World Health Organization (WHO) Coronavirus Press Conference July 7

Tarik: (00:00) And thank you very much for joining us for this regular press conference on WHO headquarters on COVID-19. We welcome all the journalists who are watching us on Zoom but also everyone who is following us on a number of WHO social media platforms. Today, we have with us WHO Director General Dr. Tedros, Dr. Maria Van Kerkhove, who is a Technical Lead COVID-19. And we have a Dr. Mike Ryan, who is WHO Executive Director for Program for Health Emergencies. Journalists who are watching this on Zoom can follow this briefing in six UN languages, Hindi and Portuguese. And this is thanks to our interpreters who are here with us, and we sincerely thank them for their presence and assistance. Journalists may also ask questions in six UN languages and Portuguese when we get to that section of the press briefing. I will give the floor now to Dr. Tedros for his opening remarks. Dr. Tedros: (01:03) Thank you. Thank you, Tarik. Good morning, good afternoon, and good evening. Tomorrow marks six months since the WHO received the first reports of a cluster of cases of pneumonia of unknown in China. The six month anniversary of the outbreak coincides with reaching 10 million cases and 500,000 deaths. This is a moment for all of us to reflect on the progress we have made and the lessons we have learned and to recommit ourselves to doing everything we can to save lives. Six months ago, none of us could have imagined how our world and our lives would be thrown into turmoil by this new virus. The pandemic has brought out the best and the worst of humanity. All over the world, we have seen heartwarming acts of resilience, inventiveness, solidarity and kindness. But we have also seen concerning signs of stigma, misinformation and the politicization of the pandemic. For the past six months, WHO and our partners have worked relentlessly to support all countries, to prepare for and respond to this new virus. Dr. Tedros: (02:51) Today, we're publishing an updated and detailed timeline of WHO's response to the pandemic on our website so the public can have a look on what happened in the past six months in relation to the response. It illustrates the range of WHO's work to stop transmission and save lives. We have worked with researchers, clinicians and other experts to bring together the evolving science and distill it into guidance. Millions of health workers have enrolled in courses through our open who.org online learning platform. We launched the Solidarity Trial to find answers fast to which drugs are the most effective. We launched the Solidarity Flights to ship millions of test kits and tons of personal protective equipment to many countries. We launched the Solidarity Response Fund, which has raised more than $223 million for the response. Three major innovative solidarity activities. And we have worked with the European Commission and multiple partners to launch the ACT Accelerator to ensure that once a vaccine is available, it's available to everyone, especially those who are at greatest risk. Dr. Tedros: (04:33) Last Friday, we launched the ACT Accelerator investment case, which estimates that more than $71 billion will be needed to accelerate the development, equitable allocation and delivery of vaccines, diagnostics and therapeutics by the end of next year. Over the weekend, WHO was proud to partner in the Global Goal: Unite for our Future pledging conference organized by the European Commission and Global Citizen. The event mobilized new resources to respond to the COVID-19 pandemic global, including in support of the ACT Accelerator. Although a vaccine will be an important longterm tool for controlling COVID-19, there are five priorities that every single country must focus on now to save lives now. Dr. Tedros: (05:40) First, empower committees. Every individual must understand that they are not helpless. There are things everyone should do to protect themselves and others. Your health is in your hands. That includes physical distancing, hand hygiene, covering coughs, staying home if you feel sick, wearing masks when appropriate and only sharing information from reliable sources. You may be in lowest category, but the choices you make could be the difference between life and death for someone else. Dr. Tedros: (06:28) Second, suppress transmission. Whether countries have no cases, clusters of cases or community transmission, there are steps all countries can take to suppress the spread of the virus: ensure that health workers have access to training and personal protective equipment, improve surveillance to find cases. The single most important intervention for breaking chains of transmission is not necessarily high tech and can be carried out by a broad range of professionals. It's tracing and quarantining contacts. Many countries actually have used non-health professionals to do contact tracing. Dr. Tedros: (07:22) Third, save lives. Early identification and clinical care saves lives. Providing oxygen and dexamethasone to people with serious and critical disease saves lives. And paying special attention to high-risk groups, including elderly people in longterm care facilities, saves lives. Japan has done this with one of the highest population of elderly people, but its death rate is low. And the reason is what we just said. Many countries can do that. They could save lives. Dr. Tedros: (08:15) Four, accelerate research. We have already learned a lot about this virus, but there's still a lot we don't know, and there are still tools we need. This week, we will convene a second meeting to assess progress on research and development and reevaluate research priorities for the next stage of the pandemic. Dr. Tedros: (08:44) And fifth, political leadership. As we have said repeatedly, national unity and global solidarity are to implementing a comprehensive strategy to suppress transmission, save lives and minimize the social and economic impact of the virus. No matter what stage the country is at, these five priorities if acted on consistently and coherently can turn the tide. WHO will continue to do everything in our power to serve countries with science, solidarity and solutions. The critical question that all countries will face in the coming months is how to live with this virus. That is the new normal. Many countries have implemented unprecedented measures to suppress transmission and save lives. These measures have been successful in slowing the spread of the virus, but they have not completely stopped it. Some countries are now experiencing a resurgence of cases as they start to reopen their economies and societies. Most people remain susceptible. The virus still has a lot of room to move. We all want this to be over. We all want to get on with our lives. Dr. Tedros: (10:33) But the hard reality is this is not even close to being over. Although many countries have made some progress, globally the pandemic is actually speeding up. We're all in this together, and we're all in this for the long haul. We will need even greater stores of resilience, patience, humility and generosity in the months ahead. We have already lost so much, but we cannot lose hope. This is a time for renewing our commitment to empowering communities, suppressing transmission, saving lives, accelerating research and political and moral leadership. But it's also a time for all countries to renew their commitment to universal health coverage at the cornerstone of social and economic development and to building the safer, fair, greener, more inclusive world we all want. I thank you. Tarik: (12:13) Thank you, Dr. Tedros, for these opening remarks marking the six months of pandemic. We'll open the floor to questions. Reminding you once again, journalists, that if they wish, they can ask question in six UN languages and Portuguese. So if we are ready from the technical side, we will go first to Georgia, a Georgian news agency. And we have with us [Constandant Unatomishrilli 00:12:44]. If you hear us, Constandant, please go ahead. Constandant: (12:48) Yes. It's Constandant Unatomishrilli [inaudible 00:12:51] Georgia. Thank you very much. My question is for Georgia as a country with a small economy, but the same time with good results of fighting the coronavirus. What will the mechanist to get access to the vaccine, which will be developed I hope [inaudible 00:13:13] organization. Are there any other possibilities to achieve so-called health immunity besides vaccinating? Thank you very much. Dr. Mike Ryan: (13:30) Good afternoon. We all hope, as you do, that we can reach a point where a safe and effective vaccine is developed and allocated fairly to countries around the world. As the Director General has said in his speech, we don't have that vaccine now. There's a lot we could do now to suppress transmission, and I believe the Republic of Jordan has been doing well in this regard, both in terms of community engagement, in terms of suppression of transmission and saving lives through adequate clinical care. But yes, we do hope that vaccine will be developed. There have been over 133 candidates put into the system. A large number are now in clinical trials. The Director General launched the ACT Accelerator in April as a means of leveraging global collaboration and innovation and funding, both for vaccines, drugs and for diagnostics. The vaccines is probably the one that'll absorb most resources and requires very deep and sustained public-private partnership. Dr. Mike Ryan: (14:36) It is the best means for countries to access the vaccine. And we have to find a way to ensure that the regional alliances that are growing to develop contracts with companies for vaccines are linked to a global movement that ensures that those vaccines are made available to all countries. The Gavi, CEPI and WHO are working together on Covax, the initiative for coronavirus vaccines. As part of that large advanced market, commitments are being put together in order to secure vaccine production. There is no other means of achieving adequate herd immunity. The herd immunity is a term usually reserved for the use of vaccines. But we also have to be cautious and careful. We desperately hope, and we can see tremendous work towards a safe and effective vaccines., But there are no guarantees of such, and therefore, that's why we have so many candidates in testing, so we have an opportunity to find the best one. Dr. Mike Ryan: (15:38) But the only other way that a virus like this may be suppressed is by us breaking chains of transmission. If you accept that you cannot do that, then the only option is to let this virus run free through society. And we have already seen the horrific impacts of that. And therefore, reducing mortality, suppressing transmission while waiting for the arrival of a safe, effective vaccine right now is our strategy for stopping this disease. Dr. Tedros: (16:18) Yep, thank you. I'd just like to what my General said, Mike. Herd immunity is very difficult even when we have vaccines because we need to have a high coverage of vaccine use to have herd immunity, and Mike had already said. To be honest with you, I think it would be important to focus on what is at hand- Dr. Tedros: (17:02) ... on what is at hand now. What is at hand now is the simple public health solution we have, and that many countries use to suppress the transmission and to save lives. I will give you one example, which is a country, South Korea. In February, I remember, South Korea had the second largest number of cases after China. I spoke with the health minister and foreign minister, came to Geneva to discuss with us in our headquarters here. We argued on the comprehensive approach and we agreed on implementing what's at hand to save lives and to suppress the transition. And South Korea has shown to the world that without even vaccines or therapeutics, that it can take the number of cases down and suppress the outbreak. So our message to the world is if the government can do its best in testing, contact tracing, isolating, quarantine cases like what South Korea did and if the communities not only the government, but in addition to the government, the communities take their responsibility of doing what's expected of them starting from hand hygiene to the rest. That can be done personally. This virus can be suppressed. Time after time and country after country, what we have seen is this virus can suppress. If the governments are serious about the things they have to do, their share, and if the community can do its share. So while doing our best to find a vaccine, which is the right thing to do, our advice from WHO is we should do everything we can using the tools we have at hand. Because many countries, including the one example, Korea, I can give you a list of countries, have shown that this virus can be suppressed and controlled using the tools at hand. Dr. Tedros: (20:04) So the basics are still important and the basics are non-pharmaceutical. And they have shown their efficiency or effectiveness in controlling or suppressing this virus. The reason I'm stressing this is the virus is spreading aggressively. It's very tragic to report to you that we have already surpassed the 10 million cases and half a million deaths. Still, this could have been prevented through the tools that we have at hand, and please focus on the tools at hand. Of course, we appreciate the investment you're doing in finding more technology, vaccines and therapeutics, but that should be in addition to the maximum use of the tools at hand. Dr. Tedros: (21:15) And these are the simple solutions that government can do and the public can do. And we have already outlined those. So, that's our message. It's six months since the virus started, it could be like a broken record to say exactly the same thing, but the same thing works, test, trace, isolate, and quarantine cases. That's for the government to do. And second, hand hygiene for each individual. Of course, wearing masks and the other things that can be done, social distancing at individual level, it works and save lives. And that's still our message. But of course we should look for vaccines and the rest, but the simple and basic public health works. And that's what we're saying. Thank you. Tarik: (22:29) Thank you, Dr. Ryan and Dr. Tedros for this answer. We will now go to Michael Bociurkiw who is a contributor to CNN. Michael, the floor is yours. Michael B.: (22:41) Yes. Can you hear me? Tarik: (22:42) Yes. Michael B.: (22:44) Thank you for taking my question. Good morning from British Columbia. Director General, this question relates to your opening statement that the pandemic has brought out the best and worst in humanity, including politicization of the pandemic. Just a few days ago, Marco Rubio, Richard Gere were among 500 people who warned in a letter that democracy is under threat by certain authoritarian leaders due to coronavirus. They cited parliament as being sidelined journalists arrested, minority scapegoated, and most vulnerable sectors of the population face alarming new dangers. My question is the following, sir, Ambassador William Taylor told me about strong men do not seem to be winning against COVID-19. The virus is having a devastating effect on strong men who aren't taking the steps that need to be taken. Do you have opinion on that or do you agree? Thank you. Dr. Tedros: (23:36) Can you repeat? Sorry. I didn't know the ambassador you mentioned [crosstalk 00:00:23:42]. Michael B.: (23:42) Oh, sorry. It's Ambassador William Taylor. He's quite well known as a US ambassador and he was in the congressional testimony a few months ago. Yeah, certain, various places around the world. And he's now with the US Institute of Peace and studies strong men [inaudible 00:07: 00]. And he said that if strong men believe that they can take advantage of COVID-19 to suppress civil liberties, they're wrong. That this will backfire on them. Dr. Tedros: (24:18) No, thank you. Our message from the start was very, very simple. I was a politician myself. I was a member of parliament. Maybe something I learned while I was a politician was, at the end of the day, what you do should be something that helps your people. And one thing maybe I learned the biggest lesson is even if we belong to different political parties, the citizens of that, any country who bring any country are the same. So whether we belong to the right or left or we're the center, what they call progressive party. What matters at the end of the day is what we do good for the people. Then if you take COVID, if you see it in doing good for our citizens, what you do is saving lives because even one life is important, whether it belongs to the left, the right or to the center. Dr. Tedros: (25:59) And that's why from the start we said, "Please, please, quarantine COVID politics. Please, we need national unity." Unity at the country level, unity among political parties, unity across ideologies, unity across beliefs, unity across races. Unity across any differences you can mention, because there was a reason why we said that. This virus has two dangerous combinations. Now we have said it many times. And even the international expert group that visited China, that was composed of many countries, including the US, Germany, Japan, Nigeria, Korea, Singapore, many countries, actually a very diverse, Russia, a very diverse group of international experts said this virus has two dangerous combinations. One is it's fast. It's contagious. Second, it's a [killer 00:10:27]. And it can exploit divisions. Divisions between us across all the lines, which I have said. And that's why WHO has been saying, "Please, avoid any division." Any differences could be exploited by the virus and that we have to fight this virus in unison. Dr. Tedros: (28:13) And that's why, whatever, what you said, I mean, our message is still the same. It's not about one country or two countries or three countries. It's not about something specific to any place. It's about how we should operate globally, whether it's at national level, subnational level, or regional level or global level. And with 10 million cases now and half a million deaths, unless we address the problems we have already identified as WHO, the lack of national unity and lack of global solidarity and the divide world, which is actually helping the virus to spread. As I said, in my speech, the worst is yet to come. I'm sorry to say that, but with this kind of environment and condition, we fear the worst. And that's why we have to bring our acts together and fight this dangerous virus together. I thank you. Tarik: (29:56) Thank, Dr. Tedros. And thanks to Michael for the question. We'll now go to the Economic Times of India and we have with us Divya Rajagopal. Divya, you've only [inaudible 00:30:10] yourself. Hello? Divya Rajagopal: (30:12) Hello. Thank you for taking my question. Am I audible? Tarik: (30:15) Yes, we can hear you. Divya Rajagopal: (30:19) Yes. Hi. I wanted to ask the question to the entire panel. Last week, Anthony Fauci of NIH has said that contact tracing is becoming increasingly difficult at this stage of the pandemic. Do you think that as infection spreads in most countries, it is still possible to use contact tracing as a factor of mitigation? Thank you. Dr. Mike Ryan: (30:45) I think yes, but it's very dependent on the background intensity of transmission. In situations where there's very intense community transmission and large numbers of cases every day, it's very hard to get on top of case isolation alone, nevermind the contact tracing. So countries may need to make some [voices 00:31:07] in that regard. But what has happened for those countries who've been affected, those countries who've stuck with contact tracing and isolation or quarantine and of contact, have found then as the number of cases drops that they can catch up on the contact trace and improve. The difficulty has been for many countries who gave up entirely on contact tracing now having to pick that up, now having to scale up the architecture of public health surveillance, as they've opened up societies and decreased the public health and social measure, or the restrictions on movement, it's quite tough for the public health system to catch up and it takes time for it to do so. Dr. Mike Ryan: (31:48) And the director general said many, many times during this period of so-called lockdowns, that this was precious time to prepare. Not only were [inaudible 00:32:00] public health and social measures having an impact on transmission, there were also clearly having a negative impact on social and economic life. And that this precious opportunity needed to be taken. And we've seen in countries who've really beefed up their capacity to do contact tracing, isolation, quarantine testing, all of the things the director general spoke about, they have done well. So yes, contact tracing, public health surveillance is a key part of a package of activities. Dr. Mike Ryan: (32:31) The [inaudible 00:32:32] has said that if individuals and communities can sustain the physical distancing, the hygiene, the mask wearing and the other things that are appropriate and advised by local government, if the public health system can continue to track and trace cases, yes, we should see a situation where the disease comes on control. And many countries have proven that. There's not proposition. Many, many countries through applying a comprehensive strategy have reached a very low level of virus transmission in their country, but always have to remain vigilant in case there are clusters are small outbreaks. Dr. Mike Ryan: (33:11) We've seen those situations raised in Germany. We've seen those situations arise in Singapore and Japan and Korea and China and other countries. And again, it's in those situations where your public health surveillance and your contact tracing and your ability to investigate clusters really comes into its own. And we've really seeing the advantage of public health and public health architecture is that ability to pounce on disease. What you have to do is push the disease down to the lowest possible level and communities made a huge sacrifice for that to happen. They stayed at home. They stayed away from their families. It's contributed tremendously to suppressing infection. And what public health authorities have needed to do is to put in place the right public health surveillance in order to take advantage of that. So as the restrictions are lifted and as we see small clusters... Dr. Mike Ryan: (34:03) The restrictions are lifted and as we see small clusters appear, the public health authorities can react quickly and suppress that infection again. And a great credit goes to countries like Germany, like Japan, like Korea and others who really focused in on that function of the system. They're able to use a multifaceted approach that will sustain community commitment to the process. High level of community acceptance, high levels of community compliance, high levels of community understanding lead to a strong public health intervention and a strict and public health system. It works. It's not a guarantee of success, but what we've seen is countries that apply a comprehensive sustained strategy with their communities on board make progress. There are no guarantees with epidemics, but this right now is the best [inaudible 00:00:34:53]. Of activities that countries have shown again and again can lead to us arriving at a situation where we can live with this virus. Dr. Maria Van Kerkhove: (35:02) I just wanted to add two points what Mike has said. One is that it can be increasingly difficult to apply this comprehensive approach as transmission increases, but it's not one activity alone. It is not conduct tracing alone. It is not case finding alone. It is not physical distancing alone. You heard the director general, you've heard us say this all time, but it's worth repeating because there tends to be a focus on a particular intervention, but it needs to be all of the above. And with an empowered community, with engaged community, with listening to the community and having the community listen and adhere to the public health measures that are in place, this can be done. And so it can be increasingly difficult. What we have seen is in countries that have been in an overwhelming situation, if prioritized, these activities, these interventions in specific areas in the countries where transmission seems to be the highest intensity, perhaps related to a super spread event or a particular cluster, and bringing that transmission down from an overwhelming situation to clusters of activity and from clusters activity to chains of transmission. Dr. Maria Van Kerkhove: (36:12) And the other point is that it can be turned around. Again, many countries are seeing situations where they're feeling completely overwhelmed and we have seen many countries demonstrate that you can turn this around, you can bring transmission under control. It is very, very difficult, but again, prioritizing the work, prioritizing the interventions where it's needed most, bringing situations under control where you can get a quicker gain and then focusing higher areas of intensity, these approaches in countries need to be administered at a lowest administrative level as possible to bring situations under control to as many places as you can as quickly as can, but it can be turned around. And we wouldn't be saying this unless we've seen it happen and unless we've seen countries demonstrate this repeatedly in multiple regions across the globe. Dr. Tedros: (37:06) Yeah. Thank you. I think this is very important and I would be happy to add my voice to my colleagues, Mike and Ryan. Mike and Maria. Mike and Maria. My client, my general is a very humble servant of humanity and he wouldn't tell you what real stories are regarding contact tracing. I know contact tracing is difficult. And I agree with you, our colleague, our friend who asked this question. And I know and understand if countries say contact tracing is difficult, but if you want to try difficult, probably add contact tracing, the number of cases you tries with a situation, which is diet to your life. Meaning try it in a place like notice [inaudible 00:04:33]. Where 20 rebels operate armed rebels and where security is not there. With your own security is [inaudible 00:04:47]. And when Mike Ryan was leading the whole effort, he was in [inaudible 00:04:54]. For several months. When there was engagement between front warring parties almost every single day. Dr. Tedros: (39:05) And when you would do contact tracing of 25,000 a day, despite that security situation. No, he didn't send me, actually, somebody sent me from the front lines. Mike Ryan wearing the helmet, the bulletproof, and also the jacket bulletproof. And going to communities to do contact tracing and rest because he had no option. If you can do contact tracing in that condition, risking your life, and he's the most senior person in terms of emergency response, one of them was here doing contact tracing in a stable and peaceful place, wherever it is in many countries, should that come as even an issue? I'm just asking. Dr. Tedros: (40:21) If there is a single failure for many of our countries to really not hunt down this virus is our failure in contact tracing, because we have lame excuses saying it's too many and it's very difficult to trace because there are too many. Trust me, there is not too many, even in a war situation. If contact tracing helps you to win the fight, you do it even risking your life or get out a place where there is peace. The reason I'm saying this is we don't tell, or we don't talk about the stories of a simple human being like Mike Ryan, who would do this in a situation that risked his life. So if you want to know if contact tracing is difficult, then I'll send you his picture in his bulletproof helmet and bulletproof jacket, because he believed that he had to do everything to stop the Ebola and to show that saving lives actually needs that level of commitment. Dr. Tedros: (42:04) So my answer is, just before I explained and hopefully that you will understand why I will say the simple phrase, because I want you to understand the background. Trust me, no excuse for contact tracing. If any country is saying contact tracing is difficult, it is a lame excuse. Thank you. Tarik: (42:39) Thank you Dr. Ghebreyesus and Dr. Ryan and Maria as well for this detailed answer on question on contact tracing. We will now go to a [Pretzelstein 00:08:51]. And we have [Mosey Uphillblatt 00:08:55]. Mosey, can you hear us? You just need to press unmute. Mosey: (43:09) I did it now. Okay. Hello. Tarik: (43:12) Yes, we can hear you. Mosey: (43:14) Okay. [inaudible 00:09:19]. My question is first, perhaps to lessons learned that Keenan's question was about contact tracing and as you said, it was thought [ inaudible 00:09:31]. Perhaps in the beginning, because most countries were overwhelmed by the number of infections. And that was a bad excuses from the [inaudible 00:09:40]. But we can still question that if you having a concern about the type of contact that's in which should apply, that I'm talking about, think about it and say, man, you're contact tracing and digital contact tracing is also involves questions about privacy. And that brings me to my question because [inaudible 00:10:02]. Assembly was to place in May, I think. And they decided that in a couple years it should shift of timing, perhaps initiate some kind of [inaudible 00:00:44:19]. Response to the coronavirus. So I would like to ask him if he has started or we think it's perhaps to early. Although, as you said in the beginning, Dr. Terrell said half a year has passed tends and [inaudible 00:10:41]. Outbreak. The investigation, which was decided, or by this assembly was to find out the sonotic cause or source of the virus, and maybe the [inaudible 00:10:58]. Investigation has stopped. Thank you. Tarik: (45:05) That's lots of question. And I'd forget to remind everyone is that you usually take one question per person, but Dr. Ryan will try to help. Dr. Tedros: (45:17) The last one on the [inaudible 00:11:19]. Source, WHO has been saying that knowing the source of the virus is very, very important. His signs, his public health. We can fight the virus better when we know everything about the virus, including how it started. And we will be sending a team next week to China to prepare for that. And we hope that that will lead into understanding how the virus started and what we can do for the future to prepare. So we're planning to send at him next week. Thank you. Dr. Mike Ryan: (46:11) Okay. I think if we listened to interviews on those done by people who've lead contact tracing in places like Singapore in Pan and in low countries, the primary success of contact tracing has come for well organized human workforce. [inaudible 00:00:46:40]. Number one was a case as detect was is a positive sign in the lab. Maybe it's from the emergency room, from the hospital, from the community that is an instant response or a case, or their family can be interviewed that contacts are identified quickly. And in that sense, the highest risk contacts, you can have a contact list that's 10 and you can have a contact list that's 10, 000 people. Then you have to decide how far and how deep you go with listing potential contacts. They all have to be contacted and followed up. Of those who are followed up, you're asking in most countries situations, you're asking for those contacts to be a self isolated or quarantined at home. Dr. Mike Ryan: (47:21) In some situations, people are asked to quarantine in the facility. So it's a very complex set of investigations and then communication between different groups. And one group has handed off the process to another group. So it's a complex interaction of public health activities. Now, obviously when you're moving information around and you're trying to, the lab has to inform the contact traders and the contact tracers have to inform the people organizing quarantine, all of those require a lot of transfer of information. And there are a number of digital tools that have really helped with that. Like the system developed by WHO Go Data, which has been implemented in a number of countries. And then of those public health authorities to integrate data from different sources within the system. There's no privacy issues there because that's really about being more efficient with publicly held data. There are then other applications that have been developed, which allow for mobility tracking or identifying potentially other high risk contacts, Bluetooth enabled apps that allow it to happen. Dr. Mike Ryan: (48:22) And some countries have implemented apps like that. And those apps can be a useful identifying contacts who may not have otherwise been list. And in some way, it's also for looking at overall population risk for transmission. Some have worked, some have not. Some have been very well accepted at community level. Some have raised really issues regarding data protection and human rights and other issues. So it's important that we continue to innovate with these tools, but it's also important to recognize that that aspect of the digital revolution is innovating and providing potential solutions and tools. Core process is still a core human driven process. It's about human contacting humans and asking questions about potential exposures and following up with other human beings. This is not an automated process. It cannot be automated in that regard. And I think that's where most countries have struggled. Dr. Mike Ryan: (49:25) It's one thing to develop an app and another thing to identify and train a human workforce that can go out and be disease detectives. And you'll see that in most countries who've been successful what they've really managed to do is train community based people who know their localities, train them in how to do contact tracing. They've trained them how to follow up within their own communities. And that's much better accepted. And we've found the same in Ebol and Congo. If you bring contact tracers into small villages where people are outsiders, it's a potential flash meet. So the more localized the response is, the better. And localization of public health intervention is a very important concept. And it's something that governments need to address. So I think that will be my address, localized contact tracing, bring it down to the lowest level, have it as much as possible based in and done by the community and enhance the efficiency of that where you can with digital systems and applications as appropriate. Dr. Mike Ryan: (50:27) But they're not in themselves the answer. With regard to your second question regarding what we learned, we're learning a lot. And interestingly, when we talk about contact tracing, we had a major meeting two weeks ago from experts from all over the world who've been implementing contact tracing. Today, we have a meeting with [inaudible 00:16:47]. Which is considering the outcomes of that meeting. I think tomorrow we begin a meeting on what we've learned in research over the last six months and the next few days. And right now at the six month period, we've been doing ourselves internally, a number of internal. Dr. Mike Ryan: (51:03) We've been doing ourselves internally, a number of internal retreat, looking at what we've learned over the last six months. Our program, the emergencies program, here is under the routine assessment of the independent oversight and advisory committee with the body that reports directly to the World Health Assembly. They've completed their first interim review of the response and performance of our program. That review was published at the time of the world health assembly. And in fact, that that committee has had a briefing today with the mission representatives of all the WHO member states. We will continue and that committee will continue with that review. There are currently reviews planned around the IHR review committee, and obviously the director general is pulling together a systematic, independent evaluation based on the WHA resolution. But we're doing internal operational reviews. We continue to review all of our performance. We review all of the language and I'll hand over to Maria because she may be able to also tell you how we're really looking at the science and what we've learned over the last six months. Dr. Maria Van Kerkhove: (52:16) Thanks Mike. Yes. Almost every time we've been up here and we are constantly learning, we are constantly evolving our guidance to fit what is known about this virus that we didn't know about six months ago. I think the way that we do that is through our international networks, where we are speaking directly with frontline workers every day, whether they're clinicians and public health professionals, whether these are virologists, laboratorians who are working with specimens with sample, looking at sequences, whether we're looking at people who are working on infection prevention and control to prevent transmission in healthcare settings, looking at the epidemiology and modeling, understanding transmission and where transmission is happening, how transmission is happening and how that affects our guidance and our advice. We are constantly looking at how we adapt our information that we share with you. And we are very careful with how we explain the situation about what we know, about what we don't know. And most importantly, how we're working with our partners to address those unknowns, because that is a constant evolution, especially with a new pathogen. Dr. Maria Van Kerkhove: (53:25) I just want to mention one last thing is about what you can do yourself. Director General mentioned this in his speech, but please feel empowered. Please know you can do things yourself to prevent yourself from getting infected. And importantly, not only protecting yourself, but protecting your family and potentially somebody who is part of a vulnerable category, who has an underlying condition, or may be of advanced age, who will go on to develop severe disease if they are infected. Knowing what you can do, if you're in a situation where there is increasing transmission or intense transmission, if you're asked to stay home, please stay home. Because there are many people who can't and those individuals who are working in health care facilities, who are caring for infected patients, who are in ICU, who are in hospital beds, they can't stay home. And if you can, please do. Dr. Maria Van Kerkhove: (54:18) We know this is difficult and we know people want this to be over. And there are many things that we all want to do, but it's going to be difficult for some time before we get out of this, but we will. And so not only do governments need to have strong leadership and be very clear on what needs to be done, adapting that to the most localized level as possible, you yourselves can also play a role; men, women, children, all of you, all of us, have a role to play. Speaker 1: (54:47) Many thanks. We had a bit longer answers today, but it's because questions were good so we will take two more questions before concluding this press briefing. First, we will go to Chen from China Daily. Chen. Chen: (55:03) Hi. Dr. [inaudible 00:55:05] you have a repeated a voice the concern over sticking with tarnation and a politicization of COVID-19, but US President Donald Trump just last week, he speak at rallies, continued to use words like "Kung Flu" or "China virus." Does WHO consider this seriously undermining the oboe solidarity and do you, WHO, usually convey such concern to your US contact like US CDC? Thank you. Dr. Mike Ryan: (55:45) From WHO's perspective, we obviously want to have international discourse that's based on mutual spec. And in that sense, we encourage all people at all levels and in all countries to try to use language that is appropriate, respectful, and is not associated with the any connotations that are negative. And in that regard, we put that message out globally. For many people around the world have used unfortunate language in this response. We certainly haven't been immune to receiving a lot of it, but we try to focus on the way ahead. We try to focus on what we need to do, and we need everybody focused as DJ said and Maria has said. We need everyone focused. Dr. Mike Ryan: (56:36) Everyone has a job. We can actually do better than we're doing right now. We have a lot of vulnerable people to protect and shield. We have a lot of communities with poor health systems and poor living conditions that we need to help and support. And we need focus on that. It is unfortunate if our global discourse is reduced to base language. That never helps, but we want to focus on moving forward. We want to focus getting this job done. Tarik: (57:11) Thank you, Dr. Ryan. And the last question, we'll go to Jamil, our Geneva neighbor, who is working for Brazilian Press. Jamil. Jamil: (57:26) [inaudible 00:57:26] Thank you. Thank you for taking my question. My question is on Brazil. What is your current evaluation about Brazil? And whether this strategy that you just mentioned now for over an hour is actually being implemented? Thank you. Dr. Mike Ryan: (57:51) Certainly in the Americas and things, I'll come to Brazil, but the overall in the Americas, the situation is difficult. The Americas as a whole represent half the cases and almost half of deaths in the whole world. If you look at Brazil itself, it represents quite a portion of all the cases in Americas, 26% that's one in four of all the cases and one and four of all of all deaths in the continent. There is no question that Brazil is still facing a big challenge. It continues to report over 30,000 cases a day from all 27 federal levels, from all over the state levels. Dr. Mike Ryan: (58:55) Brazil is still facing a challenge and yes, a comprehensive approach to the response is needed at all levels. It's tough to enforce them. Infection is high. There are many challenging situations in Brazil, there are deeply clustered and dense populated areas in the urban setting that have very poor services. There are people deep living in rural conditions as well that are difficult to reach and difficult to serve. It would be a silly to underestimate the size and the complexity of a great country like Brazil, but equally it would also be important to recognize that Brazil has a huge and proud history and the management of infectious diseases and has many excellent scientific and other institutions are shown a tremendous capacity, not only for combating infectious diseases, developing vaccines, that have stopped diseases like yellow and many other countries. So yes, we would encourage again, once more, that Brazil continues to fight against the disease, the Brazil links the efforts at federal and the state level in a much more systematic way, that there is a focus on a comprehensive approach to controlling the disease and doing that in a sustained fashion. Dr. Mike Ryan: (01:00:21) It is easy obviously to criticize any individual country and no country, no organization is without criticism or without fault, or without difficulty in this response. Again, today's message is not about what happened last week, last month, or the last three months. And the director general talks politicization as what we all need to recognize that in many countries, the government is the government of the day. And we need to find a way for each government to find a way forward, for each government to service delivery, for each government to serve its people. And we need to encourage and support governments in doing that. We need to find all of government, all of society approaches. When we talk about avoiding politicization of the virus, that goes both ways. And we may, in many situations as individuals and society, have to provide encouragement and support for a government that may not be of our choosing or liking. Dr. Mike Ryan: (01:01:27) And that is the difficulty and the challenge of national unity against a common enemy. When you choose national unity against the common enemy, you sometimes don't get to choose who leads you in that fight, and you have to find a way. You have to find a way to be able to take that forward. And that's the challenge for all countries now. And I would just say from my personal perspective, that we cannot continue to allow the fight against this virus to become and be sustained as a ideologic fight. It can't be. We cannot beat virus with ideologies. We simply cannot. And I think everybody now needs to take step back at six months, everyone, every individual needs to look in the mirror and say, "Am I doing enough?" And every politician needs to look on there and say, "Am I doing enough to stop this virus?" I think we need to have a big conversation with those on this and now is the time because we don't have time to waste. Dr. Maria Van Kerkhove: (01:02:36) If I just maybe please add, it has nothing to do with the politics, but it's of the science. And I would like to ask us to side on the side of science and to side on a side of public health and expanse. We are learning from experience. We are learning about this virus. We know what works. We're not saying that it's easy. We're not saying that it will not take more time and it will be difficult for individuals and families and communities and nations, but we are adapting our approach and tailoring our approach based on what we are learning. We need people to be with us with this science, as we communicate that with you, as we adapt within our guidance, as we modify these approaches going forward, we know what works in suppressing transmission, and we know what works for reducing mortality. Let's do that. Tarik: (01:03:31) This will conclude, longer than usual press briefing. Still, we will have audio file sent to you soon and the transcript will be posted tomorrow. From my side, I wish you a very nice evening. Tarik: (01:03:52) Thank you. Thank you, Talik and thank you all for joining. As I stated earlier, we have a new timeline of the past six months, and really appreciate it if you have a look and give us your feedback and look forward to seeing you on Wednesday. Thank you.