LIVE: WHO chief holds a briefing on hantavirus outbreak

0:02 Hello and welcome to today's special press conference here at WHO

0:08 on the Hunter virus cluster linked to cruise ship travel.

0:12 We're very glad that we were able to call this on a fairly short

0:15 notice and thank you for all of you joining us on this very short notice.

0:19 My name is Christian Lintma and I'll walk us through this briefing today.

0:23 Um let me first introduce the podium.

0:27 First and foremost in the middle we have Dr.

0:29 Alanom Gabrius, WHO Director General.

0:32 Then to his right side um is Dr.

0:36 Maria Vancerkov, acting director for epidemic and pandemic management.

0:40 Next to her is Anais Leon, technical lead for viral hemorrhagic fevers.

0:45 On Dr.

0:46 Tedra's left side, we first have Dr.

0:48 Chu Bazu.

0:50 He's um executive director for WHO's health emergency program.

0:56 And last but not least on his left side is Dr.

0:59 Abdi Mahmud.

1:00 He's director for health emergencies um alert and response.

1:05 We have few other colleagues here which I

1:07 would introduce in case we come to them.

1:10 Now we will first hear from um Dr.

1:14 Tedros opening remarks and then we will go to the questions.

1:17 Now for questions two things.

1:19 First please identify yourself clearly.

1:22 uh we will not be able to take

1:23 anyone who we cannot identify online and second we

1:28 believe we will have a lot of questions

1:30 today and you are very curious which is good.

1:33 Um but please also remember in case your question was already asked

1:37 put your hand down again um so that we can have a better

1:40 overview what is still left what we will want to deal

1:43 with now with this thank you very much and handing over to Dr.

1:47 us.

1:53 Thank you.

1:53 Thank you, Christian.

1:54 Good morning, good afternoon, and good evening.

1:58 Thank you for joining us for this briefing on the Hanta virus situation.

2:04 Let me begin by outlining what has happened, what we know,

2:08 what we don't know, and what WH has done.

2:13 Last Saturday, the United Kingdom notified

2:16 WHO under the international health regulations

2:19 of a cluster of passengers with severe

2:22 respiratory illness on a Dutch flagged cruise ship,

2:26 the MV Hondus, which had traveled from Argentina to Capo Verde.

2:33 So far, eight cases have been reported, including three deaths.

2:39 Five of the eight cases have been confirmed

2:42 as hent virus and the other three are suspected.

2:48 Hent viruses are a group of viruses carried

2:51 by rodents that can cause severe disease in humans.

2:57 People are usually infected through contact with infected

3:00 rodents or their urine droppings or saliva.

3:05 The species of antivirus involved in this case is the andis virus which is found

3:12 in Latin America and is the only speech

3:15 known to be capable of limited transmission between humans.

3:20 In previous outbreaks of Andis virus, transmission between people has been

3:25 associated with close and prolonged contact,

3:29 particularly among household members, intimate partners,

3:33 and people providing medical care.

3:38 That appears to be the case in the current situation.

3:43 The first case was in a man who developed symptoms on the 6th

3:48 of April and died on the ship on the 11th of April.

3:55 No samples were taken and because his symptoms

3:59 were similar to those of other respiratory diseases,

4:03 Hunter virus was not suspected.

4:08 The man's wife went ashore when the ship docked at the island of St.

4:13 Helena and was also symptomatic.

4:17 She deteriorated during a flight to Johannesburg

4:21 on the 25th of April and died the next day.

4:28 samples were taken which were tested at South Africa's

4:31 National Institute of Communicable Diseases and confirmed as antibirus.

4:38 The third death was of a woman on the ship who developed

4:42 symptoms on the 28th of April and died on the 2nd of May.

4:49 Another man presented to the ship's doctor

4:53 on the 24th of April and he was evacuated

4:57 on the 25th of April from the island of Ascension

5:01 to South Africa where he remains in intensive care.

5:08 Doctors from Kabu Verde boarded the ship to provide

5:11 care for the three other passengers with symptoms.

5:16 WHO coordinated their evacuation to the Netherlands for treatment.

5:21 I would like to thank Prime Minister Ruises Korea Silva of Kabu Verde

5:26 for his support in facilitating the evacuation

5:29 of this three patients based on our request.

5:34 Two are in a stable condition in hospital

5:37 and one is asytomatic and is now in Germany.

5:42 The eighth case was in a man who disembarked in St.

5:46 Helena.

5:48 Following advice from the ship's operator,

5:51 he reported himself with symptoms in Zurich,

5:54 Switzerland, and was confirmed yesterday to be infected with Hanta virus.

6:01 The Geneva University Hospitals then sequenced

6:05 the virus and confirmed it as Andis.

6:10 None of the remaining passengers or crew on the ship are currently symptomatic.

6:17 Who is aware of reports of other people with symptoms who may have had contact

6:23 with one of the passengers in each case

6:27 we're in close contact with the relevant authorities.

6:32 Given the incubation period of the Andis virus which can be up to six weeks,

6:38 it's possible that more cases may be reported.

6:43 While this is a serious incident, WHO assesses the public health risk as low.

6:52 It also shows why the international health regulations exist and how they work.

6:58 WHO is working with multiple governments

7:00 and partners on the response under those regulations.

7:06 Our priorities are to ensure the affected patients receive care,

7:11 that the remaining passengers on the ship

7:13 are kept safe and treated with dignity,

7:17 and to prevent any further spread of the virus.

7:23 On Monday, I asked Prime Minister Pedro Sanchez of Spain to accept the ship,

7:29 which he agreed to agreed to do.

7:32 And I thank Prime Minister Sanchez for his generosity,

7:35 solidarity, and meeting his moral duty.

7:40 The ship is now sailing for the Canary Islands,

7:44 and we're confident in the capacity of Spain to manage this risk,

7:48 and we're supporting them to do so.

7:52 Once again, we assess the risk to the people of the Canary Islands as low.

8:00 WHO has provided guidance to the ship's operator

8:03 on the management of health on board the vessel.

8:07 All passengers have been asked to stay in their cabins.

8:10 The cabins are being disinfected and anyone

8:13 who shows symptoms will be isolated immediately.

8:17 A who expert boarded the ship in Cababo Verde and has

8:21 been joined by two doctors from the Netherlands and an expert

8:25 from the European Center for Disease Prevention and Control who

8:29 will stay on the ship until it reaches the Canary Islands.

8:35 They're conducting a medical assessment of everyone on board

8:39 and gathering information to assess their risk of infection.

8:44 WHO is developing step-by-step operational guidance for the safe and respectful

8:49 disembarkation and onward travel of passengers and crew when they arrive.

8:57 WHO has also informed 12 countries whose nationals disembarked in St.

9:02 Helena.

9:04 Those 12 countries are Canada, Denmark,

9:07 Germany, the Netherlands, New Zealand, St.

9:10 kits and navies, Singapore, Sweden, Switzerland, Turkey,

9:15 the United Kingdom, and the United States of America.

9:22 In addition, who is supporting health authorities in South Africa

9:26 to follow up people who were on the flight from St.

9:29 Helena to Johannesburg with the woman who later died.

9:35 Meanwhile, investigations into the cause of the outbreak are continuing.

9:41 Prior to boarding the ship, the first two cases had traveled through Argentina,

9:46 Chile, and Uruguay on a bird watching trip,

9:51 which included visits to sites where the species

9:54 of rat that's known to carry and virus was present.

10:00 WHO is working with health authorities in Argentina

10:03 to understand the movements of the couple and I

10:07 thank the government of Argentina for its cooperation

10:10 given its experience and expertise with and virus.

10:16 We have also arranged for shipments of 2500

10:20 diagnostic kits from Argentina to laboratories in five countries.

10:26 I would also like to thank the governments of Kabu Verde, the Netherlands,

10:30 South Africa, Spain and the United

10:33 Kingdom for their close partnership and support.

10:37 I also thank the many partners who have

10:40 provided expertise including the NICD in South Africa,

10:45 the institute pastor Dhakar in Sagal and the HU here in Switzerland.

10:53 And I would also like to thank the ship's operator for its cooperation

10:57 and the passengers and crew who are

11:00 going through a very difficult and frightening situation.

11:05 I have been in touch with the ship's captain regularly, including this morning.

11:11 He told me morale has improved

11:13 significantly since the ship started moving again.

11:18 I thank him for everything he has done to protect those under his duty of care.

11:24 WHO will continue to work with all relevant governments

11:28 and partners to provide care for those who are affected,

11:32 protect the safety and dignity of passengers

11:36 and prevent onward spread of the virus.

11:39 Christian, back to you.

11:43 Thank you very much, Dr.

11:44 Tedos.

11:45 With this we come now to the rounds of questions and answers.

11:48 Again uh please identify yourself clearly,

11:50 raise your hand if you want to ask a question.

11:54 Um then unmute yourself if yourself if called upon and please also take down

11:59 your hand in case your question has been

12:01 asked and answered by one of the colleagues.

12:04 Now this the first question goes to Spanish news agency FA Antonio BTO.

12:08 Antonio please go ahead.

12:11 Uh thank you Christian.

12:13 Um so uh my first question is in Spain the central government and the regional

12:20 authorities of the Canary Islands remain divided

12:24 about the issue of the ship's stopover.

12:27 So could you indicate what asurances

12:30 the Spanish government has provided and what kind

12:34 of assistance the WH will provide once

12:37 the ship arrives to Tenerife in this weekend?

12:41 If I may, I have a second question about

12:44 this Dutch stwartress that has been hospitalized today in Amsterdam.

12:50 Do you have data on this case and how she may be infected?

12:56 Did she travel in the same plane than one of the disease from St.

13:02 Helen to Johannesburg?

13:04 Thank you.

13:07 Thank you very much, Antonio.

13:09 The first question we go to Dr.

13:11 Abdi Mahmud, director health and emergencies alert and response.

13:18 Thanks so much.

13:20 Echo again the appreciation of the excellent support from Spain leadership,

13:24 the technical team and all the actors included.

13:29 In terms of our understanding,

13:31 we do hear the concerns coming from the regional government and as DG indicated,

13:36 we are doing everything possible to understand the risk.

13:40 As of now, what we know that three

13:42 the two confirmed case and suspected have been evacuated.

13:46 The ship is doing everything possible to take the public health measures.

13:51 So the overall risk that from our side is minimal.

13:55 But we know that people has a long incubation period.

13:58 So we have a clear guidance working with our ECDC colleus

14:02 on the ship and the authority

14:05 in Spain understanding the risk reducation measures.

14:08 So we have clear disembarkation plan that will not add additional risk.

14:14 So we are taking all the measures required to reduce as overall our assessment

14:19 and we'll get more details from the team on the ship it's a low risk.

14:24 So we are we are coordinating with our ECDC

14:27 colleagues with the UK with the Netherlands

14:30 with all the countries who have passengers

14:35 on the plot to understand a common way.

14:39 One is to pre reduce a further spread of the disease which we see is limited

14:44 and then have a common understanding a common approach

14:47 based on public health and evidence solidarity and equity.

14:52 I think they we are in touch with them

14:54 and we'll resolve the logistic issues and the guidance

14:58 required to implement this and reduce and take any

15:01 considerations and feedback from the community the regional government.

15:06 Once again we thank the federal government for their excellent support.

15:10 Thank you very much Abdi.

15:11 For the second part we go to Maria Vancov pardon me first.

15:16 Yeah, I just wanted to add to what Abby said.

15:20 Um based on the international health regulations

15:24 uh guidance uh we have made a request to Spain and uh I have actually sent

15:31 a letter personally to his excellency the prime minister.

15:35 Um and based on that request because this is part

15:39 of the IHR regulation uh the prime minister have accepted.

15:45 Uh but one thing I'd like to address here

15:47 is on top of the um you know the guidelines

15:52 in the HR regulation solidarity is the most important here

15:59 and that's what the prime minister has has uh shown.

16:03 uh but on top of that uh I think everybody has the moral

16:07 duty to take care of the people who are on on on the ship.

16:12 Uh so um I hope uh those who have concerns at the Canori uh

16:20 island will understand and support uh

16:25 and cooperate with the uh federal uh government.

16:31 Uh, of course we understand their concerns but as I

16:34 said in my statement uh based on the risk assessment that we have um the risk

16:42 to the people in the Canary Island is actually low.

16:46 Uh so uh the ship is now sailing to Canary Island and I

16:51 hope all the support uh will be uh provided and thank you.

16:58 Thank you very much Dr.

16:59 Tedros.

16:59 The second part we go to Maria Vancerkov,

17:02 acting director, epidemic and pandemic management.

17:05 Yes, thank you.

17:06 So I I believe the second question was related to um a potential suspect case.

17:10 So as the DG said in his uh remarks,

17:13 we're getting reports of uh suspect cases or potential suspect cases.

17:18 These are alerts as we call them.

17:20 Some of them have had reported links to the ship or passengers on the ship.

17:24 All of those will be followed up with the relevant authorities in each country.

17:27 the countries themselves um whether it's through the ministries or through

17:30 the agencies in the countries are actually assessing each person case

17:34 by case looking at what type of exposure did they have

17:37 are they developing any symptoms if anyone is developing symptoms to be

17:41 isolated uh immediately testing to take place and providing the appropriate

17:46 support um this is actually how the case in Switzerland was

17:49 identified following the notification from the ship's operators which we're very

17:53 grateful for this individual presented to healthcare wasn't and feeling well,

17:57 was immediately isolated, was tested.

17:59 This is actually public health actions in work uh in the works.

18:03 Um and I did just want to add on the on the global solidarity side of things,

18:07 you know, in in all of the efforts that we're doing right now,

18:10 including the ship sailing to the Canary

18:12 Islands and to support the Spanish authorities,

18:14 we've pulled together all of the global experts related to HANA viruses,

18:18 in particular the Andes virus.

18:20 And that global solidarity also falls into place

18:23 on the technical side of things as well.

18:25 Coming together saying what do we know?

18:27 What have we learned from past outbreaks?

18:29 What's going on in the current situation?

18:31 And essentially how can we help?

18:33 Uh and that type of technical solidarity is really helpful.

18:36 Some of the diagnostic kits and the reagents

18:38 that we are sending are also going to Spain.

18:40 Um so that will support in some of the on some

18:43 of the uh further investigations that need to take place.

18:46 So there overall um we're very grateful for all of those who've

18:49 come together uh from the technical side as well to support this event.

18:55 Thank you very much.

18:56 Next question goes to Nina Larson from AFP.

19:00 Nina, please go ahead.

19:07 Yes.

19:06 Hello.

19:07 Can you hear me?

19:09 All well.

19:10 Great.

19:10 Um, so I was going to ask if you um would you consider uh this outbreak

19:16 to be an epidemic and also um should

19:21 uh what would you say about people wearing masks?

19:23 Should we be uh should people be wearing masks?

19:26 Is it considered to be airborne and also how long

19:30 should contacts remain in isolation uh to avoid further spread?

19:35 Thank you.

19:37 Thank you very much Nina.

19:38 And we go back to Dr.

19:40 Ger.

19:41 Yeah.

19:41 So, thanks Nina.

19:42 So, what we have is, you know,

19:43 obviously the situation that's happening on the ship itself and the followup

19:47 of the contacts uh of the passengers who disembarked in St.

19:50 Helena.

19:50 So, so far as you've heard, we have eight uh cases so far,

19:54 five of whom have been confirmed, three who have sadly died.

19:57 We have no further symptomatic patients who are on board

19:59 or passengers or crew on board I should say, which is a good sign.

20:03 But, of course, there is a long incubation period of the Andes virus.

20:07 We know on board um they have taken

20:09 some precautions um to try to minimize the risk.

20:12 What they have advised on board um is disinfection of the rooms.

20:16 They have confined people to their cabins and providing food and water.

20:20 And they have asked as a precautionary measure for anyone leaving their room,

20:23 excuse me, to wear a medical mask.

20:26 Um we certainly advise people who are caring for those who are suspected um

20:31 of this Andes virus or hunter viruses

20:33 to wear a higher level of personal protective equipment.

20:36 um that guidance has been given to the people on board but also there are

20:40 the two patients that are in hospital

20:42 in the Netherlands and there's a patient in ICU

20:44 uh in South Africa and I am very happy to say the patient in South

20:48 Africa is doing better and the two

20:50 patients in the Netherlands we hear are stable

20:51 so that is actually very good news so we have a a situation that we

20:56 are we are full we are uh monitoring very very carefully these these numbers may

21:00 change um as we're doing follow-up we

21:03 may see some additional cases be reported Um

21:06 and that shows that the active followup is

21:08 happening and that the testing is being done.

21:11 What we know about transmission um and there's been a lot

21:13 of questions uh posed to us about you know what is actually happening.

21:17 What we do know is that the Andes

21:18 virus in previous outbreaks there has been instances

21:22 of humanto human transmission mainly among close contacts either

21:26 providing clinical care or people who have had close

21:29 physical contact and we believe that's happening and has

21:32 happened in the case here on the ship

21:33 as well between the couple the first and second

21:36 cases and also a medical doctor providing care.

21:39 Um as you probably know those who develop um symptoms,

21:43 those who who go on to develop uh disease sometimes

21:47 uh develop very severe disease which includes severe respiratory uh disease.

21:51 So there may be some coughing,

21:52 there may be some um aerosolizing procedures that may be done

21:55 and of course that's where we would require higher level care.

21:58 So this is not COVID, this is not influenza.

22:01 It spreads very very differently.

22:03 So there are different precautions that people are taking.

22:05 So, we are supporting the ship's operators

22:08 in the mitigation measures that they are putting on board.

22:10 And as we've said, we are working to have

22:13 a proper and full disembarkment procedure step by step

22:17 to support um authorities in the Canary Islands

22:20 for the next stage of the people who are on board.

22:24 And Dr.

22:25 Mahmud, please.

22:27 No, there was the second part of the question about whether this is

22:30 an epidemic or pandemic and all the things going on social media.

22:33 I just wanted to address the situation.

22:36 What makes unique here is similarity crowded in a confined space.

22:43 We had a similar situation in Argentina in 2018

22:46 to 2019 when a symptotomatic individual attended a social gathering.

22:53 So that led to a lot of people getting infected.

22:56 So we are in a similar situation right now.

22:58 A cluster in a confined space with close contact.

23:02 Does that mean the rest of the world this disease will spread?

23:05 We had that outbreak in 2018 and it led only 34 cases.

23:10 We may had similar cases from there.

23:12 So I just want to show that if we follow public health measures

23:16 and the lessons we learned from Argentina now is shared across all countries.

23:20 What needs to happen in contact tracing isolation we can break

23:23 this chain of transmission and this doesn't need to be a large epidemic.

23:28 It's in a specific confined setting where

23:30 people are interacting in a prolonged close contact.

23:35 So we feel it's very quite familiar to the 2000

23:41 outbreak in Argentina and we don't anticipate a large epidemic.

23:45 With experience our member state have and the actions they have taken,

23:50 we believe that this will not led to subsequent chain of transmission.

23:54 But we need to be balanced, reasonable,

23:57 supportive solidarity in containing this outbreak in a difficult environment

24:04 that's happening there being in the weeks after weeks there.

24:07 It's difficult.

24:08 So the solidarity required and the support most of the people there

24:12 as DG said are healthy individuals who are going with their lives.

24:17 So is the public health measures able to break

24:21 down the chain of transmission and we believe this will

24:23 be a limited outbreak if the public health measures

24:27 are implemented and solidarity is shown across all countries.

24:32 Thank you very much both.

24:33 Next question goes to Christian from DPA.

24:36 Christristiana please go ahead.

24:42 Yes thank you very much.

24:45 Uh my question goes in the same direction but a little bit further.

24:49 We are six years out from um corona uh pandemic.

24:55 Um this also started with very few cases and you experts

25:01 know how this is different but we and our readers might not.

25:05 I was wondering whether one of you can outline specifically how

25:09 this is not uh uh uh um comparable to the uh early

25:16 days or weeks of the corona pandemic and why uh uh

25:20 the risks are lower than they were six years ago with corona.

25:24 Thank you.

25:27 Yeah, good comparison there.

25:28 Let's see if it is one Dr.

25:30 Wankerov please.

25:30 I'm going to start and then I'm going to ask our expert

25:32 here an Anna Ais to come in because this is not corona virus.

25:36 Uh this is a very different virus.

25:38 We know this virus hunter viruses have been around for quite a while.

25:42 There's a lot of detail that we know.

25:44 I am going to ask NAS to come in and say this but I want to be unequivocal here.

25:47 This is not SARS KV2.

25:49 This is not the start of a COVID pandemic.

25:51 This is an outbreak that we see on a ship.

25:54 There's a confined area.

25:55 We have five confirmed cases so far.

25:58 We completely understand why these questions are coming and we

26:02 are trying to provide all of the information that we can.

26:04 That's why we're having a press conference

26:06 here to give accurate information and we're

26:08 grateful for all of those out there who are asking these types of questions.

26:12 But this is not the same situation we were in six years ago.

26:15 Um it doesn't spread the same way um like corona viruses do.

26:19 It's very different.

26:20 It's that close intimate contact that we've seen

26:22 and most haunt viruses don't transmit between people at all.

26:26 Most haunt viruses are transmitted from rodents or their feces or their saliva

26:31 um in their droppings um to people and only this one

26:34 particular virus the Andes virus which has been identified here we've seen

26:38 some human human transmission and again I want to reiterate the actions

26:42 that are being taken on board are precautionary to prevent any onward

26:46 spread and so there's a lot that is being done right now

26:50 um to be able try to minimize the risk even further um

26:53 but I do want NI to come in and provide a little bit.

26:56 No.

26:57 Okay.

26:57 Oh, okay.

26:58 Thank you.

27:00 Thank you very much.

27:02 Um, next we have a question actually from Cabo V,

27:05 but it came in in writing, so I'm going to read it out.

27:08 It is um, hello and good afternoon.

27:11 It is to Poco, the news website in Kabo.

27:16 Thank you for that question.

27:17 On May 2nd, a person died aboard the ME on as we know.

27:22 Um the ship arrived afterwards in Cabo.

27:25 The question is where was the body stored uh

27:29 of the deceased or where is it right now?

27:35 Yeah, thank you very much.

27:35 So yes um in fact you are correct.

27:38 Um uh an older woman uh died on board.

27:42 Um the ship's operators are making arrangements

27:45 for the remains um to be um stored appropriately uh

27:49 carefully um and to make the onward um movement

27:53 of the the remains um in a dignified way.

27:56 So the the remains still are on board.

27:58 Um we are in touch with the ship's operators about

28:02 this um and about any onward um passage of the remains.

28:05 So I think I'll just leave it at that.

28:07 Um, but yes, of course, and this is a reminder, these are people.

28:10 Um, these people have families and they have questions.

28:13 Um, but we're in in contact with the operators about the safe

28:16 storage and and the onward um movement of the the remains.

28:22 Thank you very much.

28:24 Next question goes to James Gallagher from the BBC.

28:27 James, please go ahead and unmute.

28:36 Hello, James.

28:37 Do you hear us?

28:37 Yeah, here you go.

28:38 It took a while for the popup to unmute to arrive.

28:40 Thank you.

28:41 Um, my main question is,

28:43 could you outline what you think is unusual about this outbreak

28:46 or does it fit entirely within what we would expect of hivirus outbreaks?

28:51 And related on that, could you draw on whether you think

28:53 there is anything fundamentally different

28:55 or shifting within handtoiruses at the moment?

28:57 I'm just looking at the PAO reports from the end of last

29:00 year citing increases in cases and in some countries lethality in South America.

29:06 If you could draw on those as well please.

29:11 Great ch Thanks.

29:11 And we go to Anise Leon next to me.

29:13 Technical lead on viral hemorrhagic fevers.

29:16 Thanks.

29:16 Thanks a lot for for the question.

29:18 uh what is most unusual uh obviously is that we have

29:22 a transmission in a boat which I think that the first

29:26 documented to date uh with uh this particular virus

29:30 as uh mentioned by my colleagues before a boat makes it

29:33 a very specific environment uh for which uh we we

29:39 we want to make sure that we have a good understanding

29:43 on how the transmission has happened and most importantly to strengthen

29:46 all the measures that my colleagues uh developed uh previously.

29:51 Uh there is no indication to date that there is

29:54 something further unusual but obviously the fact that it happened

29:58 in a cruise ship uh with uh people from different nationalities

30:02 and uh is something uh that we haven't uh seen before.

30:07 Uh regarding your comment uh on the POW

30:10 report the epidemiological situation related to antiviruses in um

30:14 in the Americas uh you are right a slight

30:17 increase has been noted in in few countries.

30:20 Uh just to recall that this update uh

30:23 covers all antiviruses that are documented in um

30:28 in the Americas uh where most uh countries uh

30:32 at risk have good surveillance system and the increase

30:36 uh can be related to uh several factors

30:39 that needs to be determined what countries are working

30:41 on probably linked to uh incidents on rodent

30:44 population and different uh ecological and be behavioral factors.

30:49 This doesn't specifically relates to uh this virus we are

30:52 talking about and I want to recall that uh most

30:56 anti virus cannot uh transmit human to human uh only

30:59 the NS1 so it's relating to the the rodent population over

31:06 thank you very much anise next question know before I come

31:10 to the next question we have a lot of long list

31:13 of questions still um and we want to really get to everybody

31:16 so please try to um limit your questions just to one.

31:19 Um I'm pretty sure many people want to ask the same questions.

31:23 Anyway, so next question goes to Laur from Swiss News.

31:28 Now we come to Switzerland.

31:30 Lauren, please go ahead.

31:34 Yeah, thank you for for the briefing.

31:36 a question on contact tracing and the extent of what

31:40 has already been done because it seems that the guy

31:43 the the person uh who is in Zurich right now um was in a flight where not where

31:50 the contact tracing was not started right away and uh

31:54 so there is the threat that some people might

31:56 not have been traced uh uh in the in the first

31:59 days after the contact with with that person.

32:03 So do you know where whether most countries uh affected have

32:07 uh started but also probably ended uh the contact tracing process?

32:13 Thank you.

32:16 Thank you very much Laur.

32:22 Thanks.

32:22 In terms of contact tracing and the policy

32:24 for that each country has slightly different.

32:27 What we recommending from who

32:30 is extensive investigation and information sharing.

32:35 So this contact the passenger was informed on two channels.

32:39 One from the company informing the patient and then second

32:45 from the IHR South Africa sharing that information with Switzerland.

32:50 So from the national level to the canton level at least

32:54 we will see it how that information pass because most

32:58 of the information are shared at the capital level and then

33:00 it goes to canton what was done here and that's we

33:04 really need to appreciate the responsibility and the proactiveness of all

33:08 the passengers contacted they follow the public health message and taking

33:13 the necessary action now the canton and the authorities are doing

33:17 the investigation and it takes a lot of time identifying all

33:20 the contacts where he went and these are retrospective what we

33:24 call retrospective contact tracing that meaning going backward the day he

33:29 arrived and all the way until the odds so that data

33:32 is being collected analyzed and then what we are encouraging now

33:36 now that we have a confined environment and hopefully we'll

33:40 have a date of departure prepare all the countries now there's

33:44 a lot of lesson we learned from all the countries shared

33:48 from South Africa The level of preparedness may have been slightly different.

33:52 Now we all prepared and we'll have passengers and crews coming up.

33:57 We are encouraging and we'll be sharing the investigation

33:59 and the contact tracing format

34:02 and be proactive and the necessary recommendation.

34:06 Each state and sovereign state will

34:08 have a different application from our recommendation.

34:11 But we firmly believe that safe informed contact

34:17 tracing and monitoring will reduce the further spread.

34:20 So we we are finalizing that in consultation

34:23 with global expert from our European CDC from US

34:28 CDC from UK Netherlands on all that and we

34:31 will issue that guidance in the coming tomorrow hopefully.

34:35 But I we believe that the retrospective contact tracing is

34:39 going on and action is being taken here in Switzerland.

34:45 Thank you very much Dr.

34:46 Mahmud.

34:47 Uh now speaking of South Africa,

34:49 we have a South African journalist here with us online.

34:52 Um I'm not 100% sure if you're in a position to unmute.

34:56 Let's give it a try and please go ahead and and identify yourself.

35:01 Hello.

35:01 Can you hear me?

35:03 Very well.

35:04 Hi, Marvin Charles here from News24.

35:07 Um, could the World Health Organization perhaps shed

35:10 any information about any confirmed cases in South Africa?

35:15 We understand that there have been um at least

35:18 four identified contacts in the Western Cape in South Africa,

35:22 including in Somerset West where a resident is classified as high risk.

35:27 And then I I know you said that we should stick to one question,

35:30 but I just want to squeeze in just one more.

35:32 Um in terms of when um the World Health Organization um would

35:38 advise countries to take some sort of precaution, when would that be?

35:42 Because I understand that you said that you

35:44 know you um this would be a limited outbreak,

35:48 but when would you advise countries to to take some sort of precautionary steps?

35:54 Thank you.

35:57 All right.

35:58 Thank you very much.

35:58 Let's start with Dr.

36:00 Van Kirkov and then we see if we have more on the context.

36:02 Yeah, thank you very much for the question.

36:03 I love to see uh how many uh people from around the world are asking questions.

36:07 So um there have been two confirmed cases um in South Africa.

36:12 Uh one was the second case that was identified um the contact

36:16 the the wife of the first case um who sadly passed away.

36:20 Um and then there is another case that is currently in ICU

36:24 in South Africa and this person is doing better as we understand.

36:27 Um we are working with the health authorities uh

36:30 in South Africa also NICD and others on the contact tracing.

36:34 They're taking the lead on the contact tracing.

36:37 Really want to thank them for the thorough job that they have been doing.

36:40 Not only have they identified the passengers

36:42 and are following up from the flight,

36:45 but they're also following up any contacts for people who attended

36:49 to the woman who passed away who went through the airport.

36:52 Um people medically caring for the man who is in ICU.

36:56 Um and they're doing very active followup.

36:59 I don't have the details specifically on what you mentioned on where they are,

37:02 but there's active followup by the government officials

37:05 and NICD around monitoring of their health um

37:09 if they have any symptoms uh putting in isolation

37:12 and providing support and also doing further testing.

37:15 We are getting information back from South Africa.

37:17 They are doing some testing on the contacts and so far all of those tests

37:20 have come back negative and again this is showing the signs that are working.

37:24 Um and so again we really want to thank uh those that are there

37:27 uh doing that hard work and very very detailed work um for the contact tracing.

37:34 Thank you very much Dr.

37:35 Verkov.

37:37 Next question goes to Helen Branswell from Stat.

37:39 Helen please go ahead and unmute.

37:42 Thank you Christian.

37:43 Um this outbreak is happening at a time when the United

37:49 States is no longer considering itself part of the WH.

37:53 The United States has passengers on board the ship and I

37:57 think there were people who disembarked who were also Americans.

38:01 Um I'm wondering how what are what are the interactions

38:08 like between WHO and the United States in this setting?

38:12 Are they the same as they are with other countries or are there is

38:16 there less information flow as a consequence

38:19 of the W the US withdrawing from WHO?

38:23 Thank you.

38:25 Yeah, thank you very much.

38:26 Good one.

38:27 Uh Dr.

38:28 Mahmud, please.

38:31 Thanks, Helen.

38:32 In terms of collaboration with us and US institution,

38:37 it has been going very well on the technical side.

38:41 We've been exchanging information as we are speaking right now.

38:45 The US CDC has been joining Guan.

38:47 So are the state.

38:48 So the information flow is there transparent and frank

38:51 and information sharing that's one on the technical side

38:55 on the other aspect there's the IHR the high channel

38:59 channel US is still a state party to IHR and information

39:03 is being shared through South Africa NFB communicated with the US

39:07 and back and forth communication is going on but how

39:11 does that translate in a global solidarity I will

39:15 let time to tell but we really need This incident,

39:19 this outbreak has seen why with the world

39:21 needs a global entity that coordinates this.

39:24 The Argentina support how they came forward.

39:27 The support we are receiving now from US institution.

39:30 We live in an interconnected world

39:32 that outbreak from one part affects everywhere.

39:35 So in terms of collaboration, we are going both through

39:37 the technical collaborations in sharing information guidance.

39:41 We rely heavily as DG multiple side.

39:44 What I'm saying is that the expertise of USCDC is

39:47 an asset for the world and we have been benefiting

39:50 from that and we will continue and then we go through

39:53 the IHR channels in sharing formal information and the technical exchange

39:59 and anon please.

40:02 Yes, I just like would like to emphasize

40:04 the excellent collaboration on the technical standpoint

40:07 to date with my counterpart at the US

40:09 center for disease control and this include

40:12 sharing of technical assessment um discussion

40:16 about um you know very specific aspects

40:21 and and and sharing regularly uh what is what is known and what is not known.

40:26 we are we have very positive regular interaction um almost every single day.

40:32 So I just want to acknowledge that among

40:34 other um national counterparts this is very useful.

40:42 Thank you very much both.

40:44 No pardon me again.

40:46 Yeah no I just wanted to add to what colleagues uh raised.

40:51 Thank you Helen for that important question.

40:55 Um as we speak things are going actually

41:00 as it used to be meaning sharing information

41:03 from our side and also we're getting information

41:06 from the US side based on the IHR uh regulation.

41:12 Um and as you know the WHO's mission is to you know help the world to be safe

41:20 and our mission includes the US which is we

41:24 want the American people to be safe as well.

41:28 So we will continue to collaborate

41:30 from our side and continue to give uh information.

41:35 Um so the disease is not a problem in the US and the rest of the world.

41:41 uh as as as as well but as colleagues indicated

41:46 this is what makes a platform like who very very important.

41:52 Um health security needs immersality.

41:56 Uh and any vacuum any space which is not covered actually gives

42:02 advantage to the virus and the best immunity we have is solidarity.

42:10 So because of the event that's happening now

42:14 and you know both Argentina and the US are

42:17 affected um I think they will reconsider uh

42:24 their decisions because they can see how important universality is

42:29 for health security because viruses don't care about

42:34 our politics and they don't care about our borders

42:39 and they don't care about you know all the um

42:43 u excuses that uh we we we may have.

42:47 Uh so I hope this could be a good lesson

42:52 um for the whole world because solidarity is our best immunity.

42:58 I I I repeat thank you.

43:02 Thank you very much Dr.

43:03 Tedros.

43:04 Um then now we go to Ireland to Neil Michael from the Irish examiner.

43:08 Y, please go ahead and mute.

43:16 Do you hear us?

43:17 You still on?

43:20 Neil, if we can't grab you right now, then we go on to NPR.

43:24 Gabriel.

43:25 Gabrielle, Emmanuel.

43:27 Gabrielle, please try and we come back to Neil afterwards.

43:34 No.

43:34 Hi.

43:34 Thank you so much.

43:35 Here you go.

43:36 Thank you for doing this.

43:38 I wanted to follow up on that point about the US um engagement here.

43:42 Typically, my understanding is we would have had press conferences and um uh

43:47 health alerts and other information coming out of the US CDC and NIH.

43:52 Um we haven't had that and I'm wondering um you

43:56 say they're participating um in terms of a technical capacity.

44:01 Have they sent a team over like would typically happen?

44:06 um can you get into some more specifics about what is is

44:10 missing or what is different about this situation now that they have left?

44:14 Thank you.

44:16 Thank you very much Camil and we go to Dr.

44:18 Abdin Mahmud Dr.

44:21 Chikaz first.

44:23 So thank you very much.

44:25 We our colleagues have explained in detail um the collaboration

44:29 with the USCDC in the response that we have

44:32 managed uh on behalf and in collaboration with many

44:35 countries around the world and we're very grateful for that.

44:39 How many teleconferences they hold to the people

44:42 in the US is obviously the responsibility

44:45 of the US and the US CC and we leave that responsibility to them.

44:50 But however to highlight one thing um you know the one

44:54 of the core requirements of the IHR 2005 is for countries

44:59 to build the core capacities that they require uh to do

45:03 the work that we do and in this response we've

45:05 really seen the output of that the institutions across the world

45:09 and the collaboration between them from South Africa the UK

45:13 Spain Netherlands Cape V their national public health institutions the national

45:18 public health uh officials have really worked together with each other,

45:22 supporting each other, sharing information, sharing reagents,

45:27 sharing knowledge to respond rapidly to an emerging uh situation.

45:32 So I think um in all of this we see the value of one the IHRs

45:39 and what it stands for and secondly

45:41 the implementation of the ARS both in real time

45:44 but also in the longer term capacities

45:47 that that countries have built around the world and it is on that that we build

45:51 this universality that our director general just commented on.

45:55 uh one is the principle of university

45:58 but secondly is the implementation of it through

46:00 the institutions that represent that in in all

46:03 the countries around the world back to you and now Dr.

46:07 Mahmood please and Dr.

46:10 Tedra and Dr.

46:11 Chu has covered the main point.

46:13 I just wanted to answer there so that we have

46:15 clarity and it repeats again to the other question is

46:18 this pandemic is ep epidemic and how we deal with it

46:22 and how us in a system like USCD is dealing

46:26 there's a limited epidemic confined in a cruise ship idea

46:31 of sending messages across the world and panicking everyone is

46:34 not required and I think I want to take those do

46:37 the contacts and the passengers in the US been contacted

46:42 and traced We believe so and we haven't formally heard

46:45 from that but informally we're aware that rightful action has

46:49 been done so there's no need of panicking the entire

46:53 population there and it's creating this the largest epidemic is going

46:57 to happen so I just want to take this opportunity

46:59 when we look at comparing institution that is are the public

47:03 health action being taken in each of the countries where

47:08 NFP South Africa shared yes are we getting feedback Yes.

47:12 And each country will have a different approach

47:15 how they deal with and that's their own.

47:17 So I just wanted to take that point answering the specific question.

47:20 How is USCDC?

47:22 Why is no alert been sent?

47:23 Because what we have there are passengers who have contact

47:27 who went back to the US who are now currently being

47:31 traced by the local authority sharing information to your CDC

47:36 and hopefully through the IHR channel sharing back information to WH.

47:42 Thank you very much Dr.

47:43 Chick with Dr.

47:44 Abdi.

47:45 Next question we try again with Neil Michael from the Irish examiner.

47:48 No has dropped.

47:49 Then uh we go on to Jennis Coup from Bloomberg in South Africa.

47:55 Janice, hi.

47:57 Thanks very much.

47:58 Um I wanted to find out um how long does it take to get

48:02 the lab test results for the Andes

48:03 virus currently and is a specific essay needed?

48:07 And just related to that and some clarity on an earlier question,

48:10 the Kalem M flight attendant who had contact with the second

48:14 patient who died um she's now that flight attendant has

48:19 been hospitalized in the Netherlands and I was wondering is she

48:22 symptomatic and when can we expect to know her test results?

48:27 So first was about uh time and then yeah Dr.

48:36 um thank you.

48:37 Yes this is a very important question about how

48:39 long it test uh the test um are are performed.

48:44 Um so the PCR is the technology that is being used and um

48:50 uh countries are scaling up their capacity

48:52 to ensure there the adequate reagents.

48:55 As you know, this is not a very common virus.

48:58 Uh so we are supporting countries to ensure there

49:01 has the capacity to test should they have alerts.

49:04 Uh if reagents are available,

49:06 the PCR performed is fairly quick in a matter of hours.

49:11 And just to mention as well that there will be a complimentary

49:14 testing using cerology which we are also helping countries to prepare for.

49:20 That's for the first question and just on the second question very briefly.

49:24 So it it it adds on to what Anna has just said.

49:27 It depends on the type of test that's actually being done.

49:29 Um certainly any of the contacts including um the one that you've mentioned

49:33 the the flight attendant um will be isolated and testing will be done.

49:37 I don't have a specific time for when the test will be back but we

49:41 are in regular contact with our with the Dutch

49:44 authorities to receive that type of information.

49:47 So as soon as that is ready it gets reported back to us

49:49 as well and of course to to the to the patient themselves.

49:52 But it will depend on the type of sample that's done,

49:55 the type of test that's done um

49:56 for that for the timeline and when the results will be back.

49:59 But I can assure you that everybody that is involved with this is just as eager

50:03 to do the testing as quickly as they

50:05 can as long as they have the right materials.

50:07 And again, we are supporting um several countries with reagents

50:11 to be able to test for this Andes virus.

50:13 And as NIS has said,

50:14 this is not a very common virus um mainly found in the Americas.

50:18 So we're trying to provide support as one of the functions of who

50:22 to ensure rapid uh diagnosis of any uh person that is tested for this.

50:28 Thank you very much both.

50:30 And next we go to Lemon Delin Ruk.

50:34 Um Deline, please go ahead and unmute.

50:43 How does it look like?

50:45 Then can you hear me please?

50:47 Oh, here you go.

50:48 Now we're good.

50:48 Yes.

50:49 Yeah.

50:49 Perfect.

50:50 Uh thank you for for this briefing.

50:53 Um I just have a question.

50:55 When will we have more information about

50:57 the virus sequencing sequencing sorry and uh any differences

51:01 observed compared to the strength from the 20

51:05 2018 outbreak in Apen that you mentioned earlier?

51:08 Will we be able to identify which mutations are cause for concern?

51:13 Thank you.

51:15 So I did not understand everything but I think we got it and we start with

51:20 yeah if I if I understood correctly it's about the the genomic sequencing

51:24 and you actually pointed out toward very

51:27 uh interesting information that we are looking at.

51:29 Um we are awaiting the result from both South Africa,

51:34 Switzerland uh and institute pastor Daka who are all putting all

51:38 their effort into uh performing the full genome sequencing of that virus.

51:45 The full genome sequencing um if uh good coverage

51:48 is obtained will be very useful for us to see

51:51 how it clustered compared to previous outbreak as you

51:54 rightfully mentioned especially that last outbreak uh you referred to.

51:59 Um and it will give us a sense of whether or not we are seeing uh some changes.

52:05 Um and uh again we have to acknowledge

52:08 the tremendous work that are being done by these three

52:12 three laboratories that I mentioned and all

52:14 the international support that they have received to date.

52:17 Can I just want to add to that because I think again this is

52:20 another example you know of having rapid sequencing being done by these three

52:24 labs who are really exceptional labs

52:27 but the sharing of sequence information particularly

52:30 when you have outbreaks like this can provide a tremendous amount of detail

52:34 and this is important every event that we have not only are they

52:37 doing this work as rapidly as they can but we have pulled together

52:41 uh expertise in Andes viruses and they will be debating of course what

52:45 they see there and comparing with the other sequences that have been shared.

52:49 We discussed this a lot up on this panel here and how

52:52 and we've been discussing this a lot with the pandemic agreement and the PABS

52:56 annex that people have been discussing

52:58 the critical importance of sharing information

53:00 but not just that actually bringing together people to do that risk assessment.

53:04 What does it actually mean?

53:05 So from the information we have so far you

53:07 know and they're still doing the sequencing we haven't

53:09 seen anything unusual but that's why we bring together

53:11 the best minds to be able to do that.

53:13 And again that includes people from Argentina who have specific experience

53:17 with this particular virus and now we will have more people around the world.

53:20 So as soon as we know um and as soon as that analysis

53:24 is done of course we will share that information as necessary.

53:28 Thank you very much both.

53:29 Now we move back to Germany.

53:31 Deutsches blood.

53:32 Valentine Valentine please go ahead and unmute.

53:41 Valentine otherwise we come back to you.

53:46 No, you're coming.

53:50 Yeah, if we don't get to you.

53:51 Ah, here we go.

53:53 Sorry.

53:53 Valentine.

53:56 Um, thanks for the conference.

53:59 Um, my question is, so we've learned

54:01 already that the incubation time is relatively long.

54:05 So my question is so uh with the few on the people in isolation,

54:11 how long do they have to be in isolation before they are tested negatively?

54:17 Because so or in other words, how many time how how much time does it take

54:24 at most until the the antibbody or PCR tests um are positive?

54:32 I hope this was clear.

54:34 Thank you for the question.

54:35 We start with Ana.

54:39 I I hope I understood your your question correctly

54:42 and sorry for that if I if I didn't.

54:44 Your question is how long after symptoms is the PCR detecting the RNA?

54:51 Is is it correct or how long would people need to stay

54:54 in isolation to be sure that they're not uh infected?

54:57 So what what what we know is yes the incubation

55:00 can be up to 6 weeks and for that time

55:04 contact who have been potentially exposed need to monitor

55:08 their health uh for any sign of symptoms.

55:12 Um the the the RNA of the virus can be detected in a symptotomatic

55:17 person so someone who is killed uh from the first day of of onset.

55:24 Thank you very much.

55:25 Next question.

55:26 Uh, we go to global.

55:27 So, Brazil from global, Bianca Roier.

55:30 Bianca, please go ahead and unmute.

55:32 Hi, can you hear me?

55:35 Very well.

55:36 Thanks a lot.

55:37 Uh, good afternoon everyone.

55:38 A follow up on this point because you said six weeks monitoring,

55:42 but does it mean six weeks of isolation?

55:47 And now my my main question,

55:50 what is the mortality mortality rate of the and strain of ha virus?

55:55 And just uh as I'm covering this story for the Brazilian television,

56:00 my understanding is that the and strain of hav virus is also present in Brazil.

56:06 Correct.

56:06 So should Brazil's health authorities reinforce

56:10 protocols for cruise ships after this case.

56:14 Thanks a lot for your attention.

56:19 So the first was the specification

56:21 on the six weeks and then the question whether

56:24 on on this virus is also avail present

56:27 in uh Brazil and whether protocol should be adapted and and and the mortality.

56:34 Yes.

56:34 Yes.

56:35 So maybe I will start with the mortality and I

56:37 might let colleagues to to complement on other aspect.

56:42 Um the high mortality has been observed in um previous outbreak.

56:47 This is true.

56:48 Uh but we are emphasizing the importance of early supportive and intensive care

56:54 and this is why we are also putting in place this contact tracing uh measures.

56:58 It is very important that any uh patient uh can

57:03 be admitted to a safe and adequately equipped with trained staff

57:08 to ensure that patient can receive the level of care that is

57:12 needed uh in case they present severe presentation and deter deteriorate.

57:18 So hopefully with early care um survival uh can be uh can be improved.

57:23 In terms of um virus circulation in Brazil,

57:27 I'm not sure if there was a question but any uh country who have antiviruses

57:32 not just end obviously scale up their surveillance

57:36 system and one else approach to understand where

57:39 this virus in which sorry animal rodents

57:42 the virus circulate and ensure that interaction uh

57:46 with rodents can be minimized uh or conducted

57:50 safely to avoid uh rodent to human transmission.

57:53 in countries that have the virus present in their reservoir.

57:58 Thank you very much.

58:01 Maybe to add on the hunter virus as such and the question.

58:05 Yes.

58:05 So no, thank you.

58:06 Thank you very much for the question.

58:07 So um Nas had described earlier and we'll talk in general but then specifically

58:12 about the the situation with the ship and the people who are in contact.

58:16 Um certainly we have the incubation period of up to 6 weeks.

58:20 That doesn't necessarily people need people need to be in isolation for 6 weeks.

58:23 What is really important is that people have the right information.

58:26 We understand what their potential exposure is

58:28 so that we can understand their risk.

58:30 Contacts are not all the same.

58:32 Some contacts have a higher risk of exposure and therefore

58:35 a higher risk of infection and others have less.

58:37 So what is happening happening currently right now on the ship?

58:41 We have a WHO expert who is on board together with an ECDC expert.

58:46 Um we have two Dutch infectious disease physicians who are on board.

58:51 They have received protocols.

58:52 They're asking questions related to the exposures of the people

58:55 on board to really understand um you know what

58:58 what type of contact did they have with any

59:00 of the uh suspected cases or confirmed cases and what did

59:04 they generally do on the ship uh before they

59:07 got on the ship during on the ship and then

59:09 looking at what type of exposures and what type

59:11 of risk that means with that risk assessment that's being done.

59:15 there is a step-by-step plan that is being developed

59:18 and it's currently in developed with many different experts

59:21 to be able to say once that ship docks um what will happen as it goes on board.

59:26 So that is currently being developed.

59:27 Now what is really critical is that people have the right information.

59:31 This also includes people who disembarked from in St.

59:34 Helena, people who have been on board um if you are

59:37 developing any symptoms to present yourself to healthcare and just say

59:41 this is this is my potential exposure um might be Hunter

59:44 virus and then you'll be isolated and tested and provided care.

59:47 So what we're trying to do is take this in a in a staged

59:49 approach but I do want to reiterate contextually what we're talking about.

59:53 The risk to the general public is low.

59:56 HTO viruses are relatively uncommon even though there

1:00:00 may be thousands of cases estimated each year.

1:00:03 Um this is a particular situation where we are monitoring.

1:00:06 I think it's great we're raising awareness about haunt viruses in general.

1:00:10 It's great that countries are paying attention to this and hopefully

1:00:14 governments and increasing their surveillance efforts and really

1:00:17 critically using this one health approach because it is

1:00:19 predominantly in rodents and that's how people get infected.

1:00:22 So this is why as chway has said before around IHR the core capacities

1:00:27 in countries for early detection good surveillance

1:00:30 having good public health systems is critical.

1:00:32 So whatever is circulating there,

1:00:35 we have the right facilities in place to keep people safe.

1:00:41 Thank you very much.

1:00:41 And Dr.

1:00:42 Ju just a small clarification on the the question was isolation and who not

1:00:47 to be pedantic about the use of what

1:00:49 isolation are confirmed cases who are symptomatic.

1:00:54 So I just wanted to put in context and then the second the context

1:00:58 people who've been exposed to infectious we

1:01:02 we are recommending right now active monitoring.

1:01:05 What does that active monitoring means?

1:01:07 Each country will have a different approach.

1:01:09 Some countries are now introducing institutional quarantine

1:01:13 where people will be put but we have to remember most people don't have

1:01:18 putting people in six weeks are different.

1:01:20 So we lift that decision from our WHO side

1:01:24 the most highly are the cases and confirm which

1:01:28 needs to be isolated and then the contacts needs

1:01:31 to be followed duration up to maximum of 40.

1:01:34 How does that happen?

1:01:35 Active monitoring is the daily visit by healthcare workers.

1:01:39 Is it to be put in an institution?

1:01:41 It will change but just to break

1:01:43 the change of transmission we have two different approach.

1:01:46 One is the isolation of confirmed cases who we know

1:01:49 they have infections and people who are at risk who

1:01:53 been maybe have been exposed where we call active monitoring

1:01:56 and different countries use quarantine institutional quarantine and all that.

1:02:00 I just wanted to separate what who is recoming isolation of the confirmed

1:02:05 cases and the active monitoring of the exposed people who may be at risk.

1:02:11 How is that implemented?

1:02:12 may change from one country to another and then

1:02:15 take the maximum duration of the 42 days.

1:02:19 If you look at what we have seen

1:02:20 right now within two three weeks the people when

1:02:23 they got exposed they had the onset of disease

1:02:25 but the clear guidance show up to 42 days.

1:02:28 So that's the maximum that we are recommending

1:02:31 active monitoring those people who have been exposed.

1:02:36 Thank you very much to all the three of you.

1:02:38 Now we come to political Rory Neil.

1:02:41 Uh Rory, please go ahead.

1:02:46 Hello.

1:02:46 Thanks very much.

1:02:47 Um yeah, I'm just curious about what happens when passengers uh disembark.

1:02:52 Okay, you've just you just clarified your guidance on isolation there,

1:02:55 but like should passengers be going

1:02:57 on commercial flights back to their countries

1:03:00 when they disembark and would you have any concerns around that?

1:03:03 Um uh yeah, thank you.

1:03:08 So the question, how should the passengers now who disembark,

1:03:12 how should they move on with that?

1:03:15 I will start and probably my colleagues will compliment me.

1:03:18 Um, yes, a step-by-step guidance is being developed to make sure

1:03:23 that all passengers and crew members are supported throughout this journey.

1:03:29 Don't forget what they they've been through.

1:03:32 And so WHO is coordinating with U.

1:03:35 National Health Authorities uh to streamline

1:03:39 recommendation and and and guidelines on that.

1:03:41 And um uh to to to ensure that first

1:03:45 as my colleagues say that anyone who would have uh any

1:03:49 sign or symptoms can be uh properly isolated and cared

1:03:54 for while all passenger are being evaluated for their risk exposure.

1:03:59 um to um to to be able uh to inform

1:04:05 them on uh what are the recommendation moving forward.

1:04:08 Uh so this is uh still work in progress.

1:04:11 Uh the evaluation is already ongoing in the boat

1:04:14 but further guidance is is being streamlined and developed.

1:04:19 I think if I could just add to that so so

1:04:21 as you know there's a lot that's currently being discussed right now.

1:04:24 I did want to specifically mention that we are working with all

1:04:27 of the countries who have nationalities that are on board to discuss the plans

1:04:32 for the safe journey of those patients home once they disembark once they

1:04:36 are medically evaluated what those decisions will be and as NI said that is

1:04:40 currently being developed it needs to be very carefully um done um but we

1:04:44 are working with the countries about that onward passage home so I just

1:04:49 want to assure and we are also working with the ship's operator because

1:04:52 of the crew So remember on board

1:04:55 we have passengers from many different countries.

1:04:57 We also have crew from many different countries and everyone

1:05:01 involved all of the governments the ship's operators want

1:05:04 to make sure that they get home safely not

1:05:06 only minimizing their own risk but any risk to others.

1:05:09 So that is currently being developed.

1:05:11 Um and as those plans are announced then then we will make those available

1:05:16 but there's active discussion about how that will be done as safely as possible.

1:05:21 Thank you very much both.

1:05:23 Next uh we go to the Glob and Mail.

1:05:25 Mustafa Alasar, please.

1:05:30 Hello.

1:05:30 Can you hear me?

1:05:33 Well, thank you so much.

1:05:33 I appreciate your time.

1:05:34 Uh can I ask about the medical condition

1:05:36 of the Canadian passengers including the two Canadians who have been

1:05:40 evacuated in April and you have mentioned uh that the all

1:05:44 governments uh you are in contact with all governments.

1:05:47 Uh can I ask uh whether the Canadian government has been

1:05:51 in contact with the WH regarding um their safety or evacuation?

1:05:57 Uh my next question is uh what is the WHO protocol for contact tracing

1:06:02 in details and also we have been monitoring two live streams from the chip.

1:06:08 Uh in one in in one the streamer

1:06:10 appeared distressed was crying and was asking for help.

1:06:13 In the other the streamer seemed cold,

1:06:16 calm and stated that people in board were not

1:06:19 under stressed uh take the situation seriously but without panic.

1:06:23 He said to us that the situation appears to have been extremely overstated.

1:06:28 Could you please clarify uh this contrast?

1:06:31 Thank you so much.

1:06:34 Thank you Mustafa.

1:06:35 A bit more than one question but let's see.

1:06:38 I I heard three.

1:06:39 I'm not sure if I got the first question um which I

1:06:42 think was related to Canadians if we're working with the Canadian government.

1:06:46 Um we are working with all of the governments.

1:06:48 I mean this is this is what WHO does, right?

1:06:50 We are a member state organization and we work with all governments.

1:06:54 Um and they are working with us as well

1:06:56 to about the the people who are on board.

1:06:59 Um, I think your last question, I didn't get the second question,

1:07:02 but I think your last question was around the passengers who have um either live

1:07:08 streamed or said that they were under some distress um on the on the ship.

1:07:11 Yes, we've seen videos.

1:07:13 We've seen that video.

1:07:14 And in fact, in some earlier interviews,

1:07:16 I was trying to address directly the passengers

1:07:18 that are on board because we hear them.

1:07:20 As you know, the DG has been in contact

1:07:23 with the ship's captain uh several times and discussing, you know,

1:07:26 this the captain is doing the best that he can to provide the right

1:07:30 and appropriate duty of care for those people who are who are on the ship.

1:07:34 Um we hear them.

1:07:35 We are working with many including you know everybody on board

1:07:39 to ensure not only do they have medical support and that's

1:07:42 why there are two additional infectious disease doctors from the Netherlands

1:07:46 on board but also providing some psychosocial support as well.

1:07:49 This is quite frightening for those who are on board.

1:07:52 Um they want to have the right

1:07:53 information and regular information about what's happening.

1:07:56 Our understanding right now is that the morale

1:07:59 has improved because the ship is moving and plans

1:08:02 are being made um to get them safely

1:08:04 uh to shore and for their onward journey home.

1:08:07 Um so yes, we have heard that and I

1:08:09 think what you highlight here and what I would

1:08:11 like to emphasize is that it's not only the clinical

1:08:13 care but it's also care for people's mental health.

1:08:17 Um, and it's really about making sure that they have good information so

1:08:21 that they can take action because of course there is a worry on the ship.

1:08:24 But we understand there's also a worry out there.

1:08:26 And again, this is why we're trying to answer questions

1:08:28 to just put this into context of what is actually happening.

1:08:31 And again, the general the risk to the general public is low.

1:08:38 Thank you very much.

1:08:38 And I think although we have still many questions left,

1:08:41 we're ready to take one more.

1:08:43 And that one goes to Sarah Nui from the Telegraph.

1:08:46 Sarah, please go ahead.

1:08:51 Hello.

1:08:52 Thank you so much for doing this.

1:08:53 Um, I just wanted to talk quickly about medical counter measures.

1:08:56 Um, there obviously aren't any treatments or vaccines um, available.

1:09:01 Is that a blind spot in global pandemic

1:09:02 preparedness and which teams are kind of furthest ahead?

1:09:06 Um, if this did escalate, how quickly could we get a vaccine for instance?

1:09:10 Thank you.

1:09:12 Hello again.

1:09:14 Yes, thanks a very important point.

1:09:17 Currently, there is no approved uh medical counter measure if we

1:09:20 are referring to antiviral treatment

1:09:22 or specific vaccine targeting this specific virus.

1:09:26 However, as you know,

1:09:27 uh there is a coordination around research and development blueprint uh

1:09:32 that is supported by WH to ensure that all priority viral families

1:09:39 uh can timely develop uh such counter measure and the antivirus

1:09:44 are a big family that is um considered under um a cork.

1:09:51 what what we say.

1:09:52 Um so WH encourages uh scientists and and countries uh to join efforts

1:10:01 and to see how feasible it is to develop uh life-saving uh counter measure.

1:10:07 Um but I want to reemphasize the importance of early

1:10:12 supportive and intensive care uh as soon as possible

1:10:15 as a patient um has symptoms as this can

1:10:19 save life and of course we welcome additional conte.

1:10:25 Yes.

1:10:25 So the R&D blueprint for epidemics which was established

1:10:28 by who um following the Ebola outbreak in West Africa

1:10:32 in 2017 we outlined um priority pathogens and from there

1:10:37 these are priority pathogens that have an epidemic or pandemic

1:10:39 risk that didn't have medical countermeasures and a lot

1:10:42 of work has happened over the last almost 10 years

1:10:45 related to the development of better diagnostics better therapeutics

1:10:50 better vaccines for pathogens that we know have a risk.

1:10:54 Um recently the R&D blueprint has moved to more of a pathogen

1:10:57 family approach so that we take a more holistic view of how

1:11:01 research is done um to advance you know what could be done

1:11:05 ahead of time ahead of that next outbreak ahead of that next pandemic.

1:11:08 We benefited from that from from COVID for COVID

1:11:11 for the work that was done on SARS

1:11:13 and on MS and on RNA technology and this is what we want to continue to see.

1:11:17 So that investment in research, that investment in innovation,

1:11:22 the investment in the coordination of people who are working

1:11:24 on this, we're very grateful for that from a technical point of view,

1:11:28 the work of SEPY, the work of many

1:11:29 others um who are advancing this type of work.

1:11:32 But that needs a regular regular attention,

1:11:36 regular uh investment and also follow-up.

1:11:38 So what are we learning?

1:11:39 What actually needs to be done?

1:11:40 So the R&D blueprint is is working uh very hard

1:11:44 on many different types of pathogens with epidemic and pandemic

1:11:46 potential and as ana said this is one um

1:11:50 in a family of viruses where this approach is being taken.

1:11:54 So those of you who are out there who

1:11:55 are doing research in this area thank you very much.

1:11:58 Those of you who are out there who are funding research in the area,

1:12:01 please continue to do so.

1:12:03 Um because it is urgently needed because we are

1:12:06 always preparing for the next outbreak, the next epidemic.

1:12:10 And I want to reiterate again, this is not the start of an epidemic.

1:12:13 This is not the start of a pandemic.

1:12:15 But it is a good opportunity to say

1:12:16 that investment in pathogens like this are critical because therapeutics,

1:12:21 diagnostics, vaccines save lives.

1:12:26 Thank you very much.

1:12:26 Before I hand to Dr.

1:12:28 Tedros for closing remarks,

1:12:31 let me just say um any further questions uh please send to us.

1:12:35 Thanking the panel and now over to Dr.

1:12:38 Tedros.

1:12:40 No, I was I was going to add to the question about Canada.

1:12:45 Uh we know that the public health agency Canada is

1:12:48 following up on the two Canadians who have disembarked at St.

1:12:53 Helena and of course the other four in the ship

1:12:58 are also being followed by other relevant authorities of Canada.

1:13:03 Uh that's one one information I just would like to to add.

1:13:10 Uh and then um on closing our session uh today,

1:13:15 thank you so much to all members of uh the press for for joining

1:13:20 us and as needed we will continue to uh keep you updated.

1:13:25 Thank you so much.

1:13:26 All the best.