On Friday 27 March the World Health Organisation (WHO) held a press conference to a global audience to discuss responses to the COVID-19 outbreak.
On the panel were Director-General Dr Tedros Adhanom Ghebreyesus, Health Emergencies Programme Executive Director Dr Michael Ryan, Executive Director, and Maria Van Kerkhove, infectious disease epidemiologist and WHO COVID-19 Technical Lead.
Dr Tedros started the conference by providing context of the current COVID-19 situation. He detailed how there are over half a million confirmed cases globally and more than 20,000 deaths, but over 100,000 patients have recovered from the virus.
The WHO Director-General described how he attended a G20 meeting the morning before, where he presented his concept of Fight, Unite and Ignite regarding global efforts against the virus, describing how we are “one humanity with one common energy”. Dr Tedros explained the promise that G20 countries and the global community need to make to future generations by never letting a pandemic occur again on this scale – while nature will always plays its role, humanity needs to influence the impact this can have on society. Dr Tedros furthermore thanked the G20 for their commitment, their safeguarding of global economies, and their perspectives on global cooperation.
Following from this, Dr Tedros detailed a virtual meeting held earlier that day, in which representatives from China, Japan, Iran and the Republic of Korea shared their experiences in the fight against COVID-19 with 50 health ministers from across the globe. Key approaches they identified as contributing to the control of the virus included early identification, contact tracing and clear communication. The representatives did, however, identify major challenges that they faced and that other countries would increasingly face in the future, primarily related to the global impact of the personal protective equipment (PPE) shortage. WHO has so far donated over two million items of PPE to 70 countries, but more is still needed.
WHO has donated over two million items of personal protection equipment to seventy countries, but more is still required.
One of WHO’s current main focuses is increasing the global capacity to test for the virus, alongside research towards developing a vaccine, which is currently estimated to be 12-18 months away. In the short-term, there is an urgent need for therapeutics and no current cure. Dr Tedros was delighted to announce that, on the day of the conference, Norway and Spain were enrolling their first patients in what is known as the Solidarity Trial to test four treatments for COVID-19. Over 45 countries are currently contributing to the trial, which has received over $108 million USD in donations in two weeks from over 203,000 individual and corporate donors. Bent Høie, the Norwegian Minister of Health and Care Services, joined the conference at this stage to explain how one positive outcome of this “global health emergency” is the “global quest for knowledge”, with the first Solidarity Trial patient being treated at Oslo University Hospital. Høie thanked WHO for the global leadership role it has assumed at this time.
On the topic of treatment, Dr Tedros reiterated how individuals should retsrain from using unproven therapeutics, and advised those affected to “take no shortcuts”. He argued that when patients take drugs which are not yet known to cure COVID-19, they are ultimately causes shortages of these drugs for those diseases against which they are actually effective.
Individuals should restrain from using unproven therapeutics and warned against the danger shortages of other unproven drugs could represent
Discussing WHO’s active role in the global fight against COVID-19, Dr Tedros explained how over 40 reports into all aspects of the virus are available on the WHO website, and stated that over one million healthworkers have been trained online through WHO. He described how “crises like these bring out the best and worst in humanity”, addressing the dangerous rise in online scams and thanking cybersecurity teams.
He concluded his statement by quoting the Singaporean Health Minister Gan Kim, who in the call earlier that day had said: “We are only at the beginning of this fight. We need to stay calm, stay united and work together.”
“We are only at the beginning of this fight. We need to stay calm, stay united and work together.”Gan Kim, Singaporean Health Minister
After Dr Tedros’ statement, questions were opened to members of the press conference, the first of which addressed serological studies into COVID-19. The panel explained how epidemiological studies were being undertaken in over 12 countries, while many others employed age-stratified general population serol surveys. Alongside these, testing is being conducted in four separate countries on specimens already stored from patients who were hospitalised for other reasons. This is being conducted in order to better understand the differences in antibodies of people from many various backgrounds, this allows for a better map of how the virus may circulate around those with different preexisting medical issues.
The next delegate asked why it seemed that many more younger people were being hospitalised by the disease in the US and in Europe than in China. The panel acknowledged that COVID-19 can cause severe disease in those of all ages, and explained how cases of the disease are identified as mild, moderate, severe and critical. The majority of children suffer from mild cases, but there have been reports of some suffering from severe cases and deaths, including a young child in the US and in China, though these incidents often involve at least one underlying condition. When looking at the age profile of the virus, over 20% of COVID-19 fatalities in the Republic of Korea were under the age of 60, and 15% of those hospitalised by the virus in Italy are under 50 years old. The panel emphasised how “young people are not invincible” and explained how they can still transmit the virus, showing how everyone has a role to play in preventing the spread of the virus.
“Young people are not invincible”Dr Maria Van Kerkhove
The next question regarded the reliability of WHO’s statistics given that, when presenting the number of COVID-19 sufferers in China, the government does not include confirmed cases who do not show symptoms. Dr Kerkhove quickly explained how there has been a misunderstanding of the term asymptomatic, and that most of those described as asymptomatic are actually presymptomatic. She furthermore explained the necessity of this individuals being diagnosed as soon as possible, as those who are only mildly symptomatic drive the transmission of the disease.
Discussing how long the current outbreak may ask, the panel warned that, even in countries such as Singapore and China where the virus is in decline, the threat of its reemergence is still imminent. These countries consequently have to continue their measures to prevent a second outbreak of the disease. Dr Tedros explained how it is essential to introduce measures that have maximum disease control and yet minimal social and economic impact, and therefore localised measures are necessary, as there are large differences between outbreaks of the disease even within one country.
The panel furthermore stressed how the media and general population need to be careful not to overreact to changes in the daily number of confirmed cases, because this can be a disincentive against testing. The panel argued that a rise in daily confirmed cases is often instead just a sign of better detection and more accurate diagnosis. The need for this detection is paramount, as the disease escalates once community transmission starts, and therefore WHO is focusing on preventing community transmission as much as possible.
In response to a question about the spread of the disease in Nigeria, which at the time of the conference had reported fewer than 50 cases of COVID-19, the panel explained how almost every country in Africa has reported cases of the disease. While African nations generally have young populations, there are a range of other factors which need to be considered including the prevalence of both HIV/AIDS and malnutrition, but recent ebola and cholera epidemics show that the continent can respond well.
One delegate expressed concerns about the increase in governmental surveillance to monitor COVID-19, fearing that human rights may in the future be contravened if some governments choose to continue using such surveillance even after the outbreak has ended. The panel explained how in some instances it is necessary to limit individual freedom, within law, in the short-term to cause long-term public health impacts, and explained how individuals need to be selfless at this time to bring about benefits for many.
The final audience question regarded inter-EU relations amid the pandemic. The delegate voiced fears that northern EU countries such as Germany and the Netherlands were showing reluctance to help southern EU countries in fighting the outbreak of the disease. Dr Tedros appeared surprised to hear these allegations and WHO acknowledged the contribution the EU had made to support countries outside its own borders and the role the EU continues to play in uniting the world during the outbreak.
Last modified: 31st March 2020