COVID-19 Virtual Press conference transcript - 26 March 2021
Overview
00:00:18
CL Hello.
Good day to... wherever you are listening to us. Today is Friday 26th
March 2021. My name is Christian Lindmeier and I'm welcoming you to today's
global COVID-19 press conference. Simultaneous interpretation is provided in
the six official UN languages, Arabic, Chinese, French, English, Spanish and
Russian, as well as Portuguese and Hindi.
The participants today are, present in the room,
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, Dr Mike Ryan, Executive
Director of WHO's Health Emergencies Programme, Dr Maria Van Kerkhove,
Technical Lead on COVID-19, Dr Mariangela Simao, Assistant Director-General for
Access to Medicines and Health Products, Dr Soumya Swaminathan, Chief
Scientist, Dr Bruce Aylward, Special Advisor to the Director-General and the
Lead on the ACT Accelerator.
Let me hand over to the Director-General for the
opening remarks.
TAG Thank
you. Thank you, Christian. Good morning, good afternoon and good evening. At
the beginning of the year I issued a call for countries to work together to
ensure vaccination starts in all countries within the first 100 days of the
year.
177 countries and economies have started
vaccination. In just one month COVAX has distributed more than 32 million
vaccines to 61 countries. COVAX works.
00:02:04
There are now just 15 days left before the 100th
day of the year and 36 countries that are still waiting for vaccines so they
can start vaccinating health workers and older people. Of those 16 are
scheduled to receive their first dose from COVAX within the next 15 days. That
means 20 countries who're ready to go and waiting for vaccines.
COVAX is ready to deliver but we can't deliver
vaccines we don't have. As you know, bilateral deals, export bans, vaccine
nationalism and vaccine diplomacy have caused distortions in the market with
gross inequities in supply and demand.
Increased demand for vaccines has led to delays
in securing tens of millions of doses that COVAX was counting on. But getting
all countries started by day 100 is a solvable problem. COVAX needs ten million
doses immediately as an urgent stopgap measure so these 20 countries can start
vaccinating their healthcare workers and older people within the next two
weeks.
00:03:35
So today I'm asking countries with doses of
vaccines that have WHO emergency use listing to donate as many doses as they
can to help us meet that target. And I'm asking manufacturers to help ensure
these countries can rapidly donate those doses.
There are plenty of countries who can afford to
donate doses with little disruption to their own vaccination plans. The more
countries that donate as soon as possible the more doses we will have to share
with countries who need them desperately.
Sharing doses is a tough political choice and
governments need the support of their people. I am encouraged by surveys in
high-income countries showing widespread support for vaccine equity. Ten
million doses is not much and it's not nearly enough but it is a start.
We will need hundreds of millions more doses in
the coming months. There are many countries who invested in COVAX in good faith
but have been left frustrated because of the bilateral deals that have left
COVAX short.
WHO and our partners are continuing to work
around the clock to find ways to increase production and secure doses. There
are four more vaccines at different stages in the process of being assessed for
WHO emergency use listing and we hope to approve at least one of them by the
end of April.
00:05:40
WHO is also concerned about the potential for
criminal groups to exploit the huge global unmet demand for vaccines. A number
of Ministries of Health, national regulatory authorities and public procurement
organisations have received suspicious offers to supply COVID-19 vaccines.
We're also aware of vaccines being diverted and
reintroduced into the supply chain with no guarantee that cold chain has been
maintained. Some falsified products are also being sold as vaccines on the
internet, especially on the dark web and we're aware of other reports of
corruption and reuse of empty vaccine vials.
We urge the secure disposal or destruction of
used and empty vaccine vials to prevent them from being reused by criminal
groups and we urge all people not to buy vaccines outside government-run
vaccination programmes. Any vaccine bought outside these programme may be
substandard or falsified with the potential to cause serious harm.
00:07:15
It's important to remember that any harm caused
by a falsified product does not reflect a safety failure of the genuine
vaccine. WHO regularly issues global medical product alerts on substandard and
falsified products and we will do so when and if necessary for COVID-19
vaccines and therapeutics.
We urge all countries and individuals to pay
careful attention to this issue. Any suspicious sale of vaccines should be
reported to national authorities, who will report it to WHO. Information flow
is essential to map global threats and protect confidence in vaccines.
Finally I would like to wish Chag Pesach Sameach
to everyone celebrating the first night of the Passover holiday tomorrow.
Christian, back to you.
CL Thank
you very much, Director-General. With this we open the round of questions. To
get into the queue to ask questions you need to raise your hand using the raise
your hand icon and do not forget to unmute yourself when it's time. We'll start
with Antonio Broto from EFE. Antonio, please unmute yourself.
00:08:54
AN Thank
you, Christian. I want to ask about the situation in Chile. Chile is one of the
countries with a higher percentage of the population vaccinated but at the same
time is one of the countries with a higher rise of new infections in the
region, in Latin America.
So why do you think this is happening and is
this a worrying trend for WHO? Thank you very much.
CL Thank
you very much, Antonio. I'll hand over to Maria Van Kerkhove, please.
MK Thank
you for the question. The question is specific to Chile and indeed Chile has
seen an increase in cases in the last several weeks. It's a similar trend that
we've seen across the Americas and particularly in Brazil and also in the
southern cone.
But that is actually reflected in a number of
countries across the world and if we look back at the last seven days alone
across the world we've seen a 15% increase in cases and we now see an increase
in cases in the last week in all six WHO regions.
00:10:02
So this is a worrying trend that we're seeing
across a number of countries. There's a number of factors that could be
associated with this. I don't have the specifics for Chile in front of me but
across the world we are seeing that there are some changes that are happening
that increase transmission.
A lot of this has to do with the roll-out of vaccines
and vaccinations which is uneven and inequitable, as you've heard us say many,
many times. There are some individuals that are not adhering to the measures
that are in place, the physical distancing, the hand hygiene, the cleaning of
your hands, the respiratory etiquette, avoiding crowded spaces, opening the
windows.
All of that needs to take place in addition to
the vaccines being rolled out because vaccination takes time to reach those who
are most in need and it will take time to reach enough of the population to
have an impact not only on reducing severe disease and death but also reducing
transmission.
So there are a number of factors, I think, that
are associated with increases in transmission even though we're seeing
vaccination rolled out. That doesn't really make sense intuitively. You would
expect that as vaccination is underway transmission is going down but in fact
vaccination is one tool that we have to reduce the spread.
00:11:21
We cannot rely on vaccination alone. We have to ensure
that everybody adheres to the measures that are in place that keep themselves
safe and keep their loved ones safe.
So please continue to do it all across the board
and we need governments to support individuals to be able to stay at home if
they're unwell, to be in isolation, to be in supported quarantine. This needs
to still be part of our control measures for reducing transmission around the
world.
MR If
I could supplement, I believe the Health Ministry made this decision based on
the epidemiology in the first few weeks of March and have increased the
measures as a means of protecting the health system.
There are just over 3,000 critical care beds in
Chile and only 188 of those were available on 18th March so the rise
in infections was really threatening to overwhelm the capacity to provide
clinical care. Chile surpassed 7,000 daily cases on 21st March,
representing a sharp increase.
00:12:33
I think the last time cases were this high in
Chile was May and June of last year so I think the Ministry have recognised
that epidemiologically the situation is difficult, the health system is coming
under pressure and I believe they've taken rational measures to try and reduce
transmission.
As Maria said, the benefit of vaccines has not
probably kicked in yet in terms of having enough people vaccinated to protect
the maximum number of people from severe disease and hospitalisation. I think
again it emphasises the fact that without all vulnerable people being
vaccinated in all countries many countries will face a similar problem as they
get inevitable rises in cases.
That rise in cases will be paid for in severe
cases and deaths and speaks exactly to what the Director-General has been
speaking about, making sure that those most vulnerable and most likely to
suffer and those most likely to die in every country in the world have adequate
protection from vaccination.
But the Chilean Government, I think, have taken
appropriate measures. They've also taken measures with regard to travel into
the country. They have detected variants of concern within the country as well
so they're also trying to ensure that those variants don't take over the
epidemiology within Chile.
00:13:47
But, I think, a rational response on behalf of
the Chilean Government in the face of rising numbers and increased strain on
the health system.
CL Thank
you very much, Dr Ryan. Dr Aylward, please.
BA Thanks,
Christian. Antonio, thanks for the question because it's so important. Any
increase in cases is a worrying trend; let's be super-clear; there's no such
this as an unworrying increase in cases with this serious disease.
I think it highlights again as you said that
many countries are rolling out vaccines now. The obvious thing, as Mike and
Maria emphasised, is these vaccines are great vaccines, they work really well
but we do not have sufficient vaccines and at scale to be able to change the
course of the epidemic right now.
We've got so many other measures we have to be
using at the same time and we have to be using our vaccines smart. We've got to
be using them to protect those healthcare workers who've got to deal with this
oscillating disease and surges of cases and to protect the older people so that
they don't suffer the severe disease and possibly death as a result.
00:14:56
It highlights the appeal that the
Director-General made at the beginning of this press conference that not all
countries can do what Chile can do and try and roll out the vaccines to protect
people in the face of surging disease because they don't have access to the
doses.
What we need to do is get more doses of vaccine
into the COVAX facility so that were can ensure all countries can protect their
healthcare workers because this disease will continue to surge as we're seeing
in places like Chile even though we are rolling out the vaccines right now.
At the same time we've got to do everything.
It's difficult; I won't repeat what Mike and Maria said but we've go to
maintain the other measures until we get really high vaccine coverage and we're
some ways away from that yet.
CL Thank
you, Dr Aylward. I believe Dr O'Brien is also in the room and will add.
00:15:49
KOB I
just want to add a couple of points to what's already been mentioned. I think,
as everybody knows, the evidence on the vaccines is really clear about the
prevention of disease, certainly the prevention of severe disease and death for
these vaccines.
But the part of the evidence that is still
rolling in is the degree to which they also protect against getting infected
and clearly to get disease you have to get infected but just because you get
infected doesn't mean that you get disease but it certainly can mean that you
can transmit to somebody else.
So I think the other point that we're
emphasising especially as vaccines are rolling out - and there are many people
in the community who are not vaccinated and not protected against disease -
that continuation of the measures to avoid transmission, even if you're not
symptomatic, is so incredibly important as we're rolling out vaccines and that
increase in immunity in the population is continuing.
We also have variants of concern and we don't
have information that is firm and clear about the degree to which each of these
vaccines against each of the variants of concern may have some reduction or
change in the ability that they have to protect against infection and to
protect against disease.
00:17:07
So we're in just a really dynamic environment
right now as these incredible tools that are the vaccines are rolling out and
so this is the time when we should really do everything possible to keep
transmission low because it is that low transmission that will also impede and
avoid the emergence of other variants. Thank you.
CL Thank
you all for the answers. Now we move to the next on my list and we have a long
list already, Catherine [Unclear] from France 24. Catherine, please unmute
yourself.
CA Thank
you, Christian. Good afternoon to all of you. My question is related to
vaccination. As we know, vaccination is one of the tools that we have that we
can rely on and certain countries have decided to inoculate only one dose to
persons who have already got COVID-19.
So my question is, number one, is it safe, is it
efficient against the new variants and what is the safest way to identify
asymptomatic people? Because certain people don't know if they already got
COVID or not. Thank you.
00:18:24
CL Thank
you very much. Dr O'Brien, please.
KOB Thanks
for the question. Again, the strategic advisory group of experts, the expert
committee that provides recommendations to WHO for our policies on vaccines;
we've looked at a number of the vaccines for specific recommendations.
There's one that is specifically tested and
designed as a one-dose regimen and that's the Jansen product. The other
products are two-dose regimens and we are fully aware that there is evidence
around the magnitude of the immune response after a single dose of those
two-dose regimens and there is some evidence around the amount of protection
against disease after receiving a single dose.
But what we certainly don't have is evidence of
not giving the second dose for those two-dose regimens. We would not know how
long the protection from a single dose lasts, nor is it likely to be the
maximum benefit that the vaccines can offer.
00:19:34
So we recommend that for the vaccines that have
a two-dose regimen they are given in a two-dose regimen. For those people
who've had disease before, again we are aware of the evidence that there is a
strong immune response after a single dose but we're just in an environment
right now where we don't have sufficient evidence to change the recommendation.
That being said, we certainly are not
recommending that people test individuals before giving vaccine to determine
whether or not they have had COVID before. If somebody has known that they've
had COVID disease they could make an individual decision to delay the receipt
of their vaccine if it's in short supply in their community so that somebody
else could go first.
But we really just don't have enough information
on the variants to understand whether that's an optimum strategy or not. We do
recognise that countries are making the best decisions they can in their own
policies about the optimum way to use the vaccines that are available to them
and there is a range of decisions that could be made about this even while the
evidence is rolling out.
So we're very much encouraging that for any
adjustments to the schedule that countries are recommending they study those so
that we actually have evidence that could help additional countries make
decisions about the optimum use of the vaccines.
00:21:12
The most important thing at this point is to get
as much vaccine as we can available to the highest-risk people so that they can
be protected against disease and eventually a significant immunity in the
population that we hope and expect will really reduce transmission from that
broad-based immunity but we're pretty far distanced from that.
CL Dr
Swaminathan to add, please.
SS Just
to add to what Kate was saying, I think there is a specific vaccine which is
the AstraZeneca vaccine for which there is data for the gap between the two
doses being four weeks or 12 weeks and beyond.
There was data from the clinical trials which
suggested that the longer the interval, at least up to 12 weeks, the better the
immune response and the better the efficacy of the vaccine. So there's also
modelling done to show that if you have a limited number of vaccine doses and
you want to protect the population, particularly the high-risk groups, the
older groups and so on...
00:22:28
So countries like the UK for example have taken
the approach of vaccinating more people with available vaccine and then begin
the second dose at a time around 12 weeks later. The SAGE that Dr O'Brien
mentioned, the advisory group that advises WHO recommended a gap of eight to 12
weeks between the first and the second dose for the AstraZeneca vaccine.
This was based on an analysis of the data, both
the immunogeneicity data in the lab as well as the efficacy data and we're
getting more data now from the actual roll-out of vaccines in countries which
have opted to use this delayed approach, showing that the first dose is
providing significant protection against hospitalisation and severe disease.
So it seems to be a good strategy to protect
more people more quickly but of course the second dose must be given and we're
also now encouraged that there are trials going on looking at a combination of
vaccines so a first dose with one and a second dose with another one to see if that
in fact provides better protection.
We'll also have more studies hopefully coming
through with more single-dose vaccines as well as with vaccines that can be
given for example by nasal spray, which actually might create more immunity in
the respiratory tract.
00:23:49
So it's really wonderful to see so much research
going on on existing vaccines as well as new vaccines and we look forward to
more data.
The other question you asked was about
asymptomatic infection and as you know, it's very difficult on a routine basis
but what the clinical trials did was one of two things; either they used a
nasal swab in the participants every week to see if they were getting infected
even without symptoms or the used the antibody test so they took blood at
regular intervals to measure the antibodies.
So at the end of the trial we will be able to
see how well these vaccines protected against the asymptomatic infection as
well. Thank you.
CL Thank
you so much for these explanations. We'll move on to Simon Ateba from Today News
Africa. Simon, please unmute yourself.
SI Thank
you for taking my question. This is Simon Ateba with Today News Africa in
Washington DC. President Biden said days ago the US has millions of doses of
AstraZeneca vaccine that have not been used. Is the WHO in talks with President
Biden to send those vaccines to COVAX?
00:25:00
Talking about COVAX, the WHO said recently the
COVAX facility was still in need of over $20 billion to provide enough
vaccination to most people in the world and begin to crush the coronavirus. How
much money is still needed now?
I know President Biden has already pledged $4
billion to WHO and COVAX but clearly the money is not enough and the US has
more than enough money to provide the $20 billion left if the WHO [unclear] President
Biden for additional financial contribution.
Has the WHO received the first pledge from
President Biden and how significant has that contribution been so far? Thank
you.
CL Simon,
thank you very much. We have a rule of one question only. These were about ten;
I lost count but let me hand over to Dr Aylward, please.
BA Thank
you, Christian. Thank you very much, Simon. They were all good questions
though. First and foremost, on the issue of donations and what we refer to as
dose-sharing, indeed we're in discussions with all countries that have access
to substantial doses of WHO emergency-use-listed vaccines for sharing of doses
and donations of doses to the COVAX facility so that we can ensure all
countries can get started and all countries can sustain vaccination, especially
of healthcare workers and of their older populations.
00:26:34
We have been in discussions since December; if
you go back and have a look you'll see that in December we established the
dose-sharing principles for working with COVAX to ensure that high-quality
doses of vaccines can get out to all countries equitably through the COVAX
facility.
Since that time we've been in discussion with
many countries - the US, the EC, Canada, the UK and others; Australia, New
Zealand - about sharing of doses through the COVAX facility. A lot of positive
interest across countries to do that, balancing of course also their own
domestic needs.
But as you heard from the Director-General in
his opening comments, we are at a particularly crucial point right now in the
roll-out of doses globally and are encouraging any country that can help to do
so.
00:27:32
We're encouraging though - and I want to
highlight this - not just the countries that have access to doses today or have
contracts with the suppliers but we're also calling on the suppliers to help as
well because, as many of you will understand, there're contracts established
with countries for their doses but those countries may say, okay, we want to
donate those doses to COVAX.
But we need the help of the suppliers as well to
take those contracts, adapt those contracts with GAVI and with COVAX and with
the countries involved very, very rapidly, not over weeks and months but over
days and hours, to be able to ensure doses can be redirected to help in places
that really need them and need them urgently to begin the equitable roll-out.
So it's not just countries, Simon; we're also
calling on the companies as well to work with us on this as rapidly as
possible.
In terms of the financing we do need over $20
billion, $22 billion but that's for the entire ACT-A agenda or the ACT
Accelerator agenda to ensure the equitable distribution of vaccines, oxygen,
dexamethasone, PPE and diagnostics.
00:28:45
As the Director-General, Mike and Maria reaffirm
all the time, countries need that whole package to control the disease, protect
their health systems, health workers and populations and get their economies
going again so that's for that whole package.
Within the ACT Accelerator one of the
best-financed aspects is the COVAX facility but we still have an urgent $2.3
billion gap in the need to be able to procure, close some of the deals that we
have to be able to secure as much vaccine as is available this year for low and
low/middle-income countries in particular.
CL Thank
you very much, Dr Aylward. With this we'll move to the next on my list and
that's Christiana Ehrlich from DPR. Christiana, please unmute yourself.
CH Thank
you for taking my question. Dr Tedros, we heard yesterday that the COVAX crisis
is in large part due to Indian export restrictions. 90 out of the 237 million
doses that were to be delivered will not come in time in March and April so the
picture is a bit different; it's not the rich countries that have secured
millions of doses that are holding them back. It seems to be a developing
country that is the main problem.
00:30:19
Are you talking to the Prime Minister of India
to change his attitude or do you think that India as developing country should
also look after their own population first? Thank you.
TAG Yes,
thank you very much. First of all I would actually like to thank India for its
generosity. As you know, India has shared lots of vaccines globally. If you
would just call out one country who has contributed more than any country on
Earth in terms of sharing vaccines it would be India so I'd like to thank the
Prime Minister and his Government for this support.
What's happening now is not an export ban from
India, as far as we know but as you may know, the number of cases in India is
on the increase so they need more vaccines also to use locally in order to
fight the increasing number of cases so that's understandable.
But at the same time we're already in
discussions to keep a balance so that they can use locally but at the same time
continue to provide other countries vaccines from the Serum Institute of India.
So we hope that the two could be addressed and
we have a balanced solution but I would like to use this opportunity actually
to thank India and I know they will continue to collaborate with COVAX and with
WHO. Thank you.
00:32:37
CL Thank
you very much, Director-General. Dr Aylward, please.
BA The
Director-General spoke on it perfectly [?].
CL Thank
you. With this we'll move to the next question and that's Nina Larson from AFP.
Nina, please unmute yourself.
NI Thank
you for taking my question. I was going to ask, US President Biden said
yesterday that he now aims to ensure that 200 million doses of vaccine will be
given to Americans within his first 100 days in office. How concerned are you
that this might send the wrong message as it seems to run counter to your call
for vaccine solidarity among countries?
If I could just ask one housekeeping question,
if you have any update on when the Wuhan mission report will be published that would
be helpful. Thank you very much.
00:33:35
CL Thank
you very much, Nina. Let me look around on the first question about the
vaccines. Dr Aylward, please.
BA Thanks
so much, Nina, for the question. Every country and every political leader is
trying to do what it thinks is the best possible thing for its people and we
know that, we recognise that. But of course we are concerned that not all
countries have access to vaccines yet and we call on all countries to try and
help solve that problem by ensuring that we've got access to vaccines through
the COVAX facility and that all countries continue to prioritise their
healthcare workers as the first line, to protect our vital infrastructure, the
people who have got such a high risk of exposure to this disease as they try
and help people and save lives.
And then of course the older people, people with
comorbidities and depending on the country of course those can be substantial
populations. But what we're calling for is to ensure that all countries roll
the vaccines out in that order and fortunately what we're seeing in most places
is exactly that; attention being given to their healthcare workers first, then
their older populations and people with co-morbid conditions, as we've talked
about before.
00:35:01
We are concerned that some countries don't have
access to vaccines yet to be able to do that but we are encouraged that every
country is saying the right thing, they're trying to do the right thing and
they're trying to help ensure that we have the doses we need to be able to do
it.
So we continue to look for, as the
Director-General said in his opening comments, support in the near term, in the
short term to help through this urgent period that we have over the next couple
of weeks, to try and get all countries started and then coming in behind that
with the doses to be able to get coverage up.
There're lots of countries, as everyone knows -
and you've asked us about it many times - that have contracted or secured or
optioned a large number of doses that go beyond the needs of their own
countries. What we're hoping, as countries now get comfortable with the
roll-out of their products, is that they'll be able to start discussing sharing
larger numbers of doses through COVAX to be able to vaccinate populations everywhere.
00:36:04
CL Thank
you very much, Dr Aylward. I believe for the second part we have Dr Peter
Embarek online. He's WHO Expert on Food Safety and Zoonosis and the
International Lead of the WHO-convened global study of the origins of
SARS-CoV-2. Peter, please.
PBE Thank
you, Christian, and thank you for the question. You've probably heard me say in
the past that we were very close to finalising the report and I'm the first one
to regret that it's not yet out.
But the process is now finalised, we have a
joint report. We're now at the point where we are doing a [unclear] of the
document just to make sure that we don't have small errors in [unclear] and
that all the experts are okay with the content as it is.
That's happening in both languages, Chinese and
English and we are, as I said earlier, I think, working over six different time
zones and with two different languages so it's a very slow and complicated
process to get it there.
You can imagine that in the report [unclear]
stages we have hundreds and hundreds of names, of locations, of dates; small
details that need to be carefully translated, etc. In a way it's a painful
process to get to the finishing line but the content is now complete and
frankly speaking, I expect that in the next few days that whole process will be
completed and we'll be able to release it publicly. Thank you.
00:38:05
CL Thank
you very much, Dr Peter Ben Embarek. Dr Mike Ryan, please.
MR Just
a reminder that we had a number of missions to work in China but these specific
set of activities have been activities requested under the resolution of the
World Health Assembly last May and the Director-General was asked to set up a
series of collaborative and scientific missions to understand better the
origins of the virus.
This mission has been one very important piece
of that process but with respect to our member states the report will be shared
as a mission report to the member states for their consideration and discussion
and the report will obviously then be released publicly subsequently or during
that process.
But we want to show due respect for our member
states and share the report with them first as they've been the ones who have
worked very closely with the Director-General to ensure that this work has been
completed.
00:39:13
CL Thank
you very much for these clarifications. Looking at the long list of questions,
may I ask those who wanted to ask a similar question to lower their hands so
that we can see what other topics are on offer today. With this I move to
Laurent Siero from the Swiss news agency. Laurent, please unmute yourself.
LA Thank
you, Christian, for taking my question. The former Brazilian President Lula
this morning said that the current President's behaviour was the biggest
genocide in the country's history. Then yesterday the French President Macron
said that there was a new kind of world war around vaccine with Russia and
China and there have also been increasing tensions between the UK and the EU
around vaccines.
So it seems that we reached a new stage in that
rhetoric this week. What kind of effects do you see for the way the pandemic
should be handled in the next weeks and months and would you go as far as
former President Lula and say that some leaders have deliberately chosen not to
assist their people? Thank you.
CL Thank
you very much, Laurent. Let me look around. Mike Ryan maybe.
00:40:42
MR I
think all countries have faced major challenges in this and certainly Bruce and
others can speak to the issues around vaccine nationalism and that but we have
to also see that political leaders are in difficult positions regarding the
demands of populations.
It's very difficult but you also have to take
that global perspective and from WHO's perspective we look at all of the states
in the world and all of the peoples of the world and if WHO came up with a
policy where we vaccinate in one country and finish there before we vaccinate
in others it'd be very similar if a country decided to vaccinate in one state
and finish there before starting in another sub-unit of the nation.
We see the world in a global perspective, we see
all humanity as equal, all human beings born as having equal right to health
and to the preservation of their health. So some of this tension comes really
from the perspectives and where people sit, where they sit in the argument and
where they're having the argument from and who is influencing and shouting at
them.
00:41:58
So it's a very complex environment and I think
it can be oversimplified and made too simplistic. There are so many complex factors
driving this and Bruce may speak to that but I don't believe it's true that...
In the vast, overwhelming majority of cases,
regardless of ideologic perspective, most leaders are trying to do their best
for their people. No more than ourselves, they don't always do it perfectly.
That's part of the process of the imperfections that we see in every aspect of
human endeavour but I think it goes way too far to say that leaders in general
are behaving in a way that is designed against their own people. That doesn't
mean that leaders at all levels do not make mistakes. Bruce.
BA Thanks,
Mike, and thanks for the question, Laurent. It's an important one because
frankly we are in a war and leaders are right; we are in a war and it's a war
against a virus, not against each other.
One of the things that's been extraordinary in
this crisis is just how many world leaders you have an opportunity to interact
with through the Director-General and others. They have common purpose in this
and that common purpose is to beat this virus. There's absolutely no question
about that.
00:43:19
Yes, there are a lot of tensions, there are a
lot of emotions. There's a bit of friendly fire perhaps now and again but
that's the nature of a battle like this that's been going on for over a year.
People are tired, people are exhausted and there's incredible demand on
everybody including political leaders everywhere as they try to navigate the
way out of this.
But we have a common purpose, a common destiny
in this. It's very, very clear as well and every leader that we deal with; they
recognise and they reiterate again and again that we can only get out of this
together. It's the right thing to do to make sure everyone has access to these
rare or scarce - for the moment - resources, vaccines in particular.
We also have an economic reason, to get the
world economy going and we also have a health security reason because of
variants. Everyone is acutely aware of that and everybody is working to find a
common way forward.
So it is going to be a tough... It's been a
tough couple of weeks and it will be a tough few months as we go forward.
There're incredible demands on everyone but everyone is working to common
purpose and recognises that.
00:44:28
I think one of the most encouraging things -
Mike, we've been at this for 30 years, these kind of diseases - people are
committed to work together on these things. Importantly - and it goes back to
some of the questions that were asked earlier - what we're trying to ensure is
that as countries now reach more and more of their populations they look at the
vaccines that they have access to, they look at the contracts that they have
and they say, you know what, we can share some of this now at this point,
before we go into our younger populations, etc, with vaccines we can share
them.
Again it's in everyone's common interest to do
that and certainly all the leaders we've talked to feel that that's the right
thing to do. The challenge of course is realising that as soon as we can.
CL Dr
Mariangela Simao, please.
MS A
very quick complementary comment because I think we've learned a lot in this
one year - one year and two months - because we know now what works, which we
didn't know in March last year. So the fact that we need to think about public
policies being based on evidence; it's a different scenario from one year ago.
00:45:45
Now the world's better-equipped to deal with the
resurgence of cases in many places. We learned which medicines will help and
which won't; we learned what are the guidelines that should be in place to help
and save lives in the case of management of severe cases.
So I think that's another thing that we need to
think when we're looking in retrospect. It's very easy to point fingers and say
what went wrong. We need to look ahead and look at what the science has given
us and make sure that the policies that are put in place at country level are
evidence-based. I think that's quite [inaudible].
CL Thank
you very much, Dr Simao. With this we move to the next question; that's Sophie Mkwena
from SABC, South Africa. Sophie, please unmute yourself.
SO Thank
you, sir. I just want to ask a question around the coming holidays. We've heard
reports that some countries are already indicating that they are seeing the
signs of a third wave. Has the WHO perhaps observed that or have they picked up
the signs of a third wave and what must countries do during this time?
00:47:15
MK Thanks,
Sophie. I think you were asking if we were seeing signs of a third wave. We are
seeing signs of increasing transmission around the world and there're a number
of factors that are associated with this.
We are not out of this pandemic. The pandemic is
not over. I know we are over it but it is not over us. We are still in the
acute phase of this pandemic where in many parts of the world the virus is
still in control of our lives. We are not in control of the virus.
That is not true all over the world. Some
countries have actually shown that we can control COVID with the tools at hand,
with the addition of vaccination but in fact some countries have actually
controlled COVID without vaccination yet.
I think it's important to remind everyone that
we know a lot about this virus, we know about how it spreads and it really is a
factor of our mixing patterns. When we see people mixing and increasing the
number of contacts that they have, if people are spending a long amount of time
together, if they're mixing with more individuals, more families the virus will
take an opportunity to spread.
00:48:24
So we have seen with some holidays - we
certainly saw this over the December/January holidays where people had
increased the amount of mixing that they had with other families; we saw
transmission increase dramatically in a number of countries.
We now have virus variants, at least three
variants of concern that WHO is tracking; the B117 that was first identified in
the United Kingdom, the B1351 that was first identified in South Africa and the
P1 that was circulating in Brazil that was first identified in a traveller in
Japan.
There are more variants of interest that are
also being tracked. The variants of concern are more transmissible and if you
have a more transmissible virus it means it can spread more easily. If we
increase our mixing patterns, if we have virus variants transmission will
increase.
00:49:15
We're now into the fifth week where globally we
have seen an increase in transmission around the world. I mentioned in my
earlier answer, now all WHO regions are seeing an increase in transmission
compared to last week.
This is important because 15 months in people
want this to be over but we still have to put in the work. All of us have a
role to play here in reducing transmission and this includes during holidays.
All of us want to spend time with our families and travel around and there are
safe ways to be able to start to do this but we need to think about what each
of us are doing every day, what we need to be doing versus what we really want
to do.
We will get there, we will get to a point where
this pandemic will be over, I promise we will get here but we need to put in
the work now to drive transmission down, especially as we are rolling out
vaccines and vaccinations around the world.
So think about what you are able to do during
this holiday period. There are many holidays that are coming up. You can
celebrate a lot of these virtually and in some situations you can meet in the
outdoors instead of indoors and if you do need to meet with others limit the
time that you are together, do this outdoors as opposed to indoors, make sure
you keep your physical distancing, you wear your masks.
00:50:31
All of these measures still hold true. This is
true if you're celebrating Passover or Easter or your child's birthday party.
Each of these events has the potential to either facilitate transmission or not
so all of us have this role to play in the decisions that we make to make sure
that we don't spread the virus, that we don't get infected at first but if we
get infected that we isolate, we get ahold of our contacts so they can be quarantined
and we stop transmission, we break the chains of transmission.
We can do this. We need to continue to do this,
especially through these holidays in the next few months.
CL Thank
you very much, Dr Van Kerkhove. We move on to Kai Kupferschmidt from Science.
Kai, please unmute yourself.
KA Thanks,
Christian. I wanted to ask a complicated question but it's about the possible
side-effects that we have been seeing in Europe with the AstraZeneca vaccine.
It is becoming clearer that there are quite a few cases of this rare
constellation of thrombocytopenia together with thrombosis in unusual places.
00:51:40
Some of the societies for thrombosis and
haematology are starting to tell people to look out for certain symptoms.
There's an idea that the mechanism might be related to HIT. I wanted to know,
since this vaccine is so crucial for COVAX and we're talking about many young
populations as well in countries that might not have the best surveillance
system in place or treatment options for something like this, what's the
current status of WHO on these concerns? Are you sharing anything with the
countries in terms of what to look out for?
CL Thank
you very much, Kai. Let me start with Dr Mariangela Simao.
MS Let
me start and then colleagues can complement. Thank you, Kai. Actually last week
this was very hot on the news and there were a lot of follow-ups on this issue.
You know that WHO has a global advisory committee on vaccine safety that meets
regularly and that has reviewed the documentation available from all regions in
the world because the AstraZeneca vaccines are not only being used in Europe,
they're being used in different regions.
00:52:57
Also we, WHO worked together with the European
Medicines Agency and participated in discussions where the data from Europe
were assessed in a lot of data. So the position stands that the benefits
outweigh the risks, that we have not received any communications so far. We are
following very closely with all WHO regions. There is a network on
safety-monitoring for post-market introduction with different regulatory
authorities from the different regions of the world.
We did not observe an increased number of the
blood clot disorders in the general population; the rates were below the
background rates. The very rare potential - it's being investigated; a
potential link to very rare side events which we're calling very rare, which
would happen one in a million is still being investigated by WHO and also by
the European Medicines Agency and other regulatory agencies in different
countries.
That would include the intravascular coagulation
disorder and cerebrovenous thrombosis but so far this is under investigation
but still, as we're saying, this is a very important vaccine and Kate can speak
a little bit about this because our advisory group on vaccines also has
assessed the safety data.
00:54:53
So far there's no news on this. People should
continue to vaccinate because the potential risk of not vaccinating people at
higher risk of death is much, much greater than any potential side-effect that
may come up.
But we are keeping track of all vaccines, not
only AstraZeneca vaccines. We keep surveillance on all vaccines that are in the
market right now.
CL Dr
Kate O'Brien, please.
KOB Thank
you for this. I'd like to just give a couple more framing comments around this.
The first is that, as Dr Simao emphasised, the observation of these events is
that they're very, very rare events. They've been observed in the context of
tens of millions of doses of the AstraZeneca vaccine having been administered
and a small number of these cases, as serious and important as they are. We
really need to emphasise and keep in context the rare nature of the events.
The second is that, as she described, we always
are looking at the ratio of the benefit and the risk and just as an example, if
you take the UK as an example of a country that's had 1,800 COVID deaths for
every million people in the UK, 40 traffic deaths per million people and zero
COVID-vaccine-related deaths for every million doses that are given...
00:56:50
The information continues to roll out and what
is still under assessment is whether any of these rare events are directly
related to the vaccine itself and even if they are they are extremely rare
events.
We also have vaccines that we know cause other
unintended side-effects and I'll just give an example of the rotavirus vaccine,
which is associated with again rare events of intussusception but when we look
at the benefit of the vaccine to prevent a disease that is very important and a
cause of death in young children, that benefit far outweighs the potential
extremely low risk of an unintended side-effect.
So it really is this balance of the benefit and
the risk that we're seeing and this very scrupulous attention to trying to
quantify if there is a rare event what is the nature of the rare event, what is
it related to and how could we be cautious around that and especially identify
people who might need medical care should they have this very rare event.
00:58:09
Then the point about the AstraZeneca vaccine and
the critical importance of this vaccine for protection of people around the
world; again millions of doses that are already being given preventing deaths
and serious disease among elderly people, healthcare workers, people of middle
age as well as it's rolling out in different countries and the importance of
this vaccine to the global supply of these vaccines.
So we do have to always look at that ratio of
benefit and risk and then do anything that can be done to minimise the risk if
it is recognised and again it's still under an evaluation to determine whether
to not it's directly related to the vaccine itself.
CL Thank
you very much for this very important clarification again. With this we've
reached the end of our briefing. Thank you all very much. We still have a long
list of questions pending today but I hope we'll see you again next week.
Before I hand over for the final words to Dr Tedros I remind you that we send
out Dr Tedros' remarks right after the press conference and the full transcript
will be posted on the website tomorrow morning.
For any follow-up questions please send an email
to mediaenquiries@who.int. Dr Tedros, please.
TAG Thank
you. Thank you so much, Christian. I would like to repeat wishing Chag Pesach Sameach
and with that, thank you so much for joining us today and look forward to
seeing you next week. Bon week-end.
01:00:10