World Health Organization (WHO) COVID-19 Press Briefing Transcript July 30

Tarik : (00:00) ... Dr. Maria Van Kerkhove, technical lead on COVID 19, Dr. Mike Ryan, who is executive director health emergency program. We also have Derek Walton, who is our legal counsel, and we have also Dr. Martin Friede, who works on products, vaccines and research. Journalists who are online, as always should click icon, raise hands to get in line to ask a question. If possible, only one question so we can get as many as possible. As usual, we have some tenuous interpretation in six UN languages also in Hindi and Portuguese, so journalist may use any of these languages to ask their question. As we do, usually we will provide the audio file immediately after the press briefing, and we will have a transcript early tomorrow morning posted on our website. Tarik : (01:19) Just before I give the floor to Dr. Tedros for his opening remarks, I will just have to sort a little technical detail here, so we will be with you in a second. And again, just apologize for this delay. We had a little technical issue, but I think it has been sorted thanks to our colleagues. So I give the floor to Dr. Tedros for his opening remarks. Dr. Tedros Adhanom Ghebreyesus: (02:16) Thank you. Thank you, Tarik. Good morning, good afternoon, and good evening. Earlier this week, I had the honor of traveling to Bahrain and Kuwait, where the WHO has opened our two newest country offices. I also had the opportunity to visit several facilities that have been set up to respond to COVID-19 in both countries, and was very impressed by the innovative and comprehensive approach they used to fight the pandemic. We now have 152 country offices around the world, in addition to the new ones in Bahrain and Kuwait, and they're central to what WHO does, supporting countries to strengthen health systems and improve the health of their populations. Dr. Tedros Adhanom Ghebreyesus: (03:11) Before that, I was honored to be invited to Tokyo to address the International Olympic Committee, and I attended the official opening. I went to answer a question I'm often asked, when will the pandemic end? My answer was that the pandemic will end when the world chooses to end it, it is in our hands. We have all the tools we need. We can prevent this disease, we can test for it and we can treat it. And yet, since our last press conference cases and deaths from COVID-19 have continued two climb, almost four million cases were reported to WHO last week. And on current trends, we expect the total number of cases to pass 200 million within the next two weeks, and we know that is an underestimate. Dr. Tedros Adhanom Ghebreyesus: (04:20) On average, in five of WHO's six regions, infections have increased by 80% or nearly doubled over the past four weeks. In Africa, theirs have by 80% over the same period, much of this increase is being driven by the highly transmissible Delta variant, which has now been detected in at least 132 countries. Dr. Tedros Adhanom Ghebreyesus: (04:56) The WHO has warned that the COVID- 19 virus has been changing since it was first reported and it continues to change. So far, four variants of concern have emerged, and there will be more, as long as the virus continues to spread. The rise is also driven by increased social mixing and mobility, the inconsistent use of public health and social majors and inequitable vaccine youth. Hard grown gains are in jeopardy or being lost, and health systems in many countries are being overwhelmed. The increased number of infections is creating a shortage of treatment such as life saving oxygen. 29 countries have high and rising oxygen needs, and many countries have inadequate supplies of basic equipment to protect frontline health workers. Meanwhile, testing rates in low-income countries are less than 2% of what they are in high-income countries, leaving the world blind to understanding where the disease is and how it's changing. Without better testing rates globally we cannot fight the diseases on the frontline or mitigate the risk of new, more dangerous variants emerging. The WHO is supporting countries with supplies of oxygen, with guidance to help countries better detect variants, and we continue to work daily with our global networks of experts to understand why the Delta variant spreads so readily. But we need more, we need stronger surveillance. We need more strategic testing to improve the global understanding of where the virus is, where the public health interventions are most needed and to isolate cases and reduce transmission. We need patients to receive early clinical care by trained and protected health workers with more oxygen to treat the seriously ill and save lives. We need well-trained and well-protected health workers and the systems to deliver the services and the tools to save lives. We need more research and development to ensure that tests, treatments, vaccines, and other tools remain effective against the Delta variant and other emerging variants. And of course, we need more vaccines. Dr. Tedros Adhanom Ghebreyesus: (07:51) Last month, we announced that we were setting up a technology transfer hub for mRNA vaccines in South Africa, as part of our effort to scale up production of vaccines. Today, we have taken another step forward with a letter of intent that sets out terms of collaboration signed by the partners in the hub. The partners are WHO, the Medicines Patent Pool, Afrigen Biologics, the Biologicals and Vaccines Institute of Southern Africa, the South African Medical Research Council and the Africa Centers for Disease Control and Prevention. Dr. Tedros Adhanom Ghebreyesus: (08:33) The WHO's goal remains to support every country to vaccinate at least 10% of its population by the end of September, at least 40%, by the end of this year and 70% by the middle of next year. We are a long way off achieving those targets, so far, just over half of countries have fully vaccinated 10% of their population, less than a quarter of countries are vaccinated 40% and only three countries have vaccinated 70%. Almost a year ago, the WHO began to express concern about the threat of vaccine nationalism. In a press conference in November, we warned of the risk that the world's pool would be trampled in the stampede for vaccines. And at WHO's executive board meeting in January this year, we said the world was on the verge of a catastrophic moral failure, and yet the global distribution of vaccines remains unjust. Dr. Tedros Adhanom Ghebreyesus: (09:44) All regions are at risk, but none more so than Africa. On current trends, nearly 70% of African countries will not reach the 10% vaccination target by the end of September. Around 3.5 million to 4 million doses are administered weekly on the continent, but to meet the September target this must rise to 21 million doses at the very least each week. Many African countries have prepared well to roll out vaccines, but the vaccines have not arrived. Less than 2% of all doses administered globally have been in Africa, less than 2%. Just 1.5% of the continent's population are fully vaccinated, this is a very serious problem if we're going to fight this pandemic and end it. Dr. Tedros Adhanom Ghebreyesus: (10:50) In response to the Delta surge, today, the Access to COVID-19 Tools Accelerator is launching the Rapid ACT-Accelerator Delta Response, or RADAR, issuing an urgent call for 7.7 billion US dollars for tests, treatments, and vaccines. In parallel, we will need additional financing this year for COVAXs to exercise its options to purchase vaccines for 2022. This investment is a tiny portion of the amount governments are spending to deal with COVID-19. The question is not whether the world can afford to make this investment, it's whether it can afford not to. Tarik, back to you. Tarik : (11:44) Thank you very much Dr. Tedros. Before we open the floor for questions, just to note that we are also joined by Dr. Bruce Aylward, senior advisor to the director-general and the lead on ACT- Accelerator. So our first question goes to Dawn Kopecki from NBC. Dawn, unmute yourself please. Dawn Kopecki: (12:08) Hi, and thank you for taking my question. My question is, in the United States, the Delta variant, US health officials have said that it behaves differently from previous strains. It's definitely more contagious, but there's also some evidence that it may be more, not necessarily deadly, but lead to higher hospitalizations, more severe illness. My question is, is it different enough to warrant a new strain name? Are we at the point where the strains have mutated enough to justify COVID-20 or COVID-21? And if not, when do we come to that point? Tarik : (12:52) Thank you, Dawn. Maybe we will ask Maria to start. Dr. Van Kerkhove. Dr. Maria Van Kerkhove: (13:02) Thanks, Tarik. Yes, so I can start, and perhaps others may want to come in. So certainly the Delta variant is one of the variants of concern that WHO is tracking, as well as many countries around the world. It has demonstrated increased transmissibility, and we've known about this for several weeks, if not several months, in terms of the contagiousness, as you put it. The Delta variant is more transmissible than even the Alpha variant, which was first detected around the end of the year. Dr. Maria Van Kerkhove: (13:33) There are several reasons... We're really trying to get a better handle on why the Delta variant is more transmissible. There are certain mutations in the Delta variant that, for example, allow the virus to adhere to a cell more easily. There is some laboratory studies that suggest that there's increased replication in some of the modeled human airway systems. There are some laboratory studies that are looking at the CT value or the viral load of individuals who are infected with the Delta variant. And we're seeing lower CT values, which means a higher viral load in individuals with the Delta variant. And so there are a number of factors. We're working with many different groups around the world to get a better handle on all of these different reasons, but the SARS-CoV-2 virus and all of its variants are dangerous viruses. Dr. Maria Van Kerkhove: (14:25) With the Delta variant in terms of severity, we have seen a few countries demonstrate increased hospitalization rates, but we have not yet seen an increase in mortality. And so, again, we're trying to better understand why we may be seeing that. But the Delta variant, in terms of people who are infected with this variant, it has not yet translated into increased mortality. What we do know is that public health and social measures do work against the Delta variant. We know that our vaccines are safe and effective against severe disease and death. And so those who have access to the vaccine, when it's your turn, please get vaccinated and make sure that you get the full course of your dose, because it is definitely working against severe disease and death. Dr. Maria Van Kerkhove: (15:12) There is some data that suggests that people, and we, of course, have also known this as well, that people who are vaccinated can be infected and they can transmit, although the likelihood of that is much reduced if you are vaccinated. So again, we need people to be vaccinated. But it's important that we look at vaccines and in not vaccines only and that we use a comprehensive approach to understanding and to controlling transmission. Dr. Maria Van Kerkhove: (15:40) Your question about COVID-20 or COVID-19, COVID-19 actually describes the disease, and so the SARS-CoV-2 virus and the way that we named the virus and these variants of concern, there's a process that we have put in place with our virus evolution working group, which has now been formalized into a technical advisory group on virus evolution. And that is helping us to name the... Dr. Maria Van Kerkhove: (16:03) Regroup on virus evolution, and that is helping us to name these in terms of public speaking, as you call it these Delta variants. But, the naming of the virus, there's a classic way in which we do that. The disease that is caused by the variants and the variants of concern, hasn't necessarily changed. There's a wide spectrum of disease, ranging from no disease at all, to asymptomatic infection, all the way to severe disease and death. And so, the name COVID-19 reflects the disease itself. And so, we haven't discussed changing that, because the disease itself is the same. So again, it's just really important that we continue to do everything we can to drive transmission down, because the virus will continue to evolve, the more we allow it to spread. Tariq: (16:48) Thank you very much, Doctor Maria Van Kerkhove. Just looking if anyone would like to add. Dr. Ryan obviously, when you want to jump in, just signalize it, but I understand that Maria- Dr. Michael Ryan: (17:03) I can just add cleric- Tariq: (17:03) Yes. Dr. Michael Ryan: (17:03) And I think Maria addressed all the issues. Just to reassure people that the Delta variant is a challenge as the other variants have been. But, remember the diagnostics that we have all around the world still work very effectively against all of the variants and we can detect the disease quite successfully. And in terms of vaccination, the vaccines that are currently approved by WHO, all provide significant protection against severe disease and hospitalization for all the variants, including the Delta variants. So, it's important, we are fighting the same virus, but a virus that's been considered and better adapted to transmitting amongst us humans and that, that's the change. But, the way in which we fight the virus hasn't changed and vaccines, and all of the other measures still remain hugely effective, if applied in a comprehensive, fair, equitable, and rapid manner. Tariq: (18:01) Thank you very much, Dr. Ryan. So, we will go to the next question. That's Tom, the good chief from Kyodo News and Geneva-based reporter. So Tom, please unmute yourself. Tom: (18:18) Hi, good afternoon. Dr. Tedros, your recent visit to Japan was seen as an endorsement for holding Olympic Games under state of emergency in Tokyo. During the past several days, cases surged and now Japan is facing the worst ever situation. Don't you think you sent the wrong and confusing message by your visit? I like to hear Dr. Tedros' response, in his own words. Thank you. Tariq: (18:53) Thank you very much, Tom for this maybe Dr. Ryan would like to take this one. Dr. Ryan? Dr. Michael Ryan: (19:02) I think, the issue in terms of the Olympics has been an extreme focus by the Japanese authorities, by the Tokyo Organizing Committee and by the IOC on having in place really comprehensive risk management measures. First of all, there's very, very strong surveillance in place, a hugely regular testing of participants, of athletes, of delegations. A lot of measures to reduce risk of transmission and including quarantine and isolation. So, there's a very comprehensive set of measures in place to manage any risks of transmission. And yes, there have been a number of new cases in the last 24 hours. And as they have been cases through the Olympics. There've also been, I think over 3000 cases in Tokyo in the last 24 hours, or more than 10,000 in Japan. So, the Olympics, is part of that overall context. The risk management that's in place around the Olympics, it's extremely comprehensive. Dr. Michael Ryan: (20:07) I think, the Director-General's trip, was to highlight the need for the world to come together, the need for the world to act together, the need for the world to reduce the inequities that are truly driving this pandemic and to focus on what are the true drivers of this pandemic. And the two drivers of this pandemic are not within the Olympic games. They're really related to the deep inequities we have in the distribution availability of vaccine, the deep inequities in health that we have around the world. Dr. Michael Ryan: (20:39) And his call was a call to the world, at a moment of unity in sport. We need a moment of unity amongst health systems, amongst governments, amongst everybody to play fair. That's the Olympics, you play fair, you compete fairly. You try to succeed on behalf of your nation. He wants all nations to succeed on behalf of humanity. And that was his message at the Olympics, it was a very clear and simple message. And this is the important duty of the Director-General to use every opportunity that he has as a global leader, to put that message to the world and make the world face the reality that we now face, which is a pandemic that is affecting many parts of the world, very unjustly and very unfairly. Thank you. Dr. Tedros Adhanom Ghebreyesus: (21:22) Yeah, thank you. So, our colleague wanted to hear from me also, so I'd be happy to, to what Mike said. Although, Mike had already covered everything. As I said in my speech, by the way, in Tokyo, I said that there is no zero risk. There could be less or more risk. And then, for things to happen with low-risk, you try your best. And what we have seen from what Japan did, is it did its best. And IOC of course, they did their best to minimize risk, because nobody should expect zero risks, there will always be a risk. And there is no zero risk in life. So, I know that they have done their best and we have supported them all along, technical support and other support. I even myself, went through a very rigorous testing and retesting, checking and rechecking. How many PCR tests? I know it's very difficult, a PCR test, the swab and so on, but I had to go through that myself. And they have done their best and made sure that the risk is minimized and be able to host the Olympics. I think hosting the Olympics now, it will be a reminder of the world about the pandemic for generations to come. When I was attending the official opening, I saw the torch bearer with a mask and the torch, and that picture still means a lot to me. It shows that we are doing this in a very difficult condition. We are doing this when we are taken hostage by a dangerous virus. But, at the same time, shows me the determination to fight back. So, I think that picture, many people have seen it, must be a reminder in what condition we are now. And I think for future generations to understand what this pandemic meant. Then, the other part that Mike touched, I would like to say is, the very reason I wanted to be in Tokyo and to join IOC and the government of Japan in the Olympics, is to use the platform, to tell the world that we need to use the spirit of Olympics, the spirit of solidarity, the spirit of unity to end the pandemic. Dr. Tedros Adhanom Ghebreyesus: (24:47) So, taking the spirit of the Olympics from Tokyo to the whole world, so we do better. I said it in my speech earlier today, do you really accept 1.5% vaccination in Africa, while in some countries it's already 70%? Don't we need a platform like the Olympics to go and tell the truth that the world actually morally, epidemiologically and economically, is doing the wrong things? Is it really wrong to go to the mountain top of the Olympics to call for solidarity? Are you saying that's wrong? I hope not. So, that's why I went. So, imagine that's the highest mountain Olympic mountain now, while the Olympic is happening, where the world can hear what we have to say. I said the same thing that I had been saying for several months now. But, I hope that created an opportunity to make it more clear and that we are taking the wrong paths and that we need to use the spirit of the Olympics to correct it. So, by all means, I think we have to use it as opportunity. And I have a call actually, to all athletes who are participating in Japan. We want them to be the ambassadors of solidarity. Dr. Tedros Adhanom Ghebreyesus: (26:39) I know they're going back home. All of them will go back home after the Olympic. And in their respective countries, they have to advocate and use the spirit of Olympics, the spirit of sports, the spirit of winning to win on this pandemic. I hope they will accept this challenge and be the ambassadors to defeat this pandemic. Thank you. Tariq? Tariq: (27:19) Many thanks Dr. Tedros, also Dr. Ryan. Let's go to the next question, as John [inaudible 00:27:25] expressed, Christopher Vogt is with us. Christopher? Christopher Vogt: (27:30) Yes, thank you for taking my question. It's about the Delta variant. And I think there was anecdotal evidence out of the UK, that young children were more affected, in a more dangerous way, even with the hospitalizations. And I was wondering, first of all, if you had seen further studies that confirm that? And second, what your guidance would be about schooling and also vaccination? Tariq: (28:02) Thank you, Christopher. Dr. Van Kerkhove, would you like to take this question? Dr. Maria Van Kerkhove: (28:07) Sure, Tariq. So, thank you very much for the question. So, when these virus variants are detected, there's a lot of surveillance that is increased. Which is really good, because we need to know where the virus is. We need to understand which viruses are affecting different people. And a lot of this, is supported through sequencing. Data from the UK when the Alpha variant emerged, and when the Delta variant emerged, there is increased rates of infection across all age groups. There was some suggestion that the variants were specifically targeting children, but that actually is not the case. What we are seeing, is that the variants will target those who are socially mixing, those who are out. And if we increase our social mixing, and then we have people who are unvaccinated, if the virus is circulating, including the Delta variant, will infect individuals. Dr. Maria Van Kerkhove: (28:58) So, let me be very clear. We are not seeing the Delta variant specifically target children. What we do see, is that the variants that are circulating will infect people, if they are not taking the proper precautions, if there is increased social mixing, if we're not using public health and social measures, if they're not vaccinated. And so, this is why we continue to advise this comprehensive package of interventions. Whether these are at an individual level, the physical distancing, which remains critically important, critically important. Avoiding gatherings, spending more time outdoors than indoors, improving ventilation, if you are spending time indoors. Getting vaccinated when you can. And so, there tools that we have at hand, that can keep us, our loved ones and children safe. With regards to schools, we have recommended a plan for schools to reopen and stay open safely. In terms of opening in settings where the virus is controlled, making sure that transmission in the community, is driven down to a low level, because you have to remember that schools don't operate in isolation. Dr. Maria Van Kerkhove: (30:10) They operate in communities. And so, first and foremost, we need to drive transmission down. And then, work with the school systems to make sure that there are certain plans in place, to be able to detect cases, to be able to care for cases, to be able to carry out contact tracing, to be able to communicate with children and their families about the plan, should the virus be detected amongst students, or amongst the people who are working at those schools. To make sure that there's good disinfection. If children are age appropriate, to make sure that they can wear masks and that they're supervised in wearing those masks. Dr. Maria Van Kerkhove: (30:45) So, there are ways in which many countries have opened up their schools, have opened up their schools safely and kept those schools open, because schooling is critically important for children, not only for their education first and foremost, but also for security, for safety, for their social wellbeing. And in many situations, this is where children receive their food. So, it is really important that schools open, that they open safely. And there are ways in which the schools can open and can remain open, but we really do need to drive transmission down in the communities to make sure that they can open safely. Tariq: (31:27) Many thanks Dr. Van Kerkhove. So, we will go to next question. Anjalee Khemlani from Yahoo Finance. Anjalee, please unmute yourself. Anjalee Khemlani: (31:41) Thank you. Yes, thanks for taking questions. I wanted to go back to what Dr. Van Kerkhove was saying about the Delta variant being transmissible. As you've probably seen in today's reporting with the CDC in the US, there are internal documents that show just how transmissible it is. And for the past several weeks and months, I know that, not just the World Health Organization, but other agencies have been... Anjali: (32:03) ... I know that not just the World Health Organization, but other agencies have been struggling with the public health messaging about the Delta variant. I wanted to know, the recent document shows how it's as transmissible as the chicken pox. If Dr. Van Kerkhove or Dr. Ryan or anyone else wants to weigh in, if we could get maybe five bullet points on how you could easily describe, almost at a kindergarten level or a very simple level, the concerns about the Delta variant. Tarek: (32:31) Thank you, [Anjali 00:32:32]. Dr. Van Kerkhove or Dr. Ryan? Dr. Maria Van Kerkhove: (32:37) Perhaps I could start and maybe Mike would like to come in. I mean, I think your question highlights the challenges of being able to communicate about this. The virus itself, as it starts, is a dangerous virus. It's a highly transmissible virus. The Delta variant is even moreso. It's doubly more transmissible than the ancestral strains and it's about 50% more transmissible than the Alpha strain. Dr. Maria Van Kerkhove: (33:05) From a public point of view, if I was describing this at a kindergarten level to my own kids, it's a highly transmissible virus. Whether it's a hundred percent or a thousand percent or whatever percent more transmissible, this virus will spread if we allow it to. The bottom line is that we need to do everything we can to protect us, to protect ourselves and to protect our loved ones, and we can do that. Dr. Maria Van Kerkhove: (33:31) What we need to do is continue to keep ourselves safe by physical distancing, by wearing a mask, by keeping our hands clean, by spending more time outdoors than indoors. We need policies that are in place that enable people to work safely, go to school safely, live their lives safely. A lot of this is around making sure that these policies allow to adhere to these individual level measures, to improve ventilation in indoor spaces, to make sure that we have vaccines and we have access to vaccines, and that the vaccination plans that countries all over the world that have worked so hard to develop are able to be implemented by having access to that vaccines. We need to work against vaccine hesitancy and vaccine acceptance, making sure that people receive those vaccines. Dr. Maria Van Kerkhove: (34:17) From the Delta variant, the Delta variant is dangerous. The Delta variant can transmit. It is more transmissible, the most transmissible SARS-CoV-2 virus to date, but this will not be the last virus variant that you hear us talking about. What we need to do is move away from the next latest virus, the next latest variant, because there will be more. It's in the virus's interest, viruses are not alive so they don't have a brain to think through this, but they become more fit the more that they circulate. The virus will likely become more transmissible because this is what viruses do, they evolve, they change over time. We have to do what we can to drive it down. Dr. Maria Van Kerkhove: (35:03) Again, it wasn't your five bulleted short point answers, but it's more transmissible and it's the most transmissible virus to date, but we have the tools at hand that can reduce the spread. I think that's what we really need to be focused on. Tarek: (35:22) Thank you very much, Dr. Van Kerkhove. Dr. Michael Ryan: (35:22) Mike, here. Tarek: (35:24) Mike. Yes, please, Dr. Ryan. Dr. Michael Ryan: (35:28) Yeah. I wouldn't characterize us as struggling to communicate on variants, specifically on the Delta. We've been speaking about this for months now and tracking this virus through our Virus Evolution Working Group and through the wonderful work going on all over the world by so many labs and tracking this virus within the public health systems. The dangers posed by Delta have been raised time and time again by the director general and by WHO. Dr. Michael Ryan: (35:58) Fully understanding the dynamics of how and why it is more transmissible is still taking time to determine, and there's a lot of studies underway to try and understand that because that may affect what we do about this virus. But if we're explaining this to ourselves, and it's not just at kindergarten level, in some senses we're all in kindergarten when it comes to this virus, we're still learning. We've taken baby steps in trying to control this virus and when we're explaining this to people, essentially it comes down to, on average, one person with this virus will infect more new people if they have the Delta strain, unless we prevent that by continuing to practice the measures that reduce transmission, like physical distance and wearing masks and hand hygiene, and ensuring that we're not spending time in poorly ventilated spaces with lots of other people, and all of the other measures that we've spoken about again and again. Dr. Michael Ryan: (37:02) The same measures that we've applied before will stop this virus. They are stopping the Delta strain, especially when you add in vaccination, but we need to work harder. The virus has got fitter, the virus has got faster. It doesn't change our game plan. The game plan still works, but we need to implement and execute our game plan much more efficiently and much more effectively than we've ever done before. That includes getting more vaccines out there, increasing the ... The DG spoke about it, he said it in the speech, he laid it out, these are the things we need to do more of and we need to do much better and we need to do much faster. There are no gold and silver bullets here, there are no magical solutions, there's no magic dust. It's been that way for the last 18 months. People keep asking for magic dust, it doesn't exist. The one magic dust we do have this vaccination. The problem is, we're not sprinkling that evenly around the world and we're working against ourselves. Dr. Michael Ryan: (37:58) From that perspective, Delta is a warning. It's a warning that this virus is evolving, but it's also a call to action that we need to move now before more dangerous variants emerge. Dr. Bruce Aylward: (38:14) Thanks, Tarek. It's Bruce here. Just come back, Angali, to your question. When people say a virus is more transmissible in this case and what it means. As Mike and Maria said, it's simple. More transmissible means more cases, more sick people, more hospitalizations, more ICU filling up, which brings us to a choice. Do we do more stuff to stop it at an individual level, like Mike and Maria laid out, or do we have to go to more lockdowns to stop it? It's that simple. More cases, more sick people, more hospitalizations, more ICU overload, and then you get to your choice point, more lockdowns or more stuff to stop it by using your masks, using your distancing and your other measures. Dr. Bruce Aylward: (39:03) But then to the other point, just to take a step back to one of the earlier questions about vaccines and their equitable use. We could be at a very different point right now. Since the Director General held his last press conference, we have moved past four billion doses of vaccine administered. Now, if those vaccines hadn't been administered to people over 60 years of age and at risk around the world, we basically could have gotten two doses into everybody at highest risk of severe consequences when we got to a disease or a strain like the Delta strain. We actually could have vaccinated them twice, that's how much vaccine has been used in the world. Dr. Bruce Aylward: (39:45) But because we haven't, we are seeing in so many countries now what we're calling a diverging epidemiology. In one set of countries, we're seeing the cases go up but the deaths stay low. In other countries, we're seeing the cases and the deaths go up. That's another choice that we've got to make as a global community, are we going to change that now and change it such that in both settings cases may go up, the variants may become more transmissible, but deaths and hospitalization stay low. That's a choice we make about the fair and equitable distribution of vaccines around the world. Dr. Bruce Aylward: (40:20) We've seen great improvements, and a huge shout out to those countries that have been sharing doses to those manufacturers that have started to prioritize the low-income countries. But we are only at 1/10 of the level of the high-income countries still when it comes to number of doses per hundred population. In the face of the Delta variant, they're going to pay a very, very different price as a result. Tarek: (40:47) Thank you. Next question, Latika Bourke from the Sydney Morning Herald. Latika? Latika Bourke: (40:55) Thank you very much, guys. You would obviously have seen the recent comments by China saying that they do not believe that there is any need for a second push or probe into the origins of current virus. If they refuse to cooperate, what does that mean for any second phase of your investigation? Tarek: (41:16) Thank you, Latika. Dr. Ryan, would you like to address this? Dr. Michael Ryan: (41:23) I think we're in a very positive consultations now with a large number of member states, including our colleagues in China, to look at what we need to move forward next, through the process of the scientific advisory group on origins and building on the report of the phase one mission, which many, many studies were proposed going forward. We do know that Chinese colleagues are implementing some, if not all, of those studies at the moment. We're looking forward to receiving updates from our colleagues in China. On the implementation of those studies. We expect that work to continue in China and in other countries around the world. Dr. Michael Ryan: (42:04) I do think that where the DG has been clear in the past, we are expecting all countries, all member states of WHO, to cooperate and support this process. I suspect that we will get that cooperation. There's a lot of rhetoric out there at the moment, certainly. The one consistent thing we've heard from all countries has been let's not politicize the science and the next thing that happens is the science is politicized. Dr. Michael Ryan: (42:33) What we want to do, for all parties, and everybody is calling for this, there's widespread agreement amongst all of our member states, let's not politicize the process. We believe we have the basis to move forward. We have a set of studies that can be taken forward. We want to bring together a scientific advisory group at Origins to help take that forward. We want to bring members of the international team into that process to maintain continuity with the previous process, and we want to reassure our colleagues in China that this process is still, and is and has always been, driven by science. We have stuck to the principles and the process of this from the very beginning, we've not exceeded pressures on one side or the other. The DG has tried to steer a path that has been driven by science and by evidence, taking those sides and trying to reach the objectives that we all want to control COVID-19, to establish the origins of the virus and put in place what measures we can to prevent a further re-emergence of a similar virus in the future. Tarek: (43:39) Many thanks to Dr. Ryan. Next question, Isabel Saco from EFE News Agency. Isabel? Isabel Saco: (43:53) Yes. Good afternoon, thank you. I would like to have your comment, scientific comment, on the decision of the government of Israel to invite people over 60 years old today to get a third dose of the vaccine. Because as you are calling all the time on the importance of being vaccinated, you invite people to get fully vaccinated as soon as possible, as soon as they can, but we see some of these countries with one of the highest rates of vaccinated people and getting in this vicious cycle over another. We know that we will not be able to get out of this problem until we really get all people in the world vaccinated, at 80% for example, and do you think that this is realistic? Thank you. Tarek: (45:03) Thank you very much, Isabel. Dr. Aylward will try to have some elements. Unfortunately, we don't have Dr. O'Brien and Dr. Swaminathan today with us. Dr. Aylward? Dr. Bruce Aylward: (45:14) Thanks very much, Tarek. First, on the issue of booster doses, which we've discussed a number of times, and this doesn't relate to any individual country to be very clear in the comments that I'll make, but first and foremost, we've explained there's two reasons that we want to be looking at booster doses, if and when they may be needed. First, we look at the duration of immunity, is immunity sustained for long enough or do we need to boost it to ensure people remain immune? The second thing we look at is whether or not the vaccines that we have available are no longer effective against certain strains of the virus. This is particularly with respect to the ability to prevent hospitalization, severe disease, and death. Dr. Bruce Aylward: (46:01) At this point, the evidence is quite clear that all of the vaccines appear to have a good impact against severe disease and hospitalization and death. Now, we're continuing to accumulate information, and we're also seeing that the immunity protecting people seems to be relatively robust at this point. The highest priority for the world, now, we're in a pandemic, which means that we need to work together against this virus, we can't think about a priority for our country or our community, they will have differential experiences, but we have to think about how do we approach this as a world. The first priority has got to be to get at least two doses of vaccine, or one dose if it's the J&J vaccine, into all of, first of all, the healthcare workers, the older populations, the people with the comorbidities that put them at risk of severe disease and death, and then working down to what we believe would need to be at least 60% coverage in all countries, which works out to about 70% coverage globally, to really slow down the transmission and reduce the risk of emergence of new variants. Dr. Bruce Aylward: (47:08) But as we say that, I think it was Isabel who asked the question, we need to be a little bit careful that we're still, as Mike used the term, we're in kindergarten when it comes to this virus. I was hoping we're in primary school by now, but we're still very much in a learning mode. We will say, this is our best possible judgment based on the data and the information we have today, it will evolve as we go forward, but there's absolutely no question that the highest priority for vaccine suppliers, for countries that produce vaccines, for countries that are using vaccines and have contracted high quantities of vaccines, the highest priority has got to be helping all countries get to at least 10% of their population vaccinated, 20%, 40%, in line with the targets that the Director General has laid out, which are crucial to getting the entire world out of this pandemic. Hopefully that addresses the question, there were a couple of points to your- Dr. Bruce Aylward: (48:03) Hopefully that addresses the question. There were a couple of points to your question, but hopefully we've captured the key ones. Apologies if we haven't. Tarik: (48:09) Thank you very much, Dr. Aylward. If there are some aspects that have not been covered, Isabelle, feel free to send us an email and we will try to answer. Next question, Geneva based correspondent, [Peter Kenny 00:48:22], working with [Anadolu News Agency 00:48:24] and others. Peter? Peter Kenny: (48:28) Thanks for taking my question. We have heard about epidemiological divergence and the variant mutates all the time, but so has the at-risk group changed. Initially, it was over 60s and others. But now we have a much younger group in some countries. Does that mean that the advice as to what are the at-risk groups is changing? Thank you. Tarik: (49:05) Thank you, Peter. Dr. Van Kerkhove, would you like to [crosstalk 00:49:11]? Dr. Maria Van Kerkhove: (49:11) Sure, [Tarik 00:49:12]. Perhaps I could start, but I think there's two parts to this question. One part to this question relates to exactly how it was asked in terms of risk groups. But I think the second part of this question has to do with priority groups for vaccination. In terms of groups that are at risk for developing severe disease, groups that are at risk for death, from infection, from the SARS-CoV-2 virus, those have remained relatively stable over time. Dr. Maria Van Kerkhove: (49:39) We know people of advanced age, people over the age of 60, and as age increases the risk of developing severe disease and dying increases as age increases. We know with people with underlying conditions, such as chronic respiratory conditions, cardiovascular disease, HIV, obesity, diabetes, have an increased risk for developing severe disease and dying. What we do know is that over time, we do see a shift in terms of the age range in which people are getting infected. And again, that has to do with how social mixing patterns happen. Dr. Maria Van Kerkhove: (50:21) If you remember even a year ago, more than a year ago now, last spring in the Northern hemisphere, we saw what appeared to be an age shift in the average age of infection. And people were wondering, has the epidemiology changed, has the virus changed? But in fact, what that was due to was the fact that older individuals were staying home more, younger individuals who had to leave their home to go work were leaving their home and were increasing the number of contexts that they had, and we're at a higher risk of exposure and therefore a higher risk of infection. Dr. Maria Van Kerkhove: (50:52) But in terms of those people who are at an increased risk for developing severe disease and dying, it's those that have underlying conditions of any age, this includes children and people who are over the age of 60. We know that again, the increased risk increases substantially as age increases. There are differences as we see in terms of the infection rates. Dr. Maria Van Kerkhove: (51:20) But again, over time as individuals who are of the older age groups, those who are have underlying conditions, those groups are prioritized for vaccination first. Those individuals are protected against severe disease and death because again, we have several safe and effective vaccines that prevent against severe disease and death. We need access to those vaccines to actually have them work. And this is why we need good vaccine equity around the world. And so, that's the shift that we see. Tarik: (51:52) Thank you very much. Dr. Aylward, would you like to add [crosstalk 00:51:56]? Dr. Bruce Aylward: (51:55) I think Maria was clear in answering the question. The prioritization of vaccination has got to still follow the order of priorities that Maria talked about in terms of severe disease and death. What we are seeing though in the high-income countries, as you alluded to Peter, we're seeing this divergence now in the epidemiology. It's a fancy way of just saying that what the outbreak looks like and the damage it's doing, what it looks like in populations in high-income vaccinating countries is starting to look very different from what we're seeing in the low-income non-vaccinated countries, because they don't have access to vaccines. Dr. Bruce Aylward: (52:33) And so, if there needs to be a shift in our prioritization, it's not in terms of our target groups who we're vaccinating, the shift needs to be and where we're vaccinating that we need to look at vaccinating. Great, we've covered the high risk and highest older populations, health workers, et cetera, in the high-income countries. We need to make sure we are doing it in the low-income and other countries. So before we start moving down age groups, we need to look geographically at what we're we're doing. Dr. Bruce Aylward: (53:03) And again, as we've seen, you'll remember when we first started talking about Delta virus and the various other strains, these were only found in one or two countries, but they very rapidly now, as the Director-General said in his comments, spread everywhere. 132 countries now that we know have the Delta viruses, probably many more. It's a bit of a fool's bargain to think that you can vaccinate your way out of this and one country without paying attention to the rest of the world. Dr. Bruce Aylward: (53:35) I think that message is getting through now. We're starting to see more donations and response to the call and more sharing of vaccines and doses in response to the Director- General's call. But we're still nowhere near the numbers we need to get to, if we're going to get at least 10% of the population, 20% of the population vaccinated in the majority of the world's countries. So, yes, as we see more disease in younger populations as a result of the fact that older populations are vaccinated in many parts of the world, we still need to remember and look at geographically, there are huge parts of the world where those most at risk of dying are not vaccinated. Dr. Bruce Aylward: (54:17) That's the reason the most alarming statistic that the Director-General said in his comments this morning was the 80% increase in deaths in Africa over the last four weeks. This should be completely unacceptable on a global scale, the fact that we could even say those numbers without reacting to them that way. This should be completely unacceptable in an era where we have powerful, effective vaccines, where you have billions of doses of them. And in some parts of the world, 80% increase in deaths, completely unacceptable. We can't change that unless we shift our priorities from who gets this to where they're getting it and make sure there's equity in the distribution of these products. Tarik: (55:01) Thank you very much, Dr. Aylward. We have time for maybe one more question, so let's talk to [Sarah Jerving 00:55:11] from [Devex 00:55:12]. Sarah? Dr. Maria Van Kerkhove: (55:14) Thank you so much for taking my question. What percentage of the overall population on the African continent do you expect realistically will be vaccinated by the end of this year? And when do you realistically expect the African continent to reach that herd immunity threshold? Thank you. Dr. Bruce Aylward: (55:31) Sarah, people are going to disagree with me, but I tend to think the world is going to come together and realize that we have got to make a massive step change in our attention to the vaccine supplies that are going into Africa. If we look right now, we are not on track to hit 10% coverage in Africa by the end of this year. That should be a scar on all of our conscience quite frankly, if that were to evolve. There is absolutely no reason that should be the case. Dr. Bruce Aylward: (56:11) There's enough vaccine in the world. There's enough money in the world. There's enough absorptive capacity, definitely on the African continent, enough demand for the product that they could easily hit 30%, 40% coverage were the vaccine made available. So our key and our goal and what I spend my days doing and an awful lot of other people like the Director-General is trying to look at how do we shift more product into that pipeline so that we can make sure that realistically we're well over 20%, 30% by the end of this year and ideally, we are up to 40%. Dr. Bruce Aylward: (56:46) When will Africa countries be able to hit the level of immunity needed, what you called the threshold for reducing transmission, et cetera, unfortunately, Africa does not control in the countries of Africa that decision right now. Right now, that decision rests with a number of CEOs and the boards of major companies that supply vaccines of countries that produce vaccines and of countries that control the contracts for the majority of the world vaccines. We need all of them working together, freeing up product so that it can get to the African countries of Africa and so that they can boost their coverage levels. That's the problem that we're dealing with quite simply. Dr. Bruce Aylward: (57:29) I think it'd be a terrible thing for us to say, well, realistically, we think it will reach 10% or 20%. Realistically, it has to hit 40% at least like the rest of the world. We should never be talking about what do we think is going to happen in Africa versus America or versus Europe. We should have the same standard. We should have the same ambition. We should have the same aspiration and be driving for the same coverage levels. So if Europe gets to 70% or 60% by the end of this year, why shouldn't Africa get there? That's the way we should be approaching these questions. Dr. Bruce Aylward: (58:01) It's not right to be thinking differentials across these places, because frankly it's a function of the choices that are made outside of Africa about the coverage that we can get to right now. And that's a dynamic that has to change. That's part of the reason as well you're seeing such a collective effort on trying to get production capacity into Africa so that they can actually produce vaccines for use on the continent, have more control over the supply chain. Sarah, coming back what's realistic, realistic is to get to 50%, 60%, if the product was made available. Will we get there? That's the challenge to the world, but we should be measuring what's the Delta, the difference, not the Delta virus in this case, the difference between where we are in the continent and elsewhere around the world, where we are in Europe, where we are in the Americas. If all lives are equal, the effort we put into protecting them should be the same as well. Tarik: (59:01) Thanks Dr. Aylward and to all of our speakers who were online or here in the room. I will give the floor to Dr. Tedros For his closing remarks. Dr. Tedros: (59:18) Thank you. Thank you, Tarik. Thank you also to all media colleagues who have joined today and see you in our upcoming presser. Bon weekend.