Africa: Ebola, Hydroxychloroquine, COVID-19 – WHO Tackles a World of Health Challenges

Peacekeepers from the UN Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) on patrol in the Irumu Territory, Ituri, to deter militia activities.
3 June 2020

Washington, DC — Almost 50 responders from the World Health Organization (WHO) and its partners arrived today in Mbandaka in the Democratic Republic of Congo (DRC), along with 3600 doses of Ebola vaccine and 2000 cartridges for lab testing, WHO Director-General Dr. Tedros Adhanom Ghebreyesus told media in an online briefing.

Four of the first eight patients identified have died, in the same area that saw an Ebola outbreak in 2018, which was  after three months. The new outbreak is 2000 km (1200 miles) from another current Ebola outbreak that WHO, government health officials and other responders have been battling in eastern DRC for two years. The hemorrhagic disease in the east was contained, despite on-going conflict in the region, but it has re-emerged, forcing the nation to fight on two fronts, amid the COVID-19 pandemic.

When the eastern outbreak began in 2018, Director-General Tedros immediately left for eastern Congo. He visited multiple times, even in the face of armed attacks on health-care workers, as well as the civilian population, by militias operating in the area. One of his visits was two days after an attack that killed four health workers. "You cannot face Ebola and bullets without commitment, and that's why I am so proud of you," Tedros told Ebola responders.

Now, with CODIV-19 still spreading, while campaigns against other deadly diseases, such as malaria, have slowed, it is unlikely that Tedros can be as personally engaged against Ebola – although he emphasized that WHO's commitment to stemming the disease on opposite sides of the DRC has not waned. It is a reminder, he said, that "we continue to monitor and respond to many other health emergencies".

Hydroxychloroquine trials resume

Turning to COVID-19, Tedros announced that the Executive Group of the Solidarity Trial, which is comparing treatment options, has endorsed a recommendation to resume testing the controversial drug hydroxychloroquine. Last week there was a pause in testing, due to reports that patients receiving hydroxychloroquine died at a greater rate than others. After reviewing available mortality data, Tedros said, "the members of the committee recommended that there are no reasons to modify the trial protocol".

Global media have come to rely on WHO's COVID-19 briefings, usually three times a week, for substantive information on the state of research and practice as the world struggles with SARS-CoV-2 (the new corona virus). The organization has been attacked, most prominently by the United States, for not having been proactive enough in the early days of the virus's emergence. Although that criticism has dominated much media coverage, WHO has been relentless in rolling out a multi-faceted response.

Today's briefing outlined some of the responses in just the past week including:

Dr Maria Van Kerkhove, technical lead for COVID-19 at the World Health Organization, during the media briefing on June 3
  • A new report on suspected cases of multisystem inflammatory syndrome, the severe illness appearing in children thought to have been exposed to the virus;
  • Guidance on maintaining essential health services; controlling the spread of COVID-19 at border crossings between countries; recommendations for mass gatherings; and a protocol for surveillance of infections among health workers;
  • A discussion of ethical considerations for the use of digital technologies in tracking COVID-19; and
  • updated guidelines on the clinical management of patients with COVID-19, from screening to discharge.

At the same time, WHO is raising funds for the response, sponsoring a diversity of research, gathering and distributing essential supplies – including personal protective equipment and testing materials – to countries worldwide, and training millions of health workers, in medical centres and digitally. The online learning platform offers a dozen courses in 27 languages on how to deal with COVID-19.

At the regular press briefings, journalists pose questions to Tedros and a multi-national team of top WHO officials, such as American infectious disease epidemiologist Dr. Maria Van Kerkhove, technical lead for COVID-19; Irish communicable/infectious disease epidemiologist Dr Mike Ryan, executive director of WHO's Health Emergencies Programmes; and Indian paediatrician and clinician Dr. Soumya Swaminathan, WHO's chief scientist.

In response to a question from AllAfrica about an issue on the minds of many health professionals and policy planners – whether an unchecked spread of the virus in countries around the world could lead to dangerous mutations – Van Kerkhove said that there are a large number of scientists looking at more than 40,000 full genome sequences of the virus that are being shared with researchers around the world. They are on the lookout for changes, beyond insignificant mutations that occur in every virus.

This is a dangerous, dangerous virus.

Could it become more dangerous? "Part of the answer," she said, "is 'yes', because people grow tired. It's very difficult to keep up all of these measures [governments have mandated to slow the spread]. We must remain strong and vigilant."

Lockdowns must be lifted in a slow and careful way, she said. "And in some circumstances these public health and social measures may need to be re-introduced." While the virus itself is relatively stable, she said, "it could become more dangerous if we become complacent."

"This is far from over," she warned.

Ryan cautioned that concerns about the virus becoming more severe should not deflect attention from how dangerous it is already. "Dr. Tedros, sitting beside me here," he said, "has been saying again and again and again, that this is a dangerous, dangerous virus. It is dangerous enough as it is."

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