Europe Is New Epicentre Of COVID-19 Pandemic; FDA Approval of Roche High-Volume Diagnostic Could Accelerate Testing
Active cases of COVID-19 around the world as of 5:00PM CET 13 March, vividly display Europe as new epicentre. Numbers change rapidly.

Europe has now become the epicenter of the COVID-19 pandemic, with more cases and deaths than the rest of the world combined, apart from China, said WHO Director General Dr Tedros Adhanom Ghebreyesus.

Even more worrisome, there are now more new cases being reported everyday in Europe, which has a population of about 741 million people, than were reported among China’s 1.4 billion people at the height of its epidemic, Dr Tedros Adhanom Ghebreyesus said Friday at a press briefing.

Around the world, 8,527 new cases of COVID-19 were reported in the last 24 hours, for a total of 137,385 cumulative cases. In the United States, another evolving epicentre, some 1,268 cases were being reported, and US President Donald Trump was set to appear on national television today to declare a State of Emergency, major media was reporting.

New Roche Test Offers Possibility of Testing “Millions” – Opening Way to More Rapid Treatment or Quarantine 

But as cases skyrocketed around the world, there was one new bright light on the emerging drugs, diagnostics and vaccines scene.

A new test by the Swiss-based Roche pharmaceuticals, approved for emergency use on Friday by the US Food and Drug Administration, could be a game-changer on the diagnostics – the first step to combatting the disease. The newly-approved test could lead to a rapid scale up of COVID-19 testing by millions of new tests a month, based on an automated technology.

According to a press release from Roche, the widely-available Roche’s Cobas 6800/8800 automated diagnostic systems, will be used to perform the  test for the SARS-CoV-2 virus that causes COVID-19. It can provide a total of 1,440 test results with the 6800 System and 4,128 results for the Cobas 8800 System over a period of 24 hours. The can be run simultaneously with other assays provided by Roche for use on the high-throughput Cobas 6800/8800 Systems.

About 96 tests can be run in a batch, with results delivered in 3.5 hours.

Roche Cobas 6800 Diagnostic system

A Roche spokesperson told Health Policy Watch that the company would now begin ramping up a plan to deploy the tests in eligible sites, in line with the emergency FDA authorization.

“We are prioritizing those customers and laboratories with the highest ability to implement routine testing (for example, those with the necessary instruments in place for successful testing and consumable products needed to run the tests) combined with the highest market need. We will be working with customers, nonprofit and government organizations and regulatory bodies to ensure that tests make the greatest patient and community impact,” said Karsten Kleine.

“At our current rate, we can supply approximately millions tests/month on the Cobas 6800/8800 instruments globally. We are working around the clock to increase that quantity as we recognize the importance that patients need access to these critical tests,” she said.

The breakthrough is  significant because the more rapidly and easily testing can be performed, the more easily health systems can either hospitalize or quarantine people who test positive for COVID-19, avoiding further spread of the virus, as well as serious disease progression and acute respiratory distress syndrome, which requires intensive care.

The severe shortages of test capacity in the United States has received widespread attention there. However, test shortages are also plaguing European countries from Switzerland to Norway – creating a playground where the virus can replicate. Whether due to necessity or choice, some European countries are thus deliberately choosing to test only cases among high risk and highly symptomatic groups. Now it remains to be seen if policies in such countries will change – if mass testings olutions become more widely available.

WHO experts have warned that limited testing is not the right approach. Speaking at today’s press briefing, WHO’s technical Emergency lead Maria Van Kerkhove issued a plea to governments.

“Please look for cases so we can turn the tide,” she said. “If case numbers increase because countries are aggressively testing, we should support that.

Testing must, however be part of an integrated strategy, nontheless, said Dr. Tedros. “Our message to countries continues to be you must take a comprehensive approach. Not testing alone, not contact tracing along, not quarantine alone. Not social distancing alone. Do it all,” he urged.

Attendee of the 43rd Session of the UN Human Rights Council in Geneva, wears a face mask. The Human Rights Council is ongoing, but in reduced format with additional precautionary measures.

United Kingdom and Europe See Tremendous Virus Acceleration

In less than two weeks cases in the European Union and the United Kingdom have shot up to at least 29,404 infections in 32 countries.

Italy remains the epicenter of Europe’s epidemic, with a total of 15,113 confirmed cases and 1,016 deaths. But the outbreak is spreading amongst Italy’s neighbors – Spain has the second largest outbreak in Europe with 4,334 cases and 122 deaths, Germany the third largest with 3,156 cases and 7 deaths, France has reported 2882 cases and 61 deaths, and Switzerland has confirmed 1125 test-positive cases and 7 deaths as of Friday afternoon.

Meanwhile in China, only 8 new cases were reported on Friday – the country’s lowest daily figure on record since January. South Korea reported a further decline in new cases (110) after a brief spike with an outbreak in Seoul yesterday. The country has reported a total of 7979 cumulative cases and 66 deaths.

With the outbreak accelerating and decelerating in different countries around the world, WHO scientist Maria Van Kerkhove told journalists, “We will not be able to predict what will happen. We need to prepare for every scenario… the trajectory is dependent on the country.”

Another hotspot of the pandemic is Iran; the Islamic State is also taking drastic new measures to contain the virus, ordering most people to stay home and announcing a plan to test every one of its 80 million citizens for the virus.

“Iran’s strategies and priorities to control COVID-19 are evolving in the right direction… but more needs to be done,” Richard Brennan, regional director of Emergencies for WHO’s Eastern Mediterranean Region in a press release Thursday, following the conclusion of a WHO mission to Iran, and shortly before the new measures were announced.

“We are all still students of this new virus, so we need to track its spread closely and quickly apply proven public health measures… More work also needs to be done to protect health workers,” said

Switzerland Closes Border with Italy  – First Time Since Schengen Zone Creation in 1985

Meanwhile in Berne, the Swiss Federal Council announced a series of unprecedented measures, including limits on any kind of mass gathering to 100 people; a shift of education to virtual school platforms; and the closure of its border with Italy – for the first time since the European Union’s Schengen zone of free area movement was created in 1985.

According to the Federal Council announcement, the measures restrict the entry into Switzerland of people from “high-risk” countries and regions, which also share a border with Switzerland.

“At present Italy is designated a high-risk country,” the announcement stated. “People from Italy will be refused entry to Switzerland. Exceptions are possible, for example for people who live or work in Switzerland. Anyone wishing to enter Switzerland despite the entry ban must prove that one of the exceptional conditions is met. These measures are intended to assure the provision of adequate care and therapeutic products to members of the public,” said the statement.

Speaking at a press conference, Confederation President Simonetta Sommaruga said, “The situation is difficult, but we have the means and we are ready to confront this, both in terms of our health system and financially.”

Alain Berset, head of the Federal Department of Health, said: “We now have positive tests for 1,125 people.  The situation changes all of the days, but the strategy lines that we are pursuing remains the same. The principle objective is to protect the population, with measured, considered steps.

Berset said, “The measures that have been taken include to reinforce protections for the most vulnerable and to also prevent a surcharge of hospital cases.

“We are running this with calm and determination. There will never be one measure taken for all times, that will solve the problem. We are going to have to continuously adapt. So there is no particular reason to be afraid. It’s serious, but we need to be led by calm and determination,” Berset added.

He said that not only sites such as museums, but also ski stations and swimming pools would be restricted to accommodating 100 people at a time.  Education will be shifted to virtual platforms, firstly for university and high schools. Primary and secondary schools will also be asked to develop distance or individualized education solutions for high schools and elementary schools that avoid bringing large groups together. The press conference also included Swiss Vice President Guy Parmelin, Department of Justice and Peace head, Karin Keller-Sutter, in a display of unity across Swiss agencies as well as political ranks.

WHO Headquarters in the Epicentre – Staff Fears & Frustrations Growing With No Clear Move to Teleworking

Despite the nationwide Swiss shift to an emergency footing, WHO’s Administration seem to be hesitant about making its own sweeping internal shift to teleworking at the Geneva Headquarters, despite mounting staff fears and a trend to teleworking across the rest of Geneva’s global health hub agencies and NGOs.

Concerns peaked after a WHO staff member collapsed and was rushed to the hospital on Thursday by ambulance. The staff member’s partner had reportedly already been under quarantine due to his contact with a COVID-19 case at his workplace in neighbouring France, staff members, who requested anonymity, told Health Policy Watch.

So far WHO’s Aministration has told staff that there are no “confirmed” cases among staff at the Geneva headquarters, and it has made no internal or public comment on suspected cases either.

Frustration and anger was growing among the grim and worried WHO staff  over the fact that teleworking for most staff remains limited to just four days a month, even in light of the expanding pace of infection in Switzerland and the Geneva area.

“The new rules say that ‘If you are over 65 or someone with pre-existing medical conditions, which you have to have a certificate, or if you are pregnant, you can go to Staff Health and Welfare and ask for a consultation, and then Staff Health and Welfare might give you a recommendation for teleworking,” observed one staff member.

“Well, WHO doesn’t have any people over 65, that is the mandatory age of retirement…They did say they are working a system for getting teleworking approved by emails. It still is the same old, same old. The message is that teleworking is not the norm.”

A mass teleworking drill was initiated on Friday for purposes of “continuity planning”. But as of Friday afternoon staff were still being told to return to their office workstations, as usual, on Monday.

Overall, the Organization’s top leadership seemed unclear about how to respond to the unique situation of a pandemic literally at its doorsteps, rather than in a remote Asian or African country, noted the staff members who requested anonymity.

“Teleworking will be adopted either when the Swiss government forces them to, or staff revolts,” said one staff. “Until then, staff are risking getting infected while commuting, potentially exposing themselves, colleagues and others in their social circle if infected, added the source.

“We are still operating in the dark ages, we haven’t adapted,” said another at-risk staff member, echoing complaints that paperwork for expanded teleworking permissions remains onerous even for those with a pre-existing condition.

For the first time since the crisis began, however, WHO’s media briefing was conducted on Friday only by virtual format.  Over the past 6 weeks, since daily briefings began, some 20-30 journalists and staff had been crowding together every afternoon in a tiny, airless “SHOC” emergency nerve center at WHO headquarters for the events, while hundreds also watched online.

“WHO has shifted to an online format – we are only having journalists online today to pilot a teleworking format,” said Tarik Jaresevic, a WHO spokesman.

Zixuan Yang contributed to this story.

 

Image Credits: Johns Hopkins CSSE, Roche Pharmaceuticals , UN Photo / Jean Marc Ferré.