The WHO’s technical lead on Covid warns that the virus continues to circulate a lot. From the American epidemiologist’s point of view, the pandemic is not over.
Despite the fact that we are in the middle of the summer, the World Health Organization (WHO) is sounding the alarm. Between 17 July and 13 August, 1.4 million new cases of Covid and more than 2,300 deaths in six regions were recorded by the WHO. This is a 63 per cent increase in cases compared to the previous 28-day period. Overall, since the beginning of the pandemic, the number of cases has reached 769 million. More than 6.9 million people have died of SARS-CoV-2. Maria Van Kerkhove, Covid-19 technical lead of the WHO’s health emergency programme, takes stock.
Le Temps: SARS-CoV-2 has mutated nearly 30 times. Should the emergence of new Covid variants, including BA.2.86, be taken seriously?
Maria Van Kerkhove: Even if the world seems to have forgotten, we must always take Covid seriously. The virus continues to circulate a lot in many countries, increasing its chances of mutating. We are closely monitoring the latest variants, including EG.5 and BA.2.86. Indeed, we have detected it in four countries and we dispose of five sequences but it will continue to spread to many other states. The reason it is closely monitored is because, like the Omicron variant, it's giving rise to many other mutations. Supervision remains absolutely essential. Yes, we are managing these kinds of situations better than in the past but nevertheless, we should not cover our eyes: there are still very large numbers of infections, reinfections, and people getting hospitalised. People still die of this virus and continue to suffer from long Covid. So this is not the time to drop our guard.
Does the announcement of the end of the pandemic this spring explain this relaxation?
We never said the pandemic was over but we did end the Public Health Emergency of International Concern (PHEIC). We are still in a pandemic situation. I understand that the population no longer wants to use this term and wants to move forward, but the virus continues to claim the lives of many innocent people. It still constitutes a serious public health threat even if it does not have the acuity of what we experienced two or three years ago. We are lucky to benefit from some herd immunity thanks to vaccines and infections. We also have good diagnoses and great quality clinical care but it is important to maintain the existing systems. As for those who are infected, we must make sure that they do not develop serious diseases and that their lives are not in danger.
It is ironic to note that WHO member states are negotiating a pandemic treaty to improve preparedness and response to a future health crisis and that, at the same time, they are dismantling the mechanisms in place...
It is not ironic. It’s frustrating and infuriating. The director general of the WHO Tedros Adhanom Ghebreyesus may have declared that Covid no longer constitutes a global health emergency but he also specified that the worst thing that states can do now is to dismantle the system they have put in place for Covid. Because this one – which has been implemented over the last three years with considerable investments, traumas and deaths – is still definitely necessary. It is used not only to have more control over Covid-19 but also many other health threats. It has made it possible to train medical personnel with better tools to do PCR tests, or even genetic sequencing, in almost all countries. These abilities did not exist three and a half years ago. Dismantling the system is a really short-term vision. We encourage governments to act on the long term. What is frustrating is that we have already done this work... It would be frustrating to start all over again, especially since today, the fiscal conditions that states have at their disposal are less favourable because Covid is not the only threat facing nations.
What should we expect this autumn and winter?
The database on Covid cases we currently have is not sufficient to answer this because states have stopped monitoring and sending us their situation reports. Yet, we are still trying to acquire information by counting hospitalisations, people in intensive care and deaths. We are seeing an increase in cases in several countries but we do not have good enough visibility on the intensity of the spreading of this virus. This is why Dr. Tedros recently issued recommendations to maintain surveillance in terms of hospitalisations, the use of intensive care and sequencing of variants. During the autumn, people live in greater proximity and inside. Airborne pathogens take advantage of these places where aeration is minimal. We expect new waves of infections, whether by BA.2.86 or other variants. We must be vigilant if we want to avoid new deaths and a wave of hospitalisations.
Will it be necessary to have booster shots?
Absolutely. Boosters currently being carried out on a global scale are at an extraordinarily low level. However, the protection offered by vaccines against severe diseases decreases over time. It is rather robust for six to eight months depending on the number of doses received. But people with a medical history, or who are elderly, will need regular booster vaccines because the virus continues to strike. We will have to pay particular attention to vulnerable populations, those faced with war, displacement, floods, even infectious diseases. These groups are the worst affected but they do not represent the whole problem. Even countries with very developed health systems have been among the worst in terms of Covid management. It is therefore important to use the capabilities that we have in the most efficient way possible. It's all a question of leadership.
What progress has been made in the three and a half years of Covid?
We have made incredible progress with surveillance capacities, PCR testing and genomic sequencing worldwide. The same goes for clinical care and the use of oxygen, which is used for Covid and other respiratory diseases. We have also made progress in how we communicate and in the fight against disinformation. Support between communities has improved a lot. Scientifically, vaccines and rapid clinical tests have been a real step forward. Progress has also been made in supply chains, vaccine development and production. In the future, we must continue this momentum and seek to further regionalise vaccine production. One thing is certain: in the future, we will have to do better than what we have done so far.
This article was originally published in French in Le Temps. It has been adapted and translated into English by Geneva Solutions. Articles from third-party websites are not licensed under Creative Commons and cannot be republished without the media’s consent.