The World Health Organisation (WHO) has announced that the global coronavirus pandemic emergency is over – but the disease remains in circulation, and has now become a long-term health management issue.
With news that Belgian cyclist Remco Evenepoel has pulled out of Giro d’Italia following a positive Covid test, it’s obvious that coronavirus has not gone away; it’s not that long ago that experts were worrying that a new variation, known as Arcturus, may be particularly infectious. In the UK, in the seven days up to May 6th, 9,975 people tested positive for coronavirus, a decrease of 6.8 percent on the previous week, and there were 417 deaths with coronavirus on the certificate, a decrease of 13.5 percent on the previous week.
There were 3,002 hospital admission with coronavirus in the UK in the period, down 9.5 percent on the previous week, and 78,258 coronavirus tests were reported, down 7.2 percent on the previous week. The Office for National Statistics published its final weekly coronavirus infection survey on 24th March 2023.
In the fifteenth meeting of the WHO’s Emergency Committee on the COVID-19 pandemic on 5th May, the Director-General highlighted the decreasing trend worldwide in COVID-19 deaths, the decline in COVID-19 related hospitalisations and intensive care unit admissions, and the high levels of population immunity to SARS-CoV-2. The statement said that the “Committee’s position has been evolving over the last several months. While acknowledging the remaining uncertainties posted by potential evolution of SARS-CoV-2, they advised that it is time to transition to long-term management of the COVID-19 pandemic.”
The WHO Director-General concurred with the advice offered by the Committee regarding the ongoing COVID-19 pandemic, and stated that COVID-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC).
The WHO Director-General considered the advice provided by the Committee regarding the proposed Temporary Recommendations, noting that the number of weekly reported deaths and hospitalisations continue to decrease, but expressed concern that surveillance reporting to WHO has declined significantly, that there continues to be inequitable access to life-saving interventions, and that pandemic fatigue continues to grow.
The Director-General announced the publication of a 2023-2025 COVID-19 Strategic Preparedness and Response Plan, which is designed to guide countries in transitioning to long-term management of COVID-19. This plan outlines important actions for countries to consider for five areas:
- Collaborative surveillance,
- Community protection
- Safe and scalable care
- Access to countermeasures, and
- Emergency coordination
The WHO stated that while the global risk assessment remains high, there is evidence of reducing risks to human health driven mainly by high population-level immunity from infection, vaccination, or both; consistent virulence of currently circulating SARS-CoV-2 Omicron sub-lineages compared to previously circulating Omicron sub-lineages; and improved clinical case management. These factors have contributed to a significant global decline in the weekly number of COVID-19 related deaths, hospitalisations, and admissions to intensive care units since the beginning of the pandemic. While SARS-CoV-2 continues to evolve, the currently circulating variants do not appear to be associated with increased severity.
WHO provided updates on the status of global vaccination and considerations of implications for the potential termination of a PHEIC. The Committee was informed that, globally, 13.3 billion doses of COVID-19 vaccines have been administered. Currently, 89% of health workers and 82% of adults over 60 years have completed the primary series (the initial one or two doses recommended as per the vaccine schedule), although coverage in these priority groups varies in different regions.
The WHO’s vaccination operation COVAX will continue to provide funded vaccination doses and delivery support throughout 2023 in line with demand.
The Committee acknowledged that, although SARS-CoV-2 has been and will continue circulating widely and evolving, it is no longer an unusual or unexpected event. The COVID-19 PHEIC has prompted countries to enhance their functional capacities, particularly related to emergency coordination, collaborative surveillance, clinical care, and risk communications and communication engagement. The world has made significant and impressive global progress since the declaration of the PHEIC in January 2020. Reaching the point where COVID-19 can be considered as no longer constituting a PHEIC should be seen as accolade to international coordination and commitment to global health.
As it has during past meetings, the Committee deliberated the potential benefits and issues posed by maintaining the PHEIC. While the PHEIC has been a valuable instrument to support the global response to COVID-19, the Committee agreed that the time is right to move towards the long-term management of SARS-CoV-2 as an ongoing health issue.
They thanked the WHO Secretariat and States Parties for their sustained commitment and technical expertise, and emphasized that this is not the time to stop work or dismantle systems. The Committee stressed that it will be critical to address the gaps recognised during the pandemic. They highlighted the need to strengthen health systems, continue active risk communications and community engagement, implement a One Health approach to preparedness and response, and integrate COVID-19 surveillance and response activities into routine health programmes. The Committee advocated that WHO, partners, and States Parties dedicate sustained attention and resources to preparedness and resilience for emerging threats.