Deputy Director-General of WHO: Pandemic could end in 2022

WHO experts have carried out several investigations in China to find out where and how the new coronavirus was released to the whole world. Others have also done research into the origins of SARS-CoV-2, but no one has been able to prove anything so far. Will we ever know what happened? 

We will find out for sure. However, based on the experience with MERS or previous SARS epidemics, it will take many years and a great deal of cooperation and collaboration of many countries, organizations and sectors. The Director-General of the WHO has recently set up a team of experts called SAGO to identify what kind of data and data connections are needed in general to detect the origin of new pathogens in the future. 

We are continuing to work with Chinese authorities and with the countries where the virus first appeared in order to gather sufficient information.

Can it now be stated beyond a shadow of a doubt that this is not an artificially created virus?

Nothing can yet be either proven or ruled out. The possibility that the virus originated in a laboratory is just as much a hypothesis as the one that it came from the food chain, from traditional markets or from the animal world. All these possibilities have to be systematically examined, and it takes time.

Last spring, you described the virus situation as a war situation, but since then a new variant has emerged, omicron, that is even more virulent than delta. 

Our experience is that each new variant is more virulent than the previous one, so it spreads faster, and this is also true for omicron. This is evidenced by the fact that it is already present on all 6 continents and in more than 90 countries. At the moment, we don’t have enough data to say how serious an illness it causes, but we will know more in two to three weeks. For now, the vaccines seem to be effective against this variant, preventing very serious infections, the need for hospitalization and mechanical ventilation, and also deaths.

It is certain that 

omicron should not be underestimated and every effort should be made to prevent its rapid spread so that it puts less strain on health care systems. For this, the vaccination rate must reach 80 or rather 90 percent everywhere, and the well-known health protection measures,

such as the mandatory use of masks in confined spaces, social distancing, washing hands and ventilating rooms regularly, or the mandatory presentation of an immunity card in certain cases, are also important.

There are views claiming that herd immunity can finally be achieved with omicron because it spreads very quickly but does not cause very serious symptoms. Do you agree that this could be the solution, or can we only overcome the pandemic with vaccines?

Obviously, natural immunity will also help to achieve herd immunity, but as long as the vast majority of the world’s population is not vaccinated against the coronavirus, there will be no end to the pandemic. We must understand that

we will not be able to control the pandemic until we make progress on vaccine equity. This is not only a moral issue but also a strategic one, 

since the slower we progress with vaccination campaigns, the more chance we give the virus to adapt and thus develop more and more new variants. That’s why the WHO has set a target of having 70 percent of the world’s population vaccinated against Covid by mid-2022.

How successful is the Covax program of the WHO aimed at ensuring equitable global access to vaccines? 

In 2021 we made slower progress than we would have liked, mainly because the epidemic situation was dramatic also in countries with large production capacity, such as India. But now we see that 

in early 2022, this process can be accelerated, and by the end of this year about 1.8 trillion doses of Covid vaccine will be available to the 92 countries covered by the program, allowing us to fully vaccinate about 27 percent of the total population. 

We are working hard to ensure the success of the program, and in the 35 countries where the health care system is very weak, we need to make a special effort to make vaccination campaigns a success, because getting the vaccines to these places is only the first step.

Won’t new waves stall this process again? The fifth wave is already round the corner in several places in Europe. 

Yes, the fifth wave has already begun here in Switzerland as well (the headquarters of the WHO is in Geneva - ed.), but rich countries need to consider who should receive booster doses. The recommendation of the WHO advisory board on this issue says that only the elderly and chronically immunocompromised patients should receive a third vaccine, and that vaccination programmes should be started with the available vaccines in places where vaccination rates are still very low.

This is contrary to the political mindset in Europe and the practice of rich countries, where anyone can receive a third dose. 

These are understandable policies, and all efforts to protect as many people as possible against the coronavirus must be appreciated. 

The vaccination program in Hungary, where vaccines are delivered to all municipalities and even to the homes of elderly people in need, is also remarkable.

And yet, Europe is now a Covid hotspot again.

This is basically because Europe is an old continent, where the average age is much higher than in Asia or Africa, and this epidemic is much more prevalent among the elderly and those with chronic co-morbidities. But there is also the anti-vaccine sentiment, which is not a new phenomenon. I remember when I was regional director for Europe how hard we had to fight for people to accept the need for vaccination for example when measles epidemics broke out in Romania, Ukraine or Bulgaria. 

Confidence in vaccination has not always been as high in all countries as it is in Hungary, and this is reflected in vaccination rates.

The third factor is that epidemiological measures need to be not only introduced but also phased out in a careful way, and the quick opening in early summer, followed by mass gatherings, events and summer trips all contributed to the autumn wave of the coronavirus.

If vaccination against the coronavirus is not made globally mandatory, it may happen that it will be because of virus sceptics and anti-vax people that we will not be able to end the pandemic, and not because of the low vaccination rate in poor countries. Despite this, the WHO does not support mandatory vaccination. What is the reason for this? 

In general, the World Health Organization is not in favour of making vaccines compulsory, but much rather of persuasion and communication. And we mustn’t forget the fact that each country is responsible for their own vaccination policy, so they have to make their own decisions, taking into consideration many other factors. 

I’m convinced that even indirect means can lead to good results, for example if a child can only be enrolled in school if they have been vaccinated, or that more and more workplaces expect staff to take the vaccine. Even within the WHO the issue of mandatory vaccination was a controversial question, but after all, there was a straightforward decision that we should set a good example in this too. 

Do you know why SARS-CoV-2 has virtually disappeared from Japan?

It only disappeared temporarily, which isn’t unusual for viruses,

as we recently received news about newer variants of SAR-CoV-2 from Japan and also from Brazil.

Do these have such significant mutations as omicron? 

We don’t know too much about that yet, but as soon as we have more information, we’ll share it with the public. 

The extinction of a strain of influenza virus is thought to be a positive effect of the coronavirus pandemic. However, epidemiologists are predicting a serious flu outbreak this season, saying that such a variant of flu is spreading against which the vaccines are less effective. Do you think we have good reason to be worried about this?

We are experiencing flu-like illnesses across Europe, some with severe symptoms. So our view is that

everyone who is at risk of becoming seriously ill with a possible infection should get vaccinated against influenza.

It was two years ago, in December 2019 that the first cases of the new type of coronavirus were identified in Wuhan, and it will be two years in March 2022 since the WHO declared a pandemic. Will it ever come to an end? 

We want the pandemic to end in 2022, which is why we are pushing for the increase in global vaccination rates as soon as possible. 

The coronavirus will not disappear, it will probably cause local epidemics – i.e. it will become endemic -, but it will no longer have a noticeable impact on the functioning of economies.

However, booster vaccines will be important and we will soon have enough data on how often they will need to be taken. We hope once a year will be sufficient and then it can be combined with flu vaccines.

That’s the optimistic scenario, I suppose, since there is also a possibility that a new variant emerges that can cause more severe epidemics than ever before. Isn’t that right? 

Of course it is, since we can never be one hundred percent sure about anything with a virus. 

The pessimistic version, however, is based on the fact that we have failed to boost the global vaccination rates, and only high-income countries can afford to keep taking newly developed vaccines against emerging variants

and offer booster vaccines every six months or so. 

Could the truth be somewhere between the best and worst case scenarios?

Probably it is. The International Science Foundation is now preparing a mathematical modelling of the future, which will be ready in a few weeks.