New Covid-19 Variants and Promising Vaccines.

Copenhagen, 7 January 2021

Good morning,

First and foremost, I wish you a happy and healthy new year for 2021.

We are bracing for a challenging start to 2021, One year after the WHO's first news report on the virus, we have new tools at our disposal and much more knowledge, but we remain in the grip of COVID-19, as cases soar across Europe and we tackle the new challenges brought about by mutating viruses.

This moment is a tipping point in the course of a pandemic, in which science, politics, technology and values ​​must form a united front to fight this persistent and elusive virus.

The WHO European region saw more than 26 million confirmed cases of COVID-19, and more than 580,000 confirmed COVID-19 deaths in 2020. In the 27 countries participating in death monitoring, nearly 313,000 excess deaths were reported in 2020. This marks an increase of 3 in 2018, and a nearly 5-fold increase in excess deaths in 2019.

As we enter 2021, more than 230 million people in the European Region live in countries under full national lockdown, with more countries due to announce lockdown measures in the coming week. Region-wide transmission has maintained a very high infection rate.

As of January 6, among all countries and regions in Europe, nearly half had a 7-day incidence of more than 150 new cases per 100,000 population, and 1 quarter saw a more than 10% increase in case incidence over the past 2-5 days. period per week. More than a quarter of European Member countries and territories experience a particularly high incidence and a strained health system.

If there are signs of stabilization or even a reduction in incidence in some countries this needs to be done with caution. The impact of the holiday period, family and community gatherings, and relaxation without physical distance and the behavior of wearing masks, for example, cannot yet be determined. Testing and notification activities may also be lower during the festive season, resulting in an incomplete picture of the current epidemiological situation. Assessing the progress over the past few days before gradually removing any existing measures is a wise way to go.

2021 brings with it new opportunities and tools (such as vaccines) but also new challenges posed by the virus itself.

Like all viruses, as they have been circulating, the COVID-19 virus has changed over time. I understand the concerns surrounding the possible impact of the SARS-CoV-2 Variant. 22 countries in the WHO European Region have detected this new variant.

This variant is "a concern" because it has increased transmission capabilities. So far, we understand that there are no significant changes in the disease that this variant produces, which means that COVID-19 is not more, or less, severe.

It spreads to all age groups, and children do not appear to be at high risk. It is our judgment that this variant can, over time, replace other lineages in circulation as seen in England, and increasingly in Denmark.

With increased transmission and similar disease severity, the variant, however, raises awareness: without increased controls to slow its spread, there will be an increased impact on already depressed health facilities.

I would like to urge countries to reduce this burden by doing all they can to reduce transmission and raise awareness to identify new variants by:

investigating unusually rapid transmission and unexpected presentation or severity of disease;

increasing the order of systematically selected subsets of SARS-CoV-2 infection and using this data to inform initial public health measures;

share this data, so that we can better understand the true extent of this and other variants; solidarity in science is very important today.

This is a worrying situation, which means that for a short time we need to do more than we have already done and to intensify public health and social measures to ensure we can flatten steep vertical lines in some countries, which may not be visible until currently. These are the basic steps, familiar to us, that need to be intensified to reduce transmission, lift burdens in COVID-19 wards, and save lives.

Adhering to the wearing of masks in public places, limiting the number of social gatherings, physical distancing and hand washing, coupled with adequate testing and tracing systems, appropriate support for quarantine and isolation, and increased vaccination, will all work if all of us are involved.

The spread of the COVID-19 vaccine in several countries in the European region WHO has set the basis for using the "vaccine" as one of the tools to deal with the ongoing pandemic. There have been mixed reports of promising COVID-19 vaccine rollouts.

However, while I can assure you that WHO and its partners are making great efforts to get vaccines into every country, we need every country that is able to contribute, donate and support equitable vaccine access and dissemination, to do so. Collectively, we cannot leave any country, any community.

Given the limited supply of vaccines and the increasing burden on our health systems, prioritizing the vaccination of our health workers and those most at risk in our communities is paramount.

Their courage and sacrifice during the past few months cannot be forgotten; it is time to protect and support the front line workers with the new tools at our disposal.

At this point, and after months in a cycle of hope and despair, herd immunity is the desired end point. But it cannot be our main concern right away. I want to emphasize that the vaccine launch is very important, first and foremost, to reduce severe disease in vulnerable groups, relieve pressure on hospitals and avoid the risk of collapse of our health system.

While I appreciate the tremendous effort, the benefits have been phenomenal.

Following last week's WHO Emergency Use List on use of the Pfizer / BioNTech vaccine, the Immunization Specialist Strategic Advisory Group (SAGE) met on Tuesday to discuss policy recommendations around the use of the Pfizer / BioNTech vaccine. We have all noted recommendations for making the time between the first and second doses of vaccines more flexible than initially prescribed by the manufacturer.

It is important that such a decision represents a safe compromise between currently extremely limited global production capacity, and the imperative for governments to protect as many people as possible while reducing the burden on the next "wave" of health systems.

I would also like to emphasize that this decision was made in accordance with the available evidence on the efficacy of the vaccine from clinical trials. Dr Siddhartha Datta, who was with us, was able to explain this when we asked a question.

Whether it's vaccine allocations and priorities, access to medical supplies and testing, or public health measures and policies to control a pandemic, we have a responsibility to base decisions on existing core values, solidarity, equality and social justice. This is the only way out of these uncertain times, because nothing is safe until everyone safe,

Thank you.

To obtain objective information about the impact of COVID-19 on non-communicable diseases (PTM) both at the ministry level and in the health sector, WHO conducted a rapid assessment survey of resources, pandemic preparedness and service delivery for PTM. during the COVID-19 pandemic among 194 health ministries over a three week period in May 2020; 163 ministries have responded (84%).

The questionnaire is completed by the NCD focal point or a designated colleague within the ministry of health or the national agency responsible for NCD in each country. As well as answering questions, countries are being asked to provide their national COVID-19 response plans.

Methodology details are available from the global survey report. The survey confirms that prevention and treatment services for NCD have been severely disrupted since the COVID-19 pandemic began and points to the need to find and invest in innovative solutions to ensure that essential services for NCD continue during and after the COVID-19 pandemic.

Prior to COVID-19, non-communicable diseases such as cardiovascular disease, cancer, diabetes and chronic respiratory disease accounted for approximately 89% of deaths and 84% lost years of life due to disability in the WHO European Region. An estimated 23% of adults have elevated blood pressure, 7% of adults have elevated blood glucose, 59% are overweight or obese and 12.9 million have cancer.

Many of these people have increased vulnerability to COVID-19 and / or a higher risk of becoming seriously ill or dying from COVID-19. At the current level of the COVID-19 outbreak, many countries may not achieve the Sustainable Development Goals targets on NCD and on universal health coverage.

At the time of the survey, 20 of the 39 countries in the WHO European region were in the community transmission phase, and 12 were in the cluster phase. The survey results for the WHO European Region confirm service disruptions and echo many of the global findings, albeit with some important exceptions.

Three-quarters of the responding countries reported some disruption to NCD services. Within the WHO European Area, none of the 39 countries that responded had closed their outpatient services completely. However, 29 out of 39 respondents (74%) have open outpatient services with limited access and / or staff at alternative locations with different modes.

More countries reported that inpatient services (16 of 39, 41%) were open without interruption than outpatient services (9 of 39, 23%). Only six countries (15%) reported that this fully open outpatient and inpatient service was a mixture of middle and high income countries across the region.

For the WHO European Region, nearly three-quarters (74%) of countries (29 of 39) reported that ensuring continuity of NCD services was included in the list of essential health services in their COVID-19 response plans: this was higher for high-income countries (83%) than with low and middle income countries (63%).

Of those who answered yes, services for major diseases (cardiovascular disease, cancer, chronic respiratory disease, and diabetes) were included in the response plan for 72% of countries (28 of 39 respondents) and for chronic kidney disease in 69% of countries. (27 out of 39 respondents). Less likely, dental services (39%), rehabilitation services (41%) and smoking cessation services (23%).

Conclusion The results reflect the situation as of May 2020 and information was available at any given point in time. As a key informant survey, the survey responses reflect the views of the NCD focal points in the ministry of health (or equivalent office) and cannot be validated in detail. The survey results show the significant impact of the COVID-19 pandemic on NCD prevention, treatment and rehabilitation services in countries in the WHO European region.

It also provides an overview of mitigation actions by the ministry of health to ensure continuity of services. Overall, countries in the Region have patterns similar to those at the global level in service disruption. More countries in the WHO European Area than globally report that the main causes of the disorder are elective surgery, closed screening programs and closed NCD clinics.

Reduce facility-based encounters unless necessary during the community transmission phase in line with WHO operational guidelines for maintaining health services during the context of the COVID-19 pandemic. Countries in the Region are performing better than the global level in service provision, such as fewer NCD-related clinical personnel deployed for COVID-19 assistance, more personal protective equipment available to healthcare providers, increased availability of personnel and medication. essential medicine in public. facilities and availability of a larger bed.

Even though lockdowns preclude access to less than a global level of healthcare, people do not attend outpatient services in 72% of countries reporting the disorder (versus 25% at the global level). People who do not use health services may have long-term effects in terms of later diagnosis, faster and more unfavorable disease progression, complications and increased disability.

The strategy for reducing service disruption appears to follow a slightly different pattern from that of other countries in the world. Countries in the Region use telemedicine more frequently and task-shifting or delegate roles to ensure continuity of services.

This can be explained by greater access to the necessary technology and the skill mix of the health care workforce. These findings provide an early learning platform for leveraging policy options and accelerating progress at scale and pace with the Sustainable Development Goals for 2030 targeted at regional countries.