The WHO’s announcement does not trigger any new funding, protocols or regulations. But it is an acknowledgment that the disease covid-19, which is caused by the coronavirus, is spreading across many countries and continents.
For weeks now, WHO has hesitated to make the declaration because there’s little upside to it and plenty of downside, such as panicking people.
“It may cause fear,” Tedros said at press briefing earlier this month.
But on Wednesday, Tedros noted the widespread scale of the outbreak. “There are now more than 118,000 cases in 114 countries and 4,291 people have lost their lives,” he said. “In the days and weeks ahead, we expect to see the number of coronavirus cases, the number of deaths, and the number of affected countries climb even higher.“
Tedros cautioned that “pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.”
He said the reason WHO decided to declare a pandemic in part because countries were not responding quickly and profoundly enough. “We are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.”
In the past, health experts have used pandemic as a signal that efforts to contain an outbreak from spreading have failed and counties should focus their efforts more on mitigating its effects through actions like getting hospitals ready to handle an influx of patients, stockpiling materials and enacting social distancing policies.
This outbreak has behaved differently, however, and WHO has stressed in recent weeks some countries should focus on containment even as they begin ramping up efforts to mitigate. By working to contain the virus, countries with only few cases can slow down the spread of the disease and buy time to work more on mitigation strategies.
“The blended and comprehended approach should continue … it would be a mistake to abandon the containment strategy,” Tedros said. “We have never before seen a pandemic sparked by a coronavirus. And we have never before seen a pandemic that can be controlled at the same time.”
Michael Ryan, WHO director for health emergencies, said there is “no mathematical formula, no algorithm” for making pandemic declaration. He said the decision came after very serious internal and external consultation “because we understand the implication of the word.”
Ryan said the declaration is meant to be “galvanizing the world to fight” and not as a reason for government “to give up or to grow fear.”
WHO officials appeared to indicate the declaration was fueled by frustration with slow and inadequate responses by some countries as the virus has spread.
“We have called every day for countries to take urgent and aggressive action. We have rung the alarm bell loud and clear,” said Tedros. “We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic.“
“There’s a real chance to blunt the curve, a real chance to bend the curve,” Ryan noted.
WHO officials on Wednesday noted that several countries such as South Korea and China have demonstrated that the virus’ outbreak can be suppressed and controlled through old-school public health measures of aggressive contact tracing, quarantines and isolation of the sick, social distancing, mobilization the public to sanitize and prevent transmission.
“Some countries are struggling with a lack of capacity. Some countries are struggling with a lack of resources.
Some countries are struggling with a lack of resolve,” Tedros said.
In the past, WHO’s declarations of pandemic had much bigger policy implications. The last time WHO declared a pandemic was during the 2009 H1N1 swine flu, and it triggered aggressive actions, such as millions in spending to buy vaccines. But H1N1 turned out not to be as deadly and disruptive as feared and a lot of governments were mad about buying vaccines that they ended up not using and harshly criticized WHO for its declaration. Burned by that response, WHO got rid of the six-stage procedure that led up to it declaring influenza pandemic.
“Each time they went up a stage, it raised alarm. When they finally reach pandemic stage it caused enormous panic,” said Lawrence Gostin, global health law professor at Georgetown University. “It was so dysfunctional and caused so much fear and panic that WHO abandoned that approach.”
WHO’s current approach is much more vague, essentially leaving it up to leaders to declare pandemic when they deem it necessary. Experts say WHO officials may be leery of causing panic as in the past, but if they wait too long, they risk losing its trust — an essential element in public health crises.
“In many ways whether we’re in a pandemic is a semantic question,” said Alexandra Phelan, a global health lawyer at Georgetown’s Center for Global Health Science and Security. “But if officials delay describing something as what it is. That can undermine their authority and cause mistrust.”
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