase two trials that we've seen.
So there are some of the vaccines certainly that are showing promising results even amongst the older people so hopefully we will have some vaccines that will be effective because we know older people are a high-risk group and it will be important to protect them with vaccines. I hope that answers your questions.
00:46:45
FC Thank you. I would like now to ask Shen from China Daily to ask the next question. Shen, can you hear me?
SH Thank you, yes. I'm based in Brussels so I want to go back to the Europe question. Could you, Mike or Maria, talk about what you think are the... You keep talking about applying all the tools. What are the tools Europe's missing? Belgium is shutting down the restaurants, bars, [unclear] but if that's not actually the loophole they are missing that's not going to solve the problem, even after months
Is contact tracing - because I have attended the press conferences for months so is the contact tracing, quarantine really not being fostered well, strictly? Is that the problem compared to China, East Asia, you mentioned, or are there other issues? Thank you.
FC Thank you, Shen. Dr Ryan.
00:47:55
MR Again it's difficult to make those comparisons and again if you look across Europe from our perspective as our European region stretches from Vladivostok to Reykjavik you get a sense of the breadth we're talking here.
So about half of our member states within the European region have experienced a 50% increase in cases in the last week and if you actually put that to a one-third increase or more that goes up to more like two-thirds countries so clearly across the board we're seeing large increases in cases.
What we're also beginning to see now is hospitalisations starting to track that and even deaths beginning to track that and certainly going back even a couple of months we would have had maybe two to 3,000 deaths per week, even as much as two months ago but now we're seeing a very large increase in the number of deaths per week and it's now approaching something like eight, 8,500 deaths per week across 48 countries.
So you're definitely starting to see that tracking up of mortality. The question is will it go back up to the very high levels we saw in March and April or not and as Maria said, there's hope that that is not the case.
Number one, the age profile of the positive cases at the moment is much younger. Certainly clinical care pathways have got better and people may be getting lower doses of exposure.
00:49:32
We have to look at this and we are looking at this at the moment, to see whether the measures may not be fully effective at stopping transmission but maybe the physical distance, maybe the masks, maybe all of that is reducing the dose of exposure that individuals are being exposed to or the time of exposure.
Exposure time and exposure dose are related to your likelihood - number one - to be infected but in many infectious diseases very often related to the severity of infection that you actually experience. So we have a lot of factors to look at in terms of why, number one, is the disease increasing, can we keep that death rate down to the lowest possible level.
It may be - as Maria said - when you look inside those numbers and inside countries very often there are areas within countries that are driving a good percentage of that transmission. So the question for each country and for the whole region is how can we get those numbers back down to manageable levels again in order to be able to fully re-engage on case identification, contact tracing and full quarantine of contacts.
00:50:38
But let's be plain and honest here; if you are a case or you're someone who's positive you should be at home in full isolation or in a clinical care facility. If you are a contact of a case, if you know yourself to have been in contact with a case you should be in full quarantine at home without contact with other people or in a third facility and without contact with other people.
That is not so as to imprison people. That is so as to break chains of transmission and if we're seeing transmission now at community level and then we do big, major lock-downs and we push that transmission back into the household - and what we're seeing in many European countries and North America is that a good deal of transmission is occurring at the household level.
So it's gatherings at home that are doing a good deal of the transmission so even if you end up with a societal-level lock-down and people continue to gather in those environments we're still going to promote and continue transmission.
So countries are facing many dilemmas right now but for me if I get a chance, a golden wish to improve one thing with which we could really, really improve and change the game here apart from all of the other advice about using masks and physical distance and asking that people can stay the course and that it's tough.
00:52:00
But if I was being asked, as a public health physician if I was asked for one thing that could improve that might change the game here that is making sure that each and every contact of a confirmed case is in quarantine for the appropriate period of time so as to break chains of transmission.
I do not believe that has occurred systematically anywhere and particularly in countries that are experiencing large increases now. That has been very hard to sustain over the summer and I think a good part of the reason why we're seeing such high numbers at the moment.
MK I just want to supplement that because you asked what are the tools, what needs to be done and you've heard us say over many, many months about a comprehensive package of interventions, a comprehensive approach, an all-of-government, all-of-society.
00:52:48
The reason we keep saying that is because you cannot become overly reliant on any one measure. It can't just be testing alone, it can't just be case identification alone, it can't just be masks alone, it can't just be physical distancing alone; all of these different interventions need to be used.
What we have seen in some countries is that there is an over-reliance on some measures as opposed to others and you've heard Mike and I talk quite a lot today about isolation of cases and quarantining of contacts and we really can't emphasise this enough.
So this comprehensive approach includes active case finding, making sure you do active case finding and cluster investigations when you have outbreaks. It's the earlier identification of cases, using your testing, using your testing wisely, getting those results back as quickly as possible so that public health actions can take place.
That includes entering a clinical care pathway for a confirmed case, making sure that they are isolated in a medical facility if necessary or at home if they can't be isolated in a medical facility. It's the identification of contacts, of everyone who's been in contact with that case.
00:54:01
Just think yourself what you've done in the last few days; how many contacts, how many people have you come in contact with in the last few days. That needs to be done if you were to become a case and it's difficult to do. You have to find all of those contacts and they need to be in quarantine.
That means staying home or being in quarantine in a facility, fully supported by the government and the system there. It means readying your hospitals, making sure that hospital beds are available, making sure that ICU beds are available, making sure that there's appropriate trained, rested medical personnel, making sure that there's PPE available in the hospitals where necessary.
It means looking at the data that you're collecting, it means using the surveillance data that you have, the testing data that you have, the contact tracing that you have, the analysis that you are doing to see what is actually happening in the country, what is happening at a subnational level and using that to feed back into your response.
00:55:02
What are the next steps, where do I need to focus most of the energy with the resources and the capacities that we have? It means regular, open, honest communication because the situation is changing and this is difficult.
I think everybody is expecting this to be over very very quickly but this is going to take some time and I think we all need to be mentally prepared about that. This is not to scare everyone but it's just to get ourselves ready that it is going to take some time for us to get through this but that we will get through this.
But open, honest, regular conversation with communities to feed back from communities to be able to determine what it is that communities and individuals need to be able to take action. It also means individual measures that you take, that your loved ones take to protect yourself so it's all of the individual measures of avoiding the crowded spaces.
It's teleworking if you can, it's staying home if you are asked, it's physical distancing, it's wearing a mask but please continue to physical distance even if you're wearing a mask. To use your hand gel, carry a hand gel around with you, wash your hands.
00:56:19
Around the world people are trying to ensure that we have adequate hand-washing stations to improve access to hand-washing and it's about being informed, knowing your risk, taking decisions every day.
Your decisions that you take every day matter. What is it that you can do to reduce your exposure and your risk and the chances of you getting infected or the chances of you passing it on to somebody else.
So it's all of that but we cannot become overly reliant on any one measure. It needs to be this comprehensive approach otherwise there will be a false sense of security if we rely on only one or two of these measures.
FC Thank you. We have reached one hour and I would like to end this press conference by inviting Dr Tedros for final words. Dr Tedros, you have the floor.
TAG Thank you again, Fadela. We Are Family is more than a song. It's a call to action for collaboration and kindness and a reminder of the strength of family and the importance of coming together to help others in times of need. It represents that to heal the world from this pandemic we must come together like never before in national unity and global solidarity.
00:57:50
We are family and as humankind we have more in common with one another than we would ever dare to believe. Let us use this anthem, We Are Family, to help unite us, unite the world and together we won't just beat this pandemic, we will take on and successfully tackle other global challenges like air pollution and the climate crisis.
So join us in the We Are One Family campaign because together we can do anything we put our minds to. National unity and global solidarity; we are one family. Thank you all for joining and see you all in our next presser. Thank you and thank you to Kim and Natasha.
FC Thank you, Dr Tedros. I would like to thank journalists who are following our press briefing regularly and I do apologise for those whose questions I wasn't able to take for time constraints. Don't hesitate to contact us if you have any follow-up questions. I remind you that we will be sending you the audio file of those press conference alongside the DG's opening remarks. The full transcript will be available tomorrow morning on our website. Thank you and see you very soon.
00:59:36