#17,261
Although global surveillance reports (see chart below) would suggest the COVID pandemic has stabilized (roughly 1.9 million new cases and >12 000 deaths last week), we've seen a huge decline in the number of nations reporting COVID hospitalizations and deaths to the WHO (see WHO: Countries Reporting COVID Data Continues To Decline).
The above data does not include any reliable data from China - which is currently seeing millions of new cases a week - while testing has plummeted around the world and fewer than 15% of nations routinely report weekly hospitalization and ICU admission data to the WHO.
The number of infections and deaths tracked by this chart are so skewed by this lack of reporting, the WHO provides the following caveat:
Current trends in reported COVID-19 cases are underestimates of the true number of global infections and reinfections as shown by prevalence surveys. 1–4 The data should be interpreted with caution as several countries have progressively changed COVID-19 testing strategies, resulting in lower numbers of tests performed and consequently lower numbers of cases detected. Additionally, data from previous weeks are continuously updated to retrospectively incorporate changes in reported COVID-19 cases and deaths made by countries.
It is against this backdrop of `Don't test, don't tell' that the WHO (and the world) must gauge the intensity and trajectory of the COVID pandemic. While there are some hopeful signs (increased community immunity, continued relatively low severity of Omicron, etc.), the virus continues to mutate unpredictably.
On Friday the WHO's IHR (2005) Emergency Committee met for the 14th time since early 2020 in order to consider whether the COVID pandemic still constitutes a PHEIC (Public Health Emergency of International Concern).
As the tweet at the top of this blog indicates, the Emergency Committee elected to continue COVID's status as a PHEIC. Some excerpts from a much longer WHO statement follow.
Statement on the fourteenth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic
30 January 2023
Statement
Reading time: 8 min (2093 words)
The WHO Director-General has the pleasure of transmitting the Report of the fourteenth meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the coronavirus 2019 disease (COVID-19) pandemic, held on Friday 27 January 2023, from 14:00 to 17:00 CET.
The WHO Director-General concurs with the advice offered by the Committee regarding the ongoing COVID-19 pandemic and determines that the event continues to constitute a public health emergency of international concern (PHEIC). The Director-General acknowledges the Committee’s views that the COVID-19 pandemic is probably at a transition point and appreciates the advice of the Committee to navigate this transition carefully and mitigate the potential negative consequences.
The WHO Director-General considered the advice provided by the Committee regarding the proposed Temporary Recommendations. The set of Temporary Recommendations issued by the WHO Director-General is presented at the end of this statement.
The WHO Director-General expresses his sincere gratitude to the Chair and Members of the Committee, as well as to the Committee’s Advisors.
(SNIP)
Status of the Public Health Emergency of International Concern
The Committee noted a clear decoupling of case incidence from severe disease, and the high seroprevalence estimates resulting from combined infection and/or vaccination across all WHO regions. Seroprevalence data may not necessarily reflect true immune protection but seems to reflect protection against severe disease, and such studies continue to be important to monitor immune response over time.
In assessing the criteria for a public health emergency of international concern, the Committee agreed that, although the public perception is that the pandemic is over in some parts of the world, it remains a public health event that continues to adversely and strongly affect the health of the world’s population, that there remains a risk of new variants exacerbating the ongoing health impact, particularly as winter approaches in the Northern hemisphere (and learning from the Southern Hemisphere), and there is still a need for a coordinated international response to address the inequalities in access to life-saving tools.
In advising the WHO Director-General that the event still constitutes a PHEIC, the Committee developed the following arguments underpinning its advice.
First, the clear decoupling in incident cases and severe disease has led to a perception in communities that the emergency may be over and that measures to reduce transmission are no longer warranted. Although the number of weekly deaths reported to WHO is near the lowest since the pandemic began, it remains high compared with other respiratory viruses, and the added burden of COVID-19 related complications and Post COVID-19 Condition is also high and its full impact not completely understood. The evolution of the outbreak during the upcoming winter season in the Northern hemisphere must also be considered.
Second, although ongoing evolution of the virus is expected to continue, the genetic and antigenic characteristics of future variants cannot yet be reliably predicted, partly due to the current gaps in global surveillance that hinder identifying and evaluating these changes early. In addition, the ongoing virus evolution, with potentially increased properties of immune escape, may pose challenges to current vaccines and therapeutics.
Finally, inequities in access to COVID-19 vaccines and therapeutics persist between and within countries, such that the highest priority groups do not currently have access to safe and effective vaccine and therapeutics everywhere.
Given the above considerations, the Committee concurred that continued coordination of the international response is necessary to reliably evaluate the health impact of the pandemic, monitor and assess the evolution of the virus and the impact of future variants, to intensify efforts to ensure access to safe and effective countermeasures, and to enhance tailored risk communication and community engagement activities.
(SNIP)
The Committee anticipates that meaningful progress with implementing these measures would create a situation compatible with terminating the PHEIC related to the COVID-19 pandemic at a future meeting, and that the situation could continue to be characterized as pandemic even if the PHEIC is terminated. The Committee further believes that these recommendations will support appropriate public health messaging on the evolving risk of COVID-19, despite community and political “pandemic fatigue.”
The regrettable lack of reporting from member nations may serve short-term goals like boosting their economies and restoring faith in their governments, but in the long term may be about as useful as touching up a patient's X-rays to make them feel better about their prognosis.
