How WHO can decree the end of the Covid pandemic

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The reduction in deaths and severe cases of Covid-19 around the world, a direct reflection of the significant advance in global vaccination coverage, already makes the WHO (World Health Organization) itself speak openly about a possible end of the status of pandemic conferred on the disease.

Responsible for declaring the pandemic in March 2020, the entity also has the prerogative to determine the relegation to the category of endemic: a milder classification, but which still represents the occurrence of the disease in one or more regions.

In the same way that there are no fixed criteria — such as a specific number of cases and deaths — for the WHO to determine that there is a pandemic, there are also no pre-established references for it to decree the end of pandemic status.

In practice, epidemiological data are analyzed and interpreted by a committee of experts, which ultimately support the final decision.

This is what happened, for example, with the pandemic of the H1N1 virus, popularly known as swine flu, decreed by the WHO in June 2009. After a consistent drop in cases and hospitalizations, and also with the advance of immunization, the The WHO emergency advised, in August 2010, the end of the pandemic, which had been decreed in June of the previous year.

Data from the entity has already shown a decrease in Covid-19 in the world. In the last epidemiological update, referring to the period from 19 to 25 September, the WHO reported about 8,900 deaths caused by the disease, which represents an 18% reduction in relation to the previous week.

Still, circulation of the virus remains high, with at least 3 million new confirmed cases over the same period, down 11% from the previous week. As several regions have underreporting of infections, in addition to the lack of access to tests, the real number is even higher.

Professor at the Unicamp School of Medicine (Universidade Estadual de Campinas), infectious disease specialist Raquel Stucchi sees significant advances in the Covid-19 situation, but considers that caution is still needed with the disease.

“Right now, we can say that the worst is over, because the impact of Covid on mortality has already reduced a lot”, evaluates the doctor. “These are infinitely better numbers than what we’ve had throughout this pandemic. Are we sure we won’t have bad days again? Not yet, because we still have a large circulation of the virus around the world.”

The significant number of cases in some regions is a risk factor, as it could favor the emergence of new variants with the potential to escape the immunity conferred by current vaccines.

As the World Health Organization does not have the power to impose the implementation (or relaxation) of rules to combat the virus on countries, the decision on what to do, in the event of a pandemic or endemic, is in the hands of the states. It can, however, make recommendations.

This month, the entity released a series of recommendations on the pandemic, calling for an increase in testing and monitoring networks, as well as special attention against the spread of misinformation.

These are infinitely better numbers than what we’ve had throughout this pandemic. Are we sure we won’t have bad days again? Not yet, because we still have a large circulation of the virus around the world.

After optimistic statements on the 14th, when he said that the end of the pandemic could be close, the entity’s director-general, Tedros Adhanom, returned to adopting a more restrained language, saying that the danger is not over yet.

The reaction came shortly after a controversial speech by the US president on the subject. In an interview with CNN, Joe Biden said that the pandemic is over.

“We have spent two and a half years in a long, dark tunnel, and we are just beginning to see the light at the end of that tunnel,” said Tedros Adhanom, who stressed that there is still a long way to go, “with many obstacles that can cause us to stumble if we are not careful”.

In addition to the high circulation of the virus, there are important asymmetries in vaccine coverage against Covid-19. While countries like Portugal have more than 90% of the population immunized since the end of 2021, the group of poorest nations in the world only managed to overcome the barrier of 50% of immunizations in August.

“We need to increase vaccine coverage, with bivalent vaccines against the Ômicron variant, increasing vaccine coverage in an equitable way around the world. We also need access to medication for the prevention of Covid, to serve those who do not respond adequately to vaccine”, emphasizes infectologist Raquel Stucchi, from Unicamp.

The doctor also highlights the potential social and economic consequences of the so-called long Covid, when symptoms of the disease remain in patients even after the infection has ended.

“There is still a very high number of cases in the world. Although they are not reflected in mortality, a large percentage of these people, some estimates even speak of 20%, will live with Covid for a long time. quality of life, the ability to work and interact in society”, he says.

Historians of science emphasize that, in addition to medical issues, the end of pandemics also has a social component, marked by the moment when the population’s fear decreases and people learn to live with the virus.

Regardless of whether Covid-19 remains officially classified as a pandemic, several countries have already eased most of the restriction measures against the disease, including Brazil.

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