There are “concerning trends for COVID-19 ahead of the winter season in the northern hemisphere”, including increased ICU admissions and hospitalisation in Europe, and case increases in the Middle East and Asia, according to World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus.

However, the WHO’s ability to assess the threat of new COVID-19 variants is hamstrung by member countries’ lack of monitoring of the virus, Tedros told a global media briefing on Wednesday.

“Only 43 countries, less than a quarter of WHO member states, are reporting [COVID-19 cases] to WHO and only 20 provide information on hospitalizations globally,” Tedros noted.

“The increase in hospitalizations and deaths shows that COVID is here to stay and that we will continue to need tools to fight it,” he added.

Meanwhile, Dr Maria van Kerkhove, WHO’s COVID-19 lead, said that while the data was limited ‘hospitalisations are increasing in the Americas and Europe in what we call our southeast Asia region”.

“That is a worry given that, when we get to colder months in some countries, people tend to spend more time indoors aggregated together and viruses that transmit through the air like COVID will take advantage of that.”

She added that only 11 countries had shared information with the WHO’s technical advisory group for virus evolution (TAG VE) about BA.2.86, the latest “variant under monitoring”.

“Given that BA.2.86 has been detected in 11 countries since late July, that indicates to us that it is circulating,” added Van Kerkhove, but added that there were three other “variants of interests” – EG.5 (also called Eris) and two sub-lineages of XBB, which itself developed from Omicron.

“EG.5 accounts for about 30% of global sequences that are globally and was not out-competing any of the variants of interest or other variants that are in circulation,” she added.

“It is quite a complex picture globally in terms of how these variants behave because different variants circulated in different countries at different times. So what we’re trying to do is look at transmissibility. Right now we have very limited information, but we’re also looking at immune escape,” said Van Kerkhove.

Van Kerkhove added that the global influenza monitoring system is “pretty incredible”, and it was also assisting in keeping tabs on SARS-CoV2, the virus that causes COVID-19. In addition, some countries were also using wastewater monitoring for SARS-CoV2.

“What we are working on right now in this transition period of COVID is where can we integrate the systems for surveillance, integrate systems for clinical care and clinical care pathways and what needs to be standalone,” she said.

“That’s what countries are working on right now. We can’t keep up the same systems with a COVID lens only COVID needs to be dealt with in the context of all of these other circulating pathogens including flu.”