Jun 29, 2020

World Health Organization (WHO) Coronavirus Press Conference June 29

World Health Organization Press Conference June 29
RevBlogTranscriptsCOVID-19 Briefing & Press Conference TranscriptsWorld Health Organization (WHO) Coronavirus Press Conference June 29

The World Health Organization (WHO) held a coronavirus press conference on June 29. They warned that the coronavirus pandemic is speeding up as countries ease lockdown rules, and “the worst is yet to come.” Read their full update briefing on the latest COVID-19 news & findings here.

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Tarik: (00:15)
Hello everyone, and thank you very much for joining us for this regular press conference from WHO headquarters on COVID-19. We welcome all the journalists who are watching us on Zoom, but also everyone who is following us on a number of WHO social media platforms. Today we have with us WHO Director-General Dr. Tedros, Dr. Maria Van Kerkhove, who is the Technical Lead COVID-19. And we have Dr. Mike Ryan, who is WHO Executive Director for Program for Health Emergencies. Journalists who are watching us on Zoom can follow this press briefing in six UN languages, Hindi, and Portuguese. And this is thanks to our interpreters who are here with us, and we sincerely thank them for their presence and assistance. Journalists may also ask questions in six UN languages and Portuguese when we get to that section of the press briefing. I will give the floor now to Dr. Tedros for his opening remarks.

Dr. Tedros: (01:22)
Thank you. Thank you, Tarek. Good morning, good afternoon, and good evening. Tomorrow marks six months since WHO received the first reports of a cluster of cases of pneumonia of unknown cause in China. The six month anniversary of the outbreak coincides with reaching 10 million cases and 500,000 deaths. This is a moment for all of us to reflect on the progress we have made and the lessons we have learned, and to recommit ourselves to doing everything we can to save lives. Six months ago, none of us could have imagined how our world and our lives would be thrown into turmoil by this new virus. The pandemic has brought out the best and the worst of humanity. All over the world, we have seen heartwarming acts of resilience, inventiveness, solidarity, and kindness. But we have also seen concerning signs of stigma, misinformation, and the politicization of the pandemic.

Dr. Tedros: (02:55)
For the past six months, WHO and our partners have worked relentlessly to support all countries to prepare for and respond to this new virus. Today, we are publishing an updated and detailed timeline of WHO’s response to the pandemic on our website so the public can have a look on what happened in the past six months in relation to the response. It illustrates the range of WHO’s work to stop transmission and save lives. We have worked with researchers, clinicians, and other experts to bring together the evolving science and distill it into guidance. Millions of health workers have enrolled in courses through our openwho.org online learning platform. We launched the Solidarity Trial to find answers fast to which drugs are the most effective. We launched the Solidarity flights to ship millions of test kits and tons of personal protective equipment to many countries. We launched the Solidarity Response Fund, which has raised more than $223 million for the response. Three major innovative Solidarity activities. And we have worked with the European Commission and multiple partners to launch the ACT Accelerator to ensure that once a vaccine is available, it’s available to everyone, especially those who are at greatest risk. Last Friday, we launched the ACT Accelerator Investment Case, which estimates that more than $31 billion will be needed to accelerate the development, equitable allocation, and delivery of vaccines, diagnostics, and therapeutics by the end of next year. Over the weekend, WHO was proud to partner in the Global Goal: Unite for our Future, pledging conference, organized by the European Commission and Global Citizen. The event mobilized new resources to respond to the COVID-19 pandemic globally, including in support of the ACT Accelerator.

Dr. Tedros: (05:37)
Also, a vaccine will be an important long term tool for controlling COVID-19. There are five priorities that every single country must focus on now to save lives now. First, empower communities. Every individual must understand that they are not helpless. There are things everyone should do to protect themselves and others. Your health is in your hands. That includes physical distancing, hand hygiene, covering coughs, staying home if you feel sick, wearing masks when appropriate, and only sharing information from reliable sources. You may be in low risk category, but the choices you make could be the difference between life and death for someone else.

Dr. Tedros: (06:44)
Second, suppress transmission. Whether countries have no cases, clusters of cases, or community transmission, there are steps all countries can take to suppress the spread of the virus. Ensure that health workers have access to training and personal protective equipment, improve surveillance to find cases. The single most important intervention for breaking chains of transmission is not necessarily high tech and can be carried out by a broad range of professionals. It’s tracing and quarantine contacts. Many countries actually have used non-health professionals to do contact tracing.

Dr. Tedros: (07:39)
Third, save lives. Early identification and clinical care saves lives. Providing oxygen and dexamethasone to people with severe and critical disease saves lives. And paying special attention to high risk groups, including elderly people in long term care facilities, saves lives. Japan has done this. It has one of the highest population of elderly people, but its death rate is low. And the reason is what we just said. Many countries can do that. They can save lives. Fourth, accelerate research. We have already learned a lot about this virus, but there is still a lot we don’t know. And there are still tools we need. This week, we will convene a second meeting to assess progress on research and development and reevaluate research priorities for the next stage of the pandemic. And fifth, political leadership. As we have said repeatedly, national unity and global solidarity are essential to implementing a comprehensive strategy to suppress transmission, save lives, and minimize the social and economic impact of the virus. No matter what stage a country is at, these five priorities, if acted on consistently and coherently, can turn the tide.

Dr. Tedros: (09:36)
WHO will continue to do everything in our power to serve countries with science, solidarity, and solutions. The critical question that all countries will face in the coming months is how to live with this virus. That is the new normal. Many countries have implemented unprecedented measures to suppress transmission and save lives. These measures have been successful in slowing the spread of the virus, but they have not completely stopped it. Some countries are now experiencing a resurgence of cases as they start to reopen their economies and societies. Most people remain susceptible. The virus still has a lot of room to move. We all want this to be over. We all want to get on with our lives. But the hard reality is this is not even close to being over. Although many countries have made some progress, globally, the pandemic is actually speeding up.

Dr. Tedros: (11:16)
We’re all in this together. And we’re all in this for the long haul. We will need even greater stores of resilience, patience, humility, and generosity in the months ahead. We have already lost so much, but we can not lose hope. This is a time for renewing our commitment to empowering communities, suppressing transmission, saving lives, accelerating research, and political and moral leadership. But it’s also a time for all countries to renew their commitment to universal health coverage, at the cornerstone of social and economic development and to building the safer, fairer, greener, more inclusive world we all want. I thank you.

Tarik: (12:29)
Thank you, Dr. Tedros, for these opening remarks marking the six months of pandemic. We will now open the floor to questions. Reminding, once again, journalists that if they wish, they can ask question in six UN languages and Portuguese. So if we are ready from the technical side, we will go first to Georgia, Georgian News Agency. And we have with us Constantine [inaudible 00:00:13:00]. If you hear us, Constantine, please go ahead.

Constantine: (13:04)
Yes, yes, yes. Constantine [inaudible 00:00:13:09]. My press, Georgia. Thank you very much. My question is for Georgia is a country with small economy, but at the same time, we had good results of fighting the coronavirus. What will be the mechanism to get access to the vaccine that will be developed, I hope, with the support of the World Health Organization? Are there any other possibilities to achieve so-called health immunity besides vaccination? Thank you very much.

Dr. Michael Ryan: (13:46)
Good afternoon. We all hope, as you do, that we can reach a point where a safe and effective vaccine is developed and allocated fairly to countries around the world. As the Director-General has said in his speech, we don’t have that vaccine yet. And there’s a lot we can do now to suppress transmission. And I believe the Republic of Georgia has been doing well in this regard, both in terms of community engagement, in terms of suppression of transmission, and saving lives through adequate clinical care. But yes, we do hope that a vaccine will be developed. There have been over 133 candidates put into the system. A large number are now in clinical trials. The Director-General launched the ACT Accelerator in April as a means of leveraging global collaboration and innovation and funding, both for vaccines, drugs, and for diagnostics. The vaccines is probably the one that will absorb most resources and requires a very deep sustained public-private partnership.

Dr. Michael Ryan: (14:52)
It is the best means for countries to access the vaccine. And we have to find a way to ensure that regional alliances that are growing to develop contracts with companies for vaccines are linked to a global movement that ensures that those vaccines are made available to all countries. The GAVI, SEPI, and WHO are working together on Covax, the initiative for coronavirus vaccines, as part of that large advanced market commitments that are being put together in order to secure vaccine production.

Dr. Michael Ryan: (15:26)
There is no other means of achieving adequate herd immunity. The herd immunity is a term usually reserved for the use of vaccines. But we also have to be cautious and careful. We desperately hope, and we can see tremendous work towards, safe and effective vaccines. But there are no guarantees of such. And therefore, that’s why we have so many candidates in testing, so we have an opportunity to find the best one. But the only other way that a virus like this may be suppressed is by us breaking the chains of transmission. If you accept that you cannot do that, then the only option is to let this virus run free through society. And we have already seen the horrific impacts of that. And therefore, reducing mortality, suppressing transmission, while waiting for the arrival of a safe and effective vaccine right now is our best strategy for stopping this disease.

Dr. Tedros: (16:35)
Thank you. I just would like to … What my general said, Mike, herd immunity is very difficult even when we have vaccines because we need to have a high coverage of vaccine use to have herd immunity.

Dr. Tedros: (17:03)
… vaccine use to have herd immunity, and Mike had already said it.

Dr. Tedros: (17:09)
To be honest with you, I think it would be important to focus on what is at hand now. What is at hand now is the simple public health solution we have that many countries use to suppress the transmission and to save lives. I will give you one example, which is a country. South Korea. In February, I remember South Korea had the second largest number of cases after China. I spoke with the health minister, and the foreign minister came to Geneva to discuss with us in our headquarters here. We agreed on the comprehensive approach, and we agreed on implementing what’s on hand to save lives, and to suppress the transmission. And South Korea has shown to the world that, without even vaccines or therapeutics, that it can take the number of cases down, and suppress the outbreak.

Dr. Tedros: (18:38)
So our message to the world is if the government can do its best in testing, contact tracing, isolating, quarantining cases like what South Korea did, and if the communities … Not only the government, but in addition to the government, the communities take their responsibility of doing what’s expected of them, starting from hand hygiene to the rest that can be done personally, this virus can be suppressed. Time after time, and country after country, what we have seen is this virus can be suppressed if the governments are serious about the things they have to do, their share, and if the community can do its share.

Dr. Tedros: (19:42)
So while doing our best to find a vaccine, which is the right thing to do, our advice from WHO is we should do everything we can using the tools we have at hand. Because many countries, including the one example, Korea … I can give you a list of countries … Have shown that this virus can be suppressed and controlled using the tools at hand. So the basics are still important, and the basics are non-pharmaceutical. And they have shown their efficiency and effectiveness in controlling or suppressing this virus.

Dr. Tedros: (20:37)
The reason I’m stressing this is the virus is spreading aggressively. It’s very tragic to report to you that we have already surpassed the 10 million cases, and have a million deaths. Still, this could have been prevented through the tools that we have at hand. And, please, focus on the tools at hand. Of course, we appreciate the investment you’re doing in finding more technology, vaccines, and therapeutics, but that should be in addition to the maximum use of the tools at hand. And these are the simple solutions that the government can do and the public can do. And we have already outlined those.

Dr. Tedros: (21:43)
So that’s our message. It’s six months since the virus started. It could be like a broken record, to say exactly the same thing, but the same thing works. Test, trace, isolate, and quarantine cases. That’s for the government to do. And, second, hand hygiene for each individual. Of course, wearing masks, and the other things that can be done, social distancing, at individual level. It works, and save lives. And that’s still our message. But, of course, we should look for vaccines and the rest, but the simple and basic public health works, and that’s what we’re saying. Thank you.

Tarik: (22:45)
Thank you, Dr. Ryan and Dr. Tedros, for this answer. We will now go to Michael [Vulsukiev 00:22:52], who is a contributor to CNN. Michael, the floor is yours.

Michael Vulsukiev: (22:57)
Yes, can you hear me?

Tarik: (22:59)

Michael Vulsukiev: (23:00)
Thank you for taking my question. Good morning from British Columbia.

Michael Vulsukiev: (23:04)
Director General, this question relates to your opening statement that the pandemic has brought out the best and worst in humanity, including politicization of the pandemic. Just a few days ago, Marco Rubio [inaudible 00:23:17] were among 500 people who warned in a letter that democracy is under threat by certain authoritarian leaders due to coronavirus. They’ve cited parliaments being sidelined, journalists arrested, minorities scapegoated, and most vulnerable sectors of the population face alarming new dangers. My question is the following, sir. Ambassador William Taylor told me that strong men do not seem to be winning against COVID-19, that the virus is having a devastating effect on strong men who aren’t taking the steps that need to be taken. Do you have an opinion on that, or do you agree? Thank you.

Dr. Tedros: (23:53)
Can you repeat? Sorry, I didn’t know the ambassador that you mentioned.

Michael Vulsukiev: (23:58)
Oh, sorry. It’s Ambassador William Taylor. He is quite well known as a US ambassador. He was in the congressional testimony a few months ago. Served to various places around the world. He’s now with the US Institute of Peace, and studies strong men a lot, and he said that if strong men believed that they could take advantage of COVID-19 to suppress civil liberties, they’re wrong, that this will backfire on them.

Dr. Tedros: (24:25)
Mm-hmm ( affirmative).

Dr. Tedros: (24:34)
Yeah. No, thank you. Our message from the start was very, very simple. I was a politician myself. I was a member of parliament. Maybe something I learned while I was a politician was at the end of the day, what you do should be something that helps your people. And one thing may be I learned the biggest lesson is even if we belong to different political parties, the citizens of that any country, you bring any country, are the same.

Dr. Tedros: (25:38)
So whether we belong to the right or left, or we are the center, but they call progressive party, what matters at the end of the day is what we do good for the people. Then if you take COVID, if you see it in doing good for our citizens, what you do is saving lives. Because even one life is important, whether it belongs to the left, to the right, or to the center. And that’s why from the start we said please, please quarantine COVID politics. Please, we need national unity. Unity at the country level, unity among political parties, unity across ideologies, unity across beliefs, unity across races. Unity across any differences you can imagine, because there was a reason why we said that.

Dr. Tedros: (26:56)
This virus has two dangerous combinations, and we have said it many times, and even the international expert group that visited China that was composed of many countries, including the US, Germany, Japan, Nigeria, Korea, Singapore … Many countries, actually. A very diverse … Russia. A very diverse group of international experts said this virus has two dangerous combinations. One is it’s fast, it’s contagious. Second, it’s a killer. And it can exploit divisions. Divisions between us across all the lines which I have said, and that’s why WHO has been saying, please, avoid any division. Any differences could be exploited by the virus, and that we have to fight this virus in unison.

Dr. Tedros: (28:29)
And that’s why whatever what you said, our message is still the same. It’s not about one country, or two countries, or three countries. It’s not about something specific to any place. It’s about how we should operate globally, whether it’s at national level, sub-national level, or regional level, or global level. And with 10 million cases now, and half a million deaths, unless we address the problems we have already identified at WHO, the lack of national unity and lack of global solidarity, and [inaudible 00:29:30] the virus to spread, as I said in my speech, the worst is yet to come.

Dr. Tedros: (29:40)
I’m sorry to say that, but with this kind of environment and condition, we fear the worst. And that’s why we have to bring our acts together, and fight this dangerous virus together. I thank you.

Tarik: (30:06)
Thank you, Dr. Tedros, and thanks to Michael for this question. We will now go to the Economic Times of India, and we have with us [Devia 00:30:20] [Agajagopal 00:30:20]. Devia, you will need to unmute yourself. Hello?

Devia Agajagopal: (30:26)
Hello. Thank you for taking my question. Am I audible?

Tarik: (30:31)
Yes, we can hear you.

Devia Agajagopal: (30:33)
Yes. Hi. I wanted to ask this question to the entire panel. Last week, Anthony Fauci of NIH has said that contact tracing is becoming increasingly difficult at this stage of the pandemic. Do you think that as infection spreads in most countries, it is still possible to use contact tracing as a effective way of mitigation? Thank you.

Dr. Michael Ryan: (30:59)
I think yes, but it’s very dependent on the background intensity of transmission. In situations where there’s very intense community transmission, and large numbers of cases every day, it’s very hard to get on top of case isolation alone, nevermind the contact tracing. So countries may need to make some choices on that regard. But what has happened for those countries who have been effective, those countries who stuck with contact tracing and isolation or quarantine and of contacts, have found then as the number of cases drops, that they can catch up on the contact tracing, and improve.

Dr. Michael Ryan: (31:39)
The difficulty has been for many countries who gave up entirely on contact tracing now having to pick that up, now having to scale up the architecture of public health surveillance as they’ve opened up societies and decreased the public health and social measures on the restrictions of movement. It’s quite tough for the public health system to catch up, and it takes time for it to do so. And the Director General said many, many times during this period of so-called “lockdowns” that this was precious time to prepare. Not only were public health and social measures having an impact on transmission, they were also clearly having a negative impact on social and economic life, and that this precious opportunity needed to be taken.

Dr. Michael Ryan: (32:26)
And we’ve seen in countries who have really beefed up their capacity to do contact tracing, isolation, quarantine, testing, and all of the things the Director General spoke about, they have done well.

Dr. Michael Ryan: (32:38)
So, yes, contact tracing, public health surveillance is a key part of a package of activities. The DG has said it. If individuals and communities can sustain the physical distancing, the hygiene, the mask-wearing, and the other things that are appropriate and advised by local government, if the public health system can continue to track and trace cases, yes, we should see a situation where the disease comes under control. And many countries have proven that. That is not supposition. Many, many countries, through applying a comprehensive strategy, have reached a very low level of virus transmission in their countries. But always have to remain vigilant in case there are clusters or small outbreaks. We’ve seen those situations arise in Germany. We’ve seen those situations arise in Singapore and Japan, in Korea, in China, and other countries.

Dr. Michael Ryan: (33:34)
And, again, it’s in those situations where your public health surveillance and your contact tracing and your ability to investigate clusters really comes into its own. And where you’ve really seen the advantage of public health and public health architecture is that ability to pounce on disease. What you have to do is push the disease down to the lowest possible level, and communities have made a huge sacrifice for that happen. They’ve stayed at home, they’ve stayed away from their families. They’ve contributed tremendously to suppressing-

Dr. Michael Ryan: (34:03)
They’ve contributed tremendously to suppressing infection. And what public health authorities have needed to do is to put in place the right public health surveillance in order to take advantage of that. So as the restrictions are lifted and as we see small clusters appear, the public health authorities can react quickly and suppress that infection again. And a great credit goes to countries like Germany, like Japan, like Korea, and others who’ve really focused in on that function of the system. They’re able to use a multifaceted approach. They’re able to sustain community commitment to the process. High levels of community acceptance, high levels of community compliance, high levels of community understanding linked to a strong public health intervention and a strengthened public health and health system. It works.

Dr. Michael Ryan: (34:53)
It’s not a guarantee of success but what we’ve seen is that countries that apply a comprehensive sustained strategy with their communities on board make progress. There are no guarantees with epidemics, but this right now is the best package of activities that countries have shown again and again can lead to us arriving at a situation where we can live with this virus.

Dr. Maria Van Kerkhove: (35:18)
I just want to add two points to what Mike has said. One is that it can be increasingly difficult to apply this comprehensive approach as transmission increases. But it’s not one activity alone. It is not contact tracing alone. It is not case finding alone. It is not physical distancing alone. You’ve heard the Director General, you’ve heard us say this all the time. But it’s worth repeating because there tends to be a focus on a particular intervention but it needs to be all of the above. And with an empowered community, with an engaged community, with listening to the community and having the community listen and adhere to the public health measures that are in place, this can be done. And so it can be increasingly difficult but what we have seen is in countries that have been in an overwhelming situation, they’ve prioritized these activities, these interventions into specific areas within the countries where transmission seems to be the highest intensity, perhaps related to a super spreading event or a particular cluster, and bringing that transmission down from an overwhelming situation to clusters of activity and from clusters of activity to chains of transmission.

Dr. Maria Van Kerkhove: (36:26)
And the other point is, is that it can be turned around. Again, many countries are seeing situations where they’re feeling completely overwhelmed, and we have seen many countries demonstrate that you can turn this around. You can bring transmission under control. It is very, very difficult, but again, prioritizing the work, prioritizing interventions to where it’s needed most, bringing situations under control where you can get a quicker gain and then focusing on higher areas of intensity. These approaches in countries need to be administered at the lowest administrative level as possible to bring situations under control to as many places as you can as quickly as you can. But it can be turned around. And we wouldn’t be saying this unless we’ve seen it happen. And unless we’ve seen countries demonstrate this repeatedly in multiple regions across the globe.

Dr. Tedros: (37:18)
Yeah. Thank you. I think this is very important and I would be happy to add my voice to my colleagues, Mike and Ryan, Mike and Maria. Mike and Maria. Mike Ryan, my general is a very humble servant of humanity. And he wouldn’t tell you what the real stories are regarding contact tracing. I know contact tracing is difficult and I agree with you our colleague, our friend who asked this question. And I know and I understand if countries say contact tracing is difficult. But if you want to try difficult, probably add contact tracing the number of cases. You trace with a situation which is dire to your life. Meaning try it in a place like North Kivu in DRC where 20 rebels operate, armed rebels, and where security is not there. Where your own security is precarious. And when Mike Ryan was leading the whole effort, he was in DRC North Kivu for several months. When there was engagement between different warring parties almost every single day.

Dr. Tedros: (39:19)
And when you would do contact tracing of 25,000 a day despite that security situation. He didn’t send me actually, somebody sent me from the front lines, Mike Ryan wearing the helmet bulletproof, and also the jacket bulletproof and going to communities to do contact tracing and the rest, because he had no option. If you can do contact tracing in that condition, risking your life and he’s the most senior person in terms of emergency response, one of the most senior. Doing contact tracing in a stable and peaceful place wherever it is in many countries, should that come as even an issue? I’m just asking. If there is a single failure for many of our countries to really not hunt down this virus is our failure in contact tracing because we have lame excuses saying it’s too many and it’s very difficult to trace because there are too many. Trust me there is no too many even in a war situation.

Dr. Tedros: (41:09)
If contact tracing helps you to win the fight, you do it even risking your life or get about a place where there is peace. The reason I’m saying this is we don’t tell or we don’t talk about the stories of a simple human being like Mike Ryan who would do this in a situation that risked his life. So if you want to know if contact tracing is difficult, then I will send you his picture in his bulletproof helmet and bulletproof jacket because he believed that he had to do everything to stop the Ebola and to show that saving lives actually needs that level of commitment.

Dr. Tedros: (42:18)
So my answer is just brief. I explained and hopefully that you will understand why I said why I will say the simple phrase because I want you to understand the background. Trust me, no excuse for contact tracing. If any country is saying contact tracing is difficult, it is a lame excuse. Thank you.

Tarik: (42:53)
Thank you Dr. Tedros and Dr. Ryan and Maria as well for this detailed answer on question on contact tracing. We will now go to Brussels Times and we have with us some Mose Apelblat. Mose, can you hear us? You just need to press unmute.

Mose Apelblat: (43:23)
I did it now, okay. Hello? All right?

Tarik: (43:26)
Now we can hear you. Yes, we can hear you.

Mose Apelblat: (43:28)
Okay. Thank you very much. My question refers perhaps to lessons learned. The previous question was about contact tracing and as you said it was not much applied perhaps in the beginning because most countries were overwhelmed by the number of infections and that was but a bad excuse for not trying it out. But that brings to questions if you have any lessons learned about the type of contact tracing which should be applied. I’m talking about, I think about the NSA manual contract tracing and digital contact tracing, which also involves questions about privacy.

Mose Apelblat: (44:12)
And that brings me to my overall question, because I remember that there was a World Health Assembly which took place in May I think. And they decided that WHO should at it own choice of timing, perhaps initiate some kind of evaluation of its lessons learned of the response to the Coronavirus. So I would like to ask if it has started or if you think it’s perhaps too early, although already as you said in the beginning, Director General Dr. Tedros said half a year has passed since we got the first report of the outbreak. And the other investigation, which was decided by the Assembly was to find out the zoonotic cause or source of the virus. [inaudible 00:45:11] it more or less but I wonder if [inaudible 00:45:14] or investigation has started. Thank you.

Tarik: (45:19)
That’s lots of question and I did forget to remind everyone as I do usually that we take one question per person but Dr.Ryan will try to help.

Dr. Tedros: (45:29)
I will take the last one. The last one on the zoonotic source, WHO has been saying that knowing the source of the virus is very, very important. Its signs, its public health. We can fight the virus better when we know everything about the virus, including how it started and we will be sending a team next week to China to prepare for that. And we hope that that will lead into understanding how the virus started and what we can do for the future to prepare. So we’re planning to send a team next week. Thank you.

Dr. Michael Ryan: (46:31)
Okay. I think and if we listened to interviews and others done by people who’ve led contact tracing in places like Singapore, in Japan, and in other countries, the primary success of contact racing has come from a well-organized human workforce. [inaudible 00:46:53] number one. Once a case is detected, once there’s a positive sample in the lab. Maybe it’s from the emergency room, from the hospital, from the community, that there’s an instant response where a case or their family can be interviewed, that contacts are identified quickly. And in that sense, the highest risk context, you can have a contact list that’s 10, and you can have a contact list that’s 10,000 people. And you have to decide how far and how deep you go with listing potential contacts. They all have to be contacted and followed up. Of those who are followed up, you’re asking in most countries’ situations, you’re asking for those contacts to be self-isolated or quarantined at home and some situations people are asked to quarantine in a facility.

Dr. Michael Ryan: (47:38)
So it’s a very complex set of investigations and then communication between different groups. And one group has to hand off the process to another group. So it’s a complex interaction of public health activities. Now obviously when you’re moving information around, the lab has to inform the contact tracers and the contact tracers have to inform the people organizing quarantine. All of those require a lot of transfer of information. And there are a number of digital tools that have really helped with that process. Like the system developed by WHO Go.Data, which has been implemented in a number of countries. And that allows public health authorities to integrate data from different sources within the system. There’s no privacy issues there because that’s really about being more efficient with publicly held data.

Dr. Michael Ryan: (48:24)
There are then other applications that have been developed, which allow for mobility tracking or identifying potentially other high risk contacts. Bluetooth enabled apps that allow that to happen. And some countries have implemented apps like that. And those apps can be a useful in identifying contacts who may not have otherwise been listed and in some way it’s also for looking at overall population risk for transmission. Some have worked, some have not, some have been very well accepted at community level, some have raised real issues regarding data protection, and human rights and other issues. So it’s important that we continue to innovate with these tools but it’s also important to recognize that that aspect of the digital revolution is innovating and providing potential solutions and tools. The core process is still a core human-driven process. It’s about humans contacting humans and asking questions about potential exposures and following up with other human beings.

Dr. Michael Ryan: (49:33)
This is not an automated process. It cannot be automated in that regard. And I think that’s where most countries have struggled. It’s one thing to develop an app. It’s another thing to identify and train a human workforce that can go out and be disease detectives. And you’ll see that in most countries who’ve been successful, what they’ve really managed to do is train community-based people who know their localities, they’ve trained them in how to do contact tracing, they’ve trained them on how to follow up within their own communities. And that’s much better accepted. And we found the same in Ebola in Congo. If you bring contact tracers into small villages where people are outsiders, it’s a potential flash point. So the more localized the responses, the better. And localization of public health intervention is a very important concept. And it’s something that governments need to address. So I think that would be my advice.

Dr. Michael Ryan: (50:27)
Localize contact tracing, bring it down to the lowest level, have it as much as possible based in and done by the community and enhance the efficiency of that where you can, with digital systems and applications as appropriate. But they’re not in themselves the answer. With regard to your second question regarding what we learned, we’re learning a lot. And interestingly, when we talk about contact tracing, we had a major meeting two weeks ago from experts from all over the world who’ve been implementing contact tracing. Today we have a meeting of the Steering Committee of GOARN which is considering the outcomes of that meeting.

Dr. Michael Ryan: (51:03)
… of the steering committee of GOARN, which is considering the outcomes of that meeting. I think tomorrow we begin a meeting on what we’ve learned in research over the last six months in the next few days. Right now at this six-month period, we’ve been doing ourselves internally, a number of internal retreats, looking at what we’ve learned over the last six months. Our program, the Emergencies Programme here is under the routine assessment of the Independent Oversight and Advisory Committee, which is a body that reports directly to the World Health Assembly.

Dr. Michael Ryan: (51:36)
They’ve completed their first interim review of the response of the performance of our program in that. That review was published at the time of the World Health Assembly. In fact, that committee has had a briefing today with the mission representatives of all the WHO Member States. We will continue and that committee will continue with that review. There are currently reviews planned around the IHR Review Committee, and obviously the Director-General is pulling together a systematic independent evaluation based on the WHA resolution. But we are doing internal operational reviews.

Dr. Michael Ryan: (52:17)
We continue to review all of our performance. We review all of the language. I’ll hand over to Maria because she may be able to also tell you how we’re really looking at the science and what we’ve learned over the last six months.

Dr. Maria Van Kerkhove: (52:30)
Thanks Mike. Yes. We’ve said this almost every time we’ve been up here that we are constantly learning and we are constantly evolving our guidance to fit what is known about this virus that we didn’t know about six months ago. I think the way that we do that is through our international networks, where we are speaking directly with frontline workers every day. Whether these are clinicians and public health professionals. Whether these are virologists, laboratorians who are working with specimens, with samples, looking at sequences.

Dr. Maria Van Kerkhove: (53:02)
Whether we’re looking at people who are working on infection prevention and control to prevent transmission in healthcare settings. Looking at epidemiology and modeling, understanding transmission and where transmission is happening, how transmission is happening and how that affects our guidance and our advice. We are constantly looking at how we adapt our information that we share with you. We are very careful with how we explain the situation about what we know, about what we don’t know, and most importantly, how we’re working with our partners to address those unknowns. Because that is a constant evolution, especially with a new pathogen.

Dr. Maria Van Kerkhove: (53:39)
I just want to mention one last thing is about what you can do yourself. The Director-General mentioned this in his speech, but please feel empowered. Please know that you can do things yourself to prevent yourself from getting infected. And importantly, not only protecting yourself, but protecting your family and potentially somebody who is part of a vulnerable category, who has an underlying condition or maybe of advanced age, who will go on to develop severe disease if they are infected. Knowing what you can do. If you’re in a situation where there is increasing transmission or intense transmission, if you’re asked to stay home, please stay home because there are many people who can’t.

Dr. Maria Van Kerkhove: (54:20)
Those individuals who are working in health care facilities who are caring for infected patients who are in ICU, who are in hospital beds, they can’t stay home. If you can, please do. We know this is difficult, and we know that people want this to be over. There are many things that we all want to do, but it’s going to be difficult for some time before we get out of this, but we will. Not only do governments need to have strong leadership and be very clear on what needs to be done, adapting that to the most localized level as possible. You yourselves can also play a role. Men, women, children, all of you. All of us have a role to play.

Tarik: (55:01)
Many thanks. We had a bit longer answers today, but it was because questions were good. We will take two more questions before concluding this press briefing. First, we will go to Chen from China daily. Chen?

Chen: (55:17)
Hi. Dr. Tedros, you have repeatedly voiced concern over stigmatization and politicization of COVID-19, but U.S. President Donald Trump just last week in speeches and rallies continued to use words like “Kung flu” or “China virus.” Does WHO consider this as seriously undermining the global solidarity? And do you, WHO, usually convey such concerns to your U.S. contact like U.S. CDC? Thank you.

Dr. Michael Ryan: (55:59)
From WHO’s perspective, we obviously want to have international discourse that’s based on mutual respect. In that sense, we encourage all people at all levels and in all countries to use language that is appropriate, respectful, and is not associated with any connotations that are negative. In that regard, we put that message out globally. Many people around the world have used unfortunate language in this response. We certainly haven’t been immune to receiving a lot of it. But we try to focus on the way ahead.

Dr. Michael Ryan: (56:42)
We try to focus on what we need to do, and we need everybody focused as the DG has said, as Maria has said. We need everyone focused. Everyone has a job. We can actually do better than we’re doing right now. We have a lot of vulnerable people to protect and shield. We have a lot of communities with poor health systems and poor living conditions that we need to help and support, and we need to focus on that. It is unfortunate if our global discourse is reduced to base language. That never helps. But we want to focus on moving forward. We want to focus on getting this job done.

Tarik: (57:25)
Thank you, Dr. Ryan. Our last question will go to Jamil, our Geneva neighbor, who is working for number of Brazilian press. Jamil?

Jamil: (57:39)
Yes, sir. Thank you. Thank you for taking my question. My question is on Brazil. What is your current evaluation about Brazil? And whether this strategy that you just mentioned now for over an hour is actually being implemented? Thank you.

Dr. Michael Ryan: (58:05)
Certainly in the Americas, and I’ll come to Brazil, but overall in the Americas, the situation is difficult. The Americas, as a whole, represent half the cases and almost half the deaths in the whole world. If you look at Brazil itself, quite a proportion of all the cases in the Americas, 26%. That’s one in four of all the cases and one in four of all the deaths in the continent. There’s no question that Brazil is still facing a big challenge. It continues to report over 30, 000 cases a day from all 27 federal levels, or from all of the different state levels.

Dr. Michael Ryan: (59:08)
Brazil is still facing a challenge. Yes, a comprehensive approach to the response is needed at all levels. It is tough. The force of infection is high. There are many challenging situations in Brazil. There are deeply congested and dense populated areas in the urban setting that have very poor services. There are people living in rural conditions as well that are difficult to reach and difficult to serve. It would be silly to underestimate the size and the complexity of a great country like Brazil.

Dr. Michael Ryan: (59:48)
But equally it would also be important to recognize that Brazil has a huge and proud history in the management of infectious diseases and has many excellent scientific and other institutions. And has shown a tremendous capacity, not only for combating infectious diseases, but developing vaccines that have stopped diseases like yellow fever in so many other countries. Yes, we would encourage, again, once more, that Brazil continues to fight against the disease. That Brazil links the efforts at federal and at state level in a much more systematic way.

Dr. Michael Ryan: (01:00:24)
That there is a focus on a comprehensive approach to controlling the disease and doing that in a sustained fashion. It is easy, obviously, to criticize any individual country and no country, no organization is without criticism or without fault or without difficulty in this response. Again, today’s message is not about what happened last week, last month or the last three months. When the Director-General talks about politicization as well, we all need to recognize that in many countries, the government is the government of the day.

Dr. Michael Ryan: (01:01:04)
We need to find a way for each government to find the way forward, for each government to serve its citizens, for each government to serve its people and we need to encourage and support governments in doing that. We need to find all of government, all of society approaches. When we talk about avoiding politicization of the virus, that cuts both ways. We may, in many situations as individuals in society, have to provide encouragement and support for a government that may not be of our choosing or liking. That is the difficulty and the challenge of national unity against a common enemy.

Dr. Michael Ryan: (01:01:47)
When you choose national unity against a common enemy, you sometimes don’t get to choose who leads you in that fight. You have to find a way. You have to find a way to be able to take that forward, and that’s the challenge for all countries now. I would just say from my personal perspective that we cannot continue to allow the fight against this virus to become and be sustained as an ideological fight. It cannot be. We cannot beat this virus with ideologies. We simply cannot. I think everybody now needs to take a step back at six months.

Dr. Michael Ryan: (01:02:27)
Everyone, every individual, needs to look in the mirror and say, “Am I doing enough?” Every politician needs to look in the mirror and say, “Am I doing enough to stop this virus?” I think we need to have a big conversation with ourselves on this, and now is the time because we don’t have time to waste.

Dr. Maria Van Kerkhove: (01:02:49)
If I just may briefly add it has nothing to do with the politics, but it’s about the science. I would like to ask us to side on the side of science and to side on the side of public health and experience. We are learning from experience. We are learning about this virus. We know what works. We’re not saying that it’s easy. We’re not saying that it will not take more time, and it will be difficult for individuals and families and communities and nations.

Dr. Maria Van Kerkhove: (01:03:17)
But we are adapting our approach and tailoring our approach based on what we are learning. We need people to be with us with this science as we communicate this with you, as we adapt it within our guidance, as we modify these approaches going forward. We know what works in suppressing transmission, and we know what works for reducing mortality. Let’s do that.

Tarik: (01:03:44)
This will conclude a longer than usual press briefing. Still, we will have the audio file sent to you soon, and the transcript will be posted tomorrow from my side. I wish you a very nice evening.

Dr. Tedros: (01:04:05)
Thank you. Thank you, Tarik. Thank you all for joining and as I said earlier, we have a new timeline of the past six months, and would really appreciate it if you have a look and give us your feedback. And look forward to seeing you on Wednesday. Thank you.

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