The recent announcement of the Director-General of the World Health Organisation, Tedros Adhanom, considering the COVID-19 virus no longer a health emergency raising international concern, stirs many reactions and questions. This is especially true considering the three years of continuous international concern about the successive mutations of the virus and the high waves of infections and increased death rates it caused. 

Ahram Online: What are the criteria upon which the WHO relied to declare an end to the state of emergency regarding COVID-19?

Ahmed Al-Mandhari: The COVID-19 Emergency Committee met for the 15th time on 4 May, and issued its statement the next day. The statement advised the WHO Director-General that COVID-19 was no longer a public health emergency of international concern. The Director General has accepted the advice of the Emergency Committee. Although the global risk assessment of COVID-19 is still high, there is evidence of a decrease in the risks to human health, as the members of the committee based their recommendation on 4 criteria, which are: the declining deaths due to COVID-19, the decrease in the number of hospitalisations and cases of care units, Corona-related infections, and the current mutations, which do not seem to lead to an increase or severity of the disease. Finally, there were also high levels of population immunity to the virus due to infection or vaccination, or both. Hence, the Director General accepted the Committee's recommendation. This means that it is time to move on to long-term management of the COVID-19 pandemic.

AO: Does this mean that the disease has become less severe and that we will not see large numbers of cases that require intensive care?

AM: One of the reasons for ending this public health emergency of international concern has been the increase in immunity to the virus –  whether vaccine-induced or naturally induced. The situation has also improved significantly, and this is represented in the decrease in the death rate, and the decrease in the number of critical cases that require intensive care, among which previously death rates were high, in addition to the availability of diagnostic methods, vaccines, and treatments.

AO: How will this announcement be reviewed in the coming weeks or months?

AM: The Committee noted that the time has come for countries to move from an emergency situation with regard to COVID-19 to dealing with it the same way as with other infectious diseases. However, the Committee stated that the Director-General may decide in the future to form an emergency  International Health Regulations committee dealing with COVID-19 if the situation warrants it.

AO: What are the conditions that may force the WHO to re-declare a state of emergency?

AM: This possibility is unlikely given the long period of research, follow-up and investigation that the Emergency Committee took before announcing its recommendation. This last meeting was preceded by 14 regular meetings over a period of three years. The Committee's position has been evolving over the past several months. Nevertheless, countries must continue the work that they started from the beginning of the pandemic in order to maintain the status quo they have reached. The worst thing a country can do now is shut it down.

AO: The Arab region suffers from wars and conflicts, and many residents of these countries did not receive sufficient vaccine doses. What are the guidelines so that there are no hotbeds for COVID-19 mutations or any epidemic diseases?

AM: Unfortunately, this is true and requires more effort from all parties and partners. The WHO, its partners and member countries' commitment to making vaccines available continues, as the COVID-19 Vaccines Global Access (COVAX) facility will continue to operate for the remainder of this year. Decisions will be made on the continued provision of vaccines to countries that have benefited from vaccine supplies from the COVAX facility. Those discussions and decisions are still ongoing through the mechanisms of the Global Alliance for Vaccines. Vaccines work, along with all of our other efforts and measures. Life-saving work related to COVID-19 vaccines remains essential. The WHO will continue to make decisions that ensure that vaccines are available to those in need of protection.

AO: Egypt is currently taking in large numbers of refugees from Sudan who may not have been vaccinated. What are the organisation's recommendations regarding health safety and avoiding the spread of any possible infection?

AM: We thank Egypt and all countries hosting people fleeing conflict and violence. Refugees must be included in vaccination services and primary health care provided to host communities, not only to protect refugees but also to protect host communities and prevent the spread of any possible form of infection. We are aware that this represents an additional burden on countries receiving refugees, including Egypt, and we highly appreciate their efforts and contributions to refugee care, despite the pressures and burdens that health systems are already facing. We hope that the international community and the donor community will support the efforts of the host countries to enable them to cope with the increasing burden on their health systems.

AO: Are there any new health recommendations especially on getting COVID-19 vaccinated regularly?

AM: Vaccine efforts do not end with ending the public health emergency that is causing international concern. The authorisation of COVID-19 vaccines will continue to exist, and more needs to be done to move the authorisation of vaccines to more regular authorisation methods. All authorised vaccines are currently in place. The commitment will remain to support the ambition of countries to expand vaccination coverage, especially for those who need it. The WHO will continue to make decisions that ensure that vaccines are available to those in need of protection. Authorisation of COVID-19 vaccines will continue to exist, and more needs to be done to move the authorisation of vaccines to more regular authorisation methods. Vaccines work, along with all of our other efforts and measures. Life-saving work related to COVID-19 vaccines remains essential.

AO: What is the possibility of including the COVID-19 vaccine in the seasonal flu vaccines? And if so, when is it expected to be implemented?

AM: Vaccine efforts do not end with ending the public health emergency of international concern. The recommendations announced by the Emergency Committee include integrating the COVID-19 vaccination into lifelong vaccination programmes and continuing efforts to increase the coverage of COVID-19 vaccination for all individuals in high-priority groups. All authorised vaccines are currently in place.

AO: Does the organisation have any health recommendations regarding the COVID-19 health update concerning the Hajj season this year?

AM: The committee did not directly address the Hajj season or crowd medicine in general, but we know from even before the pandemic that there are recommendations that are put forward and implemented before and during the Hajj season to protect the health of the pilgrims. They are reflected in the health requirements set by the host country and adhered to by different countries before and during sending pilgrims and Umrah performers. This includes getting certain vaccinations and other important recommendations. We call on all countries to adhere to the highest level of measures for the Hajj season.