UN Geneva - Multimedia Newsroom : WHO: Virtual Press Conference On Covid

All right, let's get started.

Thank you all very much for joining this morning on a very short notice.

I don't assume that we have a huge emergency pending like more or less exactly 4 years ago, which is interesting.

Now maybe Maria will come back to that one, but the point is that Maria has an appointment at 10:30, but she can't join the regular briefing.

And we wanted this to be a bit more extensive than just 5 minutes at the Palais.

And today with possibly large focus on Gaza, we thought we better we better do it our own.

Thank you all for joining.

I see the interest is big and that's that's good because in the recent weeks, all the the the things we want to talk about, the respiratory illnesses, the flu, COVID blocked up hospitals, I think have been in the media and people have experienced it themselves.

Nearly everybody knows somebody who's who's sick these days.

So and with this, very glad that Doctor Von Kirkov Maria could join us today.

You'd all know her as a COVID focal point, but she's now the ad interim director for Epidemic and Pandemic Preparedness and Prevention.

So thank you, Maria, for joining us.

And that's fantastic.

And let's get started.

[Other language spoken]

So hi everybody.

[Other language spoken]

I was reflecting with Christian yesterday that almost four years ago to the day was the first Palais briefing I've ever done and 1st press conference I've ever done.

So I cannot believe it's four years later and I can't believe we're in the fifth year of the pandemic.

So just a point of reflection and a point of thanks for all of you who have been covering this for four years into the 5th year.

Thanks for the work that you do for communicating really difficult topics to interested audiences.

[Other language spoken]

We continue to need you.

So I just wanted to, to start off with some thanks.

So today wanted to just give a, a brief overview of sort of where we are in terms of COVID, but also in the context of other circulating respiratory pathogens and most notably influenza.

So I wanted to cover a couple of things with you and then happy to do Q&A as you wish.

So I think what's really critical right now is that the world understands that COVID, the, the public health risk from COVID remains ****.

And this is globally, we have a pathogen that is circulating in all countries.

We have ranges of percent positivity from our Sentinel sites of anywhere from 8 to 10, six to 10% from non Sentinel sites up to 18%.

Case based data that is reported to WHO is not a reliable indicator.

It has not been a reliable indicator for a couple of years now.

And so if you look at the epic curve, it looks like the virus is gone and it's not.

According to wastewater estimates that we have from a number of countries, the actual circulation of SARS COV 2 is anywhere between 2 and 19 times higher than what is being reported.

So the virus is circulating.

And what's difficult right now is that the virus continues to evolve.

So we are two years into Omicron.

We have a virus that will continue to change as we let it circulate rampantly.

What is concerning, I'll start with the positive side.

On the positive side, the numbers of deaths have reduced drastically since its peak a couple of years ago, but we still have around 10,000 deaths per month and that's only data from 50 countries.

Among those 10,000 deaths reported in December, more than half were reported from the United States of America, 1000 from Italy.

So we are missing deaths in countries from around the world.

Because countries aren't reporting deaths doesn't mean that they're not happening.

We have had a 42% and a 62% increase in hospitalizations and ICU admissions, respectively.

When we look at the data from December compared to November, we don't have data into January yet.

It's too soon.

And with the holiday season, with the gatherings around the New year, we expect those numbers to continue to increase.

So while we on the one hand we are seeing reduced impact, we feel that there is far too much burden in countries from COVID when we can prevent them with adequate tests, with adequate access and use of antivirals, with appropriate clinical care, medical oxygen and of course vaccination.

We'll come back to vaccination in a moment.

The other challenge that we face in this winter season, particularly in the Northern hemisphere is that we have Co circulation of a large number of other pathogens including flu, RSV, adenovirus, rhinovirus and a number of bacteria.

Mycoplasma pneumonia, which you've heard about from a number of countries, which goes in four to five year cycles.

And we're in a cycle of mycoplasma pneumonia causing pneumonia among children, school aged children.

So while we're not in the crisis, we and we're not seeing the levels of impact that we saw in the peak of the pandemic in 2021-2022 and even early 2023.

COVID is still a global health ****** and it's causing far too much burning when we can prevent it.

So we're seeing impact on a smaller scale to previous waves, but now the preventable burden of COVID-19 is adding to the burden of other respiratory diseases as opposed to previous years when we had public health and social measures which were in place.

And so we have to consider COVID with flu, with all of these other pathogens.

And here's why we're still in a pandemic.

1 is the virus continues to evolve.

We do not yet have a predictable pattern or seasonal pattern with COVID.

There's basically 2 groupings of viruses that are circulating right now.

We have the XBB sub lineages and we have the BA286 sub lineages.

[Other language spoken]

And most notably, JN .1 is increasing.

JN .1 represents around 57% of the global sequences that are shared with KISSAID and are analysed by WHO and our technical advisory group for virus evolution and this varies by different regions.

The second reason we're still dealing with COVID and that COVID is causing an impact is because it's not the only pathogen that's out there that I've already talked about.

We have Co circulation of other pathogens.

Despite reduced reporting from countries, the virus is still infecting, it's reinfecting, it's killing, it's causing suffering from acute disease represented by people in hospital.

And right now we estimate that there are hundreds of thousands in hospital for COVID.

We have limited data around the world and in fact the data that we have on hospitalizations only comes from 29 countries out of 234 countries and territories.

Data on ICU admissions only comes from 21 countries out of 234.

So we're really we have very little visibility on impact but from those limited number of countries, there are hundreds of thousands in hospital right now.

So we're worried about the acute disease, but we're also worried about post COVID condition.

We have estimates from some recent meta analysis suggesting that 6% of symptomatic infections will result in post COVID condition.

And the the burden of of post COVID condition effects multiple organs is very debilitating to people who suffer from it anywhere from four months to 12 months and even longer.

And we don't know the long term impacts of repeat infections separate to post COVID condition.

[Other language spoken]

You're getting reinfected.

[Other language spoken]

I may not know what I'm still testing periodically, especially any time that I have symptoms I test.

But because I have some populate, I have some immunity from vaccination and previous infection, as do you.

We don't necessarily know how often we're getting infected.

And our concern is in five years from now, 10 years from now, 20 years from now, what are we going to see in terms of cardiac impairment, of pulmonary impairment, of neurologic impairment?

[Other language spoken]

We don't know everything about this virus.

It's year five of the pandemic and I know it feels a lot longer, but there's still a lot that we don't know about it.

And we're worried about the law, the acute effects, post COVID condition and even the longer term effects going into the future.

We're also still in a pandemic and a dynamic situation because there is complacency out there.

Most people don't want to talk about COVID.

And I think the main reason for that is because of the trauma that we've gone through.

There are some serious mental health impacts from this virus from the last four years, whether you're directly impacted, losing a loved one.

But all of us have been impacted by this.

So there is complacency that's out there to not want to talk about it.

Our role as WHO is to work with governments to ensure that the legacy of COVID in the strengthening of surveillance systems, of clinical care, of community protection, of infection prevention control is maintained to deal with current and future threats.

And we are still in a dynamic situation, still in seeing impact where we shouldn't because we have very low demand for vaccination.

The coverage of vaccination around the world is low again in Year 5.

If we look at the booster coverage, we have a number of countries.

I have to put my glasses on here.

55% of older adults around the world have received a booster.

What I can't tell you is when they receive that booster, the oldest adults need to be boosted every six to 12 between 6 and 12 months.

And the coverage around the world, particularly in older groups, in Africa it's 9%, in the Americas it's 65%, in Amro it's 27%, in Euro it's 69%, in CRO, 30%, Wipro 75%.

So there's much more that needs to be done.

Healthcare worker coverage in terms of booster is even lower.

So we're not utilising the vaccines that are safe and effective and effective against the circulating variants.

So there's a lot more we feel that needs to be done.

Just a quick note on influenza for seasonal influenza, the Northern Hemisphere is seeing a rapid increase in influenza activity, especially in Europe, North America, North Africa.

Although influenza activity might have peaked, it's still **** in East Asia, especially in China.

Increasing flu activity might impact the healthcare capacities in some countries and in fact we are seeing it.

In fact, it impact and add burden in some in some as well as RSV in the younger age groups RSV maybe is still ****, but it may be declining in some countries.

If we look at percent positivity for influenza in week 51 of 2023, it was around 20, almost 21% in the Northern hemisphere and then the last two weeks of data are going to be backfilled.

So it's not an accurate representation, but around 15 to 20%.

So there are a lot of viruses that are out there.

Flu vaccination coverage is not as **** as it should be as well.

So the such big messages around getting vaccinated against flu, getting vaccinated against COVID, using tools, masking, stay home if unwell, seek clinical care, improve ventilation, all of the same messaging that we've had over the last four years, still apply.

May not be as novel to hear, but it's really important that we get that consistent message out there.

I think Christian, maybe I should stop there and just maybe take some questions.

[Other language spoken]

And if because there were a lot of figures in there, I, I would assume that's one of the first questions.

Is there a way you could share the, the talking points of the main figures afterwards?

I know you, you normally work in a different way to another script.

So if there's a way we can get that or at least a link to the main data other than the what we know, that would be great.

We promised Maria and also the Palais to do not do too long because we need to prepare for Palais and Maria needs to leave.

So we have about 15, close to 20 minutes.

And then let's get started.

[Other language spoken]

My question is on the post COVID conditions, Maria, that you mentioned.

Can you be a bit more specific?

You said 6% of symptomatic infections.

Now I'm one of the very few people in the world who's never been infected as far as I know.

So I don't know what the symptoms are, but the people I do know who have been infected say they had flu like symptoms.

Are you saying that anyone, 6% of anyone who has flu light symptoms, light light, I would say symptoms, 6% of all of those people might have post COVID conditions or, or is the the group the 6% refers to a smaller group of people who have more severe symptoms And no, what, what what are those post COVID conditions, for example?

[Other language spoken]

So thanks for the question and allowing me to clarify.

So post COVID can the 6% refers to symptomatic individuals with COVID.

So who've been diagnosed with COVID, who've had, who have been infected with SARS COV 2, not people who've had influenza like illness.

There are other estimates that suggest one in 10 infections could result in post COVID condition.

Now an infection could range from anything from asymptomatic all the way to severe disease.

The 6% I mentioned are COVID symptomatic individuals.

Post COVID condition is defined as people who have.

We have a case definition for this and we can provide that case definition for you, which we're asking clinicians to use around the world so that we have a consistency and understanding what post COVID condition is.

Typically what post COVID condition is or long COVID is.

Someone has been, has, has symptoms, which could be fatigue, severe fatigue.

You know, for example, we know people who were athletes, premier athletes who can't exercise anymore.

There's lung impairments, there's neurologic impairments, there's cardiac impairments.

3 months after that acute disease that they experienced.

So they had COVID, they got better, they got worse.

And people who have post COVID condition, that condition lasts anywhere from 4 to 12 months or sometimes even longer.

So there's a lot of work that needs to be done on, on recognising what it is, for having cohort studies around the world to better describe what post COVID condition is and to have better treatment for this as well.

So there's a lot of work in this space which we don't have enough attention on.

We certainly don't have enough financing around the world on.

Thank you very much, Maria Antonio Brotto from FS Next very much.

[Other language spoken]

In Spain, the government is requesting a wearing mask again in the hospitals.

Do you think this is enough or it should be also requested in other public places?

And my second question is on booster doses.

[Other language spoken]

Still recommends only these to vulnerable groups or.

To.

All people in general, thank you.

[Other language spoken]

So with regards to masks, our recommendation which is still in place since early 2020, sometime in 2020 is universal masking in healthcare facilities, which means anyone in health facilities should be wearing a medical mask.

People who are health workers who are working with COVID patients or suspected patients need to be wearing further materials.

So respirators or masks, gloves, face Shields, the whole the whole gamut of of personal protective equipment.

We also recommend the use of masks in communities for people who are at a higher risk of developing disease.

Anyone who is sick, we would recommend wearing a, a medical mask or a three layered mask when you're around others to prevent the spread.

Whatever you have, but especially if you're in an older group and if you're in some close quarters, if there's poor ventilation, our recommendation still is to to consider wearing masks.

We would like people to wear masks because we know that they have some effect of preventing onward spread, spread and also protecting you from infection with regards to additional doses.

So the SAGE recommendations that came out a few months ago, we make recommendations based on risk category.

We have the highest risk groups because our recommendations are for the world.

We would like everyone in the highest risk group.

So oldest age groups, so over 75 or 80 / 60 with underlying conditions.

I mean, you know, compromised individuals in all countries to receive a dose, an additional dose if you haven't had one in the last 6 to 12 months.

And then we go down in medium risk and then we have lower risk.

We don't recommend the entire planet to get a vaccine because we have limited supply and because we because we have access issues.

And so our considerations around the highest risk groups in all countries.

We do know that there are national policies.

There are different national policies in different countries, but we advocate for the use of vaccines to prevent severe disease and death.

The vaccines based on the ancestral strain, the bivalent vaccines, and the monovalent XBB vaccines that are coming online now, they all protect against severe disease and death, and we advocate for their use to reduce the burden and to keep people alive.

Thank you very much, Maria.

And to add you, you may have seen various hospitals or healthcare people around Geneva are now also starting to wear masks again as a, as a rule, sometimes, sometimes in personal protection.

But I know from the tour, for example, they, they started that with their employees again and so on and so forth.

So the, the, the, the masks are coming back more visibly.

Definitely.

Next is Stefan Boussa from Yes.

Thank you very much.

[Other language spoken]

For holding this briefing.

[Other language spoken]

First, I think WHO published a figure saying that they've.

They have been.

7 million people, 7 million deaths due to COVID and influenza.

[Other language spoken]

More or less the figures and if it's correct.

And my second question is about you talked about vaccination and and we know.

That it's a very hot topic in the.

Negotiations about the pandemic, accord is.

Our better infrastructures today to, you know to.

[Other language spoken]

Vaccination to take place.

Thank you very much.

Thanks for the two questions.

So this there, the 7 million deaths are COVID specific.

So by the end of 2020 three 31st of December, more than 7 million people have been reported to WHO as having died from COVID-19.

We know that that number is certainly higher.

We are working to estimate what this is.

We have estimates up to the end of 2021 and these have been are being revised to look at excess deaths for 20/22 and will be done for 2023 as well.

So we expect that the actual true number is at least three times higher.

So those 7 million deaths are COVID only, which is truly astonishing.

With regards to infrastructure and vaccines, yes, you know, you know, we're not in the same position we were four years ago.

There's a lot of work that's been done in terms of looking at different platforms of vaccines.

The vaccines for COVID-19, many of them are the mRNA platform, but there are other technologies that are out there.

There is improvements in production, in terms of production facilities of vaccines.

Much more work needs to be done here though and how there's a lot of questions how this is going to be sustained in terms of financially there is some improvement in terms of sharing technology, but that needs to improve.

So the short answer to that is yes, we're in a, in a, in a better place.

There's more attention to this, but we're nowhere really where we need to be.

If, if we're in a similar situation or I should say when we're in a similar situation.

Again, more planning needs to be in place.

And I think the discussions with the the Accord are quite interesting in this, but also the work of the CTAP, the work that we're doing related to access to medical countermeasures for pathogens with epidemic and products focusing on pathogens with epidemic and pandemic potential.

And of course, we have a different system for influenza.

So yes and no I think is my answer to that.

[Other language spoken]

Lisa from West of America.

[Other language spoken]

Hi, Good morning, Christian.

[Other language spoken]

Yeah, I, I got a common cold for the first time in three years.

So I'm back to masking because it lasted 3 weeks and it's horrible.

Anyway, my questions have to do with, first of all, is, has COVAX been abandoned or is it still operating?

And I'm particularly interested in the situation as it is in Africa right now.

During the height of the pandemic, the coverage there was not particularly good.

So I imagine that it's even worse.

So if you could enlighten us a bit more about what the situation is and how you're able to keep tabs on what is actually happening on the continent.

And then as far as Pax Lavid goes, it's kind of, I don't know, keep getting that mixed messages about whether to use, not to use.

What is The Who recommendation on that?

[Other language spoken]

Thanks, Lisa, and sorry to hear that you're unwell.

[Other language spoken]

Yes, Kovacs is standing down.

And I think Christian, maybe we could provide more.

I'm not the Kovacs focal point, so I don't have the full details on that.

But indeed it is standing down.

And I, you're, you're correct, you know, there has been a, a challenge of getting vaccines, COVID vaccines in particular to the continents of Africa.

We, the coverage across the continent is nowhere near what we had hoped it would have and certainly in 2021-2022 and even 2023.

Now into 2024 when your, your question on keeping tabs is a good one because we are shifting the way that we are going to be reporting on vaccination coverage by the springtime, springtime Northern hemisphere.

What we will be reporting on is the number of individuals or the proportion of individuals who received a dose within the last 6 to 12 months, which is a much better indicator than me telling you how many received a primary series or a booster.

Because we don't know when that that last booster was given.

If it was two years ago, it's nowhere near as effective as if it would have been a year ago or even 6 months ago.

So we're going to be shifting that and we are countries all over the world are working to incorporate vaccination into national programmes so that COVID vaccination is not a stand alone, but that is actually implemented within vaccine delivery within the countries themselves.

And this is a much more sustainable model.

But again, it's around working with individual countries, making sure that we maintain the gains for vaccination and vaccine delivery that have been that have occurred in the last four years.

And I do, I mean, maybe not a topic for now, but I wonder, you know, if at some point we really need to kind of, I know we talk about how many people didn't get vaccinated, but we also need to talk about how many people did, you know, in a situation and across the globe where billions of people are exposed, the entire planet exposed, billions have been vaccinated.

And that really is something that is quite astonishing.

We focus a lot on the hesitancy and that's really important because we have to work on that.

But we also should be telling the stories of the people who've been vaccinated and whose lives have been saved because I think that is a positive indicator.

You know, we need to, we need to hold on to, especially with the huge amounts of misinformation that's out there.

And the the reluctance of taking COVID vaccine by some is also impacting flu vaccination, It's impacting other vaccination programmes.

So we have a lot of work to do in this space in the coming years.

[Other language spoken]

Next on the list is Catherine.

Catherine Tianko.

[Other language spoken]

Good morning, Maria, and thank you for this briefing.

A couple short questions regarding the long COVID.

At the beginning, long COVID was not really identified by doctors.

So is there a clear process to be identified all over the world?

You spoke about the fact that it is the lasting 4 to 12 months.

Are there regions that are reporting more cases of long COVID and is there a lot of cases of long COVID among children?

Yeah, thanks for the question.

So describing long COVID globally is very challenging because many people use different definitions for this.

We have a case definition for post COVID-19 condition, also called long COVID, but the clinical word is post COVID-19 condition for adults and for children.

So your last question, yes, children can, can develop long COVID, post COVID condition as well.

For me to give you an exact, I can't give you an exact number because there's so many different definitions that are being used around the world.

What we want our clinicians around the world to use our case definition, what we want clinicians around the world and researchers around the world are to set up these cohort studies that are following patients over time to better describe the impacts of post COVID condition on the different organ systems.

Yes, most people will recover after 4 to 12 months, but there are still some people who are dealing with these long term impacts for even longer than a year.

So I we don't have the precision that we would like to be able to describe post COVID condition.

We do not have the treatment available yet because it's still so new.

There's a lot of work that's that's ongoing and this is led by our clinical management team here at WHO.

We're working with patient groups as well to to provide their input into the discussions to not only develop treatments and rehabilitation, but also to make sure that there's adequate recognition of this because it's real.

This is not in someone's head.

This is actually a real condition that needs to be studied properly.

[Other language spoken]

Next I'll take because I hope we have two more questions.

We managed to get through on time, but I'll take first Gabriella Sotomayor please, because Ashley is a special guest and she'll get the last question in case we manage.

[Other language spoken]

Thank you very much, Maria.

Thank you, Christian.

I apologise, I joined the conference late.

I don't know if you talk about these, but I would like to know if the vaccines recommended by The Who are the same or have you added any to the list of approved vaccines?

And second question, very quick.

I would like to know if all Member States are informing you about the COVID situation.

So second answer first is no, we do not have all countries informing us of their COVID situation.

With the lifting of the public health emergency last May and the lifting of national emergencies in some countries, some countries have stopped reporting.

Many are still providing some information, whether they're reporting directly to WHO or they're publishing monthly sitreps online.

Unfortunately, we're back to sort of scraping the web and finding each of those reports and adding them into our dashboard.

Please look at our new COVID dashboard that we launched at the end of the year.

Over the course of 2024, we're going to be adding more information, making the percent positivity coming from our Gistris system around the world, as well as adding wastewater data to this, trying to make sure that the deaf data from countries is updated because we only have data on deaths from 50 countries.

And we will be incorporating more information on hospitalizations and ICU because we really want to be focusing on impact on the vaccines.

I'll have to come back to you on what what we have and I'm sure we have a website that I can link you to.

I just forgot around the pexlovid question for earlier journalist.

[Other language spoken]

I can give you the specific recommendation that we have, but we recommend the use of antivirals and pexlovid to prevent severe disease.

Thank you very much.

And we're managing to get one more in.

And Ashley, who's now with Bloomberg as a special guest today.

[Other language spoken]

Thanks, Christian, and thanks, Maria.

I just have a quick question about the studies in the journal Cell from earlier this week on BA 2.86, the sub variant.

And there's concerned that they may be a bit more, it may be a bit more virulent.

And I'm wondering if you could explain a little bit more about that research and if you're concerned about it.

[Other language spoken]

Yes, so thanks very much.

So that study that was public, if it's the same one I'm thinking of, it was based on a pseudovirus.

So it's not based on JN .1, the actual virus itself, but a pseudovirus and looking at potential severity.

That was considered in the risk evaluation that we published before the paper actually came out because the information was shared with our technical advisory group for virus evolution.

We don't have any indication in people that there's a change in severity for JN .1.

And right now, as I mentioned in my opening, that represents around 57% of the global sequences worldwide.

Having said that, we are concerned and deeply concerned that this virus is circulating unchecked around the world and that we could have a variant at any time that would increase severity.

This is not meant to be a a scare tactic, but this is a scenario that we plan for and the challenge with that.

And if it were to come out in a study, I think we would see it much quicker in actual hospitalised patients.

And I should say, you know, we are seeing increased hospitalizations in a number of of countries around the world.

I had my team pull out where we're actually seeing this, but quite significant increases in in a number of countries around the world, not near the peak of what we saw during COVID, but a variant that that is more severe is a possibility.

And we don't have the agility within our systems to scale up, scale down to get those tests out, to be available so that people can get into the clinical care pathway, access to antivirals to prevent severe disease, access to medical oxygen.

We just don't have the flexibility and agility within countries because people are thinking that COVID is no longer a problem.

COVID-19 is a global ******, especially in the context of other circulating viruses.

But we are looking at all the studies.

That particular study that you mentioned is included in our risk evaluation, which is on our website.

It was published a few weeks ago and you can see that our tag the ES meeting again on Monday and we're going to be considering other pre publication data from research groups around the world who we're very grateful for to share this information with us ahead of time.

Thank you very much.

And looking at the time, this is just perfect timing.

We'll end it here.

Thank you all very much.

This was the 12 January 2024 briefing on the cold circulation of COVID fluid respiratory pathogens causing increase in cases and deaths with Doctor Maria von Kirkel.

Thank you very much for being with us, Maria.

Thank you to the UN colleagues to making this happen at such a short notice.

And thank you all for joining.

[Other language spoken]

Everybody else, I guess I'll see you in a few minutes.

[Other language spoken]

Thanks everyone.

CONTINUITY - WHO: Virtual Press Conference On Covid - 12 January 2024