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On Friday, the World Health Organization will declare whether COVID is still a public health emergency, three years after the organization first triggered the alarm.
Since that time, the number of people who have been affected by COVID is staggering — 6.7 million people have died and 664 million have been infected by the WHO’s count. (The real toll is believed much higher.)
But regardless of whether WHO continues to designate the pandemic a Public Health Emergency of International Concern, as it’s formally called (or PHEIC for short), it won’t mean the pandemic is over.
“This is a formal definition,” Dr. Isaac Bogoch, an infectious diseases specialist at University Health Network, said of the designation. “It’s a very technical term that’s used for an international health emergency … that has the potential for global impact where you need more global co-ordination and communication.”
Bogoch said the designation will eventually be lifted, but when it is, it doesn’t mean COVID will disappear.
“When that time comes, if it’s this Friday or if it’s later on down the road, they really should still strongly communicate that COVID is still here, that COVID is going to wax and wane, that COVID will continue to mutate and that people are still vulnerable to getting infected,” said Bogoch.
“And that certain individuals and communities are disproportionately impacted by this,” he said. “We still need to continue to ensure that people have timely access to vaccines, to therapeutics, and we communicate how to publicly take steps to reduce the risk of infection and create safer indoor environments.”
Canada’s chief public health officer said that regardless of what WHO decides, Canada will stay on its present course.
“I think whatever the decision is made by the director general of WHO, I think we just need to keep going with what we’re doing now,” said Dr. Theresa Tam said in a news conference last week.
“We mustn’t … let go of the gains that we’ve had in the last several years,” said Tam, including monitoring the virus for future mutations and antiviral developments. “We mustn’t reduce the research investments … on long COVID. We still have to learn about that and how to respond.”
The Jan. 30, 2020, declaration of a global health emergency, WHO’s highest level of alarm, was the sixth time since 2007 that the organization has made such a proclamation, with others occurring in the wake of outbreaks such as the H1N1 influenza pandemic, Ebola and Zika.
The alarm is designed to trigger a global response to a crisis that includes international co-operation and funding as well as the acceleration of vaccine development, therapeutics and diagnostics under emergency-use authorization, according to a historical overview published in the Journal of Travel Medicine.
At the time, there were 98 cases and no deaths in 18 countries outside China, according to the World Health Organization.
A month and a half later, on March 11, WHO declared a global pandemic.
Last fall, the WHO’s International Health Regulations Emergency Committee met to review the state of the pandemic and determined that COVID continues to be a global health emergency.
Then, WHO’s director general, Tedros Adhanom Ghebreyesus, cited inequities among countries when it came to vaccine coverage as well as access to antiviral and therapeutic treatments, as a reason for the ongoing declaration, even in the face of reduced deaths and vaccinations.
Dr. Fahad Razak, the former director of Ontario’s COVID-19 Science Advisory Table, said he doesn’t expect the emergency designation to be lifted Friday because many of the same concerns from the fall still exist today.
Razak is an internist at St. Michael’s Hospital and a professor at the University of Toronto’s Institute of Health Policy, Management and Evaluation.
“Globally, too few people are vaccinated and boosted,” said Razak. There are “problems with access to antivirals and early treatment,” as well as with the “fragility of health systems, not only with COVID, but also with the response to things like flu and RSV,” respiratory syncytial virus.
Another problem, said Razak, is misinformation and “pseudo-science” about perceived harms of the vaccines.
“I think if you consider those to be kind of critical drivers at this stage of the pandemic, it’s just as true now as it was back in the fall when they decided to renew this concern,” said Razak.
In Canada, vaccine uptake is also a worry.
Tam noted that half the population 65 and older, one of the groups most at risk, had yet to get their second booster and that the National Advisory Committee on Immunization reinforced in a recent statement that people who hadn’t had a full booster with the bivalent vaccine should get it now.
Razak said public health information campaigns have fallen off, as have outreach initiatives delivering vaccines to at-risk groups and neighbourhoods.
When the first doses of the vaccines were delivered, said Razak, “We had the highest vaccination rate” of western developed countries. “And part of that was achieved by really good public health messaging.
“But for the boosters and the bivalents, we’re very much middle-of-the-pack.”
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