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‘Very tough’ months ahead in COVID battle- WHO

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Facing another critical juncture in the COVID-19 pandemic, the World Health Organization (WHO) chief told reporters on Friday that a “very tough” few months lie ahead with too many nations seeing an exponential increase in cases. 

Tedros Adhanom Ghebreyesus said some countries were now on a “dangerous track” and the worrying rise was leading to hospitals and ICUs “running close or above capacity – and we’re still only in October.” 

“We urge leaders to take immediate action, to prevent further unnecessary deaths, and essential health services collapsing, and schools shutting again.” 

Action needed 

The WHO Director-General said countries needed to “conduct honest analysis and consider the good, the bad and the ugly.” 

For those who have brought transmission under control, he said now was the time to “double down, to keep transmission at a low level, be vigilant, ready to identify cases and clusters, and take quick action.” 

He said there were “incredible stories of hope and resilience, of people and businesses responding creatively to the outbreak, and we need to share these widely.” 

Contact tracing is essential he added, and clear instructions on how to go about it, so more mandatory stay at home orders can be avoided. 

Oxygen running low 

Turning to the need to share all resources in the COVID fight equitably, Tedros noted that a heavy toll was being taken on the world’s supplies of clinical oxygen, so crucial for those patients who need to be intubated, and many countries simply do not have enough. 

The “global oxygen gap” is particularly acute in some of the poorest nations, where some have only five to 20 per cent of what they need for patient care.  

In June, around 88,000 large cylinders were needed each day worldwide, to cope with the caseload, but with daily infections rising to around 400,000, that need has now risen to 1.2 million cylinders, just in low and middle income countries alone. 

Somalia, Chad and South Sudan, were totally reliant on cylinders from private vendors, that were expensive, and with a long distance to travel often, said Tedros. 

But now, WHO is working with ministries of health in those countries to design oxygen plants which fit their local needs, “which will result in sustainable and self-sufficient oxygen supply”, he added. 

‘End-to-end solutions’ 

“The oxygen project, reflects WHO’s commitment to end-to-end-solutions and innovation, to do what we do better, cheaper, and reach more people”, he said, giving the example of a scheme underway to harness solar power, to run oxygen concentrators in remote places that lack a reliable electricity supply. 

“Oxygen saves lives of patients with COVID-19, but it will also save some of the 800,000 children under five, that die every year of pneumonia and improve the overall safety of surgery”. 

A better world, means ensuring that oxygen is available to all, Tedros added. 

World Polio Day week 

The WHO chief also flagged the start on Saturday, of World Polio Day week, with partners around the world organising events and raising awareness of the need to eradicate polio, once and for all. 

Over the summer, the wild polio virus was banished from Africa, thanks to the efforts of hundreds of thousands of health workers reaching millions of children with vaccines, marking “one of the greatest public health achievements of all time.” 

But the risk of resurgence always remains, which cases continue, and following an initial suspension of polio and other routine immunizations due to the pandemic, vaccinations drives have now resumed, said Tedros. 

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Delta variant, a warning the COVID-19 virus is getting ‘fitter and faster’

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Cases and deaths resulting from COVID-19 continue to climb worldwide, mostly fuelled by the highly transmissible Delta variant, which has spread to 132 countries, said the head of the World Health Organization (WHO) on Friday.

Almost 4 million cases worldwide were reported last week to WHO and the agency expects the total number of cases to pass 200 million, in the next two weeks.

“And we know this is an underestimate”, underscored Director-General Tedros Adhanom Gebreyesus during his regular COVID-19 briefing.

Infections have increased in every region of the world, with some even reaching 80 per cent more in the past month. In Africa, deaths have increased by 80 per cent over the same period, the official warned.

Overwhelmed

Tedros blamed the rise of cases on increased social mixing and mobility, the inconsistent use of public health and social measures, and inequitable vaccine use. He said “hard-won gains” are in jeopardy or being lost, and health systems in many countries are increasingly overwhelmed.

“WHO has warned that the COVID-19 virus has been changing since it was first reported, and it continues to change. So far, four variants of concern have emerged, and there will be more as long as the virus continues to spread”, he underscored.

A higher viral load

Lead WHO epidemiologist and COVID-19 technical lead, Dr. Maria Van Kerkhove, explained that the Delta variant has certain mutations that allow the virus to adhere to human cells more easily and that experts are also seeing a higher viral load in individuals infected.

She called Delta “dangerous and the most transmissible SARS-CoV-2 virus to date”. 

“There are some laboratory studies that suggest that there’s increase replication in some of the modelled human airway systems”, she added.

In terms of severity, Dr. Van Kerkhove highlighted that there has been an increase in hospitalizations in certain countries affected by the variant, “but we haven’t yet seen an increase in mortality”.

The WHO expert reminded that although there is some data that suggest that people vaccinated can get infected and transmit the variant, the likelihood is much reduced after the second dose has been administered and reached full effectiveness.

She also clarified that Delta is not specifically targeting children as some reports have suggested, but warned that as long as the variants are circulating, they will infect anybody that is not taking proper precautions.

Continuing to evolve

“It’s in the virus’s interests to evolve, viruses are not alive they don’t have a brain to think through this, but they become more fit the more they circulate, so the virus will likely become even more transmissible because this is what viruses do, they evolve they change overtime”, Dr. Van Kerkhove warned, echoing Tedros’ remarks.

We have to do what we can to drive it down”, she added, reminding that public health and social measures do work against the Delta variant, and that the vaccines do prevent disease and death.

Dr. Michael Ryan, Executive Director of WHO Health Emergencies, said that even with the virus getting “faster and fitter” the gameplan does not change, but It needs to be implemented more efficiently.

“Delta is a warning that this virus is evolving, but it is also a call to action before more dangerous variants emerge”, he said.

Shots for Africa

Last month, the WHO chief announced the setting up of a technology transfer hub for mRNA vaccines In South Africa as part of WHO’s efforts to scale up production of vaccines and their distribution in Africa.

“Today we have taken another step forward, with a letter of intent that sets out the terms of collaboration signed by the partners in the hub: WHO; the Medicines Patent Pool; Afrigen Biologics; the Biologicals and Vaccines Institute of Southern Africa; the South African Medical Research Council and the Africa Centres for Disease Control and Prevention”, Tedros explained.

He added that WHO’s goal remains to aid every country in vaccinating at least 10% of its population by the end of September, at least 40% by the end of this year, and 70% by the middle of next year.

“We are a long way off achieving those targets. So far, just over half of countries have fully vaccinated 10% of their population, less than a quarter of countries have vaccinated 40%, and only 3 countries have vaccinated 70%”, Tedros warned.

The WHO head reminded that the global distribution of vaccines remains unjust, despite expert warnings and appeals, and said that all regions remain at risk, “none more so, than Africa”.

“On current trends, nearly 70% of African countries will not reach the 10% vaccination target by the end of September”, he cautioned.

New tool to fight Delta

Tedros also announced that on response to the Delta surge, the WHO’s Access to COVID-19 Tools Accelerator is launching the Rapid ACT-Accelerator Delta Response, or RADAR, and issuing an urgent call for 7.7 billion U.S. dollars for tests, treatments and vaccines. 

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COVAX and World Bank to Accelerate Vaccine Access for Developing Countries

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COVAX and the World Bank will accelerate COVID-19 vaccine supply for developing countries through a new financing mechanism that builds on Gavi’s newly designed AMC cost-sharing arrangement. This allows AMC countries to purchase doses beyond the fully donor-subsidized doses they are already receiving from COVAX.

COVAX will now be able to make advance purchases from vaccine manufacturers based on aggregated demand across countries, using financing from the World Bank and other multilateral development banks. Participating developing countries will have greater visibility of available vaccines, quantities available, and future delivery schedules, enabling them to secure doses earlier, and prepare and implement vaccination plans more effectively.

This important and timely financing mechanism, made possible now by the World Bank and Gavi teaming up on the AMC cost-sharing arrangement, will allow COVAX to unlock additional doses for low- and middle-income countries,” said Dr. Seth Berkley, CEO, Gavi, the Vaccine Alliance. “As we move beyond initial targets and work to support countries’ efforts to protect increasingly large portions of their populations, World Bank financing will help us advance further towards our goal of bringing COVID-19 under control.”

The scalable mechanism brings together COVAX’s ability to negotiate advance purchase agreements with vaccine manufacturers with the World Bank’s ability to provide predictable financing to countries for vaccine purchase, deployment and broader health systems investments. The new mechanism will mitigate risks and uncertainties in country demand and financing ability.

Accessing vaccines remains the single greatest challenge that developing countries face in protecting their people from the health, social, and economic impacts of the COVID-19 pandemic,” said World Bank Group President David Malpass. “This mechanism will enable new supplies and allow countries to speed up the purchase of vaccines. It will also provide transparency about vaccine availability, prices, and delivery schedules. This is crucial information as governments implement their vaccination plans.”

Countries with approved World Bank vaccine projects that confirm the purchase of additional doses through COVAX will agree with COVAX on the number of doses of a specific vaccine as well as related windows of delivery. On receiving a request from the country, the World Bank will provide COVAX a payment confirmation, allowing COVAX to make advance purchases of large amounts of vaccine doses with manufacturers at competitive prices.

Under the cost-sharing arrangement for AMC countries (92 low- and middle-income countries), COVAX plans to make available up to 430 million additional doses, or enough to fully vaccinate 250 million people, for delivery between late 2021 and mid-2022. There will be several supply offerings where countries will have the opportunity to select and commit to procuring specific vaccines that align with their preferences.

COVAX is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance and the World Health Organization (WHO). The World Bank and COVAX will work in partnership with UNICEF and the PAHO Revolving Fund as key implementing partners to ensure safe vaccine delivery and supply of materials such as syringes, safety boxes and other items essential for vaccination campaigns.

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Study Finds That India Might Have Half Of All Covid-19 Deaths Worldwide

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© UNICEF/Vinay

On July 20th, an analysis that was published of India’s “excess mortality estimates from three different data sources from the pandemic’s start through June 2021 … yields an estimate of 4.9 million excess deaths.” As-of July 20th, the total number of deaths that had been officially reported worldwide from Covid-19 was 4,115,391, and only 414,513 (10%) of those were in India. If this new study is correct, then the possibility exists that around half of all deaths that have occurred, thus far, from Covid-19, could be in India, not merely the currently existing 10% that’s shown in the official figures.

This study doesn’t discuss why the actual number of deaths in India from Covid-19 might be around ten times higher than the official Indian figures, but one reason might be a false attribution of India’s greatly increased death-rate from the Covid-19 epidemic not to Covid-19 but to other causes, such as to Covid-19-related illnesses.

The new study is titled “Three New Estimates of India’s All-Cause Excess Mortality during the COVID-19 Pandemic”, and the detailed version of it can be downloaded here.   The study was funded by U.S.-and-allied billionaires and their foundations and corporations, and by governments that those billionaires also might control. However, this doesn’t necessarily mean that its methodology is in any way unscientific or otherwise dubious. The study raises serious questions — it does not, in and of itself, answer any. It’s a serious scientific study.

On 1 August 2020, I headlined “India and Brazil Are Now the Global Worst Coronavirus Nations”, and reported that, “India and Brazil have now overtaken the United States as the world’s worst performers at controlling the cononavirus-19 plague. The chart of the numbers of daily new cases in India shows the daily count soaring more than in any other country except Brazil, whereas in the United States, the daily number of new cases has plateaued ever since it hit 72,278 on July 10th, three weeks ago.” At that time, there was great pressure upon India’s Government to stop the alarming acceleration in the daily numbers of people who were officially counted as being patients (active cases) from the disease, and of dying from it. One way that a government can deal with such pressures is by mis-classifying cases, and deaths, from a disease, as being due to other causes, instead.

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