The ‘end of the pandemic’ might have several ramifications
On May 5, 2023, the World Health Organization (WHO) officially put an end to the COVID-19 global health emergency.
Three and a half years ago, (December 31, 2019), the Wuhan Municipal Health Commission (China) had reported a cluster of pneumonia cases soon after which a novel coronavirus was eventually identified. It was declared a public health emergency of international concern on January 30, 2020, the highest level of alert WHO can issue.
Since then, the pathogen has caused seven million deaths according to WHO but after accounting for excess deaths, the figure is closer to 20 million.
The pandemic has been on a downward trend for the past year which led to the decision to end the global health emergency which was arrived at during the 15th meeting of the WHO’s Emergency Committee on May 4. If the situation warrants it, the director-general of WHO may decide to reconvene the Emergency Committee on COVID-19 in the future.
The H1N1 outbreak that began in the spring of 2009 caused death and illness in 74 countries was the last pandemic we saw before COVID-19. When its end was announced in August 2010, the disease had not disappeared yet and cases were still erupting. The global health body noted the H1N1 virus will continue to circulate and increase seasonally.
COVID-19 is exhibiting similar behaviour. Country-wise government data from just last week shows that while daily cases have come down considerably, SARS-CoV-2 was still claiming a life every three minutes.
Keeping this in mind, and the understudied phenomenon of long COVID, it remains critical to not let our guards down, according to the director-general of WHO.
The ‘end of the pandemic’ might have several ramifications. Countries like the United States, the United Kingdom and even India have effectively returned to normal life — with no mask mandates, lifting of restrictions and free COVID-19 testing no longer available.
Although the GAVI (Global Alliance for Vaccines and Immunization) alliance will provide vaccines to 54 of the world’s poorest countries who still want them up to 2025, the question of how the transition to long-term COVID management will happen for low and middle income countries remains unanswered.
In late 2020, Moderna had announced that it will not patent its vaccine but only till the pandemic goes on. AstraZeneca was providing its COVID-19 vaccine on a not-for-profit basis across the world for the duration of the pandemic, which is now over.
It is possible generic manufacturers will soon not be allowed to make Merck’s Molnupiravir (Lagevrio) and Pfizer’s Paxlovid to support low and middle income countries.
So the inequity in access to vaccines and treatments might just magnify now because pandemics do not end at the same time for all countries. Even after cases decline, the economic and political impacts of the disease linger on.
The WHO meanwhile, is preparing to integrate SARS-CoV-2 surveillance into the Global Influenza Surveillance and Response System and outline ways to streamline it.
COVID-19 also triggered the need to put in place a pandemic treaty to be better prepared for future outbreaks, a final draft of which is expected during the 77th World Health Assembly in 2024.
Amendments to the International Health Regulations to bridge shortcomings in its application and implementation are also under discussion. These two documents are expected to compliment each other and prepare us better for the next pandemic.
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