World Health Organization Coronavirus Briefing Transcript: March 16

Tarik: (00:16) Good afternoon everyone. Thank you very much for watching this regular press conference of COVID-19. Whether you watch it on Twitter, Facebook, YouTube channel or you have dialed in and are watching through Zoom. Today we have Dr. Tedros, Director General, we have Dr. Maria Van Kerkhove, and we have Paul Molinaro, who's our Chief Operations Support and Logistics. Tarik: (00:41) We also have a Dr. [Mike Ryan 00:00:00:43] on the phone who will be able to answer some questions before I give the floor to the [inaudible 00:00:49]. Just two small announcements said WHO has activated it's a business continuity plan and this is in order to adhere to public health guidance as well as to deliver its mandate. From today all staff is performing their functions through teleworking arrangements. Only staff whose critical functions can only be performed in the site they'll have access to this campus. Therefore there will be no media presence on the [inaudible 00:01:19] campus as of today. WHO media team will continue to provide normal services through Skype, email, and phone. Our regular briefings will be virtual press conferences and our audio visual team will continue to provide the necessary support. Tarik: (01:37) So from now on we will not have our journalists in the room and then we will inform you if that changes. The second information is that we already sent you the media advisory for tomorrow. WHO European office will convene a meeting online meeting tomorrow, 17th of March about COVID-19 representatives from the health ministries of the 53 members States of WHO European region. After the meeting WHO regional director for Europe, Dr. Hans Kluge and emergency experts will brief the press on the current situation in the region and they will be answering journalists questions on COVID-19. That press conference will be at two o'clock central European time and in the media advisory you have details how to access this press conference. Again tomorrow at two o'clock WHO office for Europe. I'll give the floor to Dr. Tedros for his opening remarks. Dr. Tedros: (02:32) Thank you. Thank you [Tarik 00:02:35]. And good afternoon everyone. In the past week we have seen a rapid escalation of cases of COVID-19. More cases and deaths have now been reported in the rest of the world than in China. We have also seen a rapid escalation in social distancing measures like closing schools and canceling sporting events and other gatherings. But we have not seen an urgent enough escalation in testing isolation and contact tracing, which is the backbone of the response. Dr. Tedros: (03:14) Social distancing measures can help to reduce transmission and enable health systems to cope. Hand-washing and coughing into your elbow can reduce the risk for yourself and others. But on their own, they're not enough to extinguish this epidemic. It's the combination that makes the difference. Dr. Tedros: (03:41) As I keep saying, all countries must take a comprehensive approach, but the most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate. You cannot fight a fire blindfolded and we cannot stop this pandemic if we don't know who is infected. We have a simple message for all countries. Test, test, test. Test every suspected case. If they test positive, isolate them and find out who they have been in close contact with up to two days before they developed symptoms and test those people too every day. Dr. Tedros: (04:41) More tests are being produced to meet the global demand. WHO has shipped almost 1.5 million tests to 120 countries. We are working with companies to increase the availability of tests for those most in need. WHO advises that all confirmed cases, even mild cases should be isolated in health facilities to prevent transmission and provide adequate care. Dr. Tedros: (05:16) But we recognize that many countries have already exceeded their capacity to care for mild cases in dedicated health facilities. In that situation, countries should prioritize all their patients and those with underlying conditions. Some countries have expanded their capacity by using stadiums and gyms to care for mild cases with severe and critical cases cared for in hospitals. Dr. Tedros: (05:49) Another option is for patients with mild disease to be isolated and cared for at home. Caring for infected people at home may put others in the same household at risk. So it's critical that caregivers follow WHO's guidance on how to provide care as safely as possible. For example, both the patient and their caregivers should wear a medical mask when they are together in the same room. The patient should sleep in a separate bedroom to others and use a different bathroom. Assign one person to care for the patient. Dr. Tedros: (06:34) Ideally someone who is in good health and has no underlying conditions. The caregiver should wash their hands after any contact with their patient or their immediate environment. People infected with COVID-19 can still infect others after they stop feeling sick. So these measures should continue for at least two weeks after symptoms disappear. Visitors should not be allowed until the end of this period. There are more details in WHO's guidance. Once again, our key messages test, test, test. This is a serious disease. Also the evidence we have suggested that those other 60 are at highest risk. Young people including children, have died. WHO has issued new clinical guidance with specific details on how to care for children, older people, and pregnant women. So far we have seen epidemics in countries with advanced and health systems, but even they have struggled to cope. As the virus moves to low income countries we're deeply concerned about the impact it could have among populations with high HIV prevalence or among malnourished children. That's why we're calling on every country and every individual to do everything they can to stop transmission. Washing your hands will help reduce your risk of infection, but it's also an act of solidarity because it reduces the risk you will infect others in your community and around the world. Dr. Tedros: (08:39) Do it for yourself, do it for others. We also ask people to express their solidarity by refraining from hoarding essential items including medicines. Hoarding can create shortages of medicines and other essential products which can exacerbate suffering. We're grateful to everyone who has contributed to the COVID-19 solidarity response fund. Since we launched it on Friday. More than 110,000 people have contributed almost 19 million US dollars. These funds will help to buy diagnostic tests, supplies for health workers and support, research and development. Dr. Tedros: (09:32) If you would like to contribute, please go to WHO.int and click on the orange donate button at the top of the page. We are also grateful for the way different sectors of society are coming together. This started with the Safe Hands Challenge, which has started celebrities, world leaders, and people everywhere demonstrating how to wash their hands. Dr. Tedros: (10:05) This afternoon, WHO and the International Chamber of Commerce issued a joint call to action to the global business community. The ICC will send regular advice to its network of more than 45 million businesses to protect their workers, customers, and local communities and to support the production and distribution of essential supplies. I would like to thank Paul [Paulman 00:00:10:41], [Ajay Banga 00:00:10:40] And John Denton for their support and collaboration. WHO is also working with Global Citizen to launch this solidarity sessions, a series of virtual concerns with leading musicians from around the world. Dr. Tedros: (11:02) This is the defining global health crisis of our time. The days, weeks, and months I had will be a test of our resolve. A test of our trust in science and a test of solidarity. Crisis like this tend to bring out the best and worst in humanity. Like me, I'm sure you have been touched by the videos of people uploading health workers from their balconies or the stories of people offering to do grocery shopping for all their people in their community. This amazing spirit of human solidarity must become even more infectious than the virus itself. Dr. Tedros: (11:54) Although we may have to be physically apart from each other for a while. We can come together in ways we never have before. We're all in this together and we can only succeed together. So the rule of the game is together. I thank you. Tarik: (12:17) Thank you very much Dr Tedros for these remarks, I will remind journalists who are dialing in by phone it's *9. Those who are watching through Zoom, it's clicking "Raise Hand". If it's possible really to have one question per journalist so we can get as many questions as possible from different people. And we will start with [Jamil Charday 00:12:44] from Brazil. Jamil, can you hear us? Jamil: (12:48) Yes, perfectly. Thank you. Tarik. Jamil: (12:50) Hello Mr. Tedros. My question is about Brazil and about the fact that President Bolsonaro yesterday on the weekend not only helped to call a mass protest in several cities of the country but also took part himself in one of them. How do you see this as helping or not fighting the virus and what is your suggestions on protests, street protests, and this case specifically that we are. Thank you very much sir. Dr. Maria Van Kerkhove: (13:31) So thank you for the question. What we know that will be helpful during this time of COVID-19 in terms of what the DG just said is everything that we can do to reduce the possibility of transmission between people. And one of the ways that countries are doing this is to stop gatherings together. And some countries have taken different decisions based on the number of people where they've restricted those gatherings. And so it's important that people do restrict themselves to go to gatherings where there's large numbers of people. Dr. Maria Van Kerkhove: (14:06) And in doing so that will reduce the possibility that people who come in close contact with one another can potentially transmit the virus to one another. And so taken together with testing and aggressive case and contact finding. It's important that we limit our [inaudible 00:14:25] mass gathering events. Tarik: (14:30) Thank you very much. And just to remind that Dr. [Mike Grant 00:14:33] is on the phone. Dr. Grant if at any time you would like to add something, just unmute your phone and start talking. [inaudible 00:14:45] this time so we'll go forward with next question, Gabriella? Can we hear Gabriella? Do we have her on the line? Gabriella: (14:58) Yes. Hello? Tarik: (14:59) Hi Gabriella, please go ahead. Gabriella: (15:00) Yes. Hi. Thank you. Do you hear me? Okay. So I'm Gabriella [inaudible 00:15:05] Mexico, a professor. My question is regarding Mexico. There are 53 cases and 170 suspected cases right now. But looking at the fatality rate with all their people and people with diabetes for example, in Mexico there are 12 million of people over 60 years old and around the 8 million with diabetes. So with this scenario, what measures should Mexico be taking at the moment? Thank you very much. Dr. Maria Van Kerkhove: (15:36) So I can start with this and perhaps Dr. Tedros and Mike would like to supplement. The measures that we would advise for Mexico are the same measures that we would advise for all countries. And what we are aiming to do in our advice is reducing transmission for individuals, reducing transmission for young, healthy people, but also reducing the possibility that we are potentially infecting vulnerable populations. We have adequate data now from a number of countries which have shown that people of older age, people above the age of 60, of 70, of 80 years old are at a higher risk of death. We've seen evidence from multiple countries that people with underlying conditions such as diabetes that you just mentioned, such as cardiovascular disease, such [inaudible 00:16:25] underlying chronic respiratory disease are at a higher risk of death. Dr. Maria Van Kerkhove: (16:29) And by reducing the possibility of transmission of yourself, you're reducing the possibility to reach transmission to vulnerable populations. So the measures that we recommend are the same. These are fundamental public health measures. It's testing as Dr. Tedros mentioned in his speech. It's finding all cases and testing cases, making sure that they are isolated and that they are cared for, in medical facility. And if that's not possible, to make sure that they are adequately cared for at home. And preventing transmission to loved ones in their household. Dr. Maria Van Kerkhove: (17:03) ... in preventing and preventing transmission to loved ones in their household. It's making sure that we have adequate numbers of labs that can test individuals and have testing kits that are available in all countries. It's using the basics, hand hygiene, respiratory etiquette, sneezing into your elbow or coughing into your elbow, coughing into a tissue and then putting that into a closed bin and washing your hands. Dr. Maria Van Kerkhove: (17:23) It's practicing social distancing, making sure that you remain separated from individuals, especially if there are sick individuals. It's staying home if you are unwell. It's working from home if possible. It's mobilizing your populations. Dr. Maria Van Kerkhove: (17:40) All of the same measures that we've been saying every day are the same measures we would recommend for Mexico, as we would recommend for every government across the globe. Dr. Tedros: (17:51) Thank you. Maria already said it. The only thing I would like to do is stressing on some of the issues. One, for any country, one of the most important things is the political commitment at the highest level. Dr. Tedros: (18:09) This pandemic is not about the health sector alone. It touches almost all sectors of the government, and the whole of government approach involving all sectors, and led by the principal is very crucial. Dr. Tedros: (18:28) That whole government approach should also be able to mobilize whole society and make sure that this response becomes everybody's business. Anyone in Mexico, this is something that can only succeed if all Mexicans actually be involved. This is not just for Mexico but the whole world. Dr. Tedros: (18:53) It's everybody's business, and that's what we are suggesting to the whole world and it will be the same for Mexico. We hope to see progress in the whole of government approach, all of society approach, and making sure that this is everybody's business. That's how we can stop this virus. Tarik: (19:14) Thank you very much. Dr. Ryan, would you like to add something? Mike: (19:18) No, [inaudible 00:19:23], I think Dr. Tedros hit it right on the spot. Tarik: (19:27) Thank you very much. Please jump in anytime you want. I will go now to a question from Norway that we received via text. It's Henrietta [Haynes 00:02:39]. I'm sorry if I don't pronounce well. The question is for Maria. It's says, "Would Maria be able to comment on the new aerosol study and various surface studies or possibly provide a general update on what do you know to date?" That's from Henrietta Haynes from Norway NTB and The Journal. Dr. Maria Van Kerkhove: (20:02) Henrietta, thank you for that question that highlights the evidence-based nature of our organization and what we are trying to do in terms of making guidance for all countries. We try to pull together all available evidence on different topics. Dr. Maria Van Kerkhove: (20:20) This one that you've mentioned about the role of virus persistence on surfaces and the potential for the virus to remain in the air. We are aware of several studies that have been published, that are in the process of being published, and that are currently underway in labs in a number of countries that have looked at different environmental conditions in which the virus could persist, looking at maybe different humidity or different temperature, UV light, and that have looked at different surfaces such as steel, hard surfaces, and looking at the new COVID-19 virus as it compares to other coronaviruses like SARS, or like MERS, or the common cold coronaviruses that are circulating. Dr. Maria Van Kerkhove: (21:05) There is a recent study that came out that looked at the role of aerosol generating procedures, how would those viruses ... as you know, this is a virus that is transmitted through droplets. These are little pieces of liquid that come out of people's noses and mouths if they cough, or they sneeze, and they talk. Dr. Maria Van Kerkhove: (21:26) What we know about droplet transmission is that when they come out of an infected person, an individual, is they go a certain distance, but then they settle. That's why we have the distance of the one to two meters apart from individuals. Dr. Maria Van Kerkhove: (21:38) When you do an aerosol generating procedure, like in a medical care facility, you have the possibility to, what we call, aerosolize these particles, which means they can stay in the air a little bit longer. Dr. Maria Van Kerkhove: (21:49) In that situation, in healthcare facilities, it's very important that healthcare workers take additional precautions when they're working on patients and doing those procedures. For the everyday person, it's the talking, and the sneezing, and the coughing, which is why we want the respiratory etiquette. Dr. Maria Van Kerkhove: (22:04) I think I'm speaking too long, but these studies are looking at how long these viruses can persist in the air. The one study that came out looked at the aerosol generating procedure and said that when you do those, that these particles could stay in the air longer than they would if you were just normally talking to someone. Dr. Maria Van Kerkhove: (22:21) We use this information to make sure that our guidance is appropriate. So far from the available studies that we have seen, we are confident that the guidance that we have is appropriate, which is, so people who are in the communities, they don't wear a medical mask unless they themselves are sick because this prevents them from infecting someone else. Dr. Maria Van Kerkhove: (22:40) In healthcare facilities, we make sure that healthcare workers use standard droplet precautions with the exception, if they're doing an aerosol generating procedure, and then we recommend airborne precautions. Tarik: (22:57) Thank you very much. I think this is very important to provide to our journalists, information what we know. Let's go to the next question, [Adrian 00:23:08] from Romania. Adrian, can you hear us? Adrianne: (23:13) Yes, hello from [inaudible 00:23:15] Romania. Authorities in China and South Korea have decided to isolate the areas affected by coronavirus and have managed to reduce the number of infections, but the European Union supports keeping the borders open. What is the best solution recommended by the World Health Organization? Dr. Maria Van Kerkhove: (23:36) I'll go ahead and start with that. We recommend that all cases in all contexts are followed so with the aggressive case finding and testing of cases, we will know where the virus is. Dr. Maria Van Kerkhove: (23:53) It is important for countries to know where the virus is circulating within their countries, and who is infected, and who is not infected by finding all cases and isolating them, providing adequate care for them, by following all of their contacts and testing those contacts to ensure that we find any possibility of onward human to human transmission. By doing so, you can effectively stop transmission between people. Dr. Maria Van Kerkhove: (24:18) In addition to that, rapid testing, immediate isolation of individuals so that you're taking them away from other individuals that they can infect. This is the most effective way that we can limit human to human transmission. Dr. Maria Van Kerkhove: (24:33) In addition, as what the DG said is, high levels of political support, making sure that there's an all of government approach. It's not just the health sector. It's involving all different sectors of the government to repurpose themselves, to fight this virus. Dr. Maria Van Kerkhove: (24:46) It's ensuring that every single person in the country, in China, in Korea, in every single country knows what their role is. How can I protect myself? How can I protect my family? What role do I have to play in actually preventing onward transmission? Dr. Maria Van Kerkhove: (25:03) Some of this does involve self isolation. Some of this does involve making some sacrifices that you don't participate in social engagement. We've said this before, this is going to be difficult for a while, but this will be temporary. It's important that we all play a role in this. Dr. Tedros: (25:24) Thank you. I have spoken to many ministers from Europe especially, and of course other regions. One of the areas we have discussed is about testing. Our recommendation from WHO was very, very clear, that all countries should be able to test all suspected cases. They cannot fight these pandemics blindfolded. Dr. Tedros: (25:58) They should know where the cases are and everything about the cases. That's how they can take decisions, actually. If they know the cases, then they move into following up with contacts, and also isolating the cases and the contacts who would be positive. Dr. Tedros: (26:23) Not only that, specific to taking care of the specific cases, or the positive cases, or the contacts, but that can help them also on how they can design their strategy to fight the pandemics. Dr. Tedros: (26:40) That was my message to many of the ministers I have spoken to, to invest in testing. That was my speech also today. Going forward, our recommendation is that they have to be able to test all suspected cases and then do everything that should be done starting from the testing or the cases they identify. Dr. Tedros: (27:16) In addition to that, we have also discussed about the containment strategy. Of course, we said last week that the situation is already a pandemic proportion, but at the same time, we have said that the containment strategy still holds as the best strategy. Dr. Tedros: (27:40) This is because of what we have seen in countries who have made progress. This is in China, South Korea, Singapore. It's the containment strategy that's showing a result and which we hope can also help other countries to make progress. Dr. Tedros: (28:02) We advise countries to stick to testing, and from there, of course, all the steps that they need to do. We advise countries to stick to containment strategy because we believe that this epidemic, this pandemic, or this virus is controllable, and the result or the outcome is in our hands. Tarik: (28:26) Thank you very much. Let's go to Tehran- Mike: (28:35) This is Mike. Can I just add something? Tarik: (28:44) Please go ahead, Mike. Mike: (28:44) Obviously Dr. Ghebreyesus has spoken to his high level contacts on the importance of it. We've consistently said that the coordinating of travel measures are only part of a comprehensive strategy, and countries who rely on travel measured as a way of blocking the virus or are just not going to succeed. Mike: (29:07) Rational measures based on risk assessment that restrict travel, particularly for sick individuals or exit screening and various measures that can reduce the spread of disease are appropriate in the context of a comprehensive strategy. Mike: (29:23) Many countries have implemented lock downs and other measures. These are an attempt to try and slow down to the spread of the virus, but within the zones that are locked down, that has no impact. We go back to the same public health measures of trying to suppress infection within a zone. Mike: (29:39) What can deal with infection within a given zone and then what can slow down infection spreading between zones are different types of measures, but relying purely on static travel measures as a ways of protecting populations is not enough. It may be useful in certain circumstances. It may have an impact, but it will not have any impact without the implementation of comprehensive approaches. Mike: (30:03) Just one clarification, when we speak about testing all suspect cases, that's extremely important. When we have identified their contacts, we also need to test any contacts who are symptomatic, just to be clear that we're not advising that every contact of every case can or should be tested. Mike: (30:22) We really need to focus on ensuring that when we identify cases, that we exhaustively follow their contacts, and if any contents are showing any symptoms of disease, they should be immediately tested as well. Thank you. Tarik: (30:37) Thank you very much. Tehran Times is in Ireland calling us from there. Let's go to the Tehran Times, international daily. Maryam, can you hear us? Maryam: (30:52) Yes, can you hear me? Tarik: (30:57) Yes ma'am. Please go ahead. Maryam: (30:58) My question, actually, I have two questions. Some believe that the number of new cases and deaths reported every day by countries are not real, and some countries might be under-reporting intentionally or some might not test all the patients, especially those with mild symptoms. Is it possible that the number of cases is much higher, therefore the death rate is lower? Maryam: (31:22) I would also like to know if [inaudible 00:31:24] has assessed effectiveness of traditional medicine on treating or relieving the symptoms of COVID-19. Tarik: (31:30) Thank you very much, Maryam. We agreed that we will have one question for person. There are lots of questions. I have to apologize right to journalists that not everyone will be able to ask a question. Maybe Maria, you want to start? Dr. Maria Van Kerkhove: (31:46) Yes, and then maybe Dr. Tedros and Mike will want to supplement. Yes, there's no doubt that we are missing cases. I think we need to be realistic about this. The reason that we are so aggressive in our statements about finding all cases and testing cases is because we need to know where this virus is. Dr. Maria Van Kerkhove: (32:07) It is possible that we are missing cases that are on the more mild end of the spectrum. That's normal in an outbreak. It's normal for a respiratory disease, especially because certainly in the beginning of outbreaks, you're focusing on people who seek care. That's where people will show up, and they have a higher likelihood of actually being tested for COVID-19 or for any emerging pathogen. Dr. Maria Van Kerkhove: (32:28) It is certainly possible, and it's highly likely that we're missing cases. What's important is that there are measures, there are processes in place that countries can take to find those cases. Dr. Maria Van Kerkhove: (32:41) It's important that we don't give up and we move to a measure to say, "We're just going to let this happen and we're going to hope for the best." Absolutely, we need to be finding all of these cases so that we can effectively isolate them and thus reduce the chances of onward transmission. Dr. Maria Van Kerkhove: (32:57) Ways in which countries are trying to improve that ability to test is increasing their lab capacity, so not only making sure that they have additional kits and tests in their countries, but making sure that they're increasing the number of labs that can test in individual countries. Whether it's at the national level, or the sub-national level, or the use of private labs, it's making sure that we have more testing capacity in addition to testing kits. Dr. Maria Van Kerkhove: (33:23) The other question, as it relates to traditional medicine, indeed, there are a number of clinical trials that are currently underway. In fact, it's more than 200 clinical trials and maybe even more than 300 at the last count. Dr. Maria Van Kerkhove: (33:35) Some of those clinical trials are indeed looking at traditional medicine, if it can relieve symptoms of COVID-19 infection. Tarik: (33:49) Thank you very much. We will go to our next question, and please, let's stick to one. Andy Kopsa, can you hear us? Andy was trying to place his question- Andy Kopsa: (34:00) Yes. Tarik: (34:00) Andy, please go ahead. Andy Kopsa: (34:01) Yes, hi. Can you hear me? Tarik: (34:03) Yes, go ahead. Tarik: (34:03) Please go ahead. Gabriella: (34:03) Yes. Hi. Can you hear me? Tarik: (34:03) Go ahead. Gabriella: (34:04) Okay, great, thank you. My question is actually about contact tracing and it's about the... I'm going back to mid-February and the Westerdam cruise ship that docked and disembarked people in Cambodia. There's conflicting reports here in the US for people that were returning from that ship that there was an actual false positive and that all of those ship passengers were tested. Can anybody confirm this? We're not getting any answers about whether or not that one person that tested positive was in fact a false positive. Thank you. Tarik: (34:58) Thank you. Thank you for your question. Dr. Maria Van Kerkhove: (35:00) I can't answer to that specific question about that one individual case but what we can say is that there is the possibility for testing that you may have a false positive or you may have a false negative. And so what we work with across the globe, is we work with laboratorians and virologists and clinicians to look at what are the most appropriate biological samples and when in the course of illness, in the course of a contact, should people be tested. And it's important whether these are upper respiratory samples or lower respiratory samples, the timing in which samples are collected, and then of course, the lab test itself. Dr. Maria Van Kerkhove: (35:42) There's always the possibility of a false negative or a false positive, which is why we recommend repeat testing where possible. We know that that's difficult to do because there is a shortage of tests in some countries, but especially for people with epidemiologic links to confirmed cases, it's important that if you have a high suspicion that they are a case- Tarik: (36:07) Real apologies, we have an issue here. Can you please, we are not able to mute you Andy, can you mute yourself please? Sorry, I think we're okay now. Dr. Maria Van Kerkhove: (36:24) Just to say that if you have a strong suspicion amongst a contact who has an epidemiologic link, which means they've had direct contact with a confirmed case, that you do a repeat sample, and so that you have increased your chances of truly detecting if that person is a case or not. Tarik: (36:43) Thank you very much. Can we go to a Xinhua right now? Who do we have from Xinhua Agency? Jamil: (36:54) Hi, it's [Lou 00:36:55] from Xinhua. Can you hear me? Tarik: (36:58) Yes, please go ahead. Jamil: (36:58) Yeah. The question is the USD Trump administration is announced a plan to cut deep its global health funds and his 2021 budget proposal. That's a slashing more than 3 billion US dollars in overall programs including part of its annual funding to WHO. So how does WHO think that will combat the COVID-19. And could you also please give us an idea of how the US has contributed to the global response to COVID- 19 so far? Thank you. Mike: (37:31) Do you want me to take this far you? Dr. Maria Van Kerkhove: (37:40) Yes, or Dr. Tedros. Dr. Tedros: (37:40) You want me to take- Dr. Maria Van Kerkhove: (37:40) Mike, yeah. Dr. Tedros: (37:42) You want me to take, Mike? Mike: (37:45) No, I can take [inaudible 00:37:45] after you, boss. Dr. Tedros: (37:49) No, thank you. I think the support we are getting for COVID-19, the response, is really encouraging. At the initial stage we were a bit worried, but now we're getting almost close to the funding we asked for and we expect more support. And the announcement from the US is really significant, and we will expect actually more countries to contribute. But we're almost close to the funding we asked based on the SPRP. Of course, the initial focus was on governments, and we appreciate all governments who have contributed. Now, we have already moved to asking contribution from the private sector and all the citizens. And as I said in my speech, more than 19 million has been secured actually in a couple of days from the private sector, and the global citizens are at large. And this is in two days, and we expect that there will be a significant contribution from the private sector and the global citizens at large. Dr. Tedros: (39:19) So, as, we have said, proposed, for each country to follow or use a whole of government and the whole of society approach, we're using the same thing globally to mobilize all governments to contribute and also all citizens to contribute. And the contribution so far is significant and encouraging. And I know we will get the amount of funding we need. But I would like to use this opportunity because you identified US specifically to use this opportunity to thank the U S government, other governments, the private sector, and all global citizens for their commitment. Dr. Tedros: (40:11) We're all in this together. It's a common enemy, and it's our unity that will break this virus. And the last few days, I have seen how the human spirit is so amazing, and how it shows us that the spirit can break the virus. So it's not just the funding, by the way, it's the human spirit which we see, the human spirit that's fighting this virus, which is coming more and more stronger, that can help us to fight it. When there is unity and solidarity of spirit and then the resources, and other things can come. So I'm really encouraged, especially the last one week or so, with a level of solidarity that I see, Tarik: (41:22) Sorry? [Inaudible 00:41:30] Mike: (41:30) I just wanted to add because you know, the US public health service is one of the finest in the world, and literally has served the US well, but over the last 50 years has helped to train and develop ethical systems all over the world, food, epidemiology, [inaudible 00:41:49] networks, and others. The National Institute of Health is an amazing platform for primary research for clinical files and others. The FDA has been hugely helpful to the rehability and the regulatory aspects of developing new medicines. And we thank them and all of those institutions, [inaudible 00:42:11] Red Field and all of our colleagues at HHS for their technical and operational support to us and to the world over many, many years, and including in this response. Mike: (42:22) Clearly we all need to invest more in global public health, in national public health where we're paying a price for ongoing investments now, but we need, as the VP said, to come together, now is not the time to look at this, now is the time to work together. But we are going to in future have to look at how we are investing in public health systems around the world and whether we're actually investing in enough. Thank you. Dr. Maria Van Kerkhove: (42:48) International contribution from the US is their scientists and their clinicians who are communicating with us regularly on the front lines with us in terms of our gathering of information and evidence and sharing of experiences. So we have American scientists and clinicians and public health professionals who are involved in every single one of our technical networks, and so we're very grateful for them as well as clinicians and public health professionals and scientists from all over the world who are sharing their experiences with us as we learn more about this virus and as that evidence is fed back into our response. Tarik: (43:27) We are receiving really huge volume of questions so we will try to go a little bit to those technical one maybe because I think this is important. Alara Pinera is asking, do we know anything more about children and COVID-19? Dr. Maria Van Kerkhove: (43:40) This is a good question. We have a lot of questions about children. What we know from the evidence to date is that children are susceptible to infection, and that children can be infected with this virus. They seem to be infected in terms of symptomatic infection, in terms of detection through reporting systems at a lower rate than adults, which is different to what we would see with influenza. And from the evidence that we are seeing, we're not seeing transmission in settings like schools, where we would worry about amplification of transmission. In many countries schools have closed. And so that is an important thing to take into consideration. We do know that children tend to have more mild infection, have more mild disease, but we have seen children die from this infection. So we can't say universally that it's mild in children. So it is important that we protect children as a vulnerable population. Dr. Maria Van Kerkhove: (44:38) What we don't know right now, and because we don't have serologic tests yet and we don't have the results of these population-based sero surveys, is we don't know the extent of a subclinical or asymptomatic infection in children. And so we're waiting for the results of those, which will help us really understand what role children are playing in this. So just to summarize, we know that children can be infected. We know that they tend to have mild disease, but they can die from this infection. So it's important that we protect them. Tarik: (45:12) Another technical one that maybe if we made, says Stefan, here from Switzerland, from Luton. He's asking what do you think about the possibility of short-lived immunity and the risk of having a massive wave of COVID-19 in next fall. Dr. Maria Van Kerkhove: (45:28) So the question of immunity is also a good one. These are the same questions we're asking. So, these are the right questions. There are some initial studies that are looking at an immune response in individuals. We've seen some studies that have come out that have looked at immune response in nonhuman primates. The data is very early, and what we're looking for is whether or not we see a robust response in people and for how long that will last. We're still 11, 12 weeks into this outbreak. And we do have some serologic assays that have been developed in a number of countries. And so we don't have a full answer to this yet, but it is something that is very important to see what level of response individuals have in terms of an antibody response, whether this will provide protection and for how long? Tarik: (46:16) Thank you very much. Let's try to get someone online, our friend Antonio from [FA 00:00:46:24]. Antonio, can you hear us? Speaker 1: (46:28) Yes. Can you hear me? So as Spain has declared a lockdown to prevent the spread of coronavirus, but today we are still seeing images of overcrowded public transport in cities like Madrid. So do you think societies have to take more seriously the threat of COVID-19, and how can we really convince the population to stay down at home? Dr. Tedros: (46:59) Yeah. To convince the public, first of all, I would like to commend the very courageous and bold action that the Spanish government has taken. I had a chance to speak to Prime Minister Pedro Sanchez and his commitment I believe is really, really strong to fight this virus. But the political commitment at the highest level alone will not be enough. That should be the cooperation of all the citizens of Spain. It's the cooperation from all citizens that will make the response actually complete. Dr. Tedros: (47:53) And I say it many times, this should be everybody's business. Each and every individual should do everything to protect himself or herself and to protect others, and should listen to the advice of the national authorities. So my advice is that this virus will not be stopped without the cooperation of the government, the whole society, and the citizens. This is everybody's business. And I repeat, this is everybody's response and responsibility. And that's how we can stop this virus. And I encourage everybody in Spain to follow the advice of the authorities. Muchas gracias. And my name is Pedrito, my other name. Thank you. Tarik: (48:59) Thank you very much. I will just ask.