WHO Europe chief Hans Kluge tells Telegraf Covid has not gone away: What to expect by end of this year

Society is slowly returning to normal, but the pandemic is still with us. And COVID-19 is not the only public health threat facing our people, says Kluge

The world has been fighting the Covid-19 pandemic for three years now. We have gone through various lockdowns affecting entire cities and countries, there have been states of emergency and various Covid restrictions.

Unfortunately, more than six and a half million people around the world died from this virus, and today we have gotten used to the "new reality" - living with the virus. World Health Organization Regional Director for Europe Dr. Hans Kluge last year spoke for Telegraf.rs about why we had not learned our lesson, and in a new interview for our portal, he reveals what kind of winter awaits us and whether we will finally be able to say that the Covid pandemic is over.

• The pandemic started almost 3 years ago. What is the situation in the world today, can we say the worst is over? Is it finally time to say: the coronavirus pandemic is over?

It is true, we are in the third year of this pandemic. I empathize with everyone who is tired of hearing about COVID-19. And while the pandemic is not yet over, we have never been in a better position to end it. The numbers of confirmed cases and deaths from COVID-19 is starting to plateau in the European Region. This is a welcome development, but we cannot afford to be complacent. With colder weather approaching, it's reasonable to expect an increase in hospitalizations and deaths in the coming months, especially if influenza is circulating alongside COVID-19, as we expect.

Countries can’t afford to be complacent. In the European Region and elsewhere, the virus continues to circulate, and we know that the number of cases that are now being reported to WHO are an underestimate – and these infections are still resulting in hospitalizations and deaths, particularly in vulnerable groups (elderly and people with chronic diseases). Just in the last week, nearly 2,500 people in our Region died as a result of COVID-19.

As we gather more inside during the winter months, we expect there to be future waves of infection caused by different sub variants of Omicron and potentially even different variants of concern, because the more this virus circulates, the more opportunities it has to change.

We can’t afford to let our guard down now and put at risk the great strides we’ve made in addressing the pandemic. We need to do everything possible to protect our populations. The more we do now, the more chance we have of limiting the spread and impact of the virus through the winter.

• What can we do?

• increasing vaccine uptake in the general population, including a first booster shot, starting with priority groups like the elderly, immunocompromised, and health workers;

• administering a second booster dose to immunocompromised people aged 5 and above and their close contacts, and considering offering a second booster to specific at-risk groups, at least 3 months after their last dose;

• promoting mask-wearing indoors and on public transportation;

• ventilating crowded and public spaces (such as schools, offices and public transport); and

• applying rigorous therapeutic protocols for those at risk of severe disease.

We must do all this because the pandemic is not over. The virus keeps changing and it is still killing far too many people.

• Today people are used to living with the coronavirus, measures are relaxed, we don't need to wear masks anymore, but is the danger over? What are the recommendations from the WHO?

In short, no, the danger is not over. Millions of people in Europe and Central Asia remain unvaccinated. In Serbia, priority groups are well-protected. For example, more than 70% of people aged 60-79 are vaccinated, but the rest of the population has some catching up to do. Serbia also needs to reach priority groups, with a focus on the elderly, with booster doses.

We have tools that can prevent infections, can prevent transmission, and critically the use of vaccines, and the early use of antivirals can prevent people from going on to develop severe disease and dying, as well as developing long COVID.

Society is slowly returning to normal, but the pandemic is still with us. And COVID-19 is not the only public health threat facing our people. Let’s not forget about the damage to health caused by climate change, the war in Ukraine and other infectious disease outbreaks including most recently, monkeypox.

I am telling governments and health authorities across the region – including Serbia – to accept this ‘new normal’ where our health systems are seemingly in a permanent crisis mode. This calls for a ‘dual track’ approach.

• What does this mean?

On one hand, we must urgently prepare for health emergencies like pandemics, climate-related crises, . On the other hand, we must urgently strengthen our current health systems and essential services to address the equally important – and deadlier – crises of noncommunicable diseases like cancer, hypertension, obesity, and heart disease. This dual track approach requires investment in the health workforce and mental health.

When the next pandemic or health threat arrives, we must be ready for it, and cannot afford to sacrifice our essential health services, like we were forced to do with COVID-19.

• Every autumn and winter experts warn about difficult times ahead. What is the prognosis about this end of the year?

We are anticipating a difficult flu season this winter, like countries in the southern hemisphere have already experienced. For example, Australia has only just emerged from its most severe flu season in at least five years during their winter (our summer). With COVID-19 still circulating intensely, it is therefore wise for both individuals and governments in the European Region to start preparing for an uptick in hospitalizations and even deaths.

WHO/Europe is urging those most at risk of developing severe disease due to influenza and/or COVID-19 to protect themselves and get vaccinated against both infections, at the same time if possible.

Co-administration of flu and COVID-19 vaccines will help increase uptake of both vaccines in priority groups, improve the efficiency of vaccine administration, and protect already stretched health care systems.

Whether it’s influenza or COVID-19, vaccines save lives. They remain the best way to fight these diseases. And people can receive both vaccines at the same time.

• We have so many Covid-19 mutations. Do we need to be careful about new one?

Yes. As I have said before, the more SARS-CoV-2 circulates, the more opportunities it has to mutate and evade our immune response. It is therefore paramount that we vaccinate all eligible populations, starting with the most vulnerable. All viruses mutate, and WHO is constantly tracking the evolution of COVID-19 variants and sub-variants. Most of the time these mutations don’t affect transmissibility or severity, but occasionally they do, and we must be prepared for this outcome at any moment.

• World was in chaos for almost 3 years. Should we fear a new pandemic, will the world be again in danger?

We should never fear a new pandemic, but we must be ready for the next one. And we must take all the steps necessary to help reduce the risks of another pandemic, from strengthening our health systems, investing in our health workforce, investing in vaccines research and development, supporting new digital health tools and empowering citizens to take charge of their personal health.

For centuries, Europe has grappled with multiple, momentous crises. But in recent years, the frequency of crises has been increasing – including those linked to climate change and emerging infectious diseases, with ever faster spread in our interconnected world.

The ongoing COVID-19 pandemic, with – so far – some 250 million confirmed cases and with over 2 million recorded deaths in Europe and central Asia, is another crisis that has put health higher on the political and growth agenda, but whose lessons many countries may not yet have fully absorbed.

Then, we have the current monkeypox public health emergency of international concern, as well as the recent re-emergence of vaccine-derived polio in our region.

Addressing both challenges requires working with civil society, building trust with communities and engaging on their terms, something Serbia has been doing successfully also in the context of monkeypox.

And, not least, a devastating war in Ukraine, which unfortunately shows no signals of de-escalation, and is compounded by horrific attacks on health facilities and providers – also triggering a mental health crisis of immense proportions.

There are other long-running crises that are relatively silent – often going unnoticed – yet compromising the health of millions and burdening our health systems region wide, and that is the crisis of noncommunicable diseases: cancer, obesity, heart disease, hypertension.

The more unstable the times, the more we need to take this as an opportunity to squarely place health at the center of the political narrative as a key stabilizer for peace and a compass for sustainable growth, in particular in this Region. This is why we should have health reflected in major foreign policy forums such as the Berlin Process or potentially the Open Balkan Initiative, not only to advance the health agenda but also to bring leaders together in dialogue.

Tackling all these crises might seem daunting but rather than surrender, we must rise to the challenge, in solidarity and partnership with others, and find workable, sustainable solutions that benefit all.

I asked you this question last year, and I'll do it now, too: What lessons should have we learned until now, and why didn't we?

• I asked you this question last year, and I'll do it now, too: What lessons should have we learned until now, and why didn't we?

The pandemic is far from over and the virus is still with us, but we continue to learn that international cooperation is essential: from delivering oxygen kits to those most in need to developing lifesaving COVID-19 vaccines and therapeutics that have together saved millions of lives.

We have also seen once again that ‘leaving no one behind’ is not a slogan but a necessity. I’d like to congratulate Serbia for leading by example and donating nearly one million vaccine doses prioritizing but not limited to neighbouring countries, and vaccinating foreign citizens but also refugees and other migrants regardless of their legal status.

Inequitable distribution of vaccines and other technologies is a recipe for prolonging the pandemic, especially with respect to severe disease and deaths. Inequity, in terms of access to vaccination, testing, and treatment, remains a major issue and needs to be resolved. We need to get vaccines to all of those people who are at risk in every single country, not just in some countries.

We know that high numbers of cases increase the opportunity for the virus to mutate. To reduce cases, we need a layered approach – this includes vaccination, but also testing, and prevention measures such as wearing a mask in crowded spaces like on a bus or train and ensuring good ventilation by opening a window or door when safe to do so.

COVID-19 will not simply vanish. We need to do the following to help everyone exit this public health emergency:

• Protect people vulnerable to severe, life-threatening disease through continued use of infection prevention and control measures, vaccination, early detection, and high quality of care

• Create stronger integrated surveillance systems that monitor and track the virus better, so we can more quickly and accurately identify its spread, as well as spot significant genomic changes that alter its characteristics significantly

• Keep health systems’ response capacities agile and ready to surge rapidly in case a new variant of concern – or even a new virus of pandemic potential – emerges

And perhaps the most important lesson of all – one without which none of the above would be possible – is the need for politicians across the region and the world to prioritize a healthy body and healthy mind in every citizen they represent, by increasing investment in their health systems and health workers as a driver for economic growth.

(Telegraf.rs)