The end of the pandemic, getting closer: what has to happen for the WHO to declare it

“The pandemic is over.” That’s how blunt it has been Joe Biden in an interview on CBS this Sunday. Such a blunt statement by the leader of the most powerful country in the world and that accumulates the most victims of the Covid (more than a million) is not something trivial, especially if one takes into account that the president of the United States is proud to base it on science. his mandate.

His statements have come in the same week that tedros ahanomdirector of the World Health Organization, claimed that the world “has never been closer to the end of the pandemic”, with the lowest number of deaths since the beginning of the crisis. Although both Biden and Adhanom have clarified that the fight against Covid must continue, the coincidence in time of these two statements suggests that the end of the pandemic is not far away.

Since the end of the omicron wave, which in the United States lasted until the end of April driven by the BA.2 variant, the North American country experienced a new wave of cases comparable to the one it had with Delta. Nevertheless, the number of deaths associated with SARS-CoV-2 has remained on a kind of plateaubeing the first time in two and a half years that the figure (between one and two daily deaths per million inhabitants) is contained over the months.

[Cuánto queda para el final de la pandemia y cómo será: el pronóstico de cuatro epidemiólogos]

Something similar happens globally. The last wave, between July and August (winter in the southern hemisphere), has been higher than those before omicron but deaths have been at the lowest levels since April 2020 for more than four months.

In Spain, the cumulative incidence in people over 60 years of age at 14 days is around 130 cases per 100,000 inhabitants, and there are less than 2,500 admitted with Covid throughout the country. Although both are figures higher than the weeks prior to the sixth wave, the ICU data is the lowest of the entire pandemic: only 146 people infected in intensive care.

In its latest report, the Ministry of Health notes, however, that only 44.8% of those hospitalized with Covid in acute beds have been due to the infection. Instead, the death toll in our country remains unusually high: around 2,000 in August, around 1,000 so far in September.

better wait for winter

“Thinking about zero deaths from Covid is not feasible and we will have to continue living with a certain number of deaths,” he values. Juan Antonio Sanzspokesperson for the Spanish Society of Preventive Medicine, Public Health and Health Management.

The same can be said, in theory, of the end of the pandemic. If a pandemic occurs when there is community transmission on several continents, it is clear that its end is not near. “But it is true that, right now, its effect is not affecting us; as citizens, it is not changing our lives.”

For this reason, Sanz does not see it as unreasonable for the WHO to make an announcement similar to that of Biden in a few months. Of course, better wait for winter. “If there is no surprise, it is possible that it will decree the end of the pandemic.” Based on the relatively unproblematic winter that the countries of the southern hemisphere have had (with the exception of Australia, which has experienced a spike in deaths similar to that of the first omicron wave), he sees it feasible that there is no need to wait for the end of the season and wait for the first bars to lift the few restrictions that still remain.

[Los ‘errores masivos’ de los gobiernos en la gestión de la Covid propiciaron 17M de ‘muertes evitables’]

“It will depend on the evolution this coming month, with the arrival of autumn, the concentration of people in closed places and others,” explains this public health specialist from the Laredo hospital in Cantabria, who recalls that a similar situation was experienced at the end of of last year until ómicron ruined everything.

If necessary, it will be possible, “if not decree the end of the pandemic, do so with the use of masks in public transport, pharmacies or even hospitals“. An announcement similar to that of Biden is only likely, for the moment, “for electoral reasons.”

And there is a small conceptual issue. The WHO declared a public health emergency of international importance due to Covid-19 on January 20, 2020. It is a tool included in the international health regulations that seeks to draw the attention of countries to put in place control mechanisms of a disease. The last one was the monkey pox this July.

[“Inviernos largos y apenas manejables”: Europa alerta sobre los escenarios de la Covid en 10 años]

This is something very different from decreeing a pandemic. The WHO can decree the end of this emergency, but not the end of the pandemic. It has already done it other times: it maintained an international emergency for Ebola for a little over a year and a half, between August 2014 and March 2016. The one who was its director at the time, Margaret Chansaid when decreeing its end: “The risk of an international extension [del ébola] moved away”. This is difficult to apply to Covid, at this point nobody believes that its international expansion can be limited.

Countries may notify WHO of events that may constitute international public health emergencies, but the criteria for doing so are not quantitative. It must meet at least two of the following: that they consider to have a serious impact on public health (for example, with the appearance of a new variant); that it is something unforeseen; there is a significant risk of international spread, or there is a significant risk of international travel or trade restrictions.

Does Covid meet these criteria to remain an international public health emergency? Joe Biden has made the American point of view clear and European countries are probably considering similar scenarios, but what about China? It still has travel restrictions and continues to impose quarantines due to suspected outbreaks: in August, it closed an Ikea store in Shanghai after detecting that a close contact of a positive person for Covid had been shopping there.

On the other hand, the first world may have the infection under control thanks to vaccination, but coverage is very uneven around the world. Asia, South America and the European Union are above 70%, but in Africa it has barely exceeded 20%. In Russia almost half of the population is unvaccinated, and in the Ukraine vaccination was paralyzed after the invasion: only 35% of Ukrainians had received the two doses of the initial guideline.

Juan Antonio Sanz recognizes that the world has become more prudent after the arrival of ómicron. A new variant can put an end to the positive evolution of recent months. However, he sees a symbolic turning point possible at the beginning of 2023 for the WHO and some governments to join Joe Biden’s message. “We will have seen the evolution of Covid in winter and its combination with the flu.” For now, we will have to cross our fingers.

Source: Elespanol

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J. A. Allen

Author, blogger, freelance writer. Hater of spiders. Drinker of wine. Mother of hellions.

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