WHO's conundrum: when and how to declare the COVID-19 pandemic over?

Three years to the day since it was declared a public health emergency of international concern (PHEIC), WHO’s Emergency Committee said on Monday that it remains so.

The virus is still with us. We are dancing around it as best as we can, but it still kills. According to the WHO, since its outbreak three years ago, COVID-19 has caused the deaths of 6.5 million people around the world. A conservative estimate, by all accounts. In the last two months only, it has killed another 170,000. So, yes, it would be premature to call the pandemic over. Three years to the day since it was declared a public health emergency of international concern (PHEIC), WHO’s Emergency Committee said on Monday that it remains so.

Experts attending the meeting explained that, in addition to the number of recent deaths, the insufficient vaccine uptake in low- and middle-income countries, and globally among the most at-risk demographics, had to be factored into their decision.

They also noted that pandemic fatigue and a reduced perception of the risk by the public have led to drastically reduced use of public health and social measures (PHSM), including mask-wearing and social distancing. Vaccine hesitancy and the continuing spread of misinformation continue to be extra hurdles to the implementation of crucial public health interventions.

The pandemic could be in a transitional phase. We might, the committee’s experts say, be at the tail end of it. But they also stress that the virus’ ability to evolve into dangerous new variants cannot be discounted. Given the yes/no binary system that says that a pandemic either is or is not a PHEIC, period, the members of the Emergency Committee chose to take the safe route, concurring with WHO’s D-G Dr Tedros.

The decision came as intense negotiations are ongoing at WHO about a pandemic treaty, and also about the International Health Regulations, guidelines that some Member States would like to see significantly strengthened.

According to the deliberations of the Committee, moving forward past the PHEIC will require the “focused commitment” of WHO, national governments, and international organizations to developing and implementing “sustainable, systematic, long-term prevention, surveillance, and control action plans.” For many low- and middle-income countries, this will require a significant effort, with health systems already under serious stress.

The experts’ recommendation is for WHO to offer guidance and develop a plan for this transition, with support from relevant technical and advisory groups.

“2023 may make or break efforts to prepare the world for the next pandemic and to deal with pressing day-to-day diseases that touch the lives of billions,” writes Suerie Moon, Co-Director of the Global Health Centre at the Science Graduate Institute of International and Development Studies. “Everything is still open to negotiation, but the final agreements could have far-reaching consequences for how quickly we are able to detect and contain the spread of new pathogens at their source, who will get access to lifesaving vaccines and treatments, and how well day-to-day health systems function for their people, among other issues.”

“Now the question is what obligations governments will be willing to make,” Moon asks in a just-published note, part of a series of policy briefs published on genevapolicyoutlook.ch, a new platform launched on Wednesday by Geneva’s Graduate Institute. “Key issues underlying pandemic treaty negotiations include inclusion, inequality, and geopolitics,” Moon insists.

WHO’s position is clear, but for the rest of the world, is the pandemic over? Hong Kong’s Chief Executive John Lee certainly thinks so. A few hours ago, he unveiled his government’s plan to launch ‘Hello Hong Kong’, a massive tourism campaign to lure visitors back. Calling it “the biggest welcome ever,” Lee said that as part of the campaign, Hong Kong would give away 700,000 free airline tickets. “There will be no isolation, no quarantine, and no restriction on experiencing our great wine-and-dine scenes, on doing business, on joining events and outings, on doing sports, on enjoying the hustle and bustle of Asia’s world city, and so much more,” Lee is quoted as saying in the South China Morning Post.

The photo shows him wearing a mask during the announcement.