WHO’s Emergency Committee initiates discussion to end declaration on global public health risk for Covid-19

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WHO Director General Dr Tedros Adhanom Ghebreyesus
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By Elesha George

[email protected]

Members of the World Health Organization’s (WHO) Emergency Committee on Covid-19 have discussed ending the “Public Health Emergency of International Concern (PHEIC)” status for Covid-19, for the first time since announcing a global pandemic almost three years ago.

To terminate the declaration, the WHO must determine that the risk of international spread for Covid is low and that individual countries have the capacity to respond rapidly to new virus emergences.

Although a decision has not yet been made and WHO Director General Dr Tedros Adhanom Ghebreyesus said it is “too early” to make such a decision, discussions were prompted by a number of factors to include the high level of population immunity.

“The new virus, clearly, is continuing to circulate but for the first time in nearly three years, because the number of deaths is less than a month ago and immunity of the human population has improved, members of the committee have discussed, for the first time, the question of termination of the Public Health Emergency of International Concern,” said Committee Chair, Professor Didier Houssin.

So far, the virus has led to the deaths of 146 people in Antigua and Barbuda and has infected almost 9,000 – nine percent of the country’s population. Millions more have died globally.

Dr Ghebreyesus’ suggestion that it was too early to lift the declaration was agreed to unanimously by the members.

According to Houssin, “there are still too many deaths; there [is] still too much uncertainty regarding the variants, the pathogenic effect, the immune escape effect, and there is still too much fear that termination of the PHEIC might aggravate existing inequalities in access to vaccine or therapeutics and might demobilise all the efforts engaged to prepare for future pandemics”.

Members did agree, however, that future efforts to terminate the declaration would require “preliminary steps” which would include winter tests in the Northern Hemisphere and analysing and preventing the negative consequences as a result of the termination, to include legal battles.

The committee has also outlined three priorities for the continued temporary recommendation, including re-integrated and re-enforced surveillance, vaccination of high-risk groups and continuing efforts for pandemic preparedness.

While new variants continue to develop, it is believed that the virus can be controlled if countries maintain the capacity and readiness to prevent, detect and respond to any ongoing and/or new clusters in future.

According to Dr Maria VanKerkhov, an infectious disease epidemiologist who serves as the technical lead for the Covid-19 response at the WHO, the organisation is tracking more than 300 sub-lineages of Omicron worldwide, but none are more dominant than the original Omicron virus.

“All of the subvariants of Omicron are showing increased transmissibility and properties of immune escape,” she said, while sharing information on two of the most recent variants – BQ1.1 and XBB.

A study of the XBB subvariant is based on a “pseudo virus,” which scientists are currently analysing to determine how easily it can escape antibodies needed to successfully fight off infection, she shared.

“It’s showing significant immune evasion and this is of concern for us because we need to ensure that the vaccines that are in use worldwide remain effective at preventing severe disease and death,” she explained. “And so, the more this virus circulates, the more opportunities it has to change.”

Both XBB and BQ1.1 are subvariants of BA.5 – recognised as the most transmissible strain of the Covid virus. And while it’s too early to determine just how severe either sub-variant is, Dr VanKerkhov agrees with the committee members that improved surveillance is required worldwide.

“There are millions of cases being reported each week, but our surveillance has declined, testing has declined, sequencing has declined and that in turn has limited our ability as an organisation, with our expert networks around the world to assess these,” she noted.

Dr Bruce Aylward, the Senior Advisor on Organizational Change to the Director-General, chimed in that focus has to be on improving products that can deal with long-term Covid control. 

“We have not got optimised products yet that give really durable protection for long periods, easy to administer, easy to manage,” he said, explaining that it would help with meeting demands which in turn ensures that populations get the products they need.

WHO, he said, is also working with GAVI (a vaccine alliance group) to ensure that low-income countries can access the vaccines that they need and expanding manufacturing hubs to ensure access for the longer-term.

The strategy will also include the provision of technical and policy support to governments around the world to achieve 100 percent coverage of healthcare workers, vulnerable populations and at least 70 percent coverage of the overall population.

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