World Health Organization March 20 Coronavirus Briefing Transcript: Warn Health Systems are "Collapsing" Under COVID-19

Dr. Tedros: (00:00) ...immune system to function properly. Second, limit your alcohol consumption and avoid sugary drinks. Third, don't smoke. Smoking can increase your risk of developing severe disease if you become infected with COVID-19. Fourth, exercise. WHO recommends 30 minutes of physical activity a day for adults and one hour a day for children. If your local or national guidelines allow it, go outside for a walk, a run, or a ride, and keep a safe distance from others. If you can't leave the house, find an exercise video online, dance to music, do some yoga, or walk up and down the stairs. If you're working at home, make sure you don't sit in the same position for long periods. Get up and take a three minute break every 30 minutes. We will be providing more advice on how to stay healthy at home in the coming days and weeks. Fifth, look after your mental health. It's normal to feel stressed, confused, scared during a crisis. Talking to people you know and trust can help. Supporting other people in your community can help you as much as it doesn't. Check on neighbors, family, and friends. Compassion is a medicine. Listen to music, read a book, or play a game, and try not to read or watch too much news if it makes you anxious. Dr. Tedros: (01:55) Get your information from reliable sources once or twice a day. To increase access to reliable information, WHO has worked with WhatsApp and Facebook to launch a new WHO health alert messaging service. This service will provide the latest news and information on COVID-19, including details on symptoms and how to protect yourself. The health alert service is now available in English and will be introduced in other languages next week. To access it, send the word, "Hi" to the following number on WhatsApp. 001798931892. We will make this information on our website later today. COVID-19 is taking so much from us, but it's also giving us something special. The opportunity to come together as one humanity, to work together, to learn together, to grow together. I thank you. Speaker 1: (03:21) Thank you Dr. Ted Ross. I'll now open the floor to questions. Well we don't have a floor, but I'll open the virtual world to questions. And first in the very long queue is [Too 00:03:32] [Liu 00:03:32] from [inaudible 00:03:35]. Too, can we please have your question? Reporter: (03:36) Hi. Can you hear me? Hello? Speaker 1: (03:41) Yes, we hear you very well. Reporter: (03:44) Oh hi, it's Liu from [inaudible 00:03:46] agency. Almost a week from now, G20 countries will be at a meeting to discuss the COVID-19 and the heavy impact on the global economy. And my question is now China has reported no new cases since yesterday. So what does that mean? What does it mean for China? What does it mean for the rest of the world? And what are the difficulties lying ahead for China in combating this global pandemic? Thank you. Dr. Ryan: (04:21) I think the simple message, and echoing the general's comment is it's a message of hope. It's a message that this virus can be suppressed. We can break chains of transmission. It takes a huge effort. It takes an all of society effort. It takes coordination. It takes solidarity. It takes activated communities. It takes brave health workers. It takes supply chains that work. It takes commitment, and if it's done, this virus can be turned around. Other countries are showing the same thing, and not by doing exactly the same thing. They're achieving the end by mixing and matching and creating a comprehensive strategy that's matched to the threat they face and to the context in which they're working. So I think there's a message of hope there from China. And that's a message of hope to many countries around the world who have very low numbers of cases right now, and who can turn this virus back. We've seen the damage this virus is doing in health systems in a number of countries, but we've also seen that this virus can be pushed back. So that's I suppose the implication that we see for this. But it's going to take time, it's going to take effort, and it's going to take solidarity, and it's going to take coordination at community level, at government level, at international level to make this happen. Dr. Tedros: (05:53) There was no specific question [inaudible 00:05:54]. Speaker 1: (05:55) Thank you very much. I'll now hand it over to [Varia 00:06:00] from Nowruz in Iran. Varia: (06:07) Hello, can you hear me? Speaker 1: (06:09) Very well. Please go ahead. Varia: (06:12) I asked this question before [inaudible 00:06:19]. It is the very first day of spring in Northern Hemisphere, spring equinox. Many people in Central Asia, Western Asia, they are celebrating it as a sign of renewal and new beginning. In this climate, what would be the WHO's message to people who are celebrating Nowruz? Especially Iranians, who are among people struggling the most with the outbreak of COVI-19? Speaker 1: (06:52) We missed your question, but was that really about temperature? Are you talking about celebrating the spring? Varia: (07:01) Hello? Speaker 1: (07:02) Dr. Ryan will answer. Dr. Ryan: (07:03) Yeah. Hi, Varia. Varia: (07:05) Hi. Dr. Ryan: (07:07) I trust you had a safe trip back to Iran. We miss you in Geneva. I think celebrations and gatherings, particularly religious gatherings, ones that celebrate renewal, are obviously very important, but we may need to change the way we celebrate things for now, and in countries like Iran. And it's very clear from the government that in Iran, we have to separate people physically so we don't transfer disease. And mass gatherings, particularly mass gatherings that bring people from far away to one place, and they mix, and then they go again far away, and that's very often religious gatherings, they can not only amplify the disease, but they can disseminate the disease very far away from the center. So they can be very, very, very dangerous in terms of epidemic management. We see the authorities in the Kingdom of Saudi Arabia, how careful they have to be every year with the Hajj because of the health risks, and that's managed extremely well. But in this particular case with this virus with this seriousness, I think we need to heed the instructions from the government in Iran, we need to heed the instructions all around the Middle East that gatherings of a certain size, and they're a different size in each country, need to be avoided. And we will support the government's efforts in that. Dr. Ryan: (08:27) But as we've seen, and it's not just in Iran where we might have religious gatherings, we have other gatherings around the world. Young people gathering, as the DG has said, and other people coming together. So whatever reasons we have to come together, and they can be very good reasons, we need to listen to local authorities, we need to listen to national authorities, and if national authorities believe that those gatherings represent a risk to those individuals, but more importantly to the vulnerable people they will go to visit after the gathering, then I think we really do have to take it upon our own personal responsibility. This is not about the responsibility of government. This is about each individual making a decision to protect themselves and protect others. We shouldn't always have to have a government telling us to do that. This is about personal responsibility. But in the case of mass gatherings in the context of countries like Iran, I think we need to be exceptionally careful at this point and we need to be very, very careful not to bring too many people together too closely at any one time. Dr. Maria Van Kerkhove: (09:31) If I can just add, you may have heard us use the phrase physical distancing instead of social distancing. And one of the things to highlight on what Mike was saying about keeping a physical distance from people so that we can prevent the virus from transmitting to one another, that's absolutely essential. But it doesn't mean that socially, we have to disconnect from our loved ones, from our family. Technology right now, it has advanced so great that we can keep connected in many ways without actually physically being in the same room or physically being in the same space with people. So as the DG highlighted in his speech, a lot about this is we say social distancing, we're changing to say physical distance. And that's on purpose. Because we want people to still remain connected. So find ways to do that. Find ways through the internet and through different social media to remain connected, because your mental health going through this is just as important as your physical health. Dr. Ryan: (10:29) Thank you. Speaker 1: (10:30) We'll now have a question from Brazil. It's Diego from Vortex. Diego, are you on the line? If so, please go ahead. Diego: (10:40) Yes, I am. Thank you very much. I would like to ask a very basic question. How central and crucial is physical distancing at this point? When you have community transmission, because there is a lot of debate going on around the world about the physical distancing measures, so I would like the most accurate data and comment possible regarding the physical distancing measures. Thank you. Dr. Tedros: (11:16) I think there are sort of a tool kit of measures that can be taken to deal with this virus. There are public health measures that focus on containment, and that is identifying cases and identifying their context. And the principle there is you take the case or the confirmed case and the contact away from everybody else. So you separate the virus from the population. When disease has reached a certain level, especially in community transmission, and it's no longer possible to identify all the cases or all of the context, then you move to separating everybody from everybody else. You create physical distance between everybody because you don't know exactly who might have the virus. Now if we look at that situation, that's- Dr. Ryan: (12:03) Now, if we look at that situation, that's very difficult to manage, because that's costly in social terms. That's costly in economic terms. And ideally, our approach to this should be to really focus on containment measures, case finding, isolation, quarantine of contacts, and in that situation, the social distancing or the physical distancing measurements or the movement restriction mechanisms may not have to be as extreme. Dr. Ryan: (12:29) If you think about Singapore and its fight against COVID-19, it never closed its schools. It didn't shut down its public health system. It didn't do lockdowns, but it was absolutely committed to the concept of case investigation, cluster investigation, case isolation, quarantine of contacts, and it really, really, really stuck to that task. Now, that was okay, because Singapore had a relatively low number of cases, so we're not criticizing in any way countries who have to take physical distancing measures. That's a necessary measure in situations with the virus is fairly widespread in communities. Dr. Ryan: (13:05) But what we should hope is, and this is maybe the thing that we have to be very careful with, large scale physical distancing, movement restriction are in a sense a temporary measure. What they do is they slow down to some extent the spread of infection in communities, and thereby take pressure off the healthcare system. They don't fundamentally deal with the problem of disease transmission, and if you want to get back to what countries like Korea are doing, Japan, or China, and Singapore, and Hong Kong and others, if you want to get back to that, you really have to get back to the hardcore public health measures of case finding, contact tracing, quarantine, isolation. Dr. Ryan: (13:46) So in some senses we need to slow down the virus, then we need to suppress the virus, and then we need to go after the virus. And that takes different combinations of different measures, but social or physical distancing measures and movement restriction measures are very hard socially, and they're very hard economically, and we need to use whatever time those measures are in place to put in place the public health architecture that can then go after the virus, because lifting those measures may result in the disease returning if you don't have in place the public health measures to deal with the virus. Maria? Dr. Maria Van Kerkhove: (14:23) Yeah. I think if you think just very simply about what physical distancing can do, if you think of a large gathering or you think of a crowded space and people are very close to one another, if you have infected individuals in that clustering of people, the opportunity for the virus to pass between people is much greater, because you are physically closer to one another. What physical distancing does is just that. It actually separates people out. So think of that same cluster of people but spread out over a much larger geographic area. Just think of a drawing, where you're seeing a bunch of dots. Either they're very close together or they're very spread apart. If those dots are spread apart, and those dots represent people, and you have infected people in those areas, you remove the exposure. You remove the opportunity for that virus to pass between one person and another. But as Mike has said and as we have said before, social distancing, physical distancing alone is not enough. It has to be part of a much larger package of interventions. Speaker 1: (15:28) Thank you, Maria. So now I have a question from Imogen, Imogen Fuchs. Are you on the line, Imogen? Imogen? Imogen Fuchs: (15:39) Yeah. Can you hear me? Hi, can you hear me? Yes? Speaker 1: (15:41) Very well. Go ahead. Great. Imogen Fuchs: (15:43) Yeah. There have been some questions about the mortality rate in Europe. Italy's is tragically really, really high. Germany's so far is quite low, and there have been some questions about how the cause of death is being recorded. For example, if somebody, an individual who already had serious underlying health conditions, do you have any data from the different countries about how they're recording cause of death? Dr. Maria Van Kerkhove: (16:11) I don't have any specifics data about how each country is recording a cause of death, whether it was associated with COVID-19 or if there were other reasons why people died. We do know from the confirmed cases if those individuals have been reported as having recovered or who have died. We spoke about this the other day, the differences in mortality as you compare them by country. We have to be very careful about how we compare countries right now. There's a combination of factors of why we're seeing differences in mortality by country. The first is about the populations that the virus is affecting and infecting. We gave the comparison between the virus moving in older populations, because we know that the virus can cause more death in older individuals, as opposed to the virus circulating in younger populations where you would see less mortality. Dr. Maria Van Kerkhove: (17:04) So there are a number of factors in which the mortality rate can vary by different populations, and we also discussed previously about the challenges of describing mortality as an epidemic unfolds, as this pandemic unfolds. Looking just at the numbers of deaths over the numbers of cases that are reported is only a snapshot, and it's an incorrect snapshot of what the true mortality is, because we don't know the extent of infection in the population on the one hand, and on the other hand there are a number of individuals who are very severe, who are still in ICU, some of whom will recover and some of whom will die. So we don't have those precise numbers yet of how many will die out of those that are infected, and we still don't know the overall infection rate in the general population. Speaker 1: (17:57) Thank you, Maria. I'm just going to ask now a question that was sent to me by email from a correspondent, a health writer in India, who's been struggling to get on virtually. Her name is Mayank Bhaguat, asks, "India has tested close to 13,000 samples. WHO says, 'Test, test, test.'" She asks, "By not scaling up the tests, has India lost critical time?" Dr. Maria Van Kerkhove: (18:30) So it's wonderful that we're seeing testing being done across countries. We know that there are challenges associated with doing that test. We know we are working very hard across all of our regions with many different manufacturers to ensure that tests are available in countries that need them. We're working with labs across all countries to ensure that the lab capacity in each country is increasing, and we're seeing many countries take additional steps to further increase that capacity. Dr. Maria Van Kerkhove: (18:59) What the DG meant when he said, "Test, test, test," was that we recommend that all suspect cases be tested, and we recommend that all contacts that have symptoms are tested. And the reason that that is absolutely critical is that we need to know where this virus is so that we could stop the onward transmission from those who are infected to infect other people. And so by doing that, by having adequate testing and ample testing as part of your strategy will help reduce this down. But that isn't enough. We know that finding those cases, isolating cases, and caring for those cases is critical. Quarantining of your contacts so that they cannot pass that virus onward is absolutely critical to stopping transmission moving between people. Speaker 1: (19:51) Thank you, Maria. DG, you want to do it? No? Okay. So now I'd like to ask, Charles Underland from Liberacia. Charles, are you on the line? Charles Underland: (20:03) Hello, this is a question to the DG. Dr. Tedros, I'd like to know how you are coping with the different press pressures you might have from member states who don't really have the same priorities or ways to fight this virus. How do you cope with the different appreciations coming from the larger member states? Dr. Tedros: (20:31) I think WHO, whether it's a small country or big, whether it's a rich country or poor, it's the same. We treat them the same, same way. And to treat all same way, the best principle is to actually be principled, and to help them, to give them advice, or to respond to their queries based on principles. So as long as we do that, then I think I don't consider anything that comes from member states as pressure. Speaker 1: (21:16) Thank you, DG. I've got another printed question that was emailed to me by John Zarocostas on behalf of France 24 and The Lancet. "What is the shortfall in the global supply of PPE and critical lifesaving medical equipment, and in view of the surge of cases, how much production do supplies needs to increase?" Dr. Ryan: (21:56) It's difficult to make an estimate obviously for the whole world, because we don't know the stocks that national governments actually hold, so we can only make estimates based on the number of health workers that we would expect to be in the front line at a certain level of service. So a shortfall is the difference between what you need and what you have, and right now we don't know how much we're going to need, because we don't know how fast this is going to develop, so we have projections for that, and there are different scenarios, and equally as difficult to know where the gap is, because we don't have full knowledge of what countries actually themselves have. Dr. Ryan: (22:37) We are going through a very sophisticated process of establishing and finalizing the gaps as we see them. We're asking countries what their gaps are specifically, we're doing market analysis as to what the supply chain has within us. It's safe to say that the supply chain is under huge pressure. We're working with a pandemic supply chain network to maximize the amount of flow of PPE into a protected supply chain for PPE for health workers around the world, but it's not just the PPE itself, it's getting that PPE now to countries. We have issues with flights, we have issues with getting access, so we're going to need an architecture. In effect, we're going to need air bridges that allow us to bring staff, to bring stuff to countries to help and assist them, and that stuff may be lab tests. That stuff may be PPE. That stuff may be expertise. Dr. Ryan: (23:36) It's becoming increasingly difficult for us to move material around, because even ships and cargo, I think as we speak, over 100,000 merchant seamen are currently sitting in ports all over the world and can't either come into the country they're in or move on in the ships they're on. So we have some serious issues within the supply chain. We are, though, and it is not without hope, and the DG may wish to speak. Dr. Ryan: (24:03) It is not what I would hope. And the DG may wish to speak to this. Manufacturers in China, in cooperation with the Chinese government have moved very significantly and offered to resupply our warehouses in Dubai and we're currently finalizing those shipments and finalizing the needs, and we will obviously continue to do that. Dr. Ryan: (24:25) We do have a whole series of numbers, John, around what is potentially needed and I'll be very happy to share some of them with you in the next couple of days as soon as they're validated. We're currently validating the number of lab tests need. Dr. Ryan: (24:39) But if I give you a sense of scale, WHO has distributed one and a half million lab tests around the world. If we look forward in this epidemic and we project ourselves forward a number of months and the amount of testing that's going to be needed, we need to scale that up approximately 80 to a hundred times. Dr. Ryan: (24:59) So it's not about doubling the availability of lab test, it's not about tripling it, it's about potentially increasing that 80-fold. Now that's an extreme analysis, but that's what we need to aim for. And the Director General outlined the mechanisms by which we're going to achieve that. Working with the public private partnership and scaling up production and access to tests as there are needed. Dr. Ryan: (25:22) Equally, we estimate that there are probably, if you look again around the world, probably in excess of 26 million healthcare workers who may have to at some point, engage in healthcare to people who potentially have COVID-19. That's an awful lot of healthcare workers to protect. You work out that those healthcare workers are doing a few hour shifts. They have to change PPE every time they do a shift. They have to be trained to use that PPE. I think you can see just what the gaps are in terms of masks and gowns and gloves in that. But as I say, we're validating those numbers because we have to match them against what countries actually have. Dr. Ryan: (26:04) The greatest tragedy for me, among all the tragedies we're seeing in this outbreak, is the prospect of losing a part of our health workforce. That those individuals, those doctors and nurses and hygienists and others who put themselves in the front line to care for our most vulnerable, would themselves become exposed, become sick and potentially die because they don't have protective equipment. It is a huge responsibility at local, at national and at global level that we protect the supply chains for health workers around the world and that we have solidarity between governments, between producers, manufacturers and others to ensure that our bravest get the best possible protection. Dr. Tedros: (26:52) I would like to add a few issues. I think Mike had covered almost everything. Whatever the amount we need ... We are saying we have shortages, but whatever amount the shortage is, without political commitment of our leaders, I don't think this shortage of supply of PPEs could be addressed. Dr. Tedros: (27:23) And as a result with that, because of lack of political commitment, one, the supply is short. Two, because the supply is short, some countries are closing borders and banning exports. And that can not be a solution. Dr. Tedros: (27:42) And the solution we are proposing is, one, if there is political commitment, and we need political commitment, we need to do three things with political commitment. One, increase production, because there is the supply demand mismatch. So to address that, increasing production is the answer. Second, we need to have free cross-border mobility, meaning we should not ban exports. And third, equitable distribution is key, because all countries may not have access based on their needs. Dr. Tedros: (28:31) So we're asking those three things and we're working with the International Chamber of Commerce very closely. And with B20, these are the businesses that belong to the G20, to address the problem of the logistics we are facing at its root. Thank you. Dr. Maria Van Kerkhove: (28:54) If I can speak to the individual level. So even the individual actions that all of you take effect the supply chain. So as it relates to masks, members of our team are having teleconferences across our infection prevention and control networks where there's very serious discussions about the use of medical and surgical masks. We need to ensure that we prioritize the use of these masks for our frontline workers. Dr. Maria Van Kerkhove: (29:19) And so we plead with you. If you do not need to wear a mask at home as an individual in the community, don't wear a mask. Don't hoard those masks. Make sure that those masks are available to the frontline workers because they're making very difficult decisions about extended use or potential reuse. And we don't want to put our healthcare workers in any further danger. So please, if you don't need to, if you're not caring for a sick person at home, then you don't need to be wearing a mask. So again, please prioritize the use of these masks for our frontline workers. Speaker 1: (29:55) Thank you. We now have question from Karin at Bloomberg. Karin, are you on the line? Karin, are you on the line? Karin: (30:08) Yes. Can you hear me? Speaker 1: (30:09) Yes, we can. Please go ahead. Karin: (30:12) Okay. So given that 10,000 deaths have been reported and many researchers estimate that the mortality rate of COVID-19 is 1%, is there any reason not to estimate that 1 million people may have already been infected? Dr. Ryan: (30:39) Yeah. I think you may be mixing up two lines of logic here. There've been over 200,000 confirmed cases reported, and we have 10,000 deaths. So deaths can be calculated as a proportion of those. We try to avoid that in general because very often your reported cases reflect infections up to 14 days before, but your deaths can actually reflect people who were exposed two weeks, three weeks, four weeks before. So it's not necessarily a good thing to make that calculation. But using deaths as a way of calculating how many people are infected is making an assumption that you can make that calculation, and unfortunately, we can't make that calculation. Dr. Ryan: (31:27) What I think we need to focus on and many people, we will have to wait for serology tests to really understand what the population attack rates are. But all of the data so far suggests that asymptomatic cases are a relatively low proportion of symptomatic cases. We don't know, beyond that, whether there are others who just get infected and just develop antibodies and never, ever know they're infected or may not even be infectious. Dr. Ryan: (31:54) The question is what's driving infection? And what we believe is driving infection is for the overwhelming majority of people who are infected, they're infected by a symptomatic other individual. Somebody who is sick and symptomatic who either coughs or sneezes close by are who contaminates a surface close by. That is the main driver of transmission, and that's what we have to focus on in order to avoid infection. We can worry about all of the other ways that we could possibly be infected theoretically, and that's important, and there are outliers in all of science, but the driving force is that. With regard to the deaths, rather than trying to ... We can say 10,000 deaths and sounds like a lot, and then other people say, well, people die of other things too. But take one look at what's happening in some health systems around the world. Look at the intensive care units. Completely overwhelmed. The doctors and nurses awfully exhausted. Dr. Ryan: (32:52) This is not normal. This isn't just a bad flu season. These are health systems that are collapsing under the pressure of too many cases. This is not normal. This is not just a little bit worse than we're used to. This is tough for systems. And therefore trying to use the absolute number of deaths as a measure of the overall impact of this outbreak is probably not the right term to use. Dr. Ryan: (33:19) But certainly when we say 1% overall case fatality, it's a number. But when I would say to you that in certain situations, particularly in the over 70s, in a number of situations, the case fatality, the clinical case fatality, the case fatality in those people admitted to hospital is up to one and five for people over the age of 70 years of age. That's a really, really serious outcome for anyone being admitted with COVID-19. Dr. Ryan: (33:51) And equally, when we look at people in intensive care. If you look in Italy at the moment, two out of three people in intensive care in Italy are under the age of 70. And in fact 12% of people in intensive care initially are under the age of 50. So again, let's look not just at death, let's look at severity, let's look at the impact this is having in society. Dr. Maria Van Kerkhove: (34:16) I just want to take this opportunity to say something about models. So mathematical models, WHO works with a large number of modeling groups across the globe, statisticians and modelers, and this is really important for us to help work through scenarios and work through the what ifs. What may happen if we don't do anything? What will the trajectory of this outbreak in each country and at the global level or by region look like if we do nothing? And those numbers are scary. I'm sure you've seen some scary numbers that have been reported in the media, and those numbers will likely continue. Dr. Maria Van Kerkhove: (34:51) But the important thing is, is that there's something we can do about this. We have seen in a number of countries now that there are several actions that can take this comprehensive approach that we've been talking about, to drive those numbers down. And we owe this to ourselves and the rest of the world to do everything we can to make sure that those predictions do not become a reality. Speaker 1: (35:15) Thank you, Maria. So now I have a question. We're moving around the globe to Greece. Costas from EIT. Are you on the line? Costas: (35:27) Yes, I on the line. Can you hear me? Speaker 1: (35:30) Please go ahead. Costas: (35:34) I will ask question to Dr.[General 00:11:32]. Give us please an update about the vaccine research. How far away are we from the lucky first day to rid COVID-19? Speaker 1: (35:51) Question about the vaccine. Dr. Maria Van Kerkhove: (35:54) So we are working across with the Research and Development blueprint R&D blueprint, with a number of scientists and researchers all over the globe. And one of the areas- Dr. Maria Van Kerkhove: (36:03) With a number of scientists and researchers all over the globe, and one of the areas that we are working on is the acceleration of vaccine development. Not just us, we're working with people across the globe. There's at least 20 vaccines that are in development for Covid 19. And you heard us report, I think Mike, you can give a little more detail on this, of the first trials that are starting 60 days after the virus was sequenced, if I'm not mistaken. Dr. Maria Van Kerkhove: (36:27) The acceleration of this process is really truly dramatic in terms of what we're able to do. Building on work that started with SARS, that started with MERS and now being used for Covid 19. We're still some time away before we would have a vaccine that could be used. And they still need to go through the trials to look at efficacy. But this work is underway and we are very grateful for all of the partners that are working to get these clinical trials underway. Mike. Dr. Ryan: (36:56) Yeah, maybe I can supplement again. Yes, I'm very pleased to see the work accelerating. And we thank our colleagues in [inaudible 00:01:04], but also working very closely with Seth Berkley and his colleagues at the Gavi and many, many others, the Gates foundation and others. I think beyond the scientific research to vaccine, and it's fantastic to see the innovation going on to develop vaccine candidates, and to take those candidates through the necessary testing. Dr. Ryan: (37:24) And many people are asking, well, why do we have to test the vaccines? Why don't we just make the vaccines and give them to people? Well, the world has learned many lessons in the mass use of vaccines. And there's only thing more dangerous than a than a bad virus. And that's a bad vaccine. So we have to be very, very, very careful in developing any product that we're going to inject into potentially most of the world's population. Dr. Ryan: (37:46) We have to be very, very, very careful that we first do no harm. So that's why people are being careful. To be eight weeks into a major event of a new disease and have a vaccine going into the arm of a volunteer this week is just unprecedented in its speed. And that would never have happened had countries not put the genetic sequences out in public. And I think that again shows why solidarity is so important. Dr. Ryan: (38:14) But we will face another challenge down the line and one that the director general is very concerned about and is reaching out to other institutions like Gavi and others to discuss right now. And that is that even if we get a vaccine that's effective, we have to have that vaccine available for everybody. There has to be fair and equitable access to such a vaccine, not just for ethics reasons, but because the world will not be protected until everyone is protected. Dr. Ryan: (38:42) So in that sense, there are other hurdles to cross now. Not just the hurdles of science, but the hurdles of how do we scale up the production of such a vaccine? How do we ensure we get enough of that vaccine in time? How do we distribute that vaccine to populations all over the world? And how do we convince people to take the vaccine? Because you've all seen over the last few years, the loss of confidence in vaccines. It's one thing having a vaccine, but people need to avail of that vaccine. So there's a lot of work to do and the director general will be leading on process with other organizations to address the issues of production, scale up, financing, advanced market commitments, and a fair and equitable distribution of those vaccines, and has already been reaching out to major institutions and global health leaders on this. Dr. Tedros: (39:34) On the vaccines, one thing I would like to stress, as Mike said, is one dispute is really unprecedented. In 60 days, to have the first person to be enrolled in vaccine trial is really amazing. I hope the vaccines under trial work. Dr. Tedros: (40:02) And at the same time though, before even we have the vaccine, as Mike said, we have to prepare so that the vaccines can reach everybody who needs it. Because this vaccine should not be for the haves. It should be for those who cannot afford it too. So we need to answer that question as early as possible. Dr. Tedros: (40:29) But the solidarity we are witnessing is very, very encouraging. My colleagues were sending me a text about another solidarity. This solidarity, which we are saying is a solidarity of scientists who came together as you remember six weeks ago to find solutions, diagnostics, treatment and vaccines. And then the other solidarity is the financing, the solidarity response fund. As you know, we started it last week. And today we have mobilized already 66 millionaires dollars. This is a record. Dr. Tedros: (41:12) But it's not the money. 175,000 people were involved in one week. And not only that, there is an outpouring support which is still flowing and including many stories that really touch our hearts. I will give you one of some of the stories. Dr. Tedros: (41:40) In New York, a theater group started a virtual singing challenge, getting people to donate. And in Ireland, Mike's country, Karen Ford is staying active and 4,000 squats in GoFundMe campaign to support the fund. And then online a popular video game streamer started hosting regular fundraisers with his followers, very innovative and on and on. I don't want to take but time on this. But these are stories of solidarity. Dr. Tedros: (42:24) And when humanity is confronted with a common enemy like this, it also gives us a chance to bring the best of us. And that's what we need. Solidarity in everything. And with that kind of solidarity, which is we said it last week, which is more infectious than the virus itself, we will be able to stop this virus. Speaker 1: (43:01) On that note, I'm going to close this press conference. It's so important that we all stay positive. I'm so sorry to the 277 journalists online that you didn't get to ask your questions. We will be sending the transcript out. We'll also send the number of the WhatsApp chat bot. You just have to put in plus 41 798 931 892 and send the word hi. Speaker 1: (43:29) But we'll send it to you so you can all use it and see what a great chat bot it is. And we will also send the usual audio files. Thank you so much for joining this briefing today. Goodbye. Dr. Tedros: (43:45) Goodbye. Thank you. And born weekend. Have a nice weekend.