COVID-19 Virtual Press conference transcript - 4 August 2021
Overview
00:00:17
TJ Hello, everyone. Welcome to the WHO COVID-19 press conference. Today is Wednesday August 4th 2021. My name is Tarik Jasarevic and I will introduce you to the speakers with us here today at WHO headquarters in Geneva. With us are Dr Tedros, WHO Director-General, Dr Maria Van Kerkhove, Technical Lead on COVID-19, Dr Mariangela Simao, Assistant Director-General, Access to Medicines and Health Products, Dr Bruce Aylward, Senior Advisor to the Director-General and the Lead on the ACT Accelerator, Dr Kate O'Brien, Director, Immunisation, Vaccines and Biologicals. Dr Mike Ryan, Executive Director of the WHO Emergencies Programme, will join online at some point during this briefing.
As always we have simultaneous translation in the six UN languages, Portuguese and Hindi and journalists may use those languages to ask their questions. With this I'll give the floor to Dr Tedros for his opening remarks. Dr Tedros.
TAG Thank you. Thank you, Tarik. Good morning, good afternoon and good evening. In January of this year a midwife from Uganda called Harriet Nayiga joined our press conference to talk about her experience as a health worker during the pandemic.
00:01:49
While vaccines were being rolled out in the wealthiest countries Harriet was one of many health workers in Africa and around the world who was still waiting for her turn to be vaccinated. At the time Uganda, like much of Africa, had relatively few cases of COVID-19.
But starting in May of this year Uganda experienced a surge in cases and deaths as variants tore through a largely unvaccinated population. This morning Harriet sent us this email. I quote; I got my first shot and am yet to receive the second. The situation was tough for the last two months, where over 2,000 people died so far, including health workers. We hope that the vaccines will be able to reach different parts of the country and hope that people will be responsible enough and go for vaccination.
She says, otherwise COVID is spreading though people are now moving to work in order to earn a living since the majority depend on hand-to-mouth; end of quote.
This is the reality for hundreds of millions of people around the world. They cannot afford to stay at home. They work to eat. These populations need vaccines urgently, especially health workers, older people and other vulnerable groups.
00:03:55
Yet even while hundreds of millions of people are still waiting for their first dose some rich countries are moving towards booster doses. So far more than four billion vaccine doses have been administered globally. More than 80% have gone to high and upper-middle-income countries, even though they account for less than half of the world's population.
I understand the concern of all governments to protect their people from the delta variant but we cannot and we should not accept countries that have already used most of the global supply of vaccines using even more of it while the world's most vulnerable people remain unprotected.
In late May I called for global support for a sprint to September to enable a country to vaccinate at least 10% of its population by the end of September. We're now more than halfway to that target date but we're not on track.
When I issued that challenge in May high-income countries had administered around 50 doses for every 100 people. Since then that number has doubled. High-income countries have now administered almost 100 doses for every 100 people.
00:05:38
Meanwhile low-income countries have only been able to administer 1.5 doses for every 150 due to lack of supply.
We need an urgent reversal from the majority of vaccines going to high-income countries to the majority going to low-income countries. Accordingly WHO is calling for a moratorium on boosters until at least the end of September to enable at least 10% of the population of every country to be vaccinated.
To make that happen we need everyone's co-operation, especially the handful of companies and countries that control the global supply of vaccines. The G20 has a vital leadership role to play as the countries that are the biggest producers, the biggest consumers and the biggest donors of COVID-19 vaccines.
It's no understatement to say that the course of the pandemic depends on the leadership of the G20. I repeat, it's no understatement to say that the course of the pandemic depends on the leadership of the G20 countries.
One month from now the G20 health ministers will meet ahead of the G20 summit in October. I call on them to make concrete commitments to support WHO's global vaccination targets. We call on vaccine producers to prioritise COVAX and we call on everyone with influence - Olympic athletes, investors, business leaders, faith leaders and every individual in their own family and community to support our call for a moratorium on booster shots until at least the end of September.
00:08:02
At the same time we must all remember that vaccines are not the only tool. Indeed there is no single tool that will defeat the pandemic. We can only defeat it with a comprehensive approach of vaccines in combination with the proven public health and social measures that we know work. Tarik, back to you.
TJ Thank you, Dr Tedros. Journalists who would like to ask a question, please click the raise hand icon so we know that you have something to ask. We'll start with Jeremie Launch from Radio France Internationale. Jeremie, the floor is yours.
JE Thank you, Tarik. Good morning, everyone. I would like to go back to what Dr Tedros just said; the call for a moratorium on boosters until September. We know that some countries - Germany and Israel for instance - already said that they're going to go for a third dose. So the question is, do you consider that those countries who will administer the third dose, booster dose are failing in their duties?
00:09:25
BA Thank you very much, Jeremie. Everyone has a role to play in trying to get global vaccination coverage up as high as possible, is what the Director-General is saying. It's the countries that provide financing and support to COVAX, countries such as Germany, actually a fantastic supporter in that regard.
But it's also the countries that are contracting doses, it's the suppliers, it's the countries that are achieving the high coverage already. All of these have an impact on the global supply situation. What the Director-General is calling for is trying to right the extraordinary and increasing inequity that we have in the distribution of vaccines.
If you look at Africa as a continent for example we're at less than 5% coverage; in terms of two doses of vaccination we're down around less than 2% coverage actually. This contrasts with the numbers in North America, in Europe, in other areas where we're getting up towards the 50% coverage now, which means in some of the most vulnerable areas of the world with the weakest health systems the healthcare workers are working without protection, as we heard the story about Harriet just now from the Director-General; the older populations remain at high risk.
00:10:42
So what we're calling for is for at least the next two months a complete global solidarity around the goal of catching up the rest of the world in terms of its immunisation coverage. So the moratorium is all about for those who've decided that they may want to use booster doses, etc, trying to put a hold on those policies until and unless we get the rest of the world caught up.
Because we have to approach this, as the Director-General said from the very beginning... We're in a pandemic. The entire world is in the middle of this and as we've seen from the emergence of variant after variant we cannot get out of it unless the whole world gets out of it together.
With the huge disparity in vaccination coverage we're simply not going to be able to achieve that and if we continue to put strain on vaccines by now going into third, fourth doses, whatever, in areas that already have high coverage we just will not be able to catch up.
So really it's a call again for that global solidarity to achieve the coverage we need to have the biggest possible public health impact and get the world out of this crisis as rapidly as possible.
00:11:55
KOB Maybe I can add a couple of comments to that. There are a very limited number of countries that have begun to administer third doses, which we would call booster doses. I think one of the really strong points that we want to make is that there are a larger number of countries that are contemplating this. The evidence is evolving, it's moving.
We don't have a full set of evidence around whether this is needed or not and the most important thing at this point is that for countries that are contemplating this, this strong message from the Director-General that we need instead to focus on those people who are most vulnerable, most at risk of severe disease and death, to get their first and second doses and that we can move on to how to advance programmes as the evidence gets stronger and as supply is assured and we have much higher coverage for those first doses in much greater percentages of populations in every country around the world.
00:13:05
I think the second point is really around this evidence point which is, this is a really big decision about administering third doses to people who've already been vaccinated and it's incredibly important that we're clear about what the data are, that the data are strong in sporting or not in support of whether or not those doses need to be administered.
If we're not really grounded in that clarity we're going to be in a place where we have forever uncertainty about what actually should be done.
TJ Many thanks, Dr O'Brien and Dr Aylward. Let's take the next question. It's Christiane Ulrich from German news agency DPA German. Christiane, please go ahead.
CH Thank you very much for taking my question. This is on the lambda variant. There's a lot of concern being raised in various quarters after the Japanese study that showed that it has mutations that might resist neutralisation by vaccine-induced antibodies. What is WHO's level of concern and should this not be listed as a variant of concern by now? Thank you.
MK Thanks very much for the question on the lambda variant. The lambda variant is one of several variants of interest that WHO is tracking around the world at the global level. As you know, we have four variants of concern, we have at least four variants of interest, we have six or 13 alerts that we're following and we have many, many more signals that we're looking at.
00:14:55
What we're doing is, the lambda variant is known as C37. It is classified as a variant of interest. I was just checking our GISAID online database and looking at where this is circulating. It's been reported in more than 40 countries right now but most of those reports of sequences that have been shared on GISAID report fewer than ten sequences.
So it is actively being discussed as a variant of interest because it is being reported in a number of countries but what we're looking at is how well it circulates, how much transmission takes off once the variant is detected.
In fact it really doesn't seem to take off once it is reported in a country. Even in Peru where it was first detected reports from our PAHO colleagues actually state that the gamma variant, the P1 variant is outcompeting the lambda variant.
00:15:49
You mentioned some mutations of interest. We're also looking at those. There are several mutations in the lambda variant, in the spike protein; there are some amenoacid deletions. There're a number of characteristics of it that cause some concern because of course any changes in the virus pose some threat to the ability for the vaccines to work.
So there are some studies that are underway. I think you're mentioning a pre-print that was just released. This is some of the data of course that we look at with any of the variants of interest, the variants of concern and quite frankly any viruses that are being studied right now.
So at the moment we classify this as a variant of interest at the global level. It doesn't mean it is less important by any means. It is one that we are actively discussing and we are actively trying to gather and garner as much information as we can from all available sources.
But so far this is where we are; it's a dynamic situation, the entire pandemic is a dynamic situation and we discussed with our virus evolution working group, which is composed of virologists and bioinformatics specialists, epidemiologists, clinicians to look at this data almost on a daily basis with our partners around the world.
00:17:09
So we will update further information through our sitreps, through our websites but it is something that we are actively following.
KOB Maybe I can just add one other note about the citation that you mentioned. As we consider the performance of vaccines against variants or performance of vaccines against clinical disease I think it's important to recognise that the serologic measures, the immune measures, the antibody measures of variants and vaccines are not fully predictive of what the performance of a vaccine is.
So although there's a lot of evidence out there around the actual antibodies and their ability to neutralise a virus or a variant of a virus there is no clear correlate between those measures and what to expect from protection against disease.
For the products that are WHO EULed against the majority of the variants and for where we have data, those products are continuing to perform well, especially for the severe end of the disease spectrum, which is of course what we're most concerned about.
00:18:22
So it's just a caution around these studies which are important and contributory, that are immunology studies but they don't actually give us the answer that we need about the performance of vaccines against the variants.
TJ Many thanks. Next question; Helen Branswell from Stat News. Helen.
HE Thank you very much for taking my question, Tarik. I'd like to ask about the moratorium that Dr Tedros is calling for. I'm wondering first of all if you think that September is going to be long enough because it's not that far off.
The second question I would ask related to it is, do you think this moratorium should apply in all cases? There's evidence that some people - for instance solid organ transplant recipients - have received almost no protection from two doses and some countries are looking at giving them a third. Should there be any kind of a carve-out for people in that kind of situation? Thank you.
00:19:32
BA Thank you, Helen, and good afternoon; good to hear from you again. Is September long enough? Not on the current trajectory. Right now if you look at how vaccines are being used globally the uptake rate by high-income countries, upper-middle-income countries is too high, absorbing too much of the global supply for the lowest-income countries to be able to access doses.
You'll remember, Helen, that the 10% goal by the end of September that the Director-General laid out was just one of the steps to 40% by the end of December. So what we're really looking toward is that goal of end of September and then trying to boost the entire global immunity by the middle of net year such that we can solidly get out of the acute phase of this pandemic if not a lot earlier.
So on the current trajectory some decisions need to be made about the prioritisation of populations in countries if we are to get out of this pandemic, save as many lives as possible, prevent as much severe disease as possible.
00:20:44
So the short answer - that was the long part - is probably not and that's why I believe the Director-General said, we will revisit it at that time and see what's needed then.
On the issue of certain populations such as solid organ transplants, what we're really looking at there, Helen, when they're given a third dose is that's still part of what we call their primary series. So for certain populations we're getting additional information that that primary series of one dose or two doses; you may not see that same reaction so they're extending it with an extra.
So again I don't think we should mix up the big picture here, what we're trying to do which is to get the global population vaccinated; the older populations, the healthcare workers, with some of those exceptional situations where obviously one would need to be doing everything possible to make that kind of a highly vulnerable population protected from the disease.
So obviously there may be certain situations but the big picture here is as a policy not to be moving forward with boosters until we get the whole world at a point where the overpopulation - people with comorbidity, people who are working at the front lines - are all protected to the degree possible with vaccines.
00:22:03
KOB May I just add a couple of things. I think the issue, as Bruce described, is that there's increasing evidence that there are some populations, small subgroups who don't respond to the vaccine as well as the general population does. This is not a new phenomenon for a COVID vaccine.
For all the vaccines - and I think we've been communicating this - vaccines don't work 100% of the time in 100% of people, which is why it's so important that as vaccines are rolling out and population coverage with vaccines is increasing, maintaining the interventions that we have that we do know work - masking, hand washing, distancing - all of the things that we've been communicating, those non-pharmaceutical interventions continue to be really important because we absolutely don't want transmission of the virus to increase at a time when vaccines are rolling out and we see escalation of cases and deaths.
There are lots of reasons for that, not the least of which is when that happens at a time when vaccines are increasing the public doesn't understand always that an increase in cases is not because of a failure of vaccines; it's because there is a release of the other interventions that are what is really maintaining the reduction in transmission.
00:23:28
So the evidence that is growing around, for certain products, for certain small sub-groups, perhaps the need for a third dose of vaccine to achieve the primary protection is really, as Bruce said - we don't want that to be confused with the policy or the evidence to determine a policy on a broader issue of whether booster doses should be given.
TJ Thank you both. Let's go to Jakarta Post now. We have Rifki Ramadan with us online. Rifki, unmute yourself, please.
RI Thank you. Good evening, everyone. In Indonesia today we just had a grim milestone with 100,000 deaths due to COVID, as well as many countries in ASEAN. The Indonesian Government bearings on self-isolation led to weak care in hospitals where death counts [?]. What is the WHO's position on how to effectively care for asymptomatic mild to medium patients?
MK Thanks for the question. I can begin on that. In terms of our approach for caring for anyone who is infected with the SARS-CoV-2 virus, variants or not; it's this comprehensive approach so it's about active case finding, knowing where the virus is.
00:24:47
If someone is infected with this virus we recommend isolation of that individual so that they don't have the opportunity to pass the virus on to somebody else. If that individual has an asymptomatic infection, meaning they have no symptoms, if they have a mild course of infection, mild disease they can self-isolate at home.
But if they isolate at home there are ways in which that could be done more safely, if that is possible; isolate in a separate room if that's possible. We know that in many parts of the world that is just not feasible so wearing of a medical mask at home, making sure that if someone is caring for them and providing them food and water and looking after them that it's one individual, a family member so that you limit the contact that you have with others.
We also recommend active contact tracing of course as well to make sure anyone who came in contact with that individual, whether they had mild disease or asymptomatic infection, is also monitored and that they quarantine at home so that again the virus doesn't have an opportunity to pass to others.
00:25:54
But if somebody has an asymptomatic infection or a mild course of disease they can be cared for at home. If that individual is of older age, above the age of 60, if that individual has an underlying condition they are at a higher likelihood of developing severe disease and so we recommend those individuals are isolated in a medical facility if possible.
So there're a variety of ways in which people can be cared for. It depends on the context of where you live, if you can isolate safely at home because we do know in many parts of the world that that's not possible.
But as you point out, there are increasing trends in a number of countries and while I have the floor if I could just take this opportunity to say, we still are globally in a very, very dynamic situation. We are still seeing cases increasing at a global level and it's been more than a month where we are seeing cases increase.
We did see a slight decline in deaths in the last week but there were more than 64,000 people who died last week alone from COVID-19 alone and that is certainly an underestimate of the true number of deaths that have occurred.
00:27:07
So we still highly recommend this comprehensive approach of making sure that we still know where the virus is through robust surveillance, through good testing with quick results back, the use of PCR tests, the use of antigen-based tests at more local levels, that we have good early clinical care for those who need it so clinical care for those who have severe disease, for those who are at risk of developing severe disease, we have good contact tracing that's ongoing so that we limit the onward spread and so on and so on.
So those measures, that comprehensive approach still applies so even though we're 19 months into a pandemic, we have several safe and effective vaccines, those vaccines are not reaching those who are most at risk around the world and so we need to have this comprehensive approach at community level, individual-level measures; wear your mask, practise your physical distancing, keep your hands clean, make sure there's good ventilation, practise respiratory etiquette; play it safe.
00:28:13
TJ Many thanks. The next question comes from Jonathan Levy, Radio News Hub. Jonathan, welcome and unmute yourself.
JO Thank you very much. You talk about restricting booster shots but what about age range. Some countries are looking at 16 to 17-year-olds. What are the pros and cons?
BA Thanks, Jonathan; a super-important point. When it comes to age ranges we come back to the original advice and Kate may want to speak to this because our scientific advisory group of experts, which is a group of experts from around the world that helps bring together global knowledge and policy and form global recommendations in this regard; they've really emphasised the need to prioritise populations in the right order if we're to ensure that these vaccines are going to have the greatest possible impact.
We often talk about that at a national level but what you're hearing from the Director-General today is the need for us to really get serious about thinking about this at a global level, which means get the healthcare workers protected first, get the population over 65 or your older population over 60 protected and then move to those with the co-morbid conditions that we've talked about frequently; diabetes, others that put you at high risk of severe consequences and then move down the age range but again some go down to over-50s, etc.
00:29:46
But once again we're in a situation now where many countries are beginning to move into very young populations that are at very low risk of severe disease or hospitalisation where healthcare workers who are dealing with infected people on a day-to-day basis in front of roaring surges of delta virus in many parts of the world are going into that completely unprotected in terms of vaccination; similarly older populations in such countries unprotected.
So, Jonathan, again the Director-General's position, our position would be we have to really get serious and take a global view on this. If we get every remaining country now to at least 10% coverage by the end of September we will have gone a long way toward protecting healthcare workers and protecting older populations in most countries.
But that's just the beginning; it's only by the end of this year if we get to 40% coverage in all countries that we will be getting down into the over-50s, the people with co-morbid conditions, etc. So our preference and our strong recommendation from a global public health perspective is we prioritise those populations before we start going into the younger populations, teenagers, etc.
00:31:00
Yes, they're at risk of COVID, very definitely but less severe disease and hospitalisation and in the face of scarce product really we need to look at this from a global perspective and try and protect those at highest risk. That will be our goal through September, through the end of the year and thank you, Jonathan, for highlighting it; so important that we prioritise the right populations in the right order.
That's the reason - sorry, just a last point on this, Jon - the Director-General said, 10% by then, 40% by then in each country so we're not saying some countries get way up there first and then we get to the other countries. That doesn't work when you're trying to get out of a pandemic in terms of the health consequences, the financial consequences, the social consequences. You've got to do it together.
KOB Just to add to the issue about the adolescents, there's a clear recommendation that for adolescents who have underlying medical conditions that put them at high risk of serious COVID disease they should absolutely be included in that group that is determined as being high-risk.
00:32:03
We only have a couple of products that really go down into the adolescent age group from an authorisation perspective and really the focus has to be that we're really focusing in the entirety of the policies to prevent serious disease, hospitalisations and death because that's what's really driving the pressure on the healthcare system and all of the overflow from that in terms of the impact on our economies and on our societies and on our families and everything that has happened over these past going on now towards two years.
So the real issue here is, do adolescents as a general group really contribute a lot to that severe end of the disease spectrum? Luckily the answer for them is, not really. They don't tend to have serious consequences of disease and that's really the focus for assuring as the highest priority to get vaccines to all people who have that highest risk, substantial risk of serious disease.
00:33:14
I also want to emphasise the importance of schools and schools remaining open and no requirement for teenagers or for kids to have to be vaccinated in order to attend school. That should not be a barrier for them to attend school because really it's about the protection of the adults around them who are the ones who really have more risk of disease.
So eventually expanding vaccination to all who need vaccination is the ultimate goal but we're in a state still where we have to focus on what the highest priorities are before moving our way down to other groups who would have benefit but are not the highest-priority groups.
TJ Thank you very much, Dr Aylward, Dr O'Brien. We are also joined by Dr Mike Ryan, who may also answer some questions if needed. Next question is from Shoko Koyama from Japanese broadcaster NHK. Shoko, please go ahead.
SH Hello, Tarik. Thank you for taking my question. My question is about herd immunity. During a Q&A session in January Dr O'Brien mentioned for COVID-19 WHO still didn't know what fraction of the population needs to be vaccinated in order to achieve herd immunity but they thought it would be something around 70% or more. Seven months after with the delta variant becoming more and more dominant do you still consider 70% to be sufficient to achieve herd immunity or do we need a much higher percentage? Thank you.
00:35:03
KOB The question of herd immunity is really this question of, are people who are non-immune, who don't have vaccination or who don't have immunity from natural infection; do they have protection from disease simply because they're living in and amongst people who themselves are immune?
So there's no one number, it's not a yes there is or no there isn't; it's the degree to which there might be some protection from non-immune people and that is totally dependent on how transmissible a virus is.
We have a lot of information about a lot of different viruses and I'll use measles as the example, which is a highly transmissible virus. In order to protect those people who aren't immune we need about 95% of other people in the population to be immune.
00:35:58
So that's a really transmissible virus and for the SARS-CoV-2 virus we don't actually know what the value is, what the number is of the proportion of people who need to be immune in order to provide some protection to those who haven't been vaccinated, who aren't immune because they haven't had natural infection.
But as we see the expansion of variants that are more transmissible it does mean that with more transmissibility of the virus the need for a greater proportion of the population to be vaccinated in order to start to provide some herd immunity is needed.
So this is a number that continues to be something of interest. We know that it's going to be a value, a proportion vaccinated that's going to be substantial and those are really questions that we can continue to look at but what's very clear is that we should be advancing the vaccine programme in all countries to get well past where we are right now.
As the Director-General has continued to say, we have targets for 10% of the population to be vaccinated, 40% of the population to be vaccinated and onwards to 70% of that population that would be prioritised for vaccination by the middle of 2022.
00:37:32
That's when we can really start focusing around the edges on just how high it needs to go beyond that but it's quite clear that with increased transmissibility it does drive up what that fraction is that is needed to be immune, largely through vaccination, in order to start to see some herd immunity. I think Maria wants to add a little bit to that.
MK Yes, just very briefly because Kate really covered a lot of it, I think part of the challenges are the uncertainties that we are facing right now about the virus itself. With the variants that we are seeing there is demonstrated increased transmissibility with these variants of concern and, as Kate has said, that drives up the proportion that would require to be vaccinated to reach this herd immunity.
I actually prefer the community immunity phrase more than herd immunity because we take into account those that have been infected naturally plus those that have been vaccinated. So yes, we need a large proportion of the world's population vaccinated to reach this community immunity level.
00:38:33
But I just want to stress that this is also why we stress the vaccines-and, not vaccines-only strategy because we are so limited in our ability to reach the world's population and there are very clear reasons for this which the Director-General has outlined many, many times.
The sharing of these vaccines, the reaching of those who are most at risk around the world quite frankly is a challenging thing to do but we just need to decide to do it and it can be done. So we need a strategy of vaccines-and, we need the public health and social measures at individual level, at community level; we need everybody to step up right now, we need everybody to play a role, whether you are a political leader of a government, whether you are a community leader, whether you are the leader in your home or an individual on the street.
Everybody has a role to play here. We need masks to be worn, we need physical distancing, we need good ventilation, we need to spend more time outdoors than indoors if possible, we need to make sure that we get the vaccine when it's our turn.
So not only do we need to reach a large proportion; we need those who are offered the vaccine to take the vaccine and there are many safe and effective vaccines that are in use right now. So this vaccines-and, not vaccines-only is absolutely critical as we go forward and we do need you to bear with us as the science grows, as the science changes, as the dynamic situation evolves but the outcome of this pandemic is completely in our hands and so how we choose to act, how we choose to behave, the decisions that each of us make matter, good and bad.
00:40:19
TJ Thank you. Dr Ryan, would you like to add something?
MR Thanks, Tarik. No, I think Maria and Kate have really spoken to it but just to explain again classically what's meant by herd immunity, what we rely on in many vaccination campaigns is that if you reach a certain level of vaccination and immunity in the population or in the community, as Maria puts it, those who are not vaccinated get indirect protection; in other words the people who are susceptible who are not vaccinated are hidden amongst people who are vaccinated so in effect vaccinated people form a barrier around unvaccinated people.
Therefore you don't need in all cases to get to 100% vaccine coverage, as Kate was stating. It's a very high number in measles. You have to vaccinate almost everybody in measles in order for those who are unvaccinated to be protected by the others.
00:41:18
For other diseases that value is much lower. We don't know where that value lies in COVID, with SARS-CoV-2. It depends on how transmissible the virus is, as Kate outlined, and we're seeing more transmissible variants arising so that factor is dynamic.
It also depends on the vaccine efficacy, the efficacy of the vaccine in an individual and we know that varies by person and it can vary by the type of vaccine used. We also know that the length of protection, how long the community stays protected by a given vaccine will also have an impact on the overall protection within the community and again we don't have long-term data on the overall length of protection and hence the discussion on boosters and many other things so in that sense that number is not known.
What we do know is with the increasing transmission and with increasing transmissibility of variants the likely number for the proportion of the community that will need to be vaccinated in order to protect those who can't or won't be vaccinated is going to be very much higher maybe than we suspected originally. This virus is proving to be a worthy adversary in that regard.
00:42:33
TJ Many thanks, Dr Ryan. Let's now go to Isabel Sacco from EFE, Spanish news agency. Isabel.
IS Hello. Do you hear me?
TJ Very well.
IS Hello?
TJ Yes, we can hear you very well. I think we have... We'll try to come back to you. Can you hear us now?
IS Yes. Can you hear me now?
TJ Isabel?
IS Yes. Sorry. I didn't hear you. Thank you. I would like to have your comments on the decision of Pfizer and Moderna to increase the prices of their vaccines in Europe. I would like also to know in relation to this if there are still talks with these companies to supply vaccines to the COVAX facility. Thank you.
00:43:53
BA Hi, Isabel. First on the issue of whether there are talks ongoing with Pfizer and Moderna to supply COVAX, yes, absolutely. As you will have heard, over the last few weeks in fact there've been some important announcement that an additional 500 million doses of Pfizer vaccine will be going through the COVAX facility as a result of a deal between COVAX, Pfizer and the United States Government, which has been a hugely important development for countries with the lowest coverage right now, the MC countries.
There's also a deal in place with Moderna that will be supplying vaccine coming into the fourth quarter through procurement by COVAX and we've already had donations again through the US Government of Moderna vaccine to COVAX. So both products are very much part of the overall diversification, let's say, of the COVAX portfolio and the armamentarium that we have.
On the issue of pricing of vaccines and the specifics of what any one country is paying or another, we wouldn't be in a position to comment on that, Isabel. What we would say of course though is that it is essential at this time that we look at trying to get vaccines to the people that need them at the best possible prices to get out of this pandemic and any changes to those prices would really need to be justified in terms of costs being borne to produce them at this point because really the goal right now is to get as many people vaccinated as rapidly as possible so we can save lives, reduce the number of people who are getting sick, take pressure of the healthcare systems and get back to a much more normal functioning of society and obviously of our economies as well.
00:45:42
So anything that might prove to be a barrier to that in terms of supply of vaccines, pricing of vaccines, etc, we would certainly want those factors to be going in the right direction to optimise supply.
MS Just complementing what my colleague, Bruce, was saying, it's very important that we have a policy that companies state policies of affordable prices and what we see is it's maybe one year on from these vaccines being developed and manufactured and we see both manufacturers, Pfizer and Moderna, by the end of last year had vaccines in the market.
Both of them have increased their manufacturing capacities, they have diversified their manufacturing plants and we understand also that they have increased efficiency in the production lines. So this would in a normal market situation lead to a decreased price, not an increase in price.
00:46:50
So what we have is clearly a market where the demand is very high in comparison with the production and we, WHO urges companies to keep prices down and affordable prices even if you're talking about countries that can afford. There are many countries around the world that cannot afford any higher price right now.
So I think it's urgent that we think about this in terms of affordable pricing in times where there is increased manufacturing from those two MRNA producers and we also hear that there are more efficient production lines as well. Thank you.
TJ Thank you, Dr Simao and Dr Aylward. We'll go to the last question for today and that's Agence France Press; Robin Millar is with us. Robin.
RO Thank you. With the number of recorded new cases still increasing and set to go past 200 million very soon how concerned are you about the numbers of people who may be suffering from long COVID and is this something that member states should be placing more attention on? Thank you.
00:48:11
MK Thanks very much for this really important question. The answer is absolutely. This post-COVID symptom or long COVID is something that WHO is deeply concerned about. We have been working with patient groups, with clinicians, some clinicians who are patients suffering from long COVID, on looking at making sure that we have recognition of this because this is real.
Individuals who pass the acute phase of infection, the acute disease and recover from that; many are suffering from long-term effects. We don't know for how long these effects last and in fact we're even working on a case definition to better understand and describe what this post-COVID syndrome is.
It can last three months, it can last six months. The head of our clinical management team, Dr Janet Diaz, and colleagues around the organisation are looking at brain health, mental health, looking at different organs in terms of how this virus is affecting people in the long term.
00:49:13
We are working to make sure that we have recognition of this, that we have better rehab for individuals who have been infected with the SARS-CoV-2 virus, who have suffered from COVID-19, who have survived it but are dealing with longer-term effects and that we have good research so that we really understand what post-COVID syndrome is and how it can be better managed.
We advise anyone who is suffering from the long-term effects following infection to seek help and to make sure that the help that they seek is of a multidisciplinary nature because it affects so many different organs of the body.
We do ask that member states take this seriously and member states are but we want to ensure that the research that is taking place is not just happening in high-income countries, that it is happening in countries all over the world so that we really study this properly and that we have good recognition, rehab and research.
TJ Thank you very much, Dr Van Kerkhove. With this we will conclude today's press briefing and before I give the floor to Dr Tedros for his closing remarks, just to remind you that the transcript will be available tomorrow and that an audio file will be sent to you immediately after this press conference. Dr Tedros, the floor is yours.
TAG Thank you. Thank you, Tarik, and I would also like to thank all media colleagues for joining today. See you in our upcoming presser. Thank you again.
00:50:54