Tag: Transition

  • Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO

    Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO

    Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO 1

    GENEVA: World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus warned here on Friday that lifting restrictions “too quickly” could lead to a deadly resurgence of Covid-19, Xinhua news agency reported.

    Noting at a regular press briefing that “some countries are already planning the transition out of stay-at-home restrictions,“ the WHO chief warned that lifting restrictions too quickly could lead to a deadly resurgence.

    “The way down can be as dangerous as the way up if not managed properly,“ he said, underlining that the WHO is working with affected countries on strategies for gradually and safely easing restrictions.

    Some European countries are already considering relaxing their restriction measures as they see a slowing trend in the number of Covid-19 infections.

    Austria, for instance, aims to gradually ease the exit restrictions and reopen shops and businesses from mid-April. Switzerland also suggested “the first relaxations” by the end of April.

    The WHO chief stressed that decision of lifting restrictions should be made on the condition that transmission is controlled; that sufficient public health and medical services are available; that outbreak risks in special settings like long-term care facilities are minimised; that preventive measures are in place in workplaces, schools and other places where it’s essential for people to go; that importation risks can be managed; and that communities are fully aware and engaged in the transition.

    Globally, nearly 1.5 million confirmed cases of Covid-19 have now been reported to the WHO, as well as more than 92,000 deaths. — Bernama

    Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO
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  • Virtual Press Conference on COVID-19- 06 April 2020

    Virtual Press Conference on COVID-19- 06 April 2020

    Originally broadcast live on 06 April 2020, the daily press briefing on coronavirus COVID-19, direct from WHO Headquarters, Geneva Switzerland with Dr Tedros WHO Director-General, Dr Micheal Ryan, Executive Director of the Health Emergencies Programme, and Dr Maria Van Kerkhove, Technical lead, WHO Health Emergencies Programme with special guests Lady Gaga and Hugh Evans, CEO and Co-founder of Global Citizen.

    Transcript:

    Speaker key:

    TJ        Tarik Jasarevic

    TAG    Dr Tedros Adhanom Ghebreyesus

    LG       Lady Gaga

    HE       Hugh Evans

    MR      Dr Michael Ryan JA  Jamie

    MK      Dr Maria Van Kerkhove KA Kai

    KT       Kate

    IN        Innocent

    YA      Yang

    00:00:19

     

    TJ        Good evening to everyone from Geneva and WHO headquarters. Welcome to the regular press conference on COVID-19. Journalists who are online can ask their questions by clicking  raise hand if  you are
    on Zoom.  Today we have a special guest but  I will  let Dr Tedros do his opening remarks and introduce them.  Before I give  the floor  to Dr Tedros, just to remind you, we will also be sending you some news from other
    WHO offices around the world with the audio file  from this  press briefing a little  bit  later. I give  the floor  immediately to Dr Tedros.

     

    00:01:07

     

    TAG    Good morning, good  afternoon and good  evening.  The COVID-19 pandemic continues to take a heavy toll on families, communities and nations the world over but it’s also giving rise to incredible acts of generosity,
    solidarity and co-operation. We have said consistently that we’re all in this together and we can only succeed together. We need an all- of-society approach with everyone playing their part. That includes  people  in  the entertainment
    industry.

     

    Today I’m very delighted to be joined by one of the biggest names in entertainment in the world, Lady Gaga, and my friend Hugh Evans, the founder and CEO of Global Citizen.

    WHO has been working with Global Citizen for several weeks on the Together At Home concert series with artists like Chris Martin and John Legend giving free online performances.

    Now we’re working with Lady Gaga and Global Citizen to take this concept and make it even bigger through the  One World  Together  At Home virtual  global  special on Saturday 18th April. It’s now my great pleasure to invite
    Lady Gaga and Hugh Evans to say more about this very special event, One World.

    00:03:10

     

    LG       Thank you very much, Dr Tedros. Good morning, good afternoon  and good  evening to everyone who’s listening and watching. I would  like  to thank the World  Health Organization and the
    United Nations as well as Global Citizen; thank you very much, Dr Tedros and Hugh Evans, for all of your leadership in this fight against COVID-19 and thank you very much to the World Health Organization  for asking  me to collaborate 
    with  you on this special.

    We are also very grateful to all of the healthcare professionals across the country and around the world who are on the front lines during COVID-19. This  global  pandemic  is  a catastrophe. I’m so thankful to them and I’m also
    praying for those who are sick. It’s been a pleasure to partner with Global Citizen  and we’ve been working  all together  behind  the scenes to raise money for the World Health Organization.

    I would also like to send my prayers as well to people  that are losing  their  jobs  and are having a hard time feeding themselves  and their  children.  We are raising  money  for  the World Health
    Organization’s COVID-19 Solidarity  Response  Fund and seven days ago we held a  call with more than 68 corporate leaders from some of the world’s biggest and most generous companies and I asked them to join my corporate kindness
    list as there have been many corporations and philanthropists that have been very, very generous during this time.

    00:04:38

     

    Since then we have also been calling on philanthropists around the world as well and tech companies included. I’d like  to reiterate our deep gratitude  to the medical  community.  My heart is very, very aching and warm for those
    who are ER doctors as well as nurses who are sleeping in cars to make sure they don’t infect their families  or  their  patients.  What you’re doing is putting  yourselves  in  harm’s way to help the world 
    and we all salute  you and you are a triumph truly.

    I am proud to say that over the past seven days we’ve raised a total of $35 million for the Solidarity Fund. This money will [inaudible]  essential PPE, supplies  and testing kits around  the world and will help improve lab capacity
    to rapidly process tests. It will also [inaudible] research development. It is so important to think globally and to support the World Health Organization to curb the pandemic and prevent future outbreaks.

    I know Dr Tedros is particularly concerned about Africa and [inaudible]. We also need to act globally by supporting local charities  and initiatives so that the front-line health  workers in most immediate need have the resources they need
    to survive during this time. It has been an honour to help with this huge broadcast event, which will take place on April 18th, where we need to tell the stories of and celebrate the front-line community, healthcare workers and their acts of kindness.

    We will be on different networks, many networks actually and I want to [inaudible] about what we’re going to be doing. What’s very important is that two things happen for all of us; that we celebrate and we highlight the singular, kind global community
    that is arising right now. Two, we want to highlight the gravity of this historically unprecedented cultural movement and, three, we want to celebrate and encourage the power of the human spirit.

    00:06:47

    I would like to, on behalf of  the World  Health Organization  and Global  Citizen,  thank Dr Tedros as well as everyone that has donated so far. We are going to continue fundraising but I would like to also let you know that
    this broadcast special is not actually a fundraiser. We all wanted to raise the money before we went on air so when we do  air  live  on  April  18th  put your wallets away, put your credit  cards away, anything 
    away that you need to and just  sit back and enjoy the show that you all very much deserve.

    I’d like to pass this now to Hugh Evans, who’s been a wonderful partner of mine. Hugh, thank you so much and thank you, Dr Tedros.

    HE       Good morning, good afternoon,  good  evening  and thank you,  Dr Tedros  and thank you, Lady Gaga. Your Excellencies,  ladies  and gentlemen;  Lady Gaga, Dr Tedros, 
    you’ve both demonstrated extraordinary leadership at an unprecedented moment when our society is being challenged like never before and we are so thankful for your leadership. I’d like to echo Lady Gaga’s sentiment and commend the incredible acts
    of bravery demonstrated by the front-line community  health  workers around the world  and I hope  that we as a shared humanity emerge from this moment forever grateful for the work of doctors, nurses, teachers, grocery store workers and all of those who are
    the backbone of our communities.

    Global health is at the very core of the global citizen mission and we must  ensure that the world’s poorest and most  marginalised  people  have  access to resources to cope with and tackle this health crisis. Through One
    World:  Together At Home on April 18th  we’ll be calling on philanthropists, corporations and governments to fund critical global COVID-19 response efforts including distribution of resources and PPE to critical front-line healthcare
    workers.

    00:09:09

    In our partnership with the WHO and United Nations Global Citizen is committed to driving action to help ensure our global health systems are strong enough to stop a future pandemic before it happens. April 18th is going to be a moment of global unity
    connecting the world through a historic global broadcast. We are bringing together the greatest artists in the world under the passionate and extremely talented curation of Lady Gaga.

    In alphabetical order some of the artists we’ll be announcing today include Alanis Morissette, Andrea Bocelli,  Billie  Eilish,  Billy  Joe Armstrong  of Green Day, Burna Boy, Chris Martin, Sir David Beckham, Eddie Vedder,
    Sir Elton John, Finneas, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington,  Lang Lang,  Lizzo, Maluma, Sir Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan, Stevie Wonder and many more to be announced over the coming weeks from all corners of the globe under the passionate and extremely talented curation of Lady Gaga.

    We’re grateful to all of you for participating and supporting this critical effort. One World Together At Home will be broadcast live on Saturday April 18th 2020 at 5:00pm PDT, 8:00pm EDT and 12:00am BST, airing on ABC, NBC, Viacom and CBS networks,
    IHeartMedia, and Bell media networks and platforms in Canada. Internationally BBC1 will run the programme on Sunday April 19th and additional  international  broadcasters include BN Media Group, Multi-Choice Group and RTE in Ireland.

    00:11:43

    The digital broadcast will celebrate and support brave community  health workers who are doing life-saving work on the front line and we’ve all seen the limitations of world leaders around this world to step up and face this extraordinary challenge 
    and we want to do our best to support the essential work of the World Health Organization, driving action and raising critical funds. Thank you again, Dr Tedros, and thank you, Lady Gaga, for your leadership.

    Thank you all.

    TJ        Thank you very much to our guests for their remarks. Dr Tedros, I guess you would like to thank them too.

    TAG    Once again I would like  to thank Lady Gaga and Hugh Evans for their  partnership. We had a call last week and I was so amazed by the energy and passion of Lady Gaga. It’s incredible commitment to humanity and that’s
    when I said, I think what she has planned can happen. It’s bringing the world together to improve awareness and to mobilise  resources to fight the pandemic so I thank her for her incredible passion and commitment  and leadership and
    also to my friend, Hugh Evans, for connecting all the dots and for his leadership.

    We all look forward to joining you for the One World: Together  At Home concert on 18th April. As the pandemic continues we recognise that individuals and governments want to do everything they can to protect themselves and others and so do we.
    We understand that some countries have recommended or are considering the use of both medical  and non-medical masks in the general population to prevent the spread of COVID-19.

    00:14:21

    First and foremost medical masks must be prioritised for health workers on the front lines  of  the response. We know medical masks can help to protect health workers but they’re in short supply globally.  We’re concerned that the mass
    use of medical  masks by the general population could exacerbate the shortage of these specialised masks for the people who need them most. In some places these shortages are putting health workers in real danger.

    In healthcare facilities WHO continues to recommend the use of medical masks, respirators and other personal protective equipment for  health workers. In the community we recommend the use of medical masks by people who are sick and those who
    are caring for a sick person at home.

    WHO has been evaluating the use of medical and non-medical masks for COVID-19 more widely. Today WHO is issuing guidance and criteria to support countries in making that decision. For example countries could consider using masks in communities where other measures such as cleaning hands and physical distancing are harder to achieve because of lack of water or cramped living conditions.

    If masks are worn they must be used safely and properly. WHO has guidance on how to put on, take off and dispose of masks. What’s clear is that there is limited research in  this  area. We encourage countries that are considering the use
    of masks for the general population to study their effectiveness so we can all learn. Most importantly masks should only  ever be used as part of a comprehensive package of interventions. There is no black or white answer and no silver bullet.
    Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and trace every contact. Mask or no mask, there are proven things all of us can do to protect ourselves and others.

    00:17:13

    Keep your distance, clean your hands, cough or sneeze into your elbow  and avoid  touching your face. Less than 100 days since WHO was notified about the new coronavirus  research has accelerated at incredible speed. The viral genome
    was mapped  in  early January and shared globally, which enabled tests to be developed and vaccine research to start. More than 70 countries have joined WHO’s Solidarity Trial to accelerate the search for an effective treatment and about
    20 institutions and companies are racing to develop a vaccine.

    WHO is committed to ensuring that as medicines and vaccines are developed they’re shared equitably with all countries  and people.  I want to thank the  Medicines  Patent Pool and Unitaid for the initiative they announced last
    Friday to include medicines and diagnostics for COVID-19 in their licensing pool.

    I also want to thank the President of Costa Rica, President Carlos Alvadaro, and the Health Minister, Daniel Salas, for their proposal to create a pool of rights to tests, medicines and vaccines with free access or licensing on reasonable and affordable
    terms for all countries. Muchas gracias, Mr President. I support this proposal and we’re working with Costa Rica to finalise the details.

    00:19:09

    Poorer countries and fragile  economies  stand to face the biggest  shock from this  pandemic and leaving anyone unprotected will  only  prolong  the health crisis  and harm economies  more.  I call
    on all countries, companies and research institutions to support open data, open science and open collaboration so that all people can enjoy the benefits of science and research.

    Finally we’re nearing the end of the Ebola outbreak in the Democratic Republic of the Congo. This is one piece of good news. If there are no more cases the Government of the Democratic Republic of Congo could declare the outbreak over  as early
    as this  Sunday.  We’re not  there yet and we remain in full response mode. We’re continuing to investigate alerts and to test samples.

    This would not have been possible without the incredible  health workers who have put themselves at risk for more than 18 months to stop this outbreak, just as health workers are putting themselves in danger to save lives from COVID-19. Health
    workers in DRC faced the 
    double threat of fighting a deadly virus in one of the world’s most dangerous and unstable regions, exposing themselves to Ebola and bullets.

    Tomorrow, as you know, is WHO’s birthday, a day we celebrate each year as World Health Day. This year we’re paying tribute to the incredible contribution of all health workers, especially nurses and midwives. Nurses and midwives are the backbone of
    every health system. They’re there from the first moments of life to the last. Tomorrow we’re publishing our first report on the state of the world’s nursing which highlights gaps and makes recommendations for all countries.

    00:22:00

    One of the lessons I hope the world learns from COVID-19 is that we must invest in health workers, not only to protect lives but also to protect livelihoods. I thank you.

    TJ        Thank you very much, Dr Tedros. Also, as always, we have Dr Mike Ryan and Dr Maria Van Kerkhove, who will be answering questions. We will  now open the floor.  I will  go to one question
    that I received by email this morning and I promised to answer; that’s Ankit Kumar from India Today. Ankit is asking; we have recently seen a spike in  cases caused through religious gatherings in India, in fact almost a third of new cases
    were linked to one gathering in India. We have also seen incidents of violence against health workers due to fear and misinformation. Is WHO concerned with these developments, what is WHO’s message to religious and community leaders and their
    followers?

    MR      First and foremost the idea of violence against health workers is driven by fear and it’s driven by misunderstanding but it’s  really  unacceptable. We ask everyone and every community to see our health workers
    as our heroes and to support them in every way we can.

    With regard to gatherings of any type, be they religious or be they for other  purposes,  there are always risks associated with such gatherings in the midst of a major epidemic. WHO has issued guidance on that. Many of these gatherings
    are now postponed or cancelled.  We’ve been working very, very closely with religious  and faith-based organisations  all  over the world including  groups  from the Islamic  tradition,  Christian 
    traditions  and others and continue to work through faith-based organisations to communicate  using  our  Epiwin platform.

    00:24:21

    We’re also continuing to develop guidance specifically  for the holy  month  of Ramadan and are working through our Eastern Mediterranean regional office to be able to advise governments and religious institutions on how best to manage
    the risks associated with such holy events.

    But it’s very important again; having COVID-19 is not anybody’s fault. Every case is a victim and every case needs to be  treated with sensitivity,  as the health workers who treat them so it’s very important that we’re not profiling COVID-19
    along  racial,  along  religious,  along ethnic lines. This is not helpful.

    TJ        Thank you very much. This was a question  from Ankit  Kumar from India  Today. Now we will go to journalists online. We will start with Jamie from Associated Press. Jamie, can you hear us?

    JA        Hi, yes. Can you hear me? TJ            Yes. Please go ahead.

    JA        Great, thank you very much. I wanted to ask you about… Over the weekend Dr Anthony Fauci mentioned that – if I understood it correctly – as much as 50% of transmission could be asymptomatic. Just aligned 
    with that, if  you could  give  us a little  bit  more  about what you’re thinking about the fact that some countries have said that this outbreak is more infectious than influenza. The CDC is saying that it’s up
    to three times more infectious than influenza so what do you have to say about that? Thanks.

    00:26:13

    MK      I’ll start and then perhaps Mike or DG would like to supplement. The modes of transmission and the way in which this virus is transmitted  are of significant  interest to all of us. What we are doing is working
    with member states, we’re working with everyone that’s affected by this, looking through the research and trying to understand  when most transmission is happening, when any transmission is happening.

    What we know from reports, what we know from published literature is that the predominant way in which transmission is occurring is amongst symptomatic individuals  and these are people that can be very early on in symptoms, even when they start
    to feel a little bit unwell. This is supported by some data that attempts to catch a virus from individuals who are symptomatic.

    We also know that it’s possible that people can transmit in the few days before they become symptomatic or in their pre-symptomatic  phase. There have been some studies  that have come out and we learned about this when we were on mission
    in China back in January or early February, that there are individuals that can shed virus one to three days before they develop symptoms.

    However it’s very important to note that even if you are pre-symptomatic or even if you don’t have any recognised symptoms you still have to transmit through  droplets,  you still  have to have these infectious particles that come out
    of your nose and your mouth. So while we know that that is possible we do not believe that it’s a major driver of transmission.

    00:27:42

    We’ve also seen modelling estimates that suggest that there’re large numbers of unrecognised transmission and I used unrecognised on purpose because I’m not saying asymptomatic. I’m saying that we may be missing people who are out there who are infected
    but we’re missing them because of current surveillance strategies. That is certainly possible in many parts of the globe.

    Whether or not those individuals are asymptomatic; we will have to wait until we see the results of serologic studies, which we hope we’ll be seeing in the coming days if not weeks.

    So what we can say is that most people are transmitting this virus while they are symptomatic.

    JA        Hi, Jamie. Just in addition because I think – I would never in any way contradict my good friend, Tony Fauci, such an eminent man. There are many different estimations of what might represent asymptomatic
    transmission or other infections in the community and we do know and everyone accepts that when the seroepidemiology studies do come online we will probably find more people who’ve been infected unknowingly; there’s no question of that.

    The thing we need to address in all of this is  very often the idea of  severity versus infection and there is a huge association  between the dose  of exposure  and the severity  of infection. We see this in many other
    infectious diseases so we also probably need to look  at who is getting sick and very sick and is the dose and the type of exposure they’re getting different to those who may be exposed and seroconverted in the community.

    00:29:26

    So it’s not just a matter of looking at how many people in the community are infected but are there specific elements  of exposure  that cause individuals  to have  a higher dose of exposure or a specific route of exposure 
    that causes more severe infection?  There is  also that concept of infectious dose when we talk about the different types of transmission. If somebody is exposed to a high dose from another individual directly or from a surface that’s
    heavily contaminated you can imagine the large dose.

    In other circumstances individual particles or virus particles potentially floating through  the air; it can be demonstrated that that may happen in certain circumstances, certainly in healthcare settings. But is that significant  in 
    terms of driving  infection,  is  that significant, does that produce an infectious dose that can successfully infect another individual?

    These are all very important things that still need to be studied. Again we’re only a number of weeks into this. I think we need to have the seroepi studies. I think  we need more information on what is the infectious  dose  and particularly 
    the relationship  between the dose  of exposure or infection and the severity of disease subsequently, which has been seen with many, many other diseases in the past including cholera, Ebola and others.

    TJ        Thank you very much, Mike and Maria. We will go now to our next question; that’s Kai Kupferschmidt. Kai, can you hear us?

    00:31:01

    KA      Yes, Tarik. Thanks a lot for taking my question. I wanted to ask about the global  push  to try and find a pre-exposure  prophylaxis  or a post-exposure  prophylaxis. I understand there’re
    several trials going on, most of them with chloroquine  or hydroxychloroquine.  I was just wondering whether you can speak a little bit to what role this could potentially play.

    Of course also there’re a lot of smaller studies going on. Is there any way to make sure that they all lead to results that can be proved in the end?

    MR      Maria can give you more detail but certainly one of the Solidarity trials – I think Solidarity 3 or 4 – we have one of the trials under design which will be a multi-centre study which will look at prophylaxis in healthcare workers to see whether there’s evidence that giving lower doses of drugs like chloroquine or hydroxychloroquine to healthcare workers would reduce their risk of becoming infected in a healthcare environment.

    Those studies are certainly underway and again there are a number of those studies underway in smaller studies around the world but again as WHO we’re trying  to bring  together  a larger set of collaborative studies that will give
    us the answers we need.

    In terms of post-exposure prophylaxis I don’t believe  we have at the moment  studies  planned but Maria can speak to that but there is certainly evidence for the use of – not proven  evidence of effectiveness but there are a number
    of studies underway and trials underway that use hyperimmune globulin  in  the treatment  of disease; in  other words  they use that purified plasma of recovered individuals to give an antibody boost to people who are
    suffering the disease.

    00:32:49

    Similar approaches have been used in post-exposure prophylaxis for other diseases but Maria may be aware of studies underway in that area.

    MK      Only to add that, as you mentioned, there are a number of smaller studies that are happening globally and across a large number of countries.  We have teams through  our science division and through GOARN,
    through the Global Outbreak Alert Network, who are pulling together  available  literature  on a number  of topics,  one  of which is  looking  at different types of therapeutics and drugs.

    The idea is until we can have a study that pulls together enough of a sample size to get these answers to these questions we’re trying  to evaluate  every piece of evidence  that is  published so that we can look at the way in
    which these studies were done, we can look at the strengths, we can look at the limitations so that can help guide us closer  towards an effective treatment for COVID-19.

    TJ        Thank you very much. The next question is from BFM Radio. Is is Kate who is with us?

    KT       Yes, hi. Good evening or good morning.  I’m from BFM Radio  Malaysia. My question is, many countries around the world have imposed lock-downs or some sort of restrictions on movement. I was wondering
    what WHO’s guidance would  be; what’s the sweet spot, the kind of data that governments need to consider before lifting or relaxing  some  of these lock- downs? Thank you very much.

    00:34:29

    MR      Thank you. It is a difficulty for governments right  now  because the lock-downs  in many situations are proving effective in dampening the flames of the epidemic  in  those countries but those
    lock-downs are also causing great economic hardship and everybody especially in the developing world needs to get to a more sustainable way of managing this epidemic and controlling COVID-19 without continuing to damage economic and social life.

    The transition strategy out  of lock-down  requires  a calibrated,  step-wise approach.  It would be probably very inadvisable just to lift a complete lock-down, all of the measures because lock-downs are a general term that
    include closure of schools, closure of  churches, stay-at- home orders, closure of workplaces. It’s a mixture of different things and I think each government needs to break out, what does our lock-down actually constitute, what are the elements
    of our lock-down, where is that happening in the country, do we now understand the epidemiology of the disease in each area in which we have an element of lock-down or shut- down.

    Then to chart the path out, you have to build strong public health capacity to take over from the lock-down. In other words the lock-down is pushing the disease down by putting people back in their homes, by separating communities. Once you raise
    the lock-down you have to have an alternative method to suppress the infection. The  way to do that is active  case finding, testing, isolation of cases, tracking of contacts, quarantining of contacts and strong community education and
    participation and ownership around normal physical distancing, hygiene and giving communities the power to control infection by in effect managing their own physical distance, managing their own capacities to support the response.

    00:36:32

    In that situation, if you’ve strong public health capacity, if you’ve got a community that’s mobilised and empowered and if you’ve strengthened your health system then you’re potentially in a position to start unlocking or unwinding the lock-down.
    The specific parameters you need to be looking at are on two sides.

    One is, it would be very inadvisable to lock down [sic] if the number  of cases coming  through the hospital is already at a level where your  occupancy of  beds is  nearly at 100%.  You need to be in a position where
    you now have free beds in your system so that you’re managing and coping with the caseload and that means you have some absorption capacity left.

    You need to look at things like the doubling  rate; how  many days does it  take for the  number of cases to double? You need to look at positivity rates; what proportion of all samples that we test are positive? You’ll see in
    somewhere like Korea two to 6% of the samples  they test are positive. Last week in New York 37% of tested samples were positive so you need to carefully look at what proportion of people you test are positive.

    00:37:45

    You need to look at the number of contacts that are generated per case and it goes on and on and WHO will be issuing guidance to countries that is a much more specific around the parameters they should be looking at. There are no absolutes here, there
    are no answers, there are no numbers that say if this number is this then you do that. That doesn’t exist but what we can do is offer countries very specific  measurements  that they need to look  at to chart the path out of lock-down.

    That step-wise approach of unlocking somewhat and then waiting to see; I think you need to say, we will stop doing this element of the shut-down  and then we will  wait and we will  look at the data and if that works we go to the next
    stage and the next stage. So a careful, calibrated, step-wise exit from lock-down with putting in place public health capacities, putting in place community capacity, building the capacity of the health system to cope should the disease bounce back up; that’s the safe path out of lock-down.

    We want to achieve it as quickly as possible and we want to avoid many countries going  into that circumstance and we still have many countries around the world who are not in a locked- down situation. In fact their epidemiology would suggest
    they can avoid the worst of this and we need to support them to avoid them going into that situation.

    The most damaging lock-downs are in many developing countries  where people  – as the  DG has said many times – can live from hand to mouth, not from pay cheque to pay cheque but from day to day and we have to find adaptive solutions
    around lock-down and around disease control in vulnerable periurban populations living in poverty,  in  poor  rural communities.  We have to find alternative, adapted ways to manage lock-downs or slow-downs or shut-downs in
    those situations.

    00:39:41

    TJ        Thank you very much. This was Kate from BFM Radio in Malaysia. Now we will  go to Nigeria to Natural Star and it’s Innocent. Innocent, can you hear us?

    IN        Thank you. Can you hear me?

    TJ        Not very well but we will try. Please go ahead.

    IN        Okay, thank you for taking my questions. I have two questions to ask. One; how will WHO assess African countries on what they’ve done concerning the lock-down and management of COVID-19?

    Then the second one; there’s news going around that vaccines are to be tested on Africans when they’re developed. How true is that and is there a window that’s in the nearer future when a vaccine will be developed for COVID-19? Thank you.

    Hello?

    TJ        Yes, we are just trying to make sure that we understood the question but we will try. MR     I think this is Nigeria. Is it?

    TJ        Yes.

    00:41:08

    MR      Maria may answer the question around vaccine development. With regard to our general assessment on lock-down – and the Director-General may wish to comment on this because he’s been speaking with many leaders in Africa
    and, I believe, spoke with  the whole of the African Union leadership and countries late last week so therefore is in a much better position than me to speak about that.

    We would characterise so far, Africa’s actually doing well in this response thus far. Countries have essential capacities for testing, many countries are taking strong action and want to really focus on finding cases and doing contact tracing and trying to stop this disease becoming much more extensive given the fact that health systems are not as strong in many countries. 

    They need support in that though, they need support in testing, they need support with protective gear and they need to be given the resources to be able to mount those types of responses so I would characterise that Africa has not suffered the worst
    of this pandemic so far. The worst of it can be avoided with very, very swift action to support those countries in Africa who really do want to take a comprehensive approach to this disease.

    With the many vulnerable  people  including  refugees and migrants  who live  in  those countries it is our responsibility to provide that support but, DG, you may wish to speak about your interactions with the African
    Union countries.

    00:42:46

    MK      I’ll answer the question  around vaccines. What we can say is  that there are a number of vaccines that are in development and vaccines will be tested through clinical trials with all ethical considerations
    in place in whichever  populations  are under  study  with informed consent, with open and transparent communication. This is of the utmost importance, that not only do we have strong, robust  scientific  evidence 
    but  we ensure that all  of the studies  that are done are done with appropriate and the highest level of ethical considerations.

    One thing on the first question around Africa is that there are a number of countries in Africa right now which have very few cases and Mike has alluded to this in his earlier response.

    Some only have imported cases and there is an opportunity here, this  window  of opportunity that the DG has spoken about exists  in  many countries  still.  There is  an opportunity to prevent the worst from happening
    in a number of countries across Africa and across countries that are still seeing their first case; in some island countries.

    We need to support those governments, those countries, all of the people in those areas to prevent the worst from happening, to prevent these individual cases from becoming clusters, these clusters from becoming community transmission. I think that’s
    where we need to put  a lot of emphasis and support so that we can prevent countries  from reaching a point  where they need to put in these very restrictive movement restrictions.

    TAG    Thank you. Thank you for that question, my brother from Nigeria. On the situation, as Mike said, of course when you see the number of cases the African continent has the lowest number of cases so far but that doesn’t mean that
    the situation will not deteriorate. It may.

    00:45:06

    So Africa should do everything to prevent this situation from getting worse and that’s why African leaders are doing their best. I had a chance to participate in a meeting, a Leaders’ Coalition which was arranged or invited by the current Chairperson
    of the African Union, the President of South Africa, President Ramaphoza and many leaders from all corners of the continent have actually participated.

    The main agenda is to have a continental strategy and also make sure that that continental strategy helps the national strategy but in addition to a coalition of political leaders or the heads of state and government they have also agreed to have a coalition of business leaders. Business leaders in Africa are also getting together because Africa will need resources and one of the major problems that was identified during the discussion
    was especially shortage of equipment starting from medical equipment, PPE and test kits and so on.

    The leaders have agreed to look for concrete solutions to address the problem and they also believe that considering the number of cases we have in the continent testing cases, tracing contacts and isolating them, meaning using the comprehensive approach,
    will actually  help. They believe that lock-downs alone may not help or the physical distancing alone cannot help and they have agreed to do everything to follow the comprehensive approach.

    From WHO’s side we have been supporting and we increased, improved  the testing capacity in Africa significantly in the past two months and many countries in Africa have now testing capability although we may have a shortage of test kits but 
    we’re working  on that too and we’re finding different ways of addressing the gap.

    00:48:06

    But we will support the African Union, we will support the Africa CDC and also we will continue working through our WHO regional office in Congo Brazzaville and continue to support and fight the pandemic together.

    Then on the vaccines issue there was, I think, a comment last week from a couple of

    scientists who said the testing ground for the new vaccines will be Africa. To be honest,  I was so appalled and it was a time when I said, when we needed solidarity these kind of racist remarks actually would not help, it goes against the solidarity.

    Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test any vaccine or therapeutics all over the world using exactly the same rules. Whether it’s

    in Europe, Africa or wherever we will use the same protocol and if there is a need to be tested elsewhere to treat human beings the same way, equally.

    The hangover from a colonial mentality has to stop — and WHO will  not  allow  this  to happen. It was a disgrace actually  and appalling  to hear during the 21st century from scientists that kind of remark and we condemn
    this in  the strongest  terms possible  but  we assure you  that this will not happen in Africa and will not happen elsewhere, in any country. Proper protocols will be followed and human beings will be treated as human
    beings because we’re all human beings.

    00:50:37

    Then after saying this the vaccine development; we’re addressing two issues and we will be announcing as soon as possible, hopefully during this week, a big initiative to accelerate the research and development and production of vaccines and also
    design mechanisms for equitable distribution of the vaccines.

    While we’re looking for vaccines, unless we break the barriers to equitable distribution of the products, whether it’s vaccines or therapeutics, we will have a problem, so we need to address the problem ahead of time, we need to address the problem
    of access or challenges to access ahead of time.

    That’s why we will put together a mechanism and we will appoint senior people from the North and South that will work out the details on how they can accelerate production but at the same time how they can ensure equitable distribution. Solidarity
    is very important here. When a vaccine or a medicine is ready we have to be able to deliver it all over the world.

    There should not be a divide between the haves and the have-nots.

    If we say solidarity, solidarity should be in its full form and I hope each and every individual, each and every human being will go for that kind of solidarity. I thank you.

    TJ        Thank you, Dr Tedros. We’ll take a couple more questions. We go to Yang from Xinhua news agency. Yang, can you hear us?

    00:52:58

    YA      Can I hear you?

    TJ        Yes, we can hear you. Please go ahead.

    YA      As World Health Day is approaching  what do you  have to say to the  front-line medical workers in China and around the world in  the global  anti-virus  efforts? This  question is
    for Dr Tedros. Thank you.

    TJ        If we understood well, the question is what is the message to health workers in China and around the world. Maybe you can repeat the question one more time, please.

    YA      Okay. As World Health Day is approaching what would you say and what message do you want to deliver to the front-line medical workers in China  and around the world  in  the global anti-virus effort?

    TAG    I think I have said it earlier;  as you  know,  this  is  the year of  the nurse and the midwife, 2020. We were ready to celebrate it in a big way and it was supposed to be the main event in our
    Assembly in mid-May. Unfortunately we’re in this situation but  we will  be launching a report tomorrow which is the first of its kind.  It’s a report on the  state of nursing. We will launch it tomorrow during the World Health
    Day.

    00:55:01

    But while launching that report, although it’s about nursing, we will celebrate all health workers, midwives, pharmacists, doctors, you name it. I think the world is now seeing the importance and the central role that health workers play. People,
    when they’re asked, of course, to choose they would say health first because it’s only when you’re healthy that you can aspire to anything, whether it’s wealth or fame or anything. It doesn’t matter if you’re not healthy.

    If you’re not healthy the first thing you ask for is to get back your health and our health workers are making sure that happens and they’re central and very important for any individual. So not only during COVID but during other times too health
    professionals are very important because they are safeguarding that very important aspect of life — that’s health.

    So we have to celebrate them every day. Of course during COVID we can see to what extent they’re sacrificing. We have lost many of them. They’re dying while  saving lives  so my message first is to the public at large; that each and every individual 
    should  recognise, whether it’s during normal times or pandemics like now, the role of health  professionals  and help them, protect them, really appreciate and respect what they are doing.

    To the health workers, although especially during this COVID pandemic you’re working in a difficult situation you should know that your work is the most blessed one, your work is something  special to the extent of losing  your  life 
    while  helping  others to live.  We respect you and appreciate you for that and we also believe in you and that you will do everything to control this pandemic.

    00:58:11

    But you should know that you have – and the world understands – the most important job. We can see the humility which is coming from some leaders because of this pandemic. I know they’re seeing, starting from their own lives, the whole world through 
    a different  prism  and they will also see your role.

    But the most important is not the recognition from the public or from leaders but the internal commitment and passion you have and believing that you’re doing the most blessed thing  and you have all our respect and appreciation and we believe in 
    you,  that together  we will  finish this pandemic. All the respect and appreciation we have to you, the greatest respect and appreciation ever. Thank you.

    TJ        Thank you very much, Dr Tedros. I think this important message will be heard from everyone and we will  conclude  this  press briefing with these important  words from Dr Tedros. We will
    have an audio file available in the minutes to come and we invite you for our next briefing on Wednesday. Thank you.

    TAG    [Inaudible] and see you on Wednesday – tomorrow actually for the launch. Yes, see you tomorrow.

    01:00:18

    Virtual Press Conference on COVID-19- 06 April 2020
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    https://www.who.int/news-room/detail/06-04-2020-virtual-press-conference-on-covid-19–06-april-2020

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  • End in sight, but flare-ups likely in the Ebola outbreak in the Democratic Republic of the Congo

    End in sight, but flare-ups likely in the Ebola outbreak in the Democratic Republic of the Congo

    Remarks by Dr Ibrahima Socé Fall, World Health Organization Assistant Director-General, Emergency Response

     

    Good afternoon. 

    I hope that your busy week was interrupted, like mine, with a moment of joy on Tuesday.

    That moment was the celebration of a woman being discharged from an Ebola treatment centre in Beni. Her name is Masiko.

    She was the last person in the Democratic Republic of the Congo confirmed to have Ebola.

    Health workers and other responders sacrificed a lot to get to this point. 

    Since the outbreak was declared in August 2018 there have been 420 attacks on health facilities in DRC, resulting in 11 deaths and 86 injuries among health care workers and patients.

    It’s been a huge amount of work. At the peak of the outbreak, more than 120 cases were being reported each week. 28 health zones were affected, with cases appearing 1200 kilometres apart. In response:

    • 11 labs have been set up to test around 3500 samples each week
    • 11 Ebola treatment centres were set up to care for people with Ebola
    • 300 000 people have been vaccinated
    • 250 000 contacts have been registered
    • 26 000 safe and dignified burials have been conducted
    • More than 3000 health facilities were identified for infection prevention and control support
    • More than 1000 metric tonnes of supplies have been delivered
    • An Ebola vaccine has been licensed, and two treatments found to be highly effective
    • Almost 160 000 million people have been screened for Ebola symptoms at borders or other points of control

    This work is continuing. The outbreak isn’t over. WHO recommends waiting two full incubation periods – that’s 42 days – after the last person tests negative a second time before declaring the end of the outbreak.

    We must stay in active response mode to get us over that finish line.

    We have to be prepared for other cases emerging. It’s is a very real risk.

    Remember that during the Ebola outbreak in West Africa flare-ups of new cases occurred after the end of the outbreak.

    There are four reasons why new cases may emerge during this 42-day period, or even after the end of the outbreak.

    • First, because of the complex security environment, Ebola transmission outside of groups under monitoring is possible.  
    • Second, Ebola virus can persist in used needles, syringes or vials for several weeks.
    • Third, Ebola virus can persist in the body fluids of survivors for many months, and can be transmitted well after recovery, or in rare cases can result in relapse – as we’ve already seen during this outbreak.
    • Finally, Ebola virus is present in an animal reservoir in the region, and there is always a risk of a new spillover to humans.

    This is why it’s critical to maintain surveillance and rapid response capacities.

    And that’s what we are doing. We’re still in full response mode.

    In addition to the activities I already mentioned, I have to underline how critical it is to continue supporting the Survivor Programme, which provides follow-up care for almost all of the 1169 survivors in 26 health areas in North Kivu and Ituri. The programme also helps reduce the risks of re-introduction events. 

    We need to continue this work until the end of the outbreak, to keep the capacity in place to rapidly respond to flare-ups, to keep supporting survivors after the outbreak, and to transition the capacities built in this response toward building a stronger health system. 

    But to be very frank, right now the world risks dropping the baton at the finish line. WHO faces an immediate US $20 million funding gap. If no new resources are received, we will run out of money before the end of the outbreak.

    We appreciate the generosity of donors who have supported the response since August 2018. Now we need to get over the finish line. WHO is calling on the international community to help us end this outbreak, and keep our promises to communities to build a stronger health system.

    If we are forced to scale back operations because of a lack of funds, and then a new case emerges, we might not have the people and resources on the ground that we need to shut down transmission quickly. Just a single case could re-ignite the epidemic.

    That would be a tragedy. An avoidable tragedy. 

    It is important that the global community doesn’t only focus efforts when there is an immediate threat, then walk away when the threat subsides.

    The health system has to be strong to stop much more than Ebola. It has to stop malaria, measles, cholera, and now COVID-19.

    There is a lot more work to do.

    Thank you.

     

    End in sight, but flare-ups likely in the Ebola outbreak in the Democratic Republic of the Congo
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  • How to Lose 50 Pounds in 11 Weeks – 5 Things You Must Do

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    Trying to lose 50 pounds in 11 weeks can seem like a formidable task, but I assure you it can be done.

    I’m assuming you’re not interested in using weight loss pills, appetite suppressants, surgery or any of that other junk to lose 50 pounds in 11 weeks, which is good…’cos I hate those things. Don’t get me wrong, they have their place in certain situations, but in most cases, are an unnecessarily extreme measure.

    When you consider that a gastric bypass operation can cost anywhere between $25,000 to $35,000 US dollars, you have to question whether the advice given to some folks to go through with it is in their best interests or that of the surgeon and his pocket.

    Trying to lose 50 pounds in 11 weeks may be a tough challenge but there are a few things you can do to make your life easier.

    Here are 5 top tips you should follow when trying to lose 50 pounds in 11 weeks.

    1) Believe in yourself / set goals

    The first and most important thing is getting in the right frame of mind. This may sound strange since you already know you want to lose 50 pounds in 11 weeks…so what do I mean?

    Well, don’t worry, I’m not gonna go all Tony Robbins on you and get you jumping up and down in a euphoric state (although there is some truth to that). Rather, I’m saying that you need a clear picture of where you want to be, and focus on it. You need to feel like you’ve already managed to lose 50 pounds in 11 weeks…think about it…how does it really feel. Are your work colleagues inspired and envious of your new body and transformation? Do you have the confidence that you were lacking to ask out that hot guy or gal you’ve had your eye on for like forever?

    Only by picturing it in your mind will you be able to set goals for your success and believe that you can and will lose 50 pounds in 11 weeks. The goals will be the checkpoints on your journey, the self-belief will be the fuel that keeps you going.

    2) Find a good trainer and surround yourself with good like-minded people

    This is an essential and often overlooked part of trying to lose 50 pounds in 11 weeks. A lot of people don’t realise that who they surround themselves with plays a huge part in their self-belief, attitude, and overall motivation and determination. It has been said that a person is the average of the 5 or 10 people they hang around with the most, and this regards health, wealth, ambition, aspiration, relationships, family etc. This is not a hard and fast rule, but I feel there is some truth to it.

    Trying to lose a lot of weight quickly will be demanding and therefore you want to surround yourself with positive folks who are rooting for you, and not people who are waiting for you to fail, so they can say “I told you so!”

    Now, I’m not saying you should just give up and avoid your family and friends, but rather to seek out folks who have similar goals, and understand your situation. Finding people who have been where you are now and achieved your goals can give you a real push to do the same. Why do you think things like Weight Watchers clubs are so successful? It’s because they bring all these people together and they help each other out.

    Where can you find these people? There are loads of forums online where you can find people who are trying to lose weight. Just going to Google or Yahoo and typing something like “weight loss + forum” (without the quotes) will yield all sorts of great things. There are also loads of weight loss and fitness programs online that you can follow to lose 50 pounds in 11 weeks.

    The same applies to your trainer, coach, or workout program that you choose to follow. Are they supportive yet ambitious, pushing you on when things get tough? If not, find one that is.

    3) Eat a healthy diet

    Obviously, diet and nutrition is fundamentally important when trying to lose 50 pounds in 11 weeks. Taking on too many calories will mean you always put on weight, period. Therefore, you will need to create a caloric deficit, by taking on fewer calories than you burn, forcing your body to burn up the fat deposits and use it as energy.

    Finding the right diet is important, and many folks go about it the wrong way. Starving yourself is a big no-no. You may lose a few pounds in the first few days, but it won’t last, as your body will transition into starvation mode and slow down your metabolism to burn less fat (it’s your in-built survival mechanism), making it even harder to lose 50 pounds in 11 weeks.

    So what can you do? Eat more! Yes, by eating smaller meals more regularly you will maintain your metabolism at a higher rate, and this, combined with exercise, will help you lose the pounds faster.

    Green fibrous vegetables like broccoli, green beans, asparagus and lettuce are great healthy foods that can actually help you to burn fat, and it’s almost impossible to overeat on them. Eating more of them in the later part of the day along with a good lean protein like chicken breast is one of the best methods of getting lean as quickly as possible, and losing 50 pounds in 11 weeks.

    4) Follow a good exercise plan

    Without exercise, even the best diet plan in the world will struggle to help you lose 50 pounds in 11 weeks. You need to exercise in order to get the full benefit of the caloric deficit we mentioned earlier. It will create the furnace where you burn off those unwanted pounds.

    Regular exercise also aids the mind, confidence and overall health. By tightening up, toning and growing your muscle, you also help your body to burn fat faster. Did you know that muscle can actually help you burn fat? So the more muscle you have the more fat you can burn, because your metabolism will work faster with more muscle.

    Find a good training and exercise plan, with a good variety of cardiovascular work for your overall fitness, endurance and toning exercises like pushups and sit-ups, and some light weight training.

    5) Stick to it!

    This is the most important and often the hardest thing when trying to lose 50 pounds in 11 weeks. The best diet, exercise routine, trainer, and goals, mean nothing without the small action of going and actually doing it. Things may get tough over the next 11 weeks, but sticking to it and following through will show results, and you’ll be amazed at what you achieve. Once you see a little success you’ll be hungry for more and then it’ll be so hard to stop the momentum you build up, that 50 pounds in 11 weeks will seem like a piece of cake!

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    Source by John Wheeler

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