Health News at Your Fingertips

Michael Ryan’s forceful remarks that a return to school must be based on the local picture and whether there is broader risk of transmission in a community stands in contrast to US education secretary Betsy DeVos’ remarks on Sunday, as reported by my colleague Lauren Aratani in New York:

We know that children get the virus at a far lower rate than any other part of the population. There’s nothing in the data that suggests that kids being back in school is dangerous to them.

DeVos did also say that hotspots should be dealt with on a case-by-case basis – but she added: “the rule should be that kids go back to school this fall”.

Here’s the story.

Van Kerkhove says she wants to focus on individuals’ responsibility. “Please make good choices,” she says. “There are many people, essential workers, who cannot stay at home. And if you can.. please stay home.”

She urges the wearing of masks, physical distancing, handwashing, and talking to children about sensible precautions. “This is far from over, so we all have to play our part,” she says.

That’s the final question and the press conference will shortly wind up.

Tedros has now left the press conference, leaving Ryan and Van Kerkhove to answer the large question of what’s gone wrong in the Americas.

Ryan says: “Reopenings have led to more intense transmission and now a number of countries face a scenario where there’s increasing and sometimes exponential transmission, not necessarily with the option of new lockdowns because of the economic damage and community acceptance.”

He calls on governments and individuals not to carry on as normal, saying: “This is the issue, turn and face the fire, turn and face the problem. It’s going to require a huge commitment on behalf of government and individuals.”

“If people continue to frequent crowded places without taking the necessary precautions… the disease will continue to transmit,” he says. But he adds that governments must be clear and consistent and make it easy for citizens to comply.

He adds: “I can’t say this strongly enough: the countries that have put in place strong public health surveillance architecture during lockdowns… are having relative success in continuing to suppress the virus.”

And he says that “believing that magically we will get a perfect vaccine that everyone has access to is not realistic” and questions whether even if a vaccine becomes available it will be fairly available to all.

Once again he emphasises clear and strong government leadership – a theme of the press conference.

Dr Michael Ryan, executive director, says there is an issue around how schools can be reopened safely but the best way is to do so in a situation of low community transmission. He adds: “we can’t turn schools into yet another political football in this game… we have to look at this carefully in the light of transmission in any given setting.”

He sounds frustrated by the nature of some of the debate around the question of school reopening as he implies that it would be foolish for the WHO to set out a hard-and-fast rule for the whole world to follow. “[Decisions] must be based on data in the specific setting in which schools are,” he says. “My fear in this is that we create these political footballs that get kicked around the place.”

In response to a question about child-to-child transmission and school reopening, and whether there is any update to the WHO position, Van Kerkhove says that some studies are currently underway or coming out as pre-print (not yet peer reviewed) papers which shed light on the question.

She says results depend on how studies break down by age but that “those above 10 seem to have similar seroprevalance [numbers with blood tests showing they have the disease] to young adults, which means that they can be infected but tend to have more mild disease”.

She says that there is still much to understand about infection among children. She concludes without appearing to set out any change in WHO advice: “Children do seem to be less affected, but they can be infected. Our understanding of transmission among children is still limited.”

Dr Maria Van Kerkhove, the WHO’s technical lead, gives her best wishes to a journalist who recently recovered from the virus.

On the question of immune response to the virus, she says that it is still not know how strong or long the protection from antibodies is. Some early data shows antibody levels “may wane over time”, she says, but adds that more information is needed.

You can read more on this subject here:

Now Tedros speaks critically of leaders in countries where “mixed messages” have led to a breakdown in trust. He says that if this approach is taken, matters are going to get “worse and worse”.

He adds: “I know that many leaders are working in difficult circumstances” and uses the example of people living in poverty around the world. “There are no short cuts out of this pandemic,” he adds.

While he has not named specific countries, some will hear a message for Donald Trump in his warning.

“There will be no return to the old normal for the foreseeable future. But there is a roadmap to a situation where we can control the virus and get on with our lives,” he says. But it will require a focus on reducing transmission, an empowered community, and strong government leadership.

“It can be done, it must be done,” he says. “I have said it before and I will keep saying it. No matter where a country is in its epidemic curve, it’s never too late to take decisive action.”

He concludes his remarks and opens the floor to questions.

The World Health Organization is holding its daily briefing on the coronavirus outbreak.

Dr Tedros Adhanom Ghebreyesus says four situations were playing out around the world. Some countries were “alert and aware” and have avoided significant outbreaks. “Leaders of those countries took command of the emergency … and pursued a comprehensive strategy,” he says.

The second group he defines is countries where a “major outbreak was brought under control” through strong leadership and public adherence.

In these situations leaders are opening up the countries on a data-driven basis, he says.

The third situation are those that overcame the first peak, but are now facing a second wave. “It would appear that many countries are losing gains as proven measures to reduce risk are not followed,” he says.

Finally, there are countries in the “intense transmission phase”, he says. He notes that the epicentre of the virus remains the Americas, but says it’s never too late to bring the virus under control.

A new Reuters tally finds that the total number of infections around the world stands at 13m, with about 570,000 dead.

The figures are based on official government reports. The story notes a few other significant points:

• The disease is accelerating fastest in Latin America. The Americas account for more than half the world’s infections and half the deaths.
• Parts of the world, especially the US, with more than 3.3m confirmed cases, are seeing huge increases in a first wave of Covid-19 infections while others “flatten the curve” and ease lockdowns.
• The first case was reported in China in early January and it took three months to reach 1m cases. It has taken just five days to climb to 13m cases from 12m recorded on 8 July.
• In countries with limited testing capacity, case numbers reflect only a proportion of total infections. Experts say official data likely under-represents both infections and deaths.

Reuters has produced an interesting, if cheerless, set of graphics showing the pace of the spread and how it’s varied around the world. You can see them here.

A quick note to say that an earlier post that said that the death toll in Latin America has gone past that of the US and Canada has been edited to clarify that the great majority of the two North American countries combined death toll is in the US.

You can see that amended post here.

Hong Kong’s chief executive, Carrie Lam, said on Monday that the financial hub will reimpose social distancing measures after a sudden spike in coronavirus infections.

They new rules will ban more than four people from gathering in public, shutter some businesses and restricting restaurants from catering to evening diners. AFP reports:

The city has had impressive success in tackling the disease with just over 1,400 infections and eight deaths. In the last two months, local transmissions had all but ended.

However, in the last two weeks a cluster of local infections has emerged and officials believe the disease is spreading undetected in the densely populated city of 7.5 million.

Here’s the South China Morning Post’s version of the story, which notes disagreements among local epidemiologists about how best to contain a new wave of infections. Some doubt that the more stringent measures will be sustainable in the long run, the paper says.

Here’s your potted guide to recent events:

• The death toll in Latin America has reached 144,758, taking it past that in the US and Canada, and leaving the region second only to Europe.
• British prime minister Boris Johnson has urged the public in England to wear masks in shops as an “extra insurance policy” against the coronavirus
• About 250,000 people in Manila will return to lockdown in an attempt to stall the infection rate there. The Philippines has the second highest number of infections in south-east Asia.
• Tokyo governor Yuriko Koike said on Monday the Olympic Games must go ahead next year as a symbol of world unity in overcoming coronavirus.
• Turkmenistan has recommended residents wear masks because of “dust” even as the government insists the country is Covid-19-free. Turkmenistan is one of a handful of countries yet to declare coronavirus cases
• A 30-year-old patient died after attending a “Covid party”, believing the virus to be a hoax, a Texas medical official has said.
• Ten million kids ‘may never return to school’ after the pandemic, Save the Children warned. The coronavirus pandemic has caused an “unprecedented education emergency” with up to 9.7 million children affected by school closures at risk of never going back to class, the charity said.
• A group of 84 of the world’s richest people have called on governments to permanently increase taxes on them and other members of the wealthy elite to help pay for the economic recovery from the Covid-19 crisis.

Premier League football supporters reduced to watching matches on TV with fake crowd noise may look enviously at sumo lovers in Japan from this weekend, when the sport’s association will let fans attend an arena event for the first time since coronavirus began.

The association had originally planned to organise the upcoming tournament without spectators but has decided to admit fans “by thoroughly taking measures to prevent infections inside the facility,” AFP reports.

Like all high-level sport, sumo takes on a slightly surreal atmosphere in the absence of fans, photos like this one suggest.

Reuters reports two experimental vaccines being rushed into the next stage of development in the US:

Two experimental coronavirus vaccines jointly developed by German biotech firm BioNTech and U.S. pharmaceutical giant Pfizer have received ‘fast track’ designation from the U.S. drug regulator, the companies said on Monday.

The candidates, BNT162b1 and BNT162b2, are the most advanced of the at least four vaccines being assessed by the companies in ongoing trials in the United States and Germany…

If the ongoing studies are successful, and the vaccine candidate receives regulatory approval, the companies said they expect to make up to 100 million doses by the end of this year and potentially more than 1.2 billion doses by 2021-end.

The companies said they expect to begin a large trial with up to 30,000 participants as soon as later this month, if they receive regulatory approval.

While many hopes remain pinned on a vaccine, there have been a number of setbacks to even the most promising attempts. Yesterday, Prof Robin Shattock, of Imperial College in London, cautioned that there was “no certainty” that any of the vaccines in development would work.

Here’s a useful explainer on the prospects of a vaccine by our science editor, Ian Sample, from last month: