Statement on the Fifth Meeting of the International Health Regulations (2005) of the Coronavirus Pandemic Emergency Commission (COVID-19)

The fifth meeting of the Emergency Committee convened by the Director-General of the WHO under the International Health Regulations (IHR) (2005) regarding coronavirus disease (COVID-19) was held on Thursday, October 29, 2020 from 12:30 to 16: 05 Geneva Time (CEST).

Proceedings of the meeting

Members and advisers of the Emergency Committee were convened by videoconference.

The Director General welcomed the Committee, highlighted the global progress and challenges in tackling the COVID-19 pandemic, and thanked the Committee for its continued support and advice.

Representatives of the Legal Department and the Compliance, Risk Management and Ethics Department (CRE) informed members about their roles and responsibilities. The CRE Ethics Officer provided members and advisors with an overview of the WHO Interest Storage process. Members and advisors are aware of their individual responsibility to disclose to the WHO in a timely manner any interests of a personal, professional, financial, intellectual or commercial nature that may lead to a perceived or direct conflict of interest. They further reminded them of their duty to maintain the confidentiality of discussions on the meeting and the work of the committee. Each member present was interviewed and no conflict of interest was identified.

The secretariat handed the meeting over to the chairman, Professor Didier Houssin. Professor Houssin also welcomed the Committee and reviewed the objectives and agenda of the meeting.

The WHO Assistant Directors-General for Emergency Response and Emergency Preparedness and International Health Regulations provided an overview of the current context and an update of the implementation of the Interim Recommendation of 1 August 2020. The WHO continues to assess the global level of risk of the COVID-19 pandemic as very high.

The Committee expressed great gratitude for the leadership and activities of the WHO during the global response. The Committee particularly appreciated the critical role of the WHO in developing evidence-based guidelines and recommendations; providing technical assistance and operational support to countries; conveying clear information and resolving misinformation; and convening a solidarity trial and an accelerator for access to COVID-19 (ACT). The Committee commended the WHO’s ongoing efforts to strengthen national, regional and global responses to the COVID-19 pandemic.

Following the discussions that follow, the Committee unanimously agreed that the pandemic continues to be an extraordinary event, a public health risk to other countries by international expansion, and still requires a coordinated international response. As such, the Board considered the COVID-19 pandemic to remain an emergency public health service of international importance and provided advice to the Director-General.

The CEO determined that the COVID-19 pandemic still represents PHEIC. It accepted the advice of the WHO Committee and issued the Committee’s advice to States Parties as interim recommendations to the IHR (2005).

The Emergency Committee shall be convened within three months, at the discretion of the Director General. The Director General thanked the Board for its work.

Council of the WHO Secretariat

Leadership and coordination

1. Continue to coordinate global and regional multilateral organizations, partners, and networks and share best practices for responding to a pandemic.

2. Provide States Parties with a mechanism that includes templates and procedures for reporting on national progress in implementing the interim recommendations; collect, analyze and keep the Committee informed of this progress.

Evidence-based response strategies
3. Continue to provide evidence-based guidance for readiness and response to COVID-19. These guidelines should include sustainable long-term response strategies, mitigation approaches for different levels of transmission, refined risk management and pandemic response indicators, a meta-analysis of the effectiveness of public health and social measures in responding to COVID-19 and lessons learned including from in-house reviews .

Research
4. Continue to convene multidisciplinary experts to agree on a consistent language and further explain: all potential modes of transmission and virulence of SARS-CoV-2; risk severity factors and epidemiology COVID-19; and the astonishing diversity of pandemic dynamics globally.

5. Continue cross-sectoral cooperation to understand the origins of SARS-CoV-2, the role / impact of animals and provide regular updates on international research findings.

6. Continue working with partners to refine mathematical models that can make policy decisions on how best to mitigate the effects of a pandemic.

Monitoring and searching for contacts
7. Continue to work with partners and networks to provide guidance, tools and training to support countries in strengthening their strong public health oversight, comprehensive contact search and cluster investigation.

8. Encourage and support countries to understand and report on their epidemiological situation and relevant indicators, including by using existing influenza control systems for COVID-19.

Risk communication and community engagement
9. Continue to work with partners to combat the current infodemia and provide guidance on community mobilization to support effective public health and social measures.

Diagnosis, therapy and vaccines
10. Continue to support the development of diagnostics, safe and effective therapies and vaccines and an impartial approach through the COVID-19 Tools Accelerator (ACT); continue to work with all ACT Accelerator partners to provide countries with additional clarity in procedures to allow fair and timely access to diagnostics, therapy and vaccines, including in humanitarian settings.

11. Accelerate support to improve countries’ readiness to introduce COVID-19 vaccines by providing guidance, tools and technical assistance for critical areas such as vaccination strategies, vaccine acceptance and demand, training, supply and logistics with a focus on cold chain and monitoring input and safety vaccines.

Health measures in relation to international traffic
12. Continue working with partners to update and review evidence-based international travel guidelines in accordance with IHR (2005) provisions. These guidelines should focus on effective, coherent risk-based approaches (including targeted use of diagnostics and quarantine) that take into account transmission levels, response capacities in countries of origin and destination, and relevant travel-specific considerations.

Basic health services
13. Work with partners to support countries in strengthening their basic health services, with a special focus on mental health, public health prevention and control systems and other impacts on society, as well as on preparing for and responding to concurrent epidemics, such as seasonal flu. Special attention should still be paid to sensitive settings.

Interim recommendations to States Parties

Leadership and coordination

1. Continue to share with WHO best practices, including reviews within activities, and apply lessons learned to mitigate COVID-19 resuscitation; invest in the implementation of national action plans for sustainable preparedness and response capabilities in line with IHR requirements.

2. Report to the WHO on progress in implementing the Interim Recommendations, in particular on major achievements, milestones and obstacles. This information will empower countries, the WHO, partners and the Committee to continue to make informed decisions during a pandemic.

Evidence-based response strategies
3. Avoid politicization or complacency regarding the response to a pandemic that negatively affects local, national, regional, and global efforts. National strategies and localized preparedness and response activities should be guided by science, data and experience and should involve and enable all sectors using a society-wide approach.

4. Implement a dynamic approach to risk management using appropriate indicators to inform about time-limited, evidence-based public health and social measures.

Research
5. Conduct research and share information on transmission, including the role of aerosols; the presence and potential impact of SARS-CoV-2 on animal populations; and potential sources of pollution (such as frozen products) to mitigate potential risks through preventive measures and international cooperation.

Monitoring and searching for contacts
6. Maintain efforts to strengthen the public health surveillance system and invest in a skilled workforce to actively find cases, comprehensively seek contacts and cluster investigations.

7. Continue to report in a timely and consistent manner to the WHO, including through platforms such as GISRS, on all recommended indicators for the epidemiology and severity of COVID-19, response measures and concurrent epidemics, to improve global understanding of pandemic developments.

Risk communication and community engagement
8. Engage and empower individuals and communities to strengthen confidence in the response to COVID-19 and to promote continued respect for public health and social measures based on the principles of solidarity and human rights; monitor and address rumors and misinformation.

Diagnosis, therapy and vaccines
9. Establish a national multidisciplinary working group, assess progress using the COVID-19 Preparedness Assessment Tool (VIRAT) and prepare a National Introduction and Vaccination Plan, which can serve as a holistic operational plan for the introduction of COVID-19. Strong emphasis should be placed on communicating with communities to prepare for vaccination against COVID-19.

Health measures in relation to international traffic
10. Regularly review measures applied to international travel in accordance with Article 43 of the IHR (2005) and continue to provide information and justification to the WHO on measures that significantly impede international traffic. Ensure that measures affecting international traffic (including targeted use of diagnostics and quarantine) are risk-based, evidence-based, coherent, proportionate and time-bound.

11. Continue to strengthen capacity at entry points to manage potential cross-border transmission risks and facilitate international contact search.

Basic health services
12. Maintain basic health services with sufficient resources, supplies and human resources; strengthen health systems to cope with the effects of a pandemic on mental health, concomitant disease outbreaks, and other emergencies.