"As many countries reduce testing, we are increasingly blind to patterns of transmission and evolution. WHO calls on all countries to maintain surveillance. Some 60% of the world’s population has now completed a primary course of vaccination, but only 13% of the population of low-income countries. Closing this gap remains essential to ending the pandemic as a global health emergency, " WHO spokesperson Tarik Jašarević said in his interview with Kurir.
Has the world become too relaxed in its attitude towards the coronavirus pandemic? The pandemic is not over yet, the virus is circulating, and the number of new infections is still high.
" Based on what we know now, the most likely scenario is that the virus continues to evolve, but the severity of disease it causes reduces over time as immunity increases due to vaccination and infection. Periodic spikes in cases and deaths may occur as immunity wanes, which may require periodic boosting for vulnerable populations. In the best-case scenario, we may see less severe variants emerge, and boosters or new formulations of vaccines won’t be necessary. In the worst-case scenario, a more virulent and highly transmissible variant emerges. Against this new threat, people’s protection against severe disease and death, either from prior vaccination or infection, will wane rapidly. Addressing this situation would require significantly altering the current vaccines and making sure they get to the people who are most vulnerable to severe disease."
What should countries do now?
"Countries need to invest in five core components. First, surveillance, laboratories, and public health intelligence; second, vaccination, public health and social measures, and engaged communities; third, clinical care for COVID-19, and resilient health systems; fourth, research and development, and equitable access to tools and supplies; and fifth, coordination, as the response transitions from an emergency mode to long-term respiratory disease management."
China is again shutting down certain parts of the country. Even North Korea, which has allegedly been resisting the virus for two years, is now reporting a high number of infections. What can we deduce from this?
" Each country will have to tailor the response to its own realities. Each country is facing a different situation in the pandemic depending on a number of factors, including the intensity of SARS-CoV-2 circulation, the level of population immunity, capacities to respond and agility to adjust measures. There is no “one-size-fits-all” solution. Countries need to tailor the response to the realities and the unique situation they face in the pandemic. Since the beginning of the COVID-19 pandemic, WHO has provided advice and guidance to countries to inform their approach to managing COVID-19 preparedness and response."
Do you recommend the fourth dose of the coronavirus vaccine?
" The vaccines currently recommended by WHO provide good protection against severe disease and death. WHO recommends a primary series and booster dose to be given to all high priority-use groups – and to expand to lower priority-use groups as high coverage rates are achieved in high priority-use groups. The number of doses required by each vaccine product varies. Currently WHO recommends an extended primary series (i.e. third dose) as well as a booster dose (i.e. fourth dose) for persons with moderate to severe immunocompromising conditions, for all COVID-19 vaccines. Homologous (same vaccine platform) and heterologous (different vaccine platform) vaccines can be used for such booster doses. Currently there is very limited evidence to support the need for, and performance of additional booster doses of COVID-19 vaccines for all population groups. Data on additional booster doses as of May 2022 only exists for the mRNA vaccines, and not for other vaccine platforms. WHO is currently reviewing the evidence on second boosters as it becomes available and WHO will publish shortly an interim statement to reflect the latest knowledge on this topic. The global priority is to achieve full protection of the highest priority-use groups in all countries with primary series and a booster dose and advancing to lower priority use groups as supply and programme capacity advances. Extensive use of multiple booster doses in a small number of countries will not end the pandemic."
Is it now known with certainty where the coronavirus leaves long-term effects?
" Some people diagnosed with COVID-19 go on to develop post COVID-19 condition, with numerous lingering symptoms, including but not limited to fatigue, breathlessness and cognitive dysfunction, e.g., brain fog. This condition is called post COVID-19 condition, also called ‘long COVID’ by some. Symptoms may be new onset, following initial recovery from an acute COVID-19 episode, or persist from the initial illness. Symptoms may also fluctuate or relapse over time. As this is still a new disease, we do not yet know what percent of patients have these longer-term effects, but published reports indicate that approximately 10–20% of COVID-19 patients experience lingering symptoms for weeks to months following acute SARS-CoV-2 infection. WHO recommends that patients who have COVID-19 (both confirmed and suspected) should have access to follow-up care if they have persistent, new or changing symptoms. WHO is working with researchers to address the urgent need to streamline data collection and reporting on post COVID-19 condition. The project, Post-COVID Condition Core Outcomes, will survey these patients to establish what core patient outcomes need to be measured to understand the condition. Later, the project will focus on how to measure these outcomes."
Although most countries in the world have lifted anti-Covid measures, could you nonetheless provide some practical advice regarding summer vacationing? How should we behave, and should we still adhere to some measures?
" WHO recommends that anyone who tests positive for COVID-19 isolates themselves to avoid spreading the virus to others. Any adjustment to the isolation period should balance the public health risks and benefits against its social and economic impact. These adjustments should be calibrated to the setting – e.g. policies in health care facilities or long-term care facilities may need to differ from policies for the general public. Policies to adjust the isolation period need to be agile and adapt to an evolving epidemiological context. Although some places have high population immunity due to vaccination and prior infection, uncertainties remain around how long immunity lasts and what the risks of reinfection are. We do know that people with immunity from vaccination or previous infection can still catch the virus and get sick, especially with the Omicron variant, although their chances of getting severely ill or dying are much lower. Even if people don’t get severely ill, they could still end up with post COVID-19 condition, which is a debilitating condition we are still learning about."
What can you tell us about the new and still inexplicable form of acute hepatitis in children? Is there reason to be afraid? How accurate are claims that it is linked to Covid?
"WHO is following reports of hepatitis of unknown cause in children. The cases remain relatively rare. WHO and national experts are looking at a range of possible explanations, including both infectious and non-infectious. Parents can take basic precautions to protect their children from common infectious disease through good hygiene practices and regular handwashing. Parents should seek medical advice if their child shows severe or persistent symptoms of vomiting, diarrhoea or abdominal pain, or the development of jaundice (yellow eyes and pale stools). Based on current information, there is nothing to suggest a link to the COVID-19 vaccine as the vast majority of affected children did not receive this vaccine. COVID-19 – both past and present infection – is one of the main hypotheses that we are pursuing. WHO urges Member States to seek out, investigate and report similar cases."
(B. K.)
