WHO Declares COVID-19 “Pandemic”; European Countries & Iran Adopt Aggressive Measures To Contain Growing Threat
Iranian healthcare workers in personal protective equipment

As cases of COVID-19 surpassed 120,000 around the world, the World Health Organization on Wednesday declared a pandemic – a move the organization stressed was intended to “trigger” even more aggressive action from governments against the virus rather than surrender to its rapid spread.

In line with current trends, numbers of COVID-19 cases, deaths and number of affected countries will “climb even higher,” Dr Tedros Adhanom Ghebreyesus warned on Wednesday, before they decline.

However, WHO sees this as a “call to action” to spur countries to scale up efforts to contain the virus and slow the spread, and prepare their health systems for an influx of patients, said WHO’s Head of Emergencies Mike Ryan.

“Declaration of a pandemic is not an “escape clause” to mitigation – a strategy focused only on saving lives when uncontrollable spread of a disease is inevitable, Ryan said. “There is a strong element of controllability in this disease.…We have a real chance to bend the curve – and give the health system a chance to save more lives.”

Dr Tedros added that the dramatic decline in new cases in certain countries, and the low numbers of cases in others means that governments still have the chance to stop the virus from spreading further.

“Eighty-one countries have no cases – they should not give any ground for this virus to set foot in their country. Fifty-seven countries have less than 10 cases – they can cut it from the bud,” he said.

‘Bending the Curve’ of Rising COVID-19 Cases

The Republic of Korea has already ‘bent the curve’  of the epidemic with an aggressive testing and containment strategy. In what was two weeks ago the largest outbreak outside of China, the daily new case count has fallen to approximately 30 – 40 per day compared to a peak of over 500 a day just last week.

Increasingly governments across the WHO European region are taking an iron fist to the virus as well, replicating tracts that have succeeded in China, Singapore and the Korea. Italy has locked down the entire country; school classes and mass gatherings across France and Germany are suspended. In Spain – now the country in Europe most affected outside of Italy – daycare centers and schools in key affected areas are closed, flights between Italy and Spain are suspended, and large sporting events have been cancelled.

In the most assertive preemptive moves so far outside of China and the Republic of Korea, Israel announced this week that it will place all Israeli citizens re-entering the country under 14 days of self-quarantine regardless of where they are coming from, and bar the entry of foreign tourists altogether.  So far Israel has reported just 76 cases, mostly among Israelis or tourists arriving from abroad, while there are 26 cases in the Israeli-occupied Palestinian territories; In contrast, Switzerland, a country of approximately the same size, now has 645 people who have tested positive.

Meanwhile, WHO was recommending that countries around the world take a ‘blended’ approach to the battle against the virus – bolstering the capacity of hospitals and health care facilities to prepare for a surge in patients while at the same time, continuing to make containment “the major pillar” of the response, said Tedros.

The trade-offs are challenging. Tracking down contacts of cases and enforcing quarantine measures to slow down transmission of the virus could slow the surge of patients that require hospital care. At the same time, they can be complex and costly to carry out.

“The difficulty is that if you do not try to suppress this, it could be very straining to your health system,” said Ryan. In Italy, for example, some 900 patients were have been hospitalized within intensive care units, who also need to be continuously monitored by health workers wearing full protective gear.

“We’ve had lots of people talking about containment vs mitigation – countries should focus on containing where there is opportunity, and preparing the health system to reduce the impact,” said Ryan.

“There’s a shortage of ventilators, a shortage of oxygen… ” he added, noting that “the caseload, the demand on the healthcare workers, and the risks that come with the fatigue and the shortage of personal protective equipment,” are overwhelming for health systems,  said Ryan. “We need to focus on getting them equipment, supplies, and the training that they need to do the job.

Pandemic Spread; Active Cases Worldwide

European Countries Declaring Emergencies – But Responses Still Lagging Behind Outbreak Curve

European governments are enacting emergency executive powers as the outbreak explodes across the continent – just days after the Prime Minister of Italy locked down the country, applying travel restrictions on its citizens that were unprecedented since the end of World War II.

Along with Italy, Switzerland, Spain, and Israel have activated national emergency rules, which allow federal powers to control aspects of daily life in order to slow the spread of COVID-19.

Spain, which is now the country with the fifth highest number of cases, has taken a “whole of society approach” to the virus – all schools, daycares and university classes are suspended in La Rioja, Basque, and Madrid, while the national government shut down all flights to Italy and canceled sporting events.

Even so, those measures may not be sufficient, Ryan warned, saying: “Countries in the EU and Western Europe should assess whether efforts are good enough to suppress the virus.”

As of noon Wednesday, 645 people in Switzerland have tested positive for the disease, and events of more than 100 people were banned by Swiss Government authorities – striking at the core of Geneva’s economy, host to dozens of UN agencies, the world’s largest global health hub, and among the world’s most popular venues for related international events..

As the case count crept higher, Geneva’s UN agencies and affiliates, as well as other global health and development organizations and non-profits, rolled out aggressive screening measures, policies on telecommuting, and new protocols for potentially sick employees.

Shortage of Hospital Equipment In Iran

Meanwhile in Iran, local and central governments have improved coordination of COVID-19 efforts, said Ryan.

Schools and universities across the country are closed until after Nowruz, the Iranian New Year that falls this year on 20 March. Opening hours of large tourist attractions have been limited, and checkpoints have been established in major cities such as Tehran according to the official state news agency IRNA.

Right now, “the concern is a shortage of ventilators and oxygen” for treating severe cases, said Ryan.

“We’ve seen this in Italy. What happens at this stage is that it generates a lot of cases, that requires a huge effort by health workers,” he added.

Data from The WHO-China Joint Commission report on COVID-19 showed that approximately 14-20% of critical or severe cases will require hospitalization. Patients can require ventilator support for more than two weeks, and must be attended by at least two healthcare workers wearing full personal protective gear at all times.

WHO and China are still supplying the country with diagnostic supplies and protective equipment. WHO shipped 140,000 diagnostic tests to Iran today, following a shipment of 7 tons of personal protective equipment along with other outbreak response supplies sent last week.

Iranian officials are now aggressively tracing contacts and testing suspect cases, as the outbreak escalated to 9000 total cases and reached the highest echelons of government. Some 24 Iranian government officials and Members of Parliament have died from the disease, and many are reportedly ill.

According to Al Jazeera more than 70,000 prisoners were released following reports of a COVID-19 cases in overcrowded prisons with inadequate isolation facilities. Those sentenced for less than five years for non-violent crimes are subject to release.

Image Credits: Twitter: @WHOEMRO.