Public health experts at the World Health Organization have begun discussing how and when to end the global Covid-19 crisis, exploring what would be a major milestone more than two years after the virus emerged.
The WHO said it is not currently considering such a declaration. While cases are down in many places, deaths have soared in Hong Kong, with China this week reporting more than 1,000 new daily cases for the first time in two years.
Instead, discussions at the Geneva-based agency focus on what conditions would eventually signal that the public health emergency declared on January 30, 2020, is over. Such a declaration would not be just a significant symbolic step, and would add momentum to the rollback of many pandemic-era public health policies.
“The Emergency Committee of the International Health Regulations on Covid-19 is analyzing the criteria necessary to declare the public health emergency of international concern over,” the agency said in an email. “As of now, we are not there yet.”
Many nations around the world have already taken steps to return to more normal social behaviors, relaxing mask-wearing and quarantine guidelines, and opening borders for travel. Still, many countries in Asia are reporting record levels of transmission, with cases in Germany recently rebounding to near record levels. There have been more than 10 million Covid cases and 52,000 deaths in the past week, the WHO said.
The researchers also warned that even if Covid-19 cases drop to lower levels, the disease is likely to continue to cause thousands of deaths a year, unlike other endemic diseases such as malaria and tuberculosis. And the potential for new and dangerous variants is unpredictable.
The WHO discussions could have implications for drugmakers like Pfizer Inc. and Merck & Co. that have agreed to allow generic competition in their Covid treatments until the pandemic is over. Vaccine makers, including AstraZeneca Plc, have said they will keep prices for their products low until the pandemic is over, without specifying what the benchmark for that would be.
The WHO has been cautious in the past in ending global health emergencies and disease outbreaks. Like the emergency declaration, the decision would ultimately be made by Director General Tedros Adhanom Ghebreyesus after consultation with experts.
Many countries no longer rely solely on WHO guidance, said David Heymann, a former WHO and US Centers for Disease Control and Prevention epidemiologist who advises the WHO on outbreaks.
“They don’t ignore the WHO, but they rely more on national and regional scientific advisory groups,” Heymann said in an interview. The role of these groups has evolved since the days of the SARS outbreak, when WHO pronouncements on travel and trade were strictly heeded. Today, countries have more up-to-date information and surveillance.
A key metric for countries considering emerging from a state of emergency is population immunity, Heymann said, meaning the proportion of people who have some antibodies to the virus, either through immunization, infection, or both. Researchers estimate that about 98% of the UK population have some immunity to the coronavirus that can prevent serious illness, he said.
It’s not the same level of antibody protection needed to achieve herd immunity, which prevents the spread of the virus, he said. Herd immunity seems extremely unlikely with the coronavirus because current vaccines don’t prevent infections and infections don’t prevent repeated bouts of the virus, she said.
In the US, about 98% of the population lives in counties where mask requirements for indoor public spaces are not necessary, according to the CDC. However, concerns are growing regarding the BA.2 variant, a version of omicron that has already spread widely in some other countries in Europe.
(Updates with WHO statement in fourth paragraph).