WHO begins discussing when and how to declare end of pandemic

Public health experts at the World Health Organization have begun discussing how and when to call an end to the global Covid-19 crisis, exploring what would be an important milestone more than two years after the emergence of the virus.

The WHO said it isn’t currently considering such a declaration. While cases have fallen in many places, fatalities have spiked in Hong Kong, and this week China reported more than 1,000 new daily cases for the first time in two years.

Instead, the discussions at the Geneva-based agency are focusing on what conditions would eventually signal that the public health emergency declared on Jan. 30, 2020, is over. Such a declaration would be not just a meaningful symbolic step, and would add momentum to the rollback of many pandemic-era public health policies.

“The International Health Regulations Emergency Committee on Covid-19 is looking at the criteria needed to declare the public health emergency of international concern as terminated,” 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 masking and quarantine guidelines, and opening borders to travel. Still, many countries in Asia are reporting record levels of transmission, and in Germany cases recently rebounded back near record levels. There have been more than 10 million Covid cases and 52,000 deaths in the past week, the WHO said.

Researchers have also warned that even if Covid-19 cases fall to lower levels, the disease is still likely to cause thousands of deaths annually, not unlike other endemic illnesses such as malaria and tuberculosis. And the potential for new, dangerous variants is unpredictable.

The WHO’s discussions could have implications for drugmakers such as Pfizer Inc. and Merck & Co. that have agreed to allow generic competition to their Covid treatments until the pandemic ends. Vaccine makers including AstraZeneca Plc have said they’ll keep prices for their products low until the pandemic ends, without specifying what the benchmark for that would be.

Cautious Call

The WHO has been cautious in the past to call an end to global health emergencies and disease outbreaks. Like the declaration of the emergency, the decision would ultimately be made by Director-General Tedros Adhanom Ghebreyesus after consultation with experts.

Many countries no longer rely solely on the WHO’s guidance, said David Heymann, a former WHO and U.S. Centers for Disease Control and Prevention epidemiologist who advises the WHO on outbreaks.

“They’re not ignoring the WHO, but they’re depending 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’s pronouncements on travel and trade were strictly heeded. Today, countries have more up-to-date information and surveillance.

A key metric for countries considering exiting emergency status is population immunity, Heymann said, meaning the proportion of people who have some antibodies to the virus either from immunization, infection, or both. Researchers estimate that about 98% of the U.K. population has some immunity to the coronavirus that may prevent severe illness, he said.

It’s not the same level of antibody protection needed to achieve herd immunity, which prevents any virus spread, he said. Herd immunity looks extremely unlikely with the coronavirus because current vaccines don’t prevent infections and infections don’t ward off repeat bouts of the virus, he said.

In the U.S., about 98% of the population lives in counties where masking requirements for indoor public spaces aren’t necessary, according to the CDC. However, concerns are rising 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.)