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    WHO: “We acted quickly to warn the world”

    Dr Tedros Adhanom Ghebreyesus, WHO Director-General, credit: WHO

    The World Health Organisation has been accused of not acting in time to alert the world about the outbreak of the pandemic in China.

    Last week, its Director-General replied to some of the criticism and defended WHO’s performance.

    At the virtual press briefing on Friday (1 May), Dr Tedros Adhanom Ghebreyesus referred to the crucial Emergency Committee’s meeting on 22 – 23 January. The Committee, consisting of 15 independent experts from around the world, was convened by the WHO to advise it on what to do.

    However, the first information about a virus in Wuhan had arrived to WHU much earlier. In his press briefing on Wednesday (29 April), the Director-General listed the events in chronological order. Already on 31 December 2019, did WHO’s Epidemic Intelligence System pick up a report about a cluster of cases of pneumonia of unknown cause in Wuhan, China.

    The report prompted to WHO to ask China for more information on the following day and to activate its Incident Management Support Team to coordinate a response. According to WHO, the first deaths in China were reported only on 11 January.

    Preliminary investigations by the Chinese authorities had found no clear evidence that human-to-human transmission was occurring. WHO posted the Chinese reports “as is” but said at a press briefing on 14 January that, based on its past experience with coronaviruses, human-to-human transmission was likely.

    After WHO staff had visited Wuhan on 20 – 21 January, and reported that the evidence suggested that human-to-human transmission was occurring, Dr Tedros decided to convene the Emergency Committee to ask it if he should declare a public health emergency of international concern.

    He described the meeting as very important but the committee was divided in its opinion. It doesn’t decide by voting and therefore asked WHO for more information. According to the Director-General, WHO didn’t waste much time. It collected more information and the Committee met again on 30 January.

    People warned WHO not to send any staff to China because of the risks, he added. “By travelling to China, we exposed ourselves to an unknown virus but we aren’t afraid of it.” On 27 January, he travelled himself with senior staff to China and met with President Xi Jinping and other leaders to learn more about the response and offer WHO’s assistance.

    Global public health emergency

    When the Committee met again on 30 January, there was consensus in the committee and it advised WHO to declare a global public health emergency – WHO’s highest level of alarm despite the low numbers of cases then.

    “To be specific, we had 82 cases outside China, and no deaths, when we declared the highest level of international emergency,” he said. “From the beginning, WHO has acted quickly and decisively to respond and to warn the world. We sounded the alarm early, and we sounded it often.”

    However, he didn’t disclose any details about WHO’s internal decision-making process or the reliability of the information it had received from China in the beginning.

    At the following press conferences, Dr Tedros has repeatedly said that the world had a window of opportunity, though steadily narrowing, to prepare and to prevent widespread community transmission.

    During the coming weeks, WHO did issue advice but it wasn’t always specific, such as proposing travel restrictions and quarantines of travellers from China and other affected countries.

    He was also reluctant to declare a pandemic spreading to more than one continent. “Pandemic isn’t a word to use lightly or carelessly. It´s a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.”

    That happened first on 11 March when WHO made the assessment that COVID-19 can be characterized as a pandemic.

    “In the days and weeks ahead, we expect to see the number of cases, the number of deaths, and the number of affected countries climb even higher,” he warned. “WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.”

    Evolving situation

    Most people listening to WHO’s Director-General at the press conferences felt that the situation was under control. He said the right words, calming against panic and at the same time warning the world that it needed to act when there still was a window of opportunity. Did he lull his listeners into a false sense of security during the first weeks of the outbreak or was his message right all the time?

    Of course, the pandemic remains a public health emergency of international concern, as the WHO Director-General said last week. The situation is evolving all the time. WHO and the world are fighting an invisible enemy which hasn’t been completely defeated during the lockdowns. A second wave when the restrictions are lifted cannot be excluded.

    It hasn’t been proven that infected persons, who have recovered, do develop antibodies that make them immune against getting infected again. The Swedish chief epidemiologist Anders Tegnell has even been quoted as saying that such thinking undermines the argument for looking for a vaccine. “If you can’t get population (group) immunity, how can we then think a vaccine will protect us?”

    Asked by The Brussels Times for a clarification, WHO media team replied that WHO expects that most people who are infected with COVID-19 will develop an antibody response that will provide some level of protection.

    “What we don’t yet know is the level of protection or how long it will last. We are working with scientists around the world to better understand the body’s response to COVID-19 infection. So far, no studies have answered these important questions.”

    M. Apelblat
    The Brussels Times