World Health Organization Press Conference Transcript April 17

Tarik: (00:00) ... Place next week, 21st of April, from our Western Pacific regional office that you may be interested in participating in. I'll give the floor now to Dr. Tedros for his opening remarks and then we'll go to questions. Dr. Tedros. Dr. Tedros: (00:17) Thank you, Tarik. Good morning, good afternoon, and good evening. Dr. Tedros: (00:27) Tomorrow, WHO is joining forces with many of the world's leading musicians, comedians, and humanitarians for the One World: Together At Home virtual global special. This is the result of a close collaboration with my good friend Hugh Evans from Global Citizens and the inspirational Lady Gaga to bring entertainment, joy, and hope into the homes of people all around the world whose lives have been turned upside down by the COVID-19 pandemic. Dr. Tedros: (01:12) I would also like to use this opportunity to thank Lady Gaga's mother, Cynthia Germanotta, who is our Goodwill Ambassador, who is doing a great job advocating for mental health around the world. And thank you so much, Lady Gaga, and thank you so much, Cynthia Germanotta, for your continued support and help. This is a family project and we really appreciate for your commitment and dedication. Dr. Tedros: (01:45) This is an opportunity to express our solidarity with frontline health workers and to mobilize philanthropists, the private sector, and governments to support the COVID-19 Solidarity Response Fund, powered by the United Nations Foundation and the Swiss Philanthropy Foundation. Dr. Tedros: (02:09) So far, the Solidarity Response Fund has generated more than US$150 million from more than 245,000 individuals, corporations and foundations. These funds are helping us to buy personal protective equipment, lab diagnostics, and other essential supplies for the countries that need it most. Dr. Tedros: (02:39) So I would like to say thank you. Thank you so much. Thank you from our heart to those who have contributed. Dr. Tedros: (02:49) For further details about tomorrow's event, I'm delighted to welcome once again, my friend and my brother, Hugh Evans to say few words to be followed by the amazing Lady Gaga. Dr. Tedros: (03:05) Hugh, over to you. Hugh Evans: (03:09) Thank you very much, Dr. Tedros, and thank you, members of the press, Your Excellencies, ladies and gentlemen. I'd also like to acknowledge Lady Gaga, who has played a leading role in curating One World: Together At Home. Hugh Evans: (03:27) During tomorrow night's special of One World: Together At Home, you will see the worlds of music and policy come together to celebrate and support the dedicated and essential work of the front line community health workers. Whether it's the doctors, the nurses, or the lab practitioners, these are the real heroes in responding to COVID-19. Their sacrifices day in and day out deserve to be honored and supported. And so that's why we've been calling on citizens everywhere to use their voices to take action, to ensure we all have access to testing, to all have access to vaccines when they're available, and all can practice social distancing. Hugh Evans: (04:15) We've also been calling on philanthropists and the private sector to step up in support of the WHO's Solidarity Fund, and local charities, who are supporting the most vulnerable people around the world, because we know that the most vulnerable in our communities must not be forgotten. And above all, we want to ensure that the frontline community health workers have the equipment and the support they need to fight this disease. Hugh Evans: (04:45) The COVID-19 pandemic has highlighted why international cooperation is more important now than ever. We must solve global problems with global solutions because we know that a virus anywhere can lead to a virus everywhere. And our mission, and at the heart of what we're wanting to achieve through One World: Together At Home tomorrow night, is ensuring that our global health systems are strengthened in the future to prevent a future pandemic so that the poorest and most vulnerable in our societies are protected. Hugh Evans: (05:20) No generation should have to endure the pain and suffering we've all experienced around the world over these last few months ever again. That's why we are proud to work with our partners and relief organizations to support communities affected by the COVID-19 pandemic. Hugh Evans: (05:38) The money raised tomorrow night will go to support both local charities and also efforts to provide PPE to community health workers around the world, face masks, protective equipments, gowns, goggles, the things that they deserve. Our health care workers deserve our support, and we know that if we all do our part, we can weather this storm. Hugh Evans: (06:07) At Global Citizen, we're so proud of what's been achieved in a few short weeks with One World: Together At Home. Since we announced the special, we've received phone calls from Mongolia to Iceland, from South Africa to India, Brazil to Korea, asking how people can support the efforts to ensure we can reach as many people as possible. This is a moment of true togetherness, and we are honored that, on Saturday, thanks to the outpouring of support, One World: Together At Home will be accessible to billions of people around the world, from Asia to Africa, Europe to the Americas. The special will be broadcast in over 100 countries and it will be accessible across the entire world on digital and audio platforms. Hugh Evans: (06:58) This will be a true shared experience and we could not have done this without the support of the WHO team. Special thanks to Paul Garwood and Gabby and the communications team for their tremendous partnership. And I'd also personally like to thank the executive producers of the special, Michelle Anthony and the team at Universal Music, Bobby Campbell, who works with Lady Gaga, Declan Kelly and the team at Teneo, for all of their efforts to rally the artist community, philanthropists, and the private sector in support of COVID-19 response efforts. Hugh Evans: (07:35) It is now my great pleasure to welcome our friend and partner in ending this crisis, who I want to sincerely thankful all the time, energy, and effort she has given to this, ladies and gentlemen, please welcome Lady Gaga. Lady Gaga: (07:55) Thank you so much, Hugh Evans. [inaudible 00:07:59] wonderful. [inaudible 00:07:59] everyone who's on this call today. Thank you so much, Dr. Tedros. I can speak on behalf of not only myself but my mother as well, we deeply appreciate your partnership and yes, it is quite true. We all know the importance of the mental health support that the medical community will need during this time and after. It will be extremely crucial and we are already getting ready. Lady Gaga: (08:31) Thank you, Hugh Evans [inaudible 00:08:33] at Global Citizen. Thank you for your continued leadership, and this fight against COVID-19 is one that the whole world will fight together. Lady Gaga: (08:43) Over the last week, I have witnessed an inspiring and fearless global effort. While watching medical workers continue to battle the front line of this pandemic, leaders, other artists of many mediums, and people of all nations have combined forces to write a love letter to the world. We call it One World: Together At Home. Lady Gaga: (09:09) It is a love letter to our doctors, a love letter to our nurses and other healthcare professionals who are risking their own lives for the sake of ours, to the delivery drivers, grocery store workers, factory workers, public transportation workers, postal workers, and restaurant workers doing the same. We celebrate your bravery and your heroism. Lady Gaga: (09:38) During this time, we have seen the coming together of a singular, kind global community. This triumph has instilled in myself and my colleagues a true calling to call upon the private sector and philanthropists to commit millions of dollars to support the world health organization's COVID-19 response. To name a few of dozens and dozens of donors, we now additionally have donations from Procter & Gamble, Johnson & Johnson, Citi, Coca-Cola, Target, The Ford Foundation, Rockefeller Foundation, and Bloomberg Philanthropies. Lady Gaga: (10:19) Updates are such that we are now at $50 million and counting and contribution to the fund and to local community focused charities. When we launched this with you all 12 days ago, the world was in a different place, and 12 days from now, the world will be different again, we hope, for the better. Lady Gaga: (10:40) We also hope that tomorrow night's event, One World: Together At Home, will continue this, telling global stories of triumph and hope and told to a global audience, truly bringing the world together. We can do something to bring joy and respite to the corners of the earth. With that, I am pleased to share with all of you some news that the Rolling Stones have joined the lineup of artists performing tomorrow. Lady Gaga: (11:12) Let's keep the momentum going. Once we see this tomorrow night, this will not be the end, and I will still be taking your phone calls if you wish to donate. Lady Gaga: (11:24) Let's keep our joy. Let's remind each other that this is a kind world. We are excited even more to announce more donations tomorrow night. Lady Gaga: (11:37) Thank you, thank you, thank you, from the bottom of my heart to all of the healthcare workers around the world. Dr. Tedros, you're truly a superstar. Thank you so much to the media for telling the stories of all of these medical professionals and getting the word out about how under- resourced their systems are, and to all the global citizens out there for supporting this effort. Lady Gaga: (12:08) I'm Lady Gaga. I'm an Italian American patriot, but I'm also a global citizen. Thank you. Dr. Tedros: (12:39) Thank you. Thank you so much, Lady Gaga, and thank you, Hugh. Dr. Tedros: (12:44) I look forward to joining you and millions of people all over the world tomorrow for what I'm sure will be a wonderful event. Dr. Tedros: (12:57) And I share what Lady Gaga said, what the world needs is love and solidarity, so please accept much gratitude and much love from myself, Lady Gaga, and Hugh Evans, and all our colleagues here. That's what the world needs. Again, what the world needs is love and solidarity to defeat this dangerous enemy. Dr. Tedros: (13:35) More than two million cases of COVID-19 have now been reported to WHO, and more than 175,000 people have lost their lives. While we mourn for those we have lost, we also celebrate those who have survived and the thousands of people who are now recovering. Dr. Tedros: (14:06) WHO is updating our guidance to include recommendations for caring for patients during their recovery period and after hospital discharge. We're encouraged that several countries in Europe and North America are now starting to plan how to ease social restrictions. We have said previously that easing these measures must be a gradual process, and we have spoken about the criteria that countries should consider. Yesterday, we published our guidance on considerations adjusting public health and social measures, which we encourage countries to read and apply. Dr. Tedros: (14:59) But although we see encouraging signs in some countries that are worrying trends in others. In the past week, there has been a 51% increase in the number of reported cases in my own continent, Africa, and a 60% increase in the number of reported deaths. With the current challenge of obtaining testing kids, it's likely that the real numbers are higher than reported. Dr. Tedros: (15:32) With WHO support, most countries in Africa now have the capacity to test for COVID-19, but there are still significant gaps in access to testing kits. We're working with partners to feel those gaps and help countries find the virus. The African Centers for Disease Control and Prevention announced yesterday that more than one million tests for COVID-19 will be rolled out across the continent starting next week. Dr. Tedros: (16:06) Strengthening and supporting African Union and institutions like the African CDC will really help not only for now, but also for future. To further strengthen support for Africa, earlier this afternoon I spoke with President Ramaphosa of South Africa, the current Chair of the African Union, and Moussa Faki Mahamat, the Chairperson of the African Union Commission, UN Secretary-General Antonio Guterres, the Managing Director of the International Monetary Fund, Kristalina Georgieva, and the President of the World Bank, David Malpass. Dr. Tedros: (16:48) In audition to tests, we're also working hard to accelerate the development, production, and equitable distribution of a vaccine. Yesterday, I spoke to President Emmanuel Macron of France, Bill Gates- Dr. Tedros: (17:02) [inaudible 00:17:01] no friends, Bill Gates and other partners to discuss how to prevent another pandemic by getting vaccines from labs to people as fast as possible and as equitably as possible. The commitment from President Macron, from Bill Gates and also from Prime Minister Boris Johnson is heartwarming. I also spoke to the Prime Minister of Barbados and the current Chair of the Caribbean countries about the challenges faced by small Island developing States in gaining access to test kits and other supplies. Dr. Tedros: (17:40) No country should be left behind and I would like to use this opportunity to appreciate the strong leadership by the Prime Minister of Barbados steering the response in the Caribbean. Today I also spoke to the President of the European Commission, Ursula von der Leyen and the Prime Minister of Finland, Sanna Marin about continuing efforts across Europe to fight the pandemic and support lives and livelihoods. Dr. Tedros: (18:17) The commitment from both leaders, President von der Leyen and Prime Minister of Finland Marin is very, very heartwarming again. I would like to clarify WHO position on wet markets. Wet markets as you know, at an important source of affordable food and livelihood for millions of people all over the world, but in many places they had been poorly regulated and poorly maintained. WHO's position is that when these markets are allowed to reopen, it should only be on the condition that they conform to stringent food safety and hygiene standards. Governments must rigorously enforced bans on the sale- Dr. Tedros: (19:19) ... WHO is committed to keeping the world informed in as many ways as possible in as many languages as possible. Our Viber Chat bot is now reaching 2.6 million people with reliable evidence based information and is available in 16 languages. This week we launched Tamil, Sinhala, Bulgarian, Greek, Italian and Hungarian, and we plan to launch Polish and Bangla next week. Now I'm pleased to say that from Monday we will be providing simultaneous interpretation for this press conferences in all official UN languages, Arabic, Chinese, French, Russian and Spanish and we will also planning to expand to include other languages like Swahili and Hindi. We look forward to having more journalists join us from all over the world. I thank you. Tarek: (21:15) Thank you very much Dr. Tedros. Indeed, this is a great news that we will have this press conference in other languages and therefore many friends around the world will be able to join. We will now open the floor for questions. I will remind the journalists to be brief if possible and to ask only one question so we try to get as many as possible. So if we are okay, we will start with our friend Bianca from Global, from Brazil. Bianca, can you hear us? Bianca: (21:53) Yes, Tarek, can you hear me? Tarek: (21:54) Yes, please go ahead Bianca? Bianca: (21:55) Yes, the question is for Dr. Tedros, the Brazilian President Jair Bolsonaro fired his Health Minister Luiz Henrique Mandetta. They were clashing over their response to the new current coronavirus, especially about the stay home recommendations and Jair Bolsonaro said that life is priceless, but they call the economy and jobs must return to normal. I would like to know how concerned are you, Dr. Tedros with the situation in Brazil and what message would you like to send to the country? Michael J. Ryan: (22:39) We are aware that the President of Brazil changed as Minister of Health today. We'd like to thank the minister for his service to the people. It's key though that not only the government of Brazil, but that's all governments take a evidence based decision of a whole of government and a whole of society approach to responding to COVID-19 pandemic. We all have a duty to protect our most vulnerable populations. Powell, our regional office for the Americas has been supporting Brazil and in preparedness and response to COVID-19 since January this year and is helping Brazil to purchase millions of PCR tests to expand their diagnostic capacity with the first batch scheduled tour next week. Michael J. Ryan: (23:29) We want to focus on providing technical, operational and scientific support to Brazil through our regional office for the America's power and to do that consistently and without fail in support of Brazil and all countries in central and South America and the Americas as a whole. Tarek: (23:53) Thank you very much. The next question Dr. Ryan. We go to Shanghai Media Group, that's [Bin Chen 00:05:47], if I'm pronouncing correctly. Can you hear us please? Bin Chen: (24:09) Yes, thank you. This is from Bin Chen from Europe Responded [inaudible 00:24:12] greetings from Berlin, so yesterday the Austrian health minister said that Great Britain's rate of new coronavirus infections frightens a lot of people in Europe. If we compare the new cases of the UK to the other seven European countries, so are you aware of this the sharp rise in the UK and what can we learn like other European countries can learn from that? Thank you. Michael J. Ryan: (24:40) Didn't hear your question very well, but I think in general you were talking about the differences in numbers in different countries in Europe and I think all countries have gone through and are in different stages of their epidemics. It is not useful to compare countries at different stages of their epidemics. I think we see countries have passed the peak or arriving at a peak and some countries are considering lifting of restrictions and some others not. I think all of those decisions had been taken carefully. Michael J. Ryan: (25:15) We've advised very clearly the countries need to make those decisions with great prudence. They need to walk back and move back and transition from measures associated with the large societal measures, lockdown, shutdowns that that needs to be done, but it needs to have in place three very important things. One, a completely empowered, educated community capable individuals who are aware of the physical distancing, the personal hygiene measures that are needed to avoid infection communities aware and involved in the process of fully empowered to act and participate as strong and acceleration and strengthening of the public health capacities for finding cases, for testing, for isolation and for quarantining of contacts. Michael J. Ryan: (26:05) This is exceptionally important. Our colleague Tom Frieden in the U S has likened this to, we need to start boxing the virus in, not boxing people in. I think it's a good analogy. We need to start finding the virus because right now with the current situation, everybody is locked down in order to stop the virus spreading. The only way we get to shift away from that is finding the virus and then limiting the measures as best we can to those individuals who may have the potential to spread it or may have the potential to develop the disease. Michael J. Ryan: (26:37) The last part of that is having a strong enough health system that the health system has recovered enough and has enough capacity but built in that it can react and you're seeing many, many countries are starting to bring online measured transition. Nobody is removing themselves from a lockdown type situation in a dramatic way. Michael J. Ryan: (26:55) You'll see countries are phasing the response and they're trying to look at the measurements that they're going to use and what we do appreciate as the countries are leaving time. They're taking some measures and they're going to wait and see and then see if those measures can be then further extended, further loosened, further adjusted. We believe this is a prudent approach. Michael J. Ryan: (27:14) I think you'll see all countries in Europe eventually doing that, but as I said, each country is in a different stage of its epidemic and we at this point I think it's really important that we don't start to compare countries as to where they are in the lifting of these public health and social measures. We have to look at the situation they're in and how they're dealing with their unique situation. Tarek: (27:41) Thank you very much, Dr Ryan. Next question comes from Chili, from Eduardo [Talsee 00:00:27:48]. Eduardo, can you hear us? Eduardo Talsee: (27:51) Yes, thanks. Hi, I'm Eduardo Talsee, thanks for your time. Here in Chile a card will be applied for recovery patients from COVID-19. The government says that this patient is stop infecting the rest of the population. We know that it is a measure that is also analyzed in other countries. My question is what is the W-H-O opinion on this measures? Is it recommended and should a PCR test be required to deliver this discharge card? What is the international experience like? Thanks. Michael J. Ryan: (28:33) I will start. Maria will follow up on the technical. WHO does not have a position on this approach. I think what we do have is advice for countries to be very prudent at this point. Number one, we need to be sure that what tests would be used to establish the status of an individual and there's lots of uncertainty around what such a test would be and how effective and how performance that test would need to be. Michael J. Ryan: (29:04) Secondly, a lot of the preliminary information that's coming to us right now will suggest a quite a low proportion of the population have actually zero converted. So it may not solve the problem. There's been an expectation maybe that herd immunity may have been achieved and that the majority of people in society may already have developed antibodies. I think the general evidence is pointing against that and pointing towards a much lower seroprevalence. So it may not solve the problem that governments are trying to solve. Michael J. Ryan: (29:35) Then thirdly, there are serious ethical issues around the use of such an approach and we need to address it very carefully. We also need to look at the length of protection that antibodies might give. Nobody is sure whether someone with antibodies is fully protected against having the disease or being exposed again. Michael J. Ryan: (29:56) Plus some of the tests have issues of sensitivity. They may give a false negative result and we may actually have someone who believes they're zero positive and protected actually in a situation where there may be exposed and in fact they are susceptible to the disease. Now it's not that these tests cannot be used, but there's a lot of work to do to standardize those tests to ensure that they're validated to ensure that they're used as part of a coherent policy and that there's a very clear public health objective to their use and that they are not misused in any way. So we will look at what Chile is doing or proposing to do. We will look at what all countries are proposing to do and we will offer the best advice we can based on science and ethics to them. Maria? Maria Van Kerkhove: (30:41) To supplement, this is an ongoing issue and we will be issuing some guidance over the weekend on this because there are a lot of countries that are suggesting to use a rapid diagnostic rapid serologic test to be able to capture what they think will be a measure of immunity. As Mike has said right now we have no evidence that the use of a serologic test can show that an individual is immune or is protected from reinfection. Maria Van Kerkhove: (31:11) What the use of these tests will do will measure the level of antibodies and it's a response that the body has a week or two later after they've been infected with this virus. These antibody tests will be able to measure that level of seroprevalence, that level of antibodies. But that does not mean that somebody with antibodies means that they're immune. And so we will be issuing some guidance around this because it is a confusing area. There's a lot of tests right now that have flooded the market and that's a good thing. It's a good thing that these things are being developed and that they are available. But we need to ensure that they are validated and so that we know what they say that they attempt to measure, they are actually measuring. So we hope to put some guidance out over the weekend and that guidance will be updated as more information becomes available. Tarek: (31:56) Okay. Thank you very much. From Chile we go to India. [Anush 00:32:04] Kumar from a Legal Desire Media. Anush, can you hear us? Anush Kumar: (32:09) Yes. Can you hear me? Tarek: (32:12) Yes, please go ahead. Anush Kumar: (32:14) Yeah. Thank you for taking my question. So there is a complete lockdown in India as the day before. Prime Minister of India extended the deadlines till third of May. So for the reason in lockdown, internet is a main source of information socializing. Our challenge is that a lot of COVID-19 fake news regarding decisions, treatment, origination and stats is spreading across social media. So can you please elaborate on what measures have WHO have taken with social media platform like Facebook, WhatsApp, Twitter to tackle such fake news and search engine like Google to remove the search listing of such places with fake news. Maria Van Kerkhove: (32:53) So I could start and perhaps Mike or DT would like to supplement. We've been working with a large number of platforms and Google and Facebook and I'm going to list them, but I'm going to forget to name them all, with Viber and WhatsApp to make sure that information that is put out is accurate information. We have been fighting this infodemic since the beginning. There's a lot of information that is out there that is inaccurate and we're working very hard to ensure that when someone searches for COVID-19 that the first thing that comes up is a reliable source. That would either be a WHO website or national websites and so that you can find accurate information. So when you search, you find the latest accurate information, because this is an evolving field. Maria Van Kerkhove: (33:37) It is confusing out there because unfortunately sometimes the misinformation gets circulated more so each of us has a responsibility that when we see something and we see something that is false or we think something is false, we don't pass that on. That's our responsibility as well. But we're trying to ensure that we address the myths. We address the inaccuracies. We have something up called MythBusters, where we- Maria Van Kerkhove: (34:02) ... inaccuracies. We have something up called Myth Busters, where we hear about rumors, potentially rumors that could be damaging and harmful to health. We address those head on to make corrections and we try to get that information out as quickly as possible to ensure that when you do a search that all of the platforms will give you the reliable information first. Michael J. Ryan: (34:21) And if I can supplement, Epi One Platform our information network for epidemic also provides direct access to many, many communities around the world, religious and faith based communities, to working communities, to commercial communities in many, many places. And we have channels for each and every one of those areas in which there are webinars and there are interactive sessions, in which we engage with civil society of all levels all around the world. But, I also just would like to say, because we never ever get a chance to do this is to really thank our media and social media teams. They're silent heroes of our response. And have engaged and understand that we don't go after the messenger, what we try to do is make sure that we replace bad information with good information. And that's as important in fighting a virus as any frontline health worker. So, chaparral to our teams who do the silent work. Dr. Tedros Adhanom Ghebreyesus: (35:22) I just would like to add to that, India has actually a strong capacity to help in this. It can play a big, big role in fighting the infodemic. And as Maria and Mike said, we're partnering with Google, Facebook and others, and we would like to use this opportunity to act not only at the global level, but at the country level. But, taking into account India's capacity will be really good. And as I said earlier, we would like to reach out to India directly using Hindi, Mujhe Hindi, [foreign language 00:02:06], but at least we would be able to send messages and partner with India to fight the infodemic, which is actually causing lots of problems and blocking millions from getting the right information. So we call on India to partner with us. We use this opportunity because of its capacity to fight infodemic, because it has a big, big capacity. Thank you. Moderator: (36:36) Thank you very much. From India, we go to the US. We have Steven from Radio World PRX, if I'm not mistaken. Steven, can you hear us, please? Steven: (36:53) I can hear you. Can you hear me? Moderator: (36:55) Yes, please. Go ahead. Steven: (36:56) Oh, perfect. In Yemen, you'll know that the first COVID-19 case was identified a week ago and since then there have been reports of contact testing, but no other cases have been identified. What do you think Yemen needs now to fight the pandemic and what do you know is being done? Michael J. Ryan: (37:25) WHO continues to support all communities in Yemen. We've put in place or are supporting local health authorities and agencies and implementing case finding and contact tracing and using polio teams and other teams to do that. And yes, we have not detected further cases, but that is not to say that has not occurred. We are constantly fearful of disease exploding in places like Yemen, or in Syria, or Iraq, or in many of the fragile States in which we work, in which many people have been displaced. Many people are living in overcrowded conditions. So we have to remain very much on alert. But what's even ... I won't say more important, because it's difficult to say something is more important than COVID-19 a right now. But for many of these communities, they have direct, real and present dangers in their lives. Michael J. Ryan: (38:22) And there are pregnant women who need to give birth safely. There are children who need to have infections treated. There are elderly or older people who need to have chronic diseases treated. And therefore, preserving lifesaving interventions, preserving feeding programs, preserving humanitarian interventions is just as important. So while we work to try and contain COVID-19, we have to remember that these people are in desperate need in many, many countries, and have been abandoned for years. And many agencies, including our own, work with local communities and with governments to try and ease the burden on these people. Michael J. Ryan: (39:01) And again, Dr. Tedros launched the humanitarian appeal for COVID-19 a number of weeks ago now, and we do thank all countries who've responded to that call, and we thank Mark Lowcock and his team on the humanitarian side and all our humanitarian partners for their untiring efforts to continue providing services, UNICEF and others, in these situations. So we are concerned, we are alert. But, we are also aware that these populations face many more difficulties than COVID-19, and we must continue to provide essential services to them regardless of the political or conflict situation in those countries. Moderator: (39:47) Thank you very much. Next question is [foreign language 00:05:51], Nina Larson. Nina. Nina Larson: (39:54) Yeah. Hi. And thank you for taking my question. I wanted to ask you, I see that ... sorry, I'm just trying to pull up my ... I see that you had said that Donald Trump said earlier today that he believes China's coronavirus total is far higher than admitted, and this came after the Wuhan revised up its death toll by 50%. I was just wondering how confident WHO is in the numbers that you've currently been provided by China and what ability do you have to actually verify them? Thank you very much. Maria Van Kerkhove: (40:34) So, I'll start. And perhaps Mike or Gigi would like to supplement. So we are aware of the new numbers that were reported overnight from China, which added an additional 325 cases and 1,290 deaths from Wuhan. And this was done in an attempt to leave no case undocumented. What we understand is that they've used an existing law of statistics to find these cases. And what they did is they reviewed different databases. They looked at the database that is kept for all of the confirmed cases. They looked at funerals, their funeral service systems. They looked at hospital systems, they looked at laboratories to see if there were any duplications or if there were any cases missing. They looked for cases in fever clinics and hospitals, at detention centers, in elderly care centers as well. And what they have reported is that the discrepancies in these cases were due to a number of factors. Maria Van Kerkhove: (41:33) First, is that the healthcare system in Wuhan was overwhelmed at one point and some patients died at home. Secondly, is that medical staff were delayed in reporting of these cases because they were focused on providing care for those patients and they didn't fill out the forms in time. Next, is that there were additional locations that were built, and if you remember in Wuhan in particular, some of the hospitals themselves were overwhelmed. And so they set up these makeshift hospitals that they called them, which were essentially stadiums and other facilities where they put mild cases to be cared for. And in those situations, the reporting wasn't done in a timely manner. And so those cases were added. And in some situations the reports weren't filled in completely. And so what they did is they did a review of that and they revised their numbers and those were the numbers that were updated overnight. Maria Van Kerkhove: (42:28) It is very important to know the numbers of people who have died from COVID-19, because this is a public health importance. And it is important that we have the accurate reporting of this. And in such, WHO has developed some guidance around this, which is they're international guidelines for certification and classification of COVID-19 as a cause of death. And this is based on ICD codes that exist. And our primary goal is to support countries in their ability to classify people who have died from COVID-19. And I just want to say that this is something that is a challenge and in ongoing outbreak to identify all of your cases and to identify all of the deaths as an outbreak happens, especially if systems are overwhelmed. Maria Van Kerkhove: (43:14) I would anticipate that many countries are going to be in a similar situation where they will have to go back and review records and look to see, did we capture all of them? I've seen a number of reports from media where people have been, in a number of different countries, where people have died outside of a hospital system. And so it will take some time for those individuals to be classified. So it is important that cases that do die from COVID-19 are recorded and we've provided some guidance to support countries to do so. Michael J. Ryan: (43:47) Thank you Maria. And thank you for the clarifications there. But we would also like countries to be as fast as possible in that process. And I know that it's somewhat forensic to go through these processes and everyone wants to be sure, but it's really important that we understand the size and scale of the pandemic as it moves forward. And the use of a probable case definition are those where you can in a sense say, yes, this was probably a COVID-19 case. Is better, it would commend the authorities in New York, for example, who've announced a list or a number of probable dead, which gives a much better sense of the impact of the epidemic. Michael J. Ryan: (44:32) And it's that kind of speed we're doing that, those numbers may change over time. But, I think it's always better when people put forward the data that they have as early as possible because that keeps us on top of what the impact is and allows us to project forward in a much more accurate way. So I think as Maria said, all countries will face this, but I do think it's important that countries provide that data as quickly as they can in the interest of moving our collective efforts forward to control this pandemic. Moderator: (45:12) Thank you very much on this. Next question is Gabriela Sotomayor, our friend from Geneva based Press Corps. Gabriela, please go ahead. Gabriela Sotomayor: (45:23) Thank you very much. Thank you for giving me the question. And it's very nice to see you all. And I have a question. I want to come back to the issue of Taiwan. We hear more criticism on Taiwan being excluded from COVID-19. They have very few cases and they can offer their experience to the world. So I would like to have your comments on this. And well, it's just that. Thank you. Maria Van Kerkhove: (45:57) So, I will start. So just to say, I will repeat what I said the other day. We have been working with colleagues from Taiwan on the technical side throughout this pandemic. And you're right, it is important that we learn from all countries who are dealing with COVID-19. I've personally, myself and Steve, have briefed members from Taiwan CDC, public health professionals and scientists. We had an exchange of information about what is happening at the global level in different regions and also from Taiwan as well. Maria Van Kerkhove: (46:33) And we have a number of people who are serving in our clinical networks and our infection prevention and control networks. And again, it's an opportunity where we regularly meet through teleconferences where there's the opportunity to exchange information peer-to-peer. And this is invaluable to be able to have firsthand experience with patients to say how are they, how are they developing disease, how can we treat them, how do we prevent onward transmission? And so there has been a regular and open dialogue throughout the pandemic. Dr. Steven A. Solomon: (47:11) Thank you. Thank you for the question and thank you Maria. Just to add, as we've said before, there's two parts to this. There's the participation within the WHO governance process, within for example, the World Health Assembly. And that's an issue that member States of the organization decide. The WHO staff does not have the mandate to decide those issues. WHO staff works technically and operationally to fulfill the mandate of WHO to coordinate, to convene, to provide advice, to furnish assistance for the response. Dr. Steven A. Solomon: (47:52) That's the work of WHO staff. The decisions about participation in the governance processes, in the membership, in the health assembly, is a decision that is and belongs to member States. But within the technical work that we do, as Maria has made clear, there are a range of areas that we cooperate, work with, engage with Taiwanese experts, both within the context of this current pandemic and generally. And we listed those, and they're available on our website. Dr. Steven A. Solomon: (48:32) I think just again to remind of three of the key ones for the response now. There is a point of contact within Taiwan CDC that has access to the international health regulations event information site. This is the key platform for exchanging information among all the parties and stakeholders in the international health regulations. There are two of the key clinical networks that Taiwanese experts participate in. The Clinical Management Network and the Infection Prevention and Control Network. These networks meet at least once a week, sometimes twice a week. Dr. Steven A. Solomon: (49:20) And there is the direct contact between WHO at a technical level, Maria just mentioned these, and Taiwan CDC. These are very important to ensure an exchange. We are looking at other ways to do so as well as this evolve and as the expertise from wherever can contribute to the response efforts. So I hope that answers the question about the technical work that is ongoing and the area that is really in the hands of member States. The formal participation of in WHO governance bodies, like the World Health Assembly. Michael J. Ryan: (50:09) Maybe I could just add to this, because I think it is important, the health authorities in Taiwan and Taiwan CDC deserve praise. They've mounted a very good public health response in Taiwan. And you can see that in the numbers. And we have praised that. And we've seen similar approaches taken in Hong Kong, SAR and across China. And we are observing and we are watching and we are bringing Taiwanese colleagues into the networks, the technical network, so they can share their experience. And they can both contribute their knowledge, but also seek new knowledge from outside. And I do believe that the health experts from Taiwan CDC were involved in one of the initial missions in China with colleagues from Hong Kong, SAR, as a joint mission to Wuhan by the National Health Commission in Beijing. So, that there is- Michael J. Ryan: (51:03) In Beijing. So that there, as Steve has said, these kinds of scientific collaborations within, without China are extremely important. But you know, Taiwan health authorities, Taiwan, CDC, professionals and health workers in Taiwan have stood on the front line. They've served and they have done service to their populations and as many others have around the world. And from our perspective we all stand with our professional scientific and health colleagues everywhere. Director General: (51:35) Okay. Thank you very much. Now we will go to Simon [inaudible 00:51:41] from Today's News Africa. Simon, can you hear us? Simon: (51:44) Yes, I can hear you. Thank you for taking my question. My name is Simon [inaudible 00:51:49] but from Today News Africa and my question is on Africa and not just Sub Saharan Africa. We know that the cases have escalated in the past few days. We have almost a thousand dead now. We have more than 17,000 cases. So is that anything that we can do in sub Saharan Africa at this moment that containment seems to have failed? And if I can quickly add something else. So here in the US we have in the past 72 hours we've had 11,000 dead. We've had almost a hundred thousand new infection. At the same time we hear authorities saying we are almost reaching the peak. So my question is, when can countries know that the peak is close or has been reached? Thank you. Michael J. Ryan: (52:49) Dr. Tedros may wish to speak to his... He did speak in the speech to his engagements with the African union and leaders across Africa, which have been very intense. I know our regional director for Africa [Chide Moete 00:02:07] has been deeply involved as have our teams. We have mounted I think 38 surge team support missions in addition to the presence of WHO in every country in sub Saharan Africa. Every country on the African continent actually. We have mounted a 38th surge missions in sub Saharan Africa. You will have heard to have sent now I think the third shipment of supplies through the solidarity flights with incumbent in collaboration with the African union, with Africa CDC, with Jack Ma Foundation and with the world food program. Michael J. Ryan: (53:45) So supplies are reaching countries in Africa in growing amounts. The DG referred to the fact that the all African countries now have the capacity to test. Some countries like South Africa, Kenya and others are developing high-throughput diagnostic capacity and can congratulate Kenya on being able to implement that extremely quickly. Michael J. Ryan: (54:07) And there are a very good reference facilities and reference labs on the African continent and [ICD 00:54:12] in South Africa, [inaudible 00:54:13] pastor in Senegal, at a Camry in Kenya, [Hoovry 00:54:21] who in Uganda. So there are real capacities across Africa to do the job that needs to be done. There's a deep history of containing epidemics, a very strong polio program across Africa. Now there they're the advantages that Africa has. But there are constraints and you're absolutely correct. These are difficult. This is a difficult disease to contain. Not on camera is our assistant director general Doctor [inaudible 00:00:54:51], who spent most of the last year and a half in the front lines fighting Ebola. And as I said previously in Ebola, in the peak of the epidemic there, we were tracing 25,000 contacts a day effectively in the middle of a shooting war. And to the great testament to the bravery, courage, professionalism of Congolese frontline professionals. Michael J. Ryan: (55:15) So I believe that African countries can achieve much more than maybe people from outside expect, but African countries need support, they need resources, they need solidarity, they need supplies, and they need the transfers of technology and knowledge that will allow them to take the fight to the virus. And I believe many countries in Africa are doing that. Michael J. Ryan: (55:41) And we don't believe that at this point the disease has passed the capacity to be contained. We believe a lot can be done to mitigate the impact of the virus and we believe that we need to accelerate those efforts as the number of cases grows on a daily basis on the continent. Like with all our member states, we will stand with African countries and stand on the front line and fight the virus together. The DG may have some comments to make at this point. No. Dr. Maria Kerkhove: (56:11) If I might add, I wanted to just touch upon something that you said when you talked about containment and that it was no longer possible. I just want to echo something that Mike said. Containment is possible. Containment is possible of this COVID19 virus. We have seen in a number of countries now, not just in Asia, in a number countries across Europe that were facing this horrible outbreak where they brought it under control. And Africa has an incredible resilience that Mike has outlined, in terms of its ability to fight infectious diseases and to mount a response, to find cases, to care for cases, to engage communities and build up communities and empower communities to be able to fight this. And so I don't... I was a little worried in what you said. I don't want you to lose hope. Dr. Maria Kerkhove: (57:05) Containment is possible. It's going to be a hard fight, but we are here and our African regional offices there and our country offices are there and the whole world wants to help. We need to do more. We need to empower everyone with the ability to test and to find cases, to have treatment centers available so that people can be cared for appropriately. To make sure that we practice physical distancing, to be able to have hand washing stations where we don't have running water. There's a lot that we can do and I just wanted to highlight that containment is possible. This virus is containable. Michael J. Ryan: (57:42) Thank you very much. We have time maybe for one, eventually two questions if we are very fast. We go to our friend John [Zarocostas 00:00:57:50]. John. John Zarocostas: (57:53) Afternoon. I was wondering... Can you hear me sir? Michael J. Ryan: (57:55) Yes please. John Zarocostas: (57:57) Yes. Good afternoon. Coming to the comments of Dr. [Tedross 00:58:02] earlier, on introducing strict disciplines on wet markets when they're reopened. We've been through this debate before with SARs, with Avian calling for good animal husbandry, and there have been some exemplary examples to my knowledge and Vietnam has been one of them. And how much is Vietnam is very good performance in this pandemic due to that very, very good animal husbandry? Michael J. Ryan: (58:32) Hi John, we miss you at the press conferences. I think, well obviously Vietnam deserve praise for anything they do to manage the animal human interface. But in this particular case, their performance in containing the disease has been in relation to imported cases in humans. So in that sense, I wouldn't believe that the necessarily... It's probably protecting Vietnam from other diseases, but at this point it's been the public health action and the action of the government across with an all of government approach that has led to a pretty good performance in controlling the spread of the disease. With regard to the broader issues in terms of markets and other things, we have work to do. A lot of work has to be done at the national level. A lot of work has to be done at the international level. Michael J. Ryan: (59:29) It needs a one health approach. We have a tripartite arrangement with our colleagues at O-I-E-N-F-I-O. But this is what many have been speaking about for many years. We live on one planet and we need a one health approach. And threats to human health in the main come from the animal kingdom are epidemic threats, emerging diseases and [zoonosis 00:59:52]. Michael J. Ryan: (59:52) So managing the interface between animals and is extremely important and that that interface has been stressed by climate variability, by environmental exploitation, by the illegal trade in wildlife and many, many other factors. And like those other things like climate change, it's not that possible to deal with simplistic... We can't, there's no simple way to deal with that. It requires a complex, again, all of government response. It requires a approach to regulation that doesn't drive things underground. Michael J. Ryan: (01:00:28) It's really important at this point that we ensure that right now around the world there's a lot of illegal trade in wildlife. And we need to be very, very sure that markets are safe, they're well-regulated, they're well run. But as the director general just said, many, many millions of people get their primary source of nutrition from such markets. How do we make markets safe? How do we make markets do their job? Which is provide nutritious food for people in a manner which is safe and that's going to require a very deep discussion between countries, within countries and across sectors in order for that to happen. Dr. Maria Kerkhove: (01:01:10) I would like to add to that. My background is in emerging diseases and zoonotic pathogens. These are viruses that jump from animals to humans. And I was very fortunate to spend almost two years in Cambodia, almost 15 years ago now. Where I was working at Institute pastor and I was studying avian influenza H five N one. And what we were doing is we were working in the markets. And there are hundreds of researchers, maybe more than that in the area of Southeast Asia that have looked at markets and have looked at animals in the markets. And where do those animals come from? Where are they onward sold, how are they sold? How are they sold in a safe manner to keep the people who are working with those animals, to keep the people who are buying those animals safe? What we have learned from the sale of animals and markets is that there are safe ways to do this. Dr. Maria Kerkhove: (01:02:07) And you're right, what we learned from Vietnam, what we've learned from Cambodia, what we've learned from Thailand, what we've learned from China, in terms of the safe operation of these markets needs to be carried forward. It needs to be done better and it needs to be done better at a global level. And we work very closely with FIO and with OIE, and we have guidance on how these markets can be operated safely to ensure that we prevent and we minimize the opportunity for these viruses to jump from animals to humans. So there is a long way to go there, but we have learned a lot over the years with avian influenza with SARS and we still need to learn about COVID19 and the zoonotic origins of COVID19. Director General: (01:02:53) Thank you. Thank you very much. So I'm looking at time and director general has important call to go to. So unfortunately we will have to conclude here, but obviously we will see you next week. We do apologize to many journalists who again, were online and we're not able to ask questions. But we are trying really our best. If you have questions that you need answers immediately to please send us an email to media@WHO.int we will have an audio file sent to you shortly, and transcript as always, tomorrow. I wish you a very nice weekend. Director General: (01:03:41) Okay. Thank you so much. So have a nice weekend and see you on Monday. [crosstalk 01:03:50] No, see you at the concert actually tomorrow. Tomorrow evening, Geneva time. But I think it will be a morning somewhere, afternoon somewhere. So see you at the concert. And I would like to use again, this opportunity to thank Lady Gaga and all the artists. Thank you so much.