COVID-19 Virtual Press conference transcript - 6 January 2022
Overview
00:01:09
MH
Hello, everybody. This is Margaret Harris in WHO headquarters, Geneva,
welcoming you to our first global press conference of 2022 on COVID-19 and
other health emergencies today, Thursday January 6th 2022. We have
as always a panel of experts to answer your questions, led by our WHO
Director-General, Dr Tedros and with Dr Tedros we also have in the room Dr Mike
Ryan, Executive Director of our Emergencies Programme, Dr Maria Van Kerkhove,
Technical Lead for COVID-19, Dr Ibrahima Soce Fall, Assistant Director-General,
Emergency Response, Dr Mariangela Simao, our Assistant Director-General for
Access to Medicines and Health Technologies, Dr Kate O'Brien, Director of
Immunisation, Vaccines and Biologicals department, Dr Bruce Aylward, Senior
Advisor to the Director-General, who leads on the ACT Accelerator, and Dr Janet
Diaz, who leads on clinical management response for COVID-19.
As usual we're translating this simultaneously
in the six official UN languages plus Portuguese and Hindi and so now without
further delay I will hand over to Dr Tedros to give us his opening remarks. Dr
Tedros, you have the floor.
TAG Thank
you. Thank you, Margaret. Happy New Year. The dawn of a new year offers an
opportunity to renew our collective response to a shared threat. I hope global
leaders who have shown such resolve in protecting their own populations will
extend that resolve to making sure that the whole world is safe and protected.
00:03:14
This pandemic will no end until we do that. Last
week I asked everyone to make a New Year's resolution to get behind the
campaign to vaccinate 70% of people in every country by the middle of 2022 and
on top of that to ensure that breakthrough treatments as well as reliable tests
are available in all countries.
To end the acute stage of the pandemic the
highly effective tools science has given us need to be shared fairly and
quickly with all countries of the world. Vaccine inequity and health inequity overall
were the biggest failures of last year. While some countries have had enough
personal protective equipment, tests and vaccines to stockpile throughout this
pandemic many countries do not have enough to meet basic baseline needs or
modest targets which no rich country would have been satisfied with.
Vaccine inequity is a killer of people and jobs
and it undermines a global economic recovery. Alpha, beta, delta, gamma and
omicron reflect that in part because of low vaccination rates we have created
the perfect conditions for the emergence of virus variants.
00:04:56
Last week the highest number of COVID-19 cases
were reported so far in the pandemic and we know for certain that this is an
underestimate of cases because reported numbers do not reflect the backlog of
testing around the holidays, the number of positive self-tests not registered
and burdened surveillance systems that miss cases around the world.
While omicron does appear to be less severe
compared to delta, especially in those vaccinated, it does not mean it should
be categorised as mild. Just like previous variants omicron is hospitalising
people and it's killing people. In fact the tsunami of cases is so huge and
quick that it is overwhelming health systems around the world.
Hospitals are becoming overcrowded and
understaffed, which further results in preventable deaths from not only
COVID-19 but other diseases and injuries where patients cannot receive timely
care.
First-generation vaccines may not stop all
infections and transmission but they remain highly effective in reducing
hospitalisation and death from this virus.
00:06:43
So as well as vaccination, public health and
social measures including the wearing of well-fitting masks, distancing,
avoiding crowds and improving and investing in ventilation are important for
limiting transmission.
At the current pace of vaccine roll-out 109
countries would miss out on fully vaccinating 70% of their populations by the
start of July 2022. The essence of the disparity is that some countries are
moving toward vaccinating citizens a fourth time while others haven't even had
enough regular supply to vaccinate their health workers and those at most risk.
Booster after booster in a small number of
countries will not end the pandemic while billions remain completely
unprotected. But we can and must turn it around. In the short term we can end
the acute stage of this pandemic while preparing now for future ones.
00:08:00
First we must effectively share the vaccines
that are being produced. Throughout most of 2021 this was not the case but
toward the end supply increased. Now it's crucial that manufacturers and those
donating countries share delivery timings ahead of time so that countries have
adequate preparation to roll them out effectively.
Second, let's take a never-again approach to
pandemic preparedness and vaccine manufacturing so that as soon as the next
generation of COVID-19 vaccines become available they're produced equitably and
countries don't have to beg for scarce resources.
A few countries have provided a blueprint for
how high-quality vaccines and other health tools can be mass-produced quickly
and distributed effectively and now we need to build on it. WHO will continue
to invest in vaccine manufacturing hubs and work with any and all manufacturers
who're willing to share know-how, technology and licences.
I'm encouraged by some of the vaccines currently
going through trial where innovators have already committed to waiving patents
and sharing licences, technology and know-how.
00:09:36
It reminds me of how Jonah Salk did not patent
his polio vaccine and in doing so saved millions of children from the disease.
Let's also invest and build the public health and health systems we need with
strong surveillance, adequate testing, a strengthened, supported and protected
health workforce and an empowered, engaged and enabled global population.
Finally I call on citizens of the world
including civil society, scientists, business leaders, economists and teachers
to demand that governments and pharmaceutical companies share health tools
globally and bring an end to the death and destruction of this pandemic.
We need vaccine equity, treatment equity, test
equity and health equity and we need your voices to drive that change. Equity,
equity, equity.
No place is this message of equity more true
than in countries or regions dealing with humanitarian crises and conflict
zones. In these areas tackling the pandemic as well as keeping health service
on track is extremely challenging. The base requirement for life-saving
intervention is humanitarian access and we're on the ground in every
humanitarian crisis and in all instances have found ways to reach populations
with aid and supplies.
00:11:37
For example in Afghanistan until recently over
three-quarters of health facilities reported stock-outs of essential medicines
and there was a threat to sustaining health workers in their posts. But as of
December over 2,300 health facilities have received new supplies and 25,000
health workers have been paid, ensuring the functionality of 96% of the health
system through a joint WHO/UNICEF effort, especially the Sehatmandi programme.
In Ethiopia WHO was able to dispatch 14 [?]
metric tonnes of medical supplies to Afar and 70 metric tonnes to Amhara in
December, two places which have been affected by the conflict.
In Tigray WHO has not been permitted to deliver
medical supplies since mid-July of last year. This is despite repeated requests
from WO to provide medical supplies to Tigray region, which would help meed
some of the humanitarian and health needs in Tigray.
Even in the toughest periods of conflict in
Syria, South Sudan, Yemen and others WHO and partners have had access to save
lives. However in Tigray the de facto blockade is preventing access to
humanitarian supplies, which is killing people.
00:13:20
At the top I spoke of how the New Year is a time
to renew. I urge all leaders and key stakeholders in conflict to remember that
those who work for peace are the heroes history remembers. We need health for
peace and peace for health. To build trust and save lives a good starting point
is to ensure humanitarian and health corridors are open in all conflict zones
so international agencies and civil society groups can do what they do best,
save lives.
And to those celebrating Orthodox Christmas
tomorrow, may your homes be filled with peace, happiness and good health.
Margaret, back to you.
MH Thank
you, Dr Tedros. Now I'll open the floor for questions but we've got hundreds of
you online so I'd remind you that we have to restrict you to just one question.
When I call on you please unmute yourself and ask your question. I'll start
questions with Jamie Keaton from Associated Press. Jamie, please unmute
yourself and ask your question.
JA Hi,
Margaret. Hi, Dr Tedros. Thank you very much. Happy New Year to all. My
question is about what people should be doing given this rage of omicron cases.
Aside from getting vaccinated if they haven't already how can people change
their behaviours to help prevent omicron from spreading beyond what many people
were already doing to help stop the other variants?
00:15:23
For example should people be double-masking more,
washing hands more regularly, should they stop hugging, should they spend even
fewer moments in a confined space with other people and even keep a distance
while passing people for just milliseconds in the street?
Is omicron that contagious? In short, what more
can individuals do to fight this highly transmissible new variant that is
raging in so many places? Thank you.
MH Thanks,
Jamie. I think that's a question for Dr Maria Van Kerkhove.
MK Thanks,
Margaret. I'll start and then others will probably want to come in but I think
this is a great question. People can do so much. The power that people have in
hands, the power that everyone has in their hands to be able to protect
themselves and their loved ones has never been more important.
00:16:18
What we have advised and what we are continuing
to advise is to take a comprehensive approach in knowing what your risk is
where you live and take measures to lower your risk to be exposed to this virus
and if you happen to be exposed to this virus for the potential to pass it on
to others.
It is about making personal decisions and making
decisions for you and your family and also having the policies to support you
in those decisions to be able to keep yourself safe. This is about distancing,
keeping your distance from others outside of your immediate household, wearing
of a well-fitting, appropriately-made mask.
Not all masks are the same that are out there.
There are masks that are out there that are better than others. We make
recommendations on the minimum standards of masks in terms of layers, in terms
of the way that they are constructed. There are standards that are out there so
get ahold of a well-fitting and well-made mask and please make sure you wear it
appropriately.
00:17:19
I've spent a couple of days outside of the
office during this holiday period and I'm struck by how people actually are
wearing masks. When you put a mask on your face you need to have clean hands.
It needs to cover your nose and your mouth. Wearing a mask below your nose,
wearing a mask off your ear, wearing a mask below your chin is useless and it
gives you a false sense of security that you have something on and it's
protecting you. It will not.
It needs to be well-fitted over your nose and
your mouth. It's about making sure that you spend more time in places where
there's better ventilation, either outdoors or inside where there's better
ventilation.
It's about businesses, workplaces, schools,
governments investing in good ventilation. That takes investment, it takes time
but this is a good investment not only for COVID-19 but for other contaminants
that are out there.
It's about making choices about limiting your
contacts with others, avoiding crowded spaces. These are really important right
now but we also need to make sure that there are national policies that support
you in doing this, staying home if you're unwell, making sure that there's good
testing facilities that are out there and that people have access to reliable
tests so that they know if they are infected and if they are infected to get
into the clinical care pathway early because early clinical care saves lives.
00:18:40
To isolate and make sure that you don't pass the
virus on to someone else. Alerting your contacts if you are a confirmed case,
letting your contacts know that they need to quarantine so that if they happen
to be infected they don't pass the virus on to others.
Basically we are asking everyone to play a part
in this. We are asking governments to have rational, evidence-based, tailored,
comprehensive policies with a layered approach of all of these different types
of interventions that keep people safe. Essentially do it better, do everything
that we have been advising better, more comprehensively, more purposely.
We will not be in this situation forever. Your
question was around omicron and this wave that we have seen right now and it is
really quite astonishing how well this virus spreads but this variant with the
properties that it has and the increased transmissibility it has, it's also in
the context of immune evasion so people can be reinfected.
00:19:41
It's also in the context of people mixing
without measures in place. Any variant will thrive in that situation so we need
everybody to play their part and really focus on what you can do to keep
yourself safe.
So thank you very much for the question. Just
please be purposeful in what you are doing, take the steps to lower your
exposure to this virus and again keep in mind that all pandemics end. This
pandemic will end as well. We need, as the Director-General said, to ensure
equity to tests, to therapeutics, to vaccines and as individuals you can fight
for that as well.
So please get vaccinated when it's your turn and
please follow the public health and social measures that can keep you and your
loved ones safe.
IN May
the interpreters kindly request Dr Van Kerkhove to speak closer to the
microphone. Thank you very much.
MR And
certainly, Jamie, we do agree that omicron is more transmissible but it's a
relative increase in transmissibility. If we look at the secondary attack rate
studies that have been done in the UK and in South Africa, I think in the
United Kingdom we're talking somewhere between ten and 60% further transmission
within households.
00:20:59
In South Africa it was slightly higher and that
may reflect the size of households in that situation but certainly the increase
in risk of transmission with omicron in that setting was twice as high so for
example in the UK studies I think it went from about 10% risk of transmission
to 15% risk of transmission, in South Africa similar.
Also people who had been fully vaccinated had a
much lower risk of having a secondary transmission in their household so
there's lots we can do. Get vaccinated, recognise that the household is a place
where you can reduce the risk of transmission and many people have done that
successfully by ensuring that if you're sick, if you're symptomatic
self-isolating until you're tested, until you get a diagnosis.
If you're a contact, going by the national
guidelines for your quarantine periods and also be aware of the context that a
lot of transmission - and we've all heard anecdotal reports but there are a
number of reports of large-scale transmission in particular indoor crowded
settings.
00:22:01
So again it's the same basic things that Maria
has said. It's knowing your risk, it's recognising that omicron is more
transmissible so the chances of you getting the virus in the same situation are
higher now than they were before but it's exactly the same behaviours that will
protect you. You just need to do them more assiduously, more often and you need
to be more careful about where you go, how long you spend, where you spend your
time and how you protect yourself.
There are no easy answers and it's a good
message and thank you for asking the question, Jamie. It's important that we
get the opportunity to communicate with people around what will protect them
and it is exactly what protected people before.
But I would say and I'm sure everyone at this
table would say, one of the best protections is to get vaccinated. If you're
offered a vaccine please take the vaccine.
MH Thank
you very much for those answers. The next question comes from Belisa from W
Magazine in Portugal. Belisa, please unmute yourself and ask your question.
00:23:10
BE Happy
New Year to all. Thank you very much for taking my question. I received some
information that I kindly ask WHO to confirm or clarify. The discovery in
southern France by the Mediterranean Institute of Infection at University
Hospital Centre, about the new variant of COVID-19.
Is it true? France said that already resisted
[?] 12 cases of this variant and if it's true, I ask, do the vaccines that are
being administered protect people from this mutation? Thank you.
MH Thank
you. Dr Van Kerkhove will start and we may then pass to Dr Kate O'Brien to
discuss the vaccines.
MK Yes,
this variant that you're asking, it's this B1640. The earliest detection of
this variant was in September 2020 in a number of countries and there was a
pre-print that was published coming from our researchers in France recently.
This variant has been discussed with our
technical advisory group on virus evolution and it was characterised as a
variant under monitoring in November 2020 and this variant does have a large
number of mutations.
00:23:10
Our understanding, it's not very
well-circulating. Within France less than 1% of the samples that were sequenced
in France were of this particular variant. There're two sublineages of it, the
B1640.1 and the B1640.2. We classify both of those as a variant under
monitoring and this means that it's important that we track this, particularly
because of the numbers of mutations that it has.
But it isn't circulating widely at the moment
and the reason we classify it as a variant under monitoring is to raise
awareness and for people to be on the lookout for that. So as more sequencing
is done - and we thank governments and countries and researchers who have
worked so hard to improve sequencing around the world - it's important that
those sequences are shared on platforms like GISAID.
We should say, in the month of December more
than one million sequences were shared with GISAID. That is unprecedented and
we need more of that to continue because that helps us track. So this is a
variant that we are considering under monitoring and if that were to change or
if that changes we will be certain to let you know.
00:25:51
But it is not uncommon for research to be done
and for those pre-prints to come out and that information is shared with us so
it is really important. I do just want to highlight - and Kate will probably
comment on the vaccines but I just want to make the point that the vaccines
that are available for COVID-19 work against all variants that are circulating,
all of the SARS-CoV-2 viruses that are circulating and they are highly
effective against preventing severe disease and death.
I think that's really important for the public
to know and, as has been said many times, when it is your turn get vaccinated
because it's really critical. Vaccines save lives.
KOB Perhaps
I'll just add a couple of comments on the issue of this particular variant and
the vaccines. As Maria described, not a variant that is increasing in
prevalence, a small fraction of the strains that are circulating and so the
specific details on the performance of the vaccines, specific evidence of the
performance against this particular variant is still a matter to be evaluated.
00:27:03
But the really important point here, as Maria
said and I'll just reinforce, is that the real intent, the priority for vaccine
programmes is the protection against severe disease, hospitalisation and death
and even with the omicron variant where we've seen substantial reductions in
neutralisation of the virus the vaccines are still performing against that
severe end of the disease spectrum.
So we don't have an expectation that these
vaccines would have reduced performance or compromised performance against the
variant but again a minor circulating strain and really it's a matter still of
evaluation.
MK Margaret,
can I correct something? Sorry. I said that the first sequences were detected
in September 2020. I meant September 2021. I think I can't believe we're in
2022 so apologies for that but it was first detected in multiple countries in
September 2021 and it was classified as a variant under monitoring in November
2021. Thanks.
MH Thank
you for those answers. The next question goes to Nobu Sunaga from Jiji Press,
Japanese press, Berlin. Nobu, please unmute yourself and ask your question.
NO Thank
you very much for taking my question and Happy New Year to everyone. I'd like
to ask about the Winter Olympics in Beijing, which starts in one month.
00:28:43
Firstly could you tell us the WHO's assessment
on the safety of that Games? Is postponing the event not necessary in spite of
the expected [?] omicron? I'm sorry but please let me ask a very simple, second
related question to Dr Tedros. Dr Tedros, are you going to Beijing as you did
to Tokyo last summer on the occasion of the Olympic Games? Thank you.
MH Thank
you. Dr Mike Ryan will answer your question.
MR Thank
you for the question. We've continued to work, as we do with many organisations
organising mass-gathering events around the world and we've supported and
worked with so many different agencies over the last two years and we thank
them for their partnership.
As with the Summer Games, we have worked with
the Chinese authorities and through the International Olympic Committee in
order to provide technical advice on the safe operation of the Winter Games.
The Chinese authorities have very strict measures in place and they've released
a series of different playbooks.
00:29:56
We continue to review those playbooks with the
IOC and I'm confident given the information that we have that the measures that
are in place for the Games are very strict and very strong and we don't at this
point see any increased risk of disease transmission in that context.
However, as you know, China has been
experiencing some pretty large outbreaks of coronavirus or COVID-19 over the
last number of weeks and you'll see that the authorities in China are taking a
very strong approach to dealing with those outbreaks.
So we will continue to monitor the situation but
certainly at this stage, given the arrangements that have been put in place for
the athletes and by the organisers we don't perceive that there's any particular
extra risk in hosting or running the Games. But obviously we will keep all of
the measures that are being put in place under constant review.
MH Thank
you. We don't discuss travel of any of our staff. We'll go on to the next
question from Bianca Rotier from Globo from Brazil. Bianca, please unmute
yourself and ask your question.
00:31:20
BI Hi,
Margaret. Thanks a lot. Happy New Year, everyone. My question is regarding
Brazil. In Rio De Janeiro for example the number of cases increased by nearly
7,000% in 20 days and there is a feeling there and in some other Brazilian
cities, I believe as never before, that everyone has someone close with COVID,
a friend, a relative, a colleague from work.
Many people are feeling lost. Unfortunately some
of them think that as the virus has changed the necessary measures have also
changed. You already explained that but at this moment it's very important.
What message could WHO send to Brazilians right
now, how should they feel and react, what to expect? Is there a reason for
panic or only concern and then how big should this concern be? Thanks a lot.
MH Thank
you, Bianca. Dr Van Kerkhove will answer your question.
00:32:23
MK I
think I'll start and others may want to come in but I think the big message
that we have for all Brazilians and everyone around the world is don't give up.
We are in this pandemic together, we will get out of this pandemic together. We
have tools at hand that will end the acute phase of the pandemic and what we
mean by that is really gaining some control over this virus so this virus
doesn't control our lives.
We have the possibility right now to reduce
transmission significantly. Omicron is complicating that because it is so
efficiently transmitting. You will see in our weekly epidemiological report
that will be published tonight that the change in the case numbers in the last
seven days increased at a global level by 71%.
It varies by region of course. In the Americas
it increased by 100% but in the African regions it increased by about 7%. Of course
we are severely hampered by the ability of testing around the world and access
to tests. 9.5 million cases reported to WHO last week alone and we know that
that is an underestimate.
Next week will be higher because in the last 24
hours more than 2.2 million cases were reported. Having said that, given that
there is this increased transmission and given that so many people we know are
being infected we need people to hang in there and really fight against this
virus together.
00:33:54
Be kind to one another and fight the virus and
not each other. This is really, really critical because we are in this
together. We do know that omicron is causing less severe disease but it doesn't
mean that it is just a mild disease.
Omicron is not the common cold, it can still
cause severe disease, particularly among people who are not vaccinated but of
course people of older age, people with underlying conditions and we're just
starting to do analyses on the data coming in from countries and seeing data
from countries that exhibit this.
But when you have a huge number of cases
happening so quickly it will burden the healthcare system so what we need is
everybody to play their part and first and foremost prevent the opportunity to
get infected.
So getting vaccinated and fighting for vaccine
equity around the world is so absolutely critical but we need everybody's help.
Don't give up, please, because you have a role to play and an important role to
play and whatever position you have out there, whatever leadership role you
have - and don't be fooled.
00:34:56
Every single one of you out there is a leader in
your family, in your community, in your job. Play a positive role in getting us
towards the end of this pandemic. I think if you hear anything please hear that
and know that you can do something to get us closer to the end of this horrible
situation.
MH Thank
you, Dr Van Kerkhove. The next question goes to Robin Millard of Agence France
Press. Robin, please unmute yourself and ask your question.
RO Thank
you. It's now 2022 and we're more than two years since the start of this
pandemic which has killed more than five million people and blighted the health
and lives of millions more. How optimistic are you that by the end of 2022 for
those people we will be any further forward in getting answers on how this
pandemic began? Thank you.
MR I
think that answer is in our own hands. The reality is - and I think the last
two years has demonstrated, particularly with the arrival of vaccines, that we
can significantly reduce the disease severity, significantly reduce
hospitalisation, significantly reduce deaths through the equitable distribution
of vaccines around the world, particularly to those who are most vulnerable.
00:36:23
Vaccines have offered us the prospect, combined
with the other measures, of actually finding our way out of the acute phase of
the pandemic and I say that, as the DG mentioned in his speech about ending
this acute phase, this phase of death and hospitalisation and disruption.
The virus itself is very unlikely to go away.
We've seen its ability to evolve and to stick around and it will continue to do
that. What we would like to see is a situation where the virus settles into a
very low-level pattern which may have occasional outbreaks in under-vaccinated
populations.
But certainly if we can get close or achieve or
exceed the objectives set out by Dr Tedros and first and foremost we had the -
and Bruce may wish to speak to this - the original targets of 10%, 40% and now
70%. We haven't reached that 40% coverage yet in so many countries and getting
there right now is an absolute priority.
00:37:26
We have seen even with these huge numbers of
cases of omicron around the world and continued transmission of delta, we've
seen this decoupling of the incidence, of the number of cases per day from the
number of hospitalisations and from the number of deaths.
We've seen the impact, we have seen this
pandemic effectively come under control from the perspective of the disease and
death it causes by the proper and strategic use of vaccination. Our problem is
globally we have not distributed those vaccines in a way that we can do that
job everywhere at the same time.
Unless and until we get vaccines to every
country, to every vulnerable person, to everyone who needs a vaccine then I'm
afraid we will be sitting here at the end of 2022 having somewhat the same
conversation, which in itself would be a great tragedy.
That's why Dr Tedros has called for a renewal of
commitment, a redoubling of our efforts and we've seen governments in
industrialised countries go to extreme lengths to protect their own populations
and that is their primary responsibility, to protect their own citizens.
00:38:31
We've seen the push to increase vaccination
coverage, we've seen the push for boosters, we've seen the energy that's been
put in, the cost and the investment that's been put in to get vaccine coverage
in many of these developed and industrialised countries to a high level.
We've seen it can be done. The resources are there.
What the DG is calling for today is for us to redouble our efforts and look
beyond national borders and realise this is a pandemic affecting every country.
There's only one way out of any pandemic and
that's every country coming out of that pandemic. We will not come out of this
pandemic unless and until we get the same level of control in every country and
that's why today Dr Tedros is really calling for that redoubling of efforts. I
don't know, Bruce, if you want to comment.
BA Thank
you, Mike. I think, to the point Mike made - and thanks for the useiton, Robin
- when we set out over a year-and-a-half ago now - nearly - with the ACT
Accelerator, when the Director-General launched that the goal was to get the
countermeasures developed and distributed, especially vaccines, in a way that
we could take the heat out of this pandemic or take the teeth out of this
virus.
00:39:41
As Mike said, these vaccines have proven
incredibly effective in that regard. Kate summarised it earlier. They reduce
the risk of severe disease, hospitalisation and the numbers we're seeing from
some countries are staggering. Of the patients with severe disease up to 90% of
those are unvaccinated so clearly these vaccines are having a huge impact.
So to Mike's point, the big goal is take the
heat out of this thing, make this thing a more almost normal disease, if we can
say such a thing, and we have the tools to do that. It's how we distribute
them.
So as we look forward to that goal of 70% of the
population vaccinated in every country, the first step has got to be 10% in
every country. 36 countries still aren't there, many of them because they did
not have the supply of the vaccines that they needed.
Then there's another group who need
international support to get their coverage up. Then as we look to the 40%
target, that really is the crucial one because that covers your most vulnerable
populations in all countries and your healthcare workers.
00:40:49
90 countries, nearly half the countries in the
world aren't there and they can't get there without the global solidarity that
Mike talks about and the solidarity not just of countries but especially of
manufacturers who are making these vaccines.
We need them to really prioritise the countries
most in need. They are the ones that need the long lead times, they are the
ones that need full sight on what they're going to be getting and when.
So the solution to this is in the hands of
manufacturers who make these tools. They're so important to the progress that's
made, crucial to getting it finished but then to the countries as well who've
got to finance the means to support the countries that are struggling to get
the vaccinators they need, the logistics they need to be able to counter the
miscommunication and other issues.
00:41:39
To the last point that Mike made, everybody now
is acutely aware of the costs of failing to vaccinate. It's the arrival of new
variants, of new challenges so the sooner we get the equitable distribution the
sooner we get out of this pandemic.
Could we do it by the end of 2022? There's
absolutely nothing we've seen so far that suggests that we cannot. There is no
need to finish 2022 in a pandemic.
MH Thank
you very much for those answers. The next question goes to Tiu Li from Xinhua
news agency. Tiu, could you unmute yourself and ask your question.
TI Hi.
Thank you for taking the question, which is about vaccines. Dr Abdi Muhamed,
the WHO Incident Manager, mentioned at the UN press briefing on Tuesday that
the omicron variant had mostly spread to countries that used the best-known
vaccines but there was no indication that other vaccines such as Sinovac or
Sinopharm were not effective against the variant.
So could WHO provide any specific statistics on
the efficacy of the vaccines, particularly Sinovac or Sinopharm, against
omicron or delta variants? Or could you please describe the role of the two
Chinese vaccines within the COVAX strategy, like the usage coverage in terms of
the numbers of countries or populations outside China via the distribution of
COVAX? Thank you.
00:43:18
MH Dr
Aylward will answer that question. Oh, no. Sorry. We have two experts. Dr Kate
O'Brien will start and then Dr Aylward.
KOB Thanks
so much for the question. We're monitoring extremely carefully the evidence on
the performance of the vaccines against omicron, against specifically the
primary interest in having vaccines that are protecting against the severe end
of the disease spectrum.
Since the omicron issue has started we've really
been emphasising that it does take time for this evidence to accrue. We now
have nine studies on the performance of vaccines but many, many more studies on
the laboratory performance of vaccines, in other words, the sera of individuals
who've been vaccinated and the ability of those sera to neutralise the replication
of the virus.
We don't have any studies specifically on the
two inactivated vaccines, Sinopharm and Sinovac, on their clinical performance
but there is some evidence on the neutralisation activity. Like all vaccines
there is a substantial reduction in neutralisation but what we're really
interested in is the clinical performance of the vaccines.
00:44:39
I think the other really important thing to
mention is that we also have evidence about the mixing and matching of
vaccines, that now we know a lot more about when you have one dose from one
product and another dose from another product, that in some of those
combinations there can be better performance than frankly if you get the same
product.
So still early days for the two inactivated
vaccines and we would very much like to have a set of effectiveness data,
clinical data on the performance of these vaccines, especially for the
protection against that hospitalisation end of the disease spectrum.
These are really important vaccines for the
global supply and have demonstrated their effectiveness outside the context of
omicron so we really would like to have that evidence and are watching very
carefully for that to come forward. Bruce, you may want to add a few things to
that.
00:45:43
BA If
you insist I make a comment on this question. First, thanks, Xinhua, for the
question. The first point I'd make is - and it relates to one of the earlier
ones that was made - when we think about vaccine and coronavirus what we're
learning is we shouldn't be thinking, does a vaccine work, yes or no. It's how
well does a vaccine work because what we're seeing is all of these vaccines are
doing what we need them to do, which is to save lives, prevent severe disease,
hospitalisation, take the pressure off the ICUs.
As Kate highlighted, we have more data for some
vaccines than we do for others and we have to be very careful that we don't
think an absence of data is an absence of impact so let's be careful about
that.
Mike made the comment some months ago that the
best vaccine you can get is the one that you can get the soonest and that
remains the case today. Get that initial protection in place. You can always
boost, as Kate alluded to, with a heterologous boost and further boost the
impact of these vaccines if needed but the key thing is get that initial dose.
00:46:54
Then in terms of the question about the use of
the vaccines, through COVAX we've shipped it to 49 countries, either the
Sinovac or Sinopharm vaccine and over 180 million doses now, which is nearly
20% of the total vaccines that have been shipped to COVAX so this has been an
important part, as Kate alluded to, of the overall roll-out of products around
the world to try and boost immunity, save lives and get in front of this
pandemic.
So important products, still learning about
these products, as we are about all products as we go forward. The other thing
we need to remember as well, the virus continues to evolve and these variants
continue to evolve and how it operates against one, as we're learning, may be
different against others.
So right now we want to take advantage of the
full armamentarium of vaccines that we have.
MH Thank
you very much for those questions. We'll now go to Mexico, to Manuel Lino from
EJE Central Mexico. Manuel, please unmute yourself and ask your question.
MA Hello.
Thank you for taking my question. How real is the increase in paediatric
hospitalisations due to omicron and how worried should we be about it?
00:48:25
MH Thank
you. That's one for Dr Janet Diaz, our clinical lead.
JD Thanks
for the question. It is an important question and I think the data's still
coming in from various countries and we are grateful for the countries that are
reporting that. With omicron we are seeing in general what's looking like...
With the increased transmissibility of the virus
then we are seeing associated with that an increased hospitalisation and that's
what people have been describing. When we look though to see, is this different
than what we saw within the delta period - is also the analysis that's being
done and that's how we're trying to distinguish what is the severity associated
with omicron.
When we look at severity we look at a few
things. We look at the rate of hospitalisation but more importantly we also
look at those patients that are hospitalised and require oxygen therapy or
those patients that are hospitalised and require intensive care therapy and of
course the worst outcome, which would be death.
00:49:24
So in the early studies that we're seeing now
from a few different countries, we are seeing the odds of being hospitalised
during the omicron variant circulation versus during the delta period
circulation to be reduced so that means a reduced risk of hospitalisation with
omicron variant when compared to delta.
That reduction as well is being seen with the
severity of the disease being observed. When we look at sub-populations, which
is what you're saying, and stratification - and so more data needs to be
analysed for this but when we actually look at the stratification of younger
people versus older people we are seeing that reduced risk of hospitalisation
and the reduced risk of severity is also seen within the younger people and
within children as well as within older people.
So it does seem that it's consistent, that
reduced association with severity within the different stratified groups of
ages. Why is that? There's still more to learn. There's more to learn in the
analysis and taking into account the various risks, other factors that may be
associated with severity.
One of course would have been age. The other is
the presence of chronic conditions and the other one whether or not populations
have been vaccinated or whether or not they've had previous infection.
00:50:50
So many of the studies we're seeing now are
starting to look and make sure that those analyses are robust and being
adjusted for the other co-factors.
With what we have seen though with the children
that have been hospitalised with omicron is that those that are at increased
risk continue to be those patients that have chronic conditions so again
looking like, as we know for other variants, that when you have a chronic
condition you're at increased risk for severe disease.
So thank you for that question but still lots to
learn and we do again thank member states for sharing data with WHO on clinical
characterisation, the clinical data platform in order for us to do these
in-depth analyses. Thank you.
MH Thank
you very much, Dr Diaz. The next question goes to Jeremy Launch from Radio
France International. Jeremy, please unmute yourself and ask your question.
JE Thank
you, Margaret. Good afternoon to everyone. There are reports or mostly
statements by some experts that omicron might be the last variant of the
pandemic considering the high level of infection and thus the high level of
immunisation among the population.
00:52:07
I was wondering, how likely is this scenario to
happen? Thank you.
MR Maybe
I can... Maria, I'm sure, will supplement. I think it's wishful thinking, quite
frankly, at this point. We saw with very high levels of transmission in
previous variants and very high levels of seroprevalence how omicron was able
to come in and exploit the immunity gaps that existed, that do exist around the
world.
So I do think there still is a lot of energy in
this virus. As Bruce alluded to, there're still billions of people, as the DG
alluded to, who are unvaccinated so there is still plenty - unfortunately -
opportunity for this virus to spread and to generate new variants.
We hope that that doesn't happen but at the
moment we're not doing enough to prevent that from happening in terms of
protecting people and in terms of distributing vaccine in a way that would
assist with reducing the emergence of variants.
The delta variant... I remember at the time we
had discussions, Tedros and Maria, with various scientists who said, this is
the fittest, best-adapted virus that we've ever seen, we cannot see how this
virus could adapt any more.
00:53:27
And yet it did and we've seen a further variant
emerge that is even more transmissible than delta, which was itself more
transmissible than previous variants. So no, I think it's not premature for us
to hope. We can hope for anything, we should hope for everything but the
reality is we're not doing well enough yet globally to be able to say with any
degree of certainty that we can avoid the emergence of new variants.
MK Yes,
Mike, you often say hope is not a strategy but unfortunately I think it's very
unlikely that omicron will be the last variant that you will hear us discussing.
Certainly the virus continues to evolve and if you recall, we have omicron and
there's a lot of attention to omicron right now because it is circulating so
widely.
In some countries omicron is replacing delta. In
other countries delta is competing quite well with omicron and it may take some
time to determine which variant will outcompete the other but omicron is very
efficient.
00:54:33
But delta is also evolving as well. There are
about 30 sublineages of delta that we are tracking as well. We have meetings
every single day with our member states, with researchers from member states
who are analysing and tracking circulation of this virus, the variants that
they are detecting within their countries, some of which are variants of
concern and of course delta continues top be a variant of concern.
But the virus is evolving and, as Mike just
said, as the DG has said, we are giving this virus plenty of opportunity to
circulate and the more the virus circulates the more opportunities it has to
change.
So I think unfortunately this will not be the
last variant you will hear us discuss, it will not be the last variant of
concern. There is some very important discussion that's being had right now
about how much more fit the virus can become in terms of its transmission, its
transmissibility.
Omicron is quite interesting because it has so
many mutations and there are a number of factors why omicron is so
transmissible.
00:55:41
It has the mutations that allow the virus to
adhere to the cell more easily and infect people more easily. We also have
immune evasion, which means people can be reinfected either from past infection
or from vaccination although it's still happening at a low level.
And we do have evidence of replication of
omicron in the upper respiratory tract. There're a number of factors that are
happening and the question is, what will happen as this virus continues to
evolve and what will those additional mutations mean.
There are a lot of very, incredibly smart,
compassionate, hard-working people who work with WHO through our technical
advisory groups to help us discuss this and make sense of what we're actually
seeing out there.
00:56:26
So we are grateful for that scientific, that
public health, that expertise and that collaboration that's happening
regularly. The other question is about severity and whether or not any future
variants will become more or less severe.
There is no inevitability that the next variant
will be less severe or more severe. We just have to see what happens as this
virus evolves but the big point is the less this virus circulates the fewer
opportunities it has to change so getting vaccinated is critically important
and vaccination coverage in all countries, among those who are most at risk in
all countries is really critical as well as driving down transmission as much
as we can with simple public health measures that exist, proven public health
measures.
Masking, distancing, avoiding crowded spaces,
investing in ventilation, etc. Those two sides of that equation are really,
real critical as we move forward because this virus isn't going away but
there's a lot that we can do to minimise its future impact.
KOB Let
me just add on the last part of your question, we really have to have humility
here as we go into this now almost third year of the pandemic. The last part of
your question was about, we've got high vaccination coverage in a number of countries.
But I think it's very worth repeating again that
by the end of last year, 2021, the DG had called for every country to achieve
40% coverage and of course there were many countries that were constrained from
actually achieving that.
00:58:06
There were 92 countries that did not achieve
that 40% target and of those 92 there were 36 that weren't able to achieve even
10% coverage, which means health workers, older people, people with underlying
medical conditions, the very highest-priority people still by the end of 2021,
in spite of over nine billion doses of vaccine administered around the world,
had not been vaccinated.
So we really have to go into 2022, as the DG
said, with not just doubling but tripling, maximising every single effort to
assure that vaccines are getting to those countries that are still so far from
the targets that we think are necessary in order to end the acute phase of this
pandemic.
It is vaccines and. As we're facing omicron it
has to be all of the tools that we have but we've got to get vaccines where
they need to be.
00:59:06
I'd like to emphasise that out of the COVAX
facility in December there were 320 million doses that were shipped into
countries in that month alone. November and December together was over half of
the shipments into countries for the whole of the year.
So we are on the right trajectory but that's
only a trajectory if it continues and so this really has to be a January that
exceeds even those shipments and that means manufacturers prioritising COVAX and
AVAT. It means donor countries who are sharing doses continuing to do that so
that those countries that are still below 10%, below 40% can get where they
need to be and achieve the 70% coverage by the middle of 2022 so we can all get
to the end of this pandemic.
MR Sorry
to come back again but I just wanted to because Maria mentioned this and I
think it's important that we recognise the huge efforts made by scientists and
laboratory workers around the world because we talk about equity and one
direction and sharing.
We haven't done so well at sharing vaccines. The
scientists in the world have done an incredible job of sharing knowledge,
sharing sequences, getting that information and putting it on fabulous
platforms like the GISAID platform, the NextStrain platform and again very
often those platforms are funded through soft investments and they're not very
stable and they need to be invested in at global level.
01:00:38
But also now working to expand that sequencing
capacity around the world and we've been working with the G7, with the UK, with
Germany, pandemic surveillance networks and looking at the expansion of the
capacity to do genomic and genetic sequencing around the world.
Because this has been vital knowledge because we
wouldn't have a clue where we are right now with these various strains. We'd be
so confused because we'd have all of these different forms of transmission
going on, all of this different epidemiology happening.
One of the great advances for us globally in
this pandemic is that we've been able to precisely link different patterns of
transmission or severity to specific strains, specific changes in the virus and
we've been able to predict potentially what these viruses will do depending on
those genetic sequences.
01:01:24
We've had this massive outpouring of scientific
knowledge and innovation so this is really a message of hope in this pandemic.
We have demonstrated collectively and the scientists of the world have
demonstrated that it is possible to innovate, it is possible to share and it is
possible for all of us to benefit from that knowledge and that holding
knowledge or holding innovation in the hands of a few has no benefit to anybody
in the long run.
I think our colleagues working in the laboratory
sciences have clearly proven that it is possible to prosper and to share and
I'd just like to shout out to those colleagues at national level, particularly
our colleagues in GISAID and in NextStrain and other platforms internationally,
who've worked selflessly over the...
I don't know how they've kept going, quite
frankly, because they've literally dealt with millions and millions of data
pieces to provide that information in real time to us and to governments around
the world so thank you.
MH Thank
you very much, Dr Ryan. We are coming up to the hour so I think we've only got
time for one more question and that will go to Imogen Foulkes from BBC. Imogen,
please unmute yourself and ask your question.
01:02:32
IM Hi.
Can you hear me okay? Thank you for taking my question.
MH Yes,
we can hear you very well. Go ahead.
IM Thank
you. Okay. Just to go right back to the beginning where both Maria and Mike
talked about the measures we all need to take typically with this very
fast-spreading new variant, do you still really advise contacts of people
who've been infected to go into quarantine?
Because at the moment that seems to be what is
imposing an awful lot of stress, particularly on the health service, so many
people who are just not able to go to work. Do you see any flexibility about
how quarantine could work and whether everybody actually needs to do it?
MK Thanks,
Imogen, for the question. This global strategy that we have since the beginning
is about reducing transmission, suppressing transmission, saving lives and
saving livelihoods and part of the strategy is about reducing transmission and
quarantine plays very important role in that.
01:03:30
What we recommend of course is we need good
testing systems in place to be able to identify cases so that cases can
isolate. Patients need to be cared for, need to get into the clinical care
pathway but having the contacts of confirmed cases being put in quarantine or
quarantining at home is really critical to prevent the onward spread.
We know that that is very difficult to do, we
know that that takes effort, people need to be able to not work and be
supported to not work, be supported in quarantine to make sure that they can
provide for their family, that they have food, etc, and that is not a small
matter.
We have recommendations for contacts to continue
to quarantine. Our recommendations include recommendations if you cannot do
testing but we also provide provision within our guidance to set policies that
you could shorten the quarantine period if you add testing to that.
So there is some flexibility in terms of what
can be done with quarantine but it is a really important measure and it depends
on your goals. The goals that we have set through our strategic preparedness
and response plan, first published on 4th February 2020 and revised
several times... Quarantine plays a critical role in the prevention of onward
spread.
01:04:50
The policies that governments set and that they
decide upon need to balance the prevention of onward spread and keeping
societies open so we recognise that and we recognise that there needs to be
some flexibility in the timing of quarantine, with the addition of tests of
course, if people are vaccinated.
But it is important not to abandon that because
if we abandon the isolation of cases and the quarantining of contacts the virus
will just spread and especially in the context of highly transmissible
variants, in the context of increased social mixing and social mobility, in the
context of the inappropriate use of public health and social measures, in the
context of conflicting messaging and politicisation viruses will thrive.
This virus has shown us over and over and over
again - alpha, beta, gamma, delta, omicron - that it will take advantage of any
opportunities it has to spread. So it's an important element of the global
response.
01:05:57
MR I
think Maria's point is important here, the difference between science and
policy. Science isn't the only issue that affects policy. Economy affects
policy, the need for education of kids affects policy, the availability of health
workers, the availability of front-line workers affects policy and it is a
trade-off between the two.
The SARS-CoV-2 virus has a very wide range of
incubation periods. Some people can take a day or two to develop symptoms. Some
people can take up to 14 days or beyond but the vast majority of people will
develop disease within five or six days of their last exposure to the virus.
After that the risk of developing the disease
drops off exponentially and, as Maria said, we have made provision for countries
that have testing to use some form of testing during the period of quarantine
in order to shorten that period.
The fact remains that for every day you reduce
the quarantine a small proportion of people will go on to develop symptoms and
potentially affect others. But you could say that's 14 days or 40 days and you
can go into a very long period.
01:07:08
So this is a trade-off. The science gives you a
range and that range peaks, I think, at about five or six days and then falls
off exponentially. So based on a country's need, based on the economy, based on
the availability of teachers, health workers and others, based on the
availability of tests countries have flexibility within that to set the periods
of quarantine that meet their goals.
I think Maria has been very specific in saying,
what are your goals? You have public health goals, you have economic goals,
there are social goals, there are educational goals and you've got to find the
right balance.
And you've got the realities of whether you have
testing available or not, you have the realities of people's lives and
livelihoods and whether people can afford to stay home for that long. In a
country that has income support, that has sick leave and all of those
provisions in place staying at home for a week is potentially not a major
imposition.
Where you're working hand-to-mouth, where your
next meal may come from your next day at work then it's a different equation.
So we leave it very much to countries to find that balance of what is the right
period of quarantine that meets the public health and social goals in any given
country.
01:08:21
But certainly - and I think there is some
evidence that the incubation period for omicron may be slightly shorter but
it's not that much so the equation really hasn't changed with omicron. It
really is a matter for countries to make that decision.
I know some countries are faced with that right
now and they should make those decisions as evidence-based as possible and be
clear and transparent with their populations why they're making that choice.
Please don't use science - in other words, policy-driven evidence generation,
in other words collecting the data that supports your new policy. That's not
the way we want to go.
The science is the science and then you make a
policy and then you're transparent in those trade-offs and you say to people,
we're making this decision even though we know the incubation periods can be
longer, on the basis of our social and economic needs we're going to shorten
the period of quarantine and add testing and yes, there will be some cases who
will develop disease after those dates but on balance that is better for our
society, that is better for our economy.
01:09:20
I think that's a better way to communicate and
make decisions rather than go to the scientists and say, please find us the
data that supports our new policy. There's been too much of that in this
pandemic already.
MH Thank
you very much. On that note we're well past the hour so I will close the floor
to questions. I know there were many more of you with hands up and I apologies
to you now. Do send your questions to media enquiries and we'll do our best to
answer them.
We will also post the audio file and the
Director-General's remarks later this evening and send you the links and the
transcript will be available tomorrow. With that I'll now hand over to Dr
Tedros for his final remarks.
TAG Thank
you. Thank you, Margaret. Again Happy New Year and Merry Christmas also to
those who are celebrating tomorrow and see you next time.
01:10:21