WHO: World is likely at an “inflexion point,” but covid remains public health emergency

The World Health Organization has concluded that although the world is likely at a “transition point” on covid-19 the pandemic still constitutes a public health emergency.

The recommendation to extend the public health emergency of international concern (PHEIC) was made by the International Health Regulations Emergency Committee after it convened for the fourteenth time on 27 January.

A PHEIC is the highest level of global health alert WHO can make and allows the organisation’s director general to make recommendations which all countries should follow. Around 6.8 million people have died from the illness since WHO declared the first PHEIC for covid-19 in January 2020.

Countries have made great strides in increasing protection against the coronavirus since then. Vaccination has decoupled the number of global infections from the number of deaths, WHO’s director general Tedros Adhanom Ghebreyesus said at the 152nd session of WHO’s executive board on 30 January. “As we enter the fourth year of the pandemic, there is no doubt we are in a far better situation now than we were a year ago, when the omicron wave was at its peak,” Tedros said.

The number of government reported deaths has been increasing each week since December 2022, however, concerning WHO experts. At least 170 000 people have died from covid-19 in the past eight weeks according to official figures and the actual number is probably higher because of underreporting.

A surge in infections in China after the country relaxed strict covid restrictions in December is one driver of the global increase in covid-19 deaths. An adviser to the WHO expert committee told the news agency Reuters in December that the uncertainty surrounding covid in the country of 1.4 billion increased the likelihood of WHO extending the PHEIC.1

The experts on the emergency committee identified several challenges that should be tackled this year if the world is to transition away from the pandemic and the PHEIC is to be declared over. Vaccination rates in low and middle income countries and the highest risk demographics remain insufficient, the committee said, and the continued evolution of SARS-CoV-2 remains a cause for concern as the public has simultaneously lowered its guard against the illness.

“Pandemic fatigue and reduced public perception of risk have led to drastically reduced use of public health and social measures, such as masks and social distancing. Vaccine hesitancy and the continuing spread of misinformation continue to be extra hurdles to the implementation of crucial public health interventions,” WHO said in a statement on the committee’s meeting.2

Long covid will also have a “serious ongoing impact on populations” and countries have not found adequate ways to treat the condition.

“We can’t control the virus, but we can do more to tackle the vulnerabilities in populations and health systems,” Tedros said. “That means vaccinating 100% of the most at-risk groups; increasing access to testing and early antiviral use; taking context specific measures when there is a surge in cases; maintaining and expanding laboratory networks; and fighting misinformation.”

The committee said WHO and member nations must look for ways to move out of the current stage of the pandemic as the world “may be approaching an inflexion point” through infection induced immunity and vaccination. “While eliminating this virus from human and animal reservoirs is highly unlikely, mitigation of its devastating impact on morbidity and mortality is achievable and should continue to be a prioritised goal,” the committee said.

If countries continue working to protect their most vulnerable populations and track the evolution of the coronavirus, there is cause for optimism that the virus should fade further to the foreground, Tedros said. WHO is working on new strategies to implement given the new stage of the pandemic, he added.

“We remain hopeful that in the coming year, the world will transition to a new phase in which we reduce hospital admissions and deaths to the lowest possible level, and health systems are able to manage covid-19 in an integrated and sustainable way,” he said. “Vaccination will remain an essential part of our approach. We are now working to determine the most effective mechanism for advising member states and manufacturers on vaccine composition and vaccination frequency.”