Summary: This declaration of a pandemic does not mean that we should say the fight is over - that would lead to unnecessary suffering and death.
With every press conference, the WHO have called on countries to take urgent and aggressive action and this hasn’t changed.
More than 90% of the cases are in just four countries (Iran, Italy, SK and China). Two of those four countries have significantly declining cases (South Korea and China)
81 countries have no cases yet, and 57 have 10 or less.
All countries can still turn the tide on this virus, even ones with community transmission or large clusters. Several countries have shown the virus can be suppressed and controlled.
The challenge for countries is not whether they can do as they did - any country can stop it. The challenge is whether they will stop it.
Some countries have problems of lack of capacity or resources. Some have just a lack of resolve.
We are grateful for the measures Iran, Italy and South Korea are taking to slow the virus and control their epidemics. This is a crisis that will touch every sector of society and countries must take a whole of government all of society approach.
Governments need to communicate to the public about risks and how to protect themselves.
They must also find, isolate, protect, and treat every case and trace every contact.
They must ready hospitals and protect and train health workers.
We are in this together, and need to do the right things calmly, and protect the citizens of the world. It is doable.
See also my
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Here I am talking about this press conference:
--------------------------------------Here is the press conference itself
(click to watch on Youtube)
QUESTIONS AND ANSWERS
This is all based on my paraphrase and transcript typed as they spoke, as the WHO release their transcript only a few days after the press conference.
What is your recommendation about closing schools, borders and airports - and what is happening in Iran?
No specific rule. But closing schools and social distancing is a poor substitute for contact tracing.
With contact tracing we are chasing the virus. You then just need to isolate the people who could have it.
Social distancing is for when you give up on keeping track of the virus and try to isolate everyone from everyone else.
For countries with small numbers of cases and clusters then social distancing doesn’t have the same impact as contact tracing.
When the number of cases is large it may be worth doing. WHO just offer advice. Countries evaluate what to do based on social acceptability and the stage of the virus.
Iran has a high number of deaths and sick people. Their intensity of surveillance and number of cases has increased - the WHO would like to see these increase further.
Q. What is the mechanism within WHO concering declaration of pandemic.
There is no mathematical formula to decide it, but something the WHO decide based on a broad range of input, also taking into account the effect of the word. It can galvanize the world to fight but has a risk of them also giving up.
Q. grateful about measures Iran made to counter the virus.
Please elaborate and say more - what else is needed inside Iran, lack of medical supplies and equipment becausae of the sanctions.
Iran now has an all of government approach, a coherent plan and single strategy.
However they have shortages of supplies. The WHO brought 140,000 test kits in total (100,000 then 40,000) and personal protection equipment, which cost millions of dollars to supply, and China brought 20,000 tests.
Iran has a shortage of oxygen and ventilators.
Italy has nearly 900 people in intensive care. That takes 2–3 health workers for each person, and they have to be in Personal Protection Equipment for hours on end.
This uses up a lot of PPE and they also get exhausted quickly.
Iran and Italy are suffering and need our help now. Others will be in that situation soon.
Iran is doing its best, all it can.There is still a shortage and they need lots of supplies and we are trying to mobilize more support for them.
Q. China - any word from the serology study?
We encourage all countries to do these investigations and the protocol will let us see how it is spreading depending on age. It will take some time to get the results.
Q. are countries taking enough measures?
This is not the time to move to mitigation only - you have to contain it where you can meanwhile preparing the health system if it escapes control.
Spain is using a whole of government whole of society approach
87 countries without the virus need to do everything to prevent importing cases. 57 countries with at most 10 cases need to cut it at the bud.
Many countries have already shown that however big the number of cases is it can still be contained.
They are not suggesting a shift to mitigation.
They believe the best way forward is the blended approach with containment as major pillar.
Q. Overview of the preparedness of Africa. Surveillance etc.
Africa has made very rapid progress in preparedness. Example, Nigeria has built a 100 bed containment ward in 48 hours. Congo which has its first case is repurposing its facilities for treating the Ebola outbreak (which is now over) to isolation and treatment of covid19.
The WHO thinks there may be an element of underdiagnosis in some African countries and are chasing this up to activate surveillance in the whole continent.
They have sent millions of dollars for personal protection equipment, training, support for labs etc. Very happy with progress so far, and will continue to build on it.
Q. Reaction to Italy, shortage of equipment, supply, health workers. Are there some Chinese health workers going to go to Italy or from countries not affected? Is WHO coordinating the platform for this?
China has offered support - PPE, ventilators etc and trying to prioritize supply chains to Iran and Italy.
Q. China numbers down radically Also SK
Where do you see biggest impact. Lots of countries don’t have the ability to do large scale contact tracing?
Contact tracing is not expensive - anyone can do it. Teams in the Congo during the Ebola outbreak were following 25,000 people every day in the middle of a shooting war.
So yes anyone can do this. It is very tough on the people asked to self isolate. But it is far less expensive than the next stage of closing schools and businesses
Countries should focus on the contact tracing as long as they can.
If they didn’t have the experience of China and South Korea, the WHO would have thought the same as the people who say it won’t work. But they show that it can. This is not influenza.
Mike Ryan said he has been doing contact tracing for 25 years - it is far better than shutting down whole societies.
Maria: they have seen very creative approaches for contact tracing using technology. Ther are lots of tools you can use. It is not a matter of tools but of will.
Q. You said there are some countries with alarming levels of inaction, and last week were critical of some countries, but declined to name them. Are you willing to say which ones are not doing enough?
Don’t single out countries publicly (they know who they are) but some things that they are doing are
- Testing only a small proportion of people likely to have covid19
- over restrictive testing - over a certain age and full symptoms of covid19
- only testing travelers from China because they haven’t updated their guidelines
- not got any system to prevent infections in hospitals - not isolating them
- giving up contact tracing too soon
- not communicating well with the public with confusion and issues of trust for the government
- not co-ordinating between sectors or between national and provincial government.
- Lack of resilience and capacity due to the health system running “lean and mean” at 99% of capacity
- public with deep distrust of government messaging
Q. First covid19 death in Ireland. A week or two behind the worst affected countries. Should we be doing more, more aggressive response given what we have learnt in Italy, Korea.
Ireland is doing the right thing. You don’t need highly trained health professionals for contact tracing - can use civil servants and volunteers. The Italian government is using comomunity organizations. You can also use NGOs (Non Governmental Organizations)
Each country needs to look at what they are doing and at gaps and take action. Need to ask “are we doing enough” regularly and repeatedly.
See also my
(click to watch on Youtube)
This article originated on my blog on Quora - and you can find it here along with my rough paraphrase / transcript of the press conference:
- WHO declare Covid19 as a pandemic that CAN BE CONTAINED - not a question of if we CAN but if we WILL
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