Countries Urged to Reopen with Caution as World Surpasses Four Million COVID Deaths
Fans watching a Premier League football match in London Stadium in lat May. Spectators were socially distanced and hygiene safety warning signs were displayed.

WHO urged high income countries in Europe and elsewhere to reconsider the reopening of mass events, and keep strict social distancing rules in place – in the wake of a surge in COVID cases almost everywhere but Latin America. 

They spoke at a press briefing on the day that the world passed the tragic milestone of four million COVID-19 deaths since the beginning of the pandemic in January 2020. 

“The world is at a perilous point in this pandemic,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, at the WHO press conference on Wednesday.

Globally, only a slight increase in new weekly cases has been recorded over the past two weeks – but that is still worrisome after six weeks or more of declines in Europe, Asia and Africa. 

“More than two dozen countries have epidemic curves that are almost vertical right now,” said Dr Maria Van Kerkhove, WHO COVID-19 Technical Lead. 

Among those are the United Kingdom, where new cases have increased 18 fold since 20 May, and by 67% over just the past week, according to WHO. Deaths in the UK also are increasing, although much more gradually – testifying to the continued efficacy of vaccines.   

Cases on Rise in Most Parts of World 

Indeed, after sharp declines in most regions and key countries of the world over the past eight weeks, new cases are now on the increase almost everywhere – except for Latin America which had been riding an enormous fourth COVID wave, now in decline (see related HP-Watch story). 

Outside of the UK, infections were also rising fast in other European countries that have been slowly reopening this summer, with a 30% overall increase in incidence, as well as in the United States, with deaths also tilting upwards. 

This was followed by a 15% increase in cases in the African region, 11% increase in the Eastern Mediterranean region, 10% increase in the Western Pacific region, and 7% increase in the Southeast Asia region. 

In Africa, which has very low vaccine rates as well as hospital capacity, deaths per capita are approaching the all time peaks seen in January 2021, during Africa’s second wave. 

African Region Seeing Fastest Rise in Mortality  

Even more worrisome, the African region, which also lacks hospital and oxygen capacity,  has witnessed a sharp increase in mortality by 23% over just the past week, the highest out of all six WHO regions, WHO said. 

“Compounded by fast moving variants and shocking inequity in vaccinations, far too many countries in every region of the world are seeing sharp spikes in cases and hospitalizations,” said Tedros. “This is leading to an acute shortage of oxygen treatments and driving a wave of deaths in parts of Africa, Asia, and Latin America.”

Devastating Milestone – Four Million 

“Today, the world passed another devastating milestone: four million reported deaths,” said Jeremy Farrar, Director of Wellcome, in a statement. “Sadly, the true figure is undoubtedly much higher.”

“In countries with widespread vaccination coverage there thankfully appears to be a weakened link between infection rates, hospitalizations and deaths. But for large parts of the world facing a vaccine shortfall and the highly infectious Delta variant, it’s a tragically different picture,” Farrar said. 

The four major factors that are driving transmission are: the more transmissible virus variants, particularly the Delta variant; increased social mixing in reopening economies; reduced or inappropriate use of public health and social measures; and inequitable and uneven distribution of vaccines, said Van Kerkhove. 

Dr Maria Van Kerkhove, WHO COVID-19 Technical Lead, at the press conference on Wednesday.

The Delta variant, first identified in India and classified as a WHO variant of concern in mid-May, is considered 40-60% more transmissible than the Alpha variant, identified in the United Kingdom. It has been reported in 104 countries and is expected to become the dominant variant worldwide in the coming months.

WHO Urges Continued Restrictions – Despite Tourism & European Cup Pressures 

European countries have been in the process of gradually lifting public health measures for the summer months, in an attempt to revive economies, including sports summer tourism, after vaccinating a significant proportion of their populations.  

Despite the surge in new cases, the UK, which is also one of the most heavily vaccinated European countries nearly 50% of the total population fully covered, has taken the most dramatic steps towards the easing of COVID restrictions since the lockdowns were first applied last year. 

Meanwhile, European Cup matches have been played out over the past several weeks across the region in stadiums of live fans, for the first time in over a year, with the finals set for the UK’s Wembley Stadium on Sunday. However Dr Mike Ryan, WHO Head of the Health Emergencies Programme, declined to comment on whether it was wise for UK officials to permit live spectators at specific events.  

“I’m not going to comment on specific events for mass gatherings, but I would want to make sure that all of those individuals, countries, and institutions planning events in the coming months take due care and attention to managing risks,” Ryan said. 

Dr Mike Ryan, WHO Head of the Health Emergencies Programme.

On 19 July, limits on the number of people that can gather in the UK, as well as the legal obligation to wear face masks will be lifted, and all businesses still closed due to such restrictions will be allowed to reopen.

The government has made this controversial decision despite the doubling of new cases every nine days and predictions that the country could see two million individuals contract COVID over the summer.

A drop off in hospitalizations and deaths has been seen in countries with high vaccination coverage, however, the vaccination rate is not high enough to prevent transmission. In addition, the science is not yet clear on the ability of vaccinated people to transmit the virus or become reinfected, said WHO officials.

Some 49.9% of the UK’s population is fully vaccinated and 66.9% have received at least one dose. 

“The lifting of all public health and social measures [is] prudent at this time,” said Ryan.

“We would ask governments to be really careful at this moment not to lose the gains they’ve made,” said Ryan. “I would hope that in the European environment we won’t see a return to the overwhelmed hospitals and the exhausted health workers, but that’s not a given.”

He stressed the continued need for robust surveillance, active testing, and contact tracing to prevent cases from spiralling out of control again. 

“Risk management hasn’t been perfect in this pandemic, but it has saved lives, slowed down the pandemic, and kept the pressure off the health system,” said Ryan. 

“Our goal is to suppress transmission and save lives, so we need those policies in place in all countries” to meet the goal, said Van Kerkhove.

Calls for Action on Vaccine Inequity 

“Variants are currently winning the race against vaccines because of inequitable vaccine production and distribution, which also threatens the global economic recovery,” said Tedros, sounding yet another, in a series of calls to mobilise the global conscience – with mixed results.  

Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“At this stage in the pandemic, the fact that millions of health and care workers have still not been vaccinated is abhorrent,” said Tedros. 

The WHO Director General has set out a goal of vaccinating 10% of people in all countries by September, 40% by the end of the year, and 70% by mid 2022 – although at present vaccination rates, it remains entirely unclear if those targets can really be reached. 

“In this pandemic right now…protect[ing] vulnerable healthcare workers and the elderly in low-income countries before expanding into populations in high-income countries that may not suffer the same consequences of the infection,” should be prioritised, said Ann Lindstrand, WHO Head of the Essential Programme on Immunisation. 

WHO officials called upon the Group of 20 (G20) finance ministers, who will meet later this week, to take the steps necessary to end the acute phase of the pandemic, provide the funding to scale up vaccine manufacturing, and get behind Tedros’ vaccination targets.

“We have the tools we need to end this pandemic – vaccines, treatments and tests – but this will only work when they’re available to everyone, everywhere,” said Farrar. “Recent pledges from the G7 and G20 do not go far or fast enough. They are the only ones that can make vaccines available now.”

Image Credits: Wikimedia, WHO.

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