Before I go on, let me back up a bit and talk about our Center for Disease Control Pandemic Team. After 45 was elected, during the Transition co-working time, the incoming team worked with President Obama's out-going team practicing several scenarios (as each Transition team has done for the past century). One of the scenarios that was acted upon was a pandemic caused by a flu-like virus that originated in Asia and swept across Europe. The CDC and WHO specialists covered all available actions that the US government could perform, use, or draw upon. Thirty members of 45's incoming team participated in this exercise. Less than ten of those people remain in the current administration, according to one of the men who participated. And they apparently don't remember anything they learned in that exercise.
In May 2018, the top White House official in charge of the US response to pandemics left the current administration. Rear Admiral Timothy Ziemer was the senior director of global health and bio-defense on the National Security Council and oversaw global health security issues, a specialty that had been bolstered under President Obama.
After Ziemer's departure, the global health team was reorganized as part of an effort by then National Security Adviser John Bolton. Meanwhile, Tom Bossert, a homeland security adviser who recommended strong defenses against disease and biological warfare, was reportedly pushed out of the administration by Bolton in 2018. Neither White House official, nor their teams, which were responsible for coordinating the US to pandemics across governmental agencies, have been replaced.
In November 2019, a bipartisan group of lawmakers and experts formally recommended that health security leadership on the NSC should be restored. And on 18 February 2020, a group of 27 Senators sent a letter to current National Security Adviser Robert O'Brien to ask him to appoint a new global health security expert to the NSC.
"The fact that they explicitly dismantled the office in the White House that was tasked with preparing for exactly this kind of a risk is hugely concerning," said Jeremy Konyndyk, who ran foreign disaster assistance during the Obama administration. "Both the structure and all the institutional memory are now gone."
As of this morning, 19 March 2020, the United States does not have a CDC Pandemic Response Team in place.
I'm going to be referencing the World Health Organization a lot after this; so if you are not aware of WHO, what they are and what they do, read this. WHO is a specialized agency of the United Nations which is responsible for international public health. It is a part of the UN Sustainable Development Group. The WHO Constitution, which establishes the agency's governing structure and principles, states it's main objective as ensuring "the attainment by all peoples of the highest level of health." It is headquartered in Geneva, Switzerland; and has six semi-autonomous regional offices and 150 field offices worldwide.
*********
On 31 December 2019, a case of pneumonia with an unknown cause was reported to the World Health Organization in China. From the WHO report: "At the close of 2019, the WHO China Country Office was informed of a pneumonia of unknown cause, detected in the city of Wuhan, in Hubei province, China. According to the authorities, some patients were operating dealers or vendors in the Huanan Seafood market." Staying in close contact with national authorities, WHO began monitoring the situation and requested further information on the laboratory tests performed and the different diagnoses considered.
4 January 2020 - WHO announced a cluster of pneumonia cases - with no deaths - in Wuhan, China. They said they were actively investigating the cause. WHO announced it would work across all three of its levels - country office, regional office, and Headquarters - to track the situation and share details as they emerged.
5 January 2020 - WHO published its risk assessment and advice, and reported on the status of patients and the public health response by national authorities to the cluster of pneumonia cases in Wuhan, China.
10 January 2020 - WHO issues its first guidance regarding the novel coronavirus. Developed with reference to other coronaviruses, such as SARS and MERS, WHO issued a tool for countries to check their ability to detect and respond to this novel coronavirus. This information was/is to help with identifying main gaps, assessing risks and planning for additional investigations, response, and control actions.
12 January 2020 - China shares the genetic sequence of the novel coronavirus, which will be very important for other countries as they develop specific diagnostic kits and testing.
13 January 2020 - Officials confirmed a case of the novel coronavirus in Thailand. It was not unexpected that cases of the novel coronavirus would emerge outside of China and reinforces why WHO calls for active monitoring and preparedness in other countries.
21 January 2020 - WHO made a field trip to Wuhan, China. The delegation observed and discussed active surveillance processes, temperature screening at Wuhan Tianhe airport, laboratory facilities, infection prevention and control measures at Zhongnan hospital and its associated fever clinics, and the deployment of a test kit to detect the virus. The delegation also discussed public communication efforts and China's plan to expand the case definition for the novel coronavirus, which will build a clearer picture of the spectrum of severity of the virus.
At the end of the visit, the Chinese Government released the primers and probes used in the test kit for the novel coronavirus to help other countries detect it. Chinese experts also shared a range of protocols that will be used in developing international guidelines, including case definitions, clinical management protocols, and infection control.
22 & 23 January 2020 - The WHO Director General convened the Emergency Committee to consider the outbreak of the novel coronavirus in China, with cases also now reported in the Republic of Korea, Japan, Thailand, and Singapore.
Several Committee members considered it still too early to declare a Public Health Emergency of International Concern (PHEIC), given its restrictive and binary nature. Among other recommendations, the Committee advised that it be recalled in approximately 10 days to again view the spread of the outbreak, if any.
25 January 2020 - WHO launches a free introductory "course" about the novel coronavirus on-line. Available in English, French, Spanish, and Chinese, this introduction covers topics such as why the novel coronavirus is a global threat to human health, and how to effectively engage communities in response to it.
28 January 2020 - WHO Director General Dr. Tedros Adhanom Ghebreyesus met with China's President Xi Jinping in Beijing, China about the coronavirus outbreak. Dr. Tedros was joined by WHO Regional Director Dr. Takeshi Kasai and Executive Director of the WHO Emergencies Program Dr. Mike Ryan, and also met State Councilor and Minister of Foreign Affairs Wang Yi and Minister of Health Ma Xiaowei.
The discussions focused on continued collaboration on containment measures in Wuhan, public health measures in other cities and provinces, conducting further studies on the severity and transmissibilty of the virus, continuing to share data, and for China to share biological material with WHO. These measures will advance the development of medical countermeasures such as vaccines and treatments.
The two sides agreed that WHO would send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts.
30 January 2020 - A Public Health Emergency of International Concern was declared by WHO Director General Dr. Tedros Adhanom Ghebreyesus following a second meeting of the Emergency Committee convened under the International Health Regulations. Acknowledging that 2019-nCoV cases have been reported in five WHO regions in month, the Committee noted that early detection, isolating and treating cases, contact tracing, and social distancing measures - in line with the level of risk - can all work to interrupt virus spread.
5 February 2020 - With the 2019-nCoV outbreak set to test the resilience of countries around the world, WHO invokes the $675 million (United States $) Strategic Preparedness and Response Plan, that aims to protect states with weaker health systems.
Covering areas ranging from international coordination to country readiness to research and innovation, the SPRP aims to limit transmission, provide early care, communicate key information, and minimize social and economic impacts.
11 February 2020 - The novel coronavirus is named COVID-19. Guidelines mandated that the name of the disease could not refer to a geographical location, an animal, an individual, or group of people. It also needed to relate to the disease and be pronounceable. This choice will help guard against the use of other names that might be inaccurate or stigmatizing. This is how the name came about: COronaVirus Infectious Disease; and since it was first reported in 2019, the -19.
12 February 2020 - More than 400 experts and funding partners met at WHO's Geneva Headquarters to accelerate research to stop the COVID-19 outbreak. Featuring updates from the front lines of the response in China, the meeting addressed issues such as: developing easy-to-apply diagnostics, accelerating existing vaccine candidates and preventing infection.
Also on this day, WHO activated the Crisis Management Team (CMT), which brings together WHO, OCHA, IMO, UNICEF, ICAO, WFP, FAO, the World Bank, and several UN Secretariat departments. The CMT will be managed by the Executive Director of WHO Health Emergencies Program, Dr. Mike Ryan. It will help WHO focus on the health response while the other agencies will bring their expertise to bear on the wider social, economic, and developmental implications of the outbreak.
15 February 2020 - "We must be guided by solidarity, not stigma. The greatest enemy we face is not the virus itself, it's the stigma that turns us against each other. We must stop stigma and hate." WHO Director General Dr. Tedros called on the international community to use the window of opportunity to prepare for COVID-19 at the Munich Security Conference, a leading global forum on preeminent crises and future security challenges.
17 February 2020 - Based on lessons from the H1N1 flu and Ebola, WHO has outlined planning considerations for organizers of mass gatherings, in light of the COVID-19 outbreak. It has also issued advice on how to detect and take care of ill travelers, who are suspected COVID-19 cases.
18 February 2020 - WHO and other countries are engaged in acts of outbreak preparedness. WHO has shipped supplies of personal protective equipment to 21 countries. By the end of this week, 40 countries in Africa and 29 in the Americas are due to have the ability to detect COVID-19.
21 February 2020 - WHO Director General Dr. Tedros emphasized that the window of opportunity to contain the COVID-19 outbreak is "narrowing" and that the international community needs to act quickly, including through financing. His Tweet: "Countries with weaker health systems nedd the world's focus & support now, due to the potential for #COVID19 to spread to those locations. We must take advantage of the window of opportunity we have to contain the outbreak. We don't want to look back later & regret failing to act."
Also on this day, Dr. Tedros appointed six special envoys on COVID-19, to provide strategic advice and high-level political advocacy and engagement in different parts of the world. They are:
Professor Dr. Maha El Rabbat, former Minister of Health of Egypt
Dr. Davis Nabarro, former special adviser to the United Nations Secretary-General on the 2030 Agenda for Sustainable Development and Climate Change
Dr. John Nkengasong, Director for the African Centers for Disease Control and Prevention
Dr. Mirta Roses, former Director of the WHO Region of the Americas
Dr. Shin Young-soo, former Regional Director of the WHO Region of the Western Pacific
Professor Samba Sow, Director-General of the Center for Vaccine Development in Mali
22 February 2020 - WHO's Director General and the Regional Director for Africa addressed an emergency meeting of ministers of health to agree on a continental strategy for Africa to strengthen preparedness and responses to the COVID-19 outbreak. During the past month about 11,000 African health workers have been trained using WHO's on-line courses regarding COVID-19.
24 February 2020 - UN Secretary-General Antonio Guterres met with the WHO Director General and other WHO leaders, receiving a briefing on COVID-19, Ebola, and polio. He expressed great admiration for health workers, including in China, who are working tirelessly to save lives. The UN Secretary-General also stressed that there is no space for stigma and discrimination and said we must be guided by science and human rights-based interventions.
A team of experts from WHO and the European Center for Disease Prevention and Control (ECDC) will focus on: understanding how events developed, learning from the Italian experience, and supporting control and prevention efforts by the authorities.
To limit further human transmission, WHO experts will provide support in the areas of clinical management, infection prevention and control, surveillance, and risk communication.
25 February 2020 - A WHO team of 25 international and Chinese experts traveled to several different provinces in China, with a small group going to Wuhan, the epicenter of the outbreak. Among the team's findings was that the epidemic peaked and plateaued between the 23rd of January and the 2nd of February, and has been steadily declining since then. The team also estimates that the measures taken in China have averted a significant number of cases. In a press conference in Geneva, Dr. Bruce Aylward, the mission's lead, reported back on what China has done, its impact, and implications.
The WHO Director General has repeatedly called for "solidarity, not stigma" to address COVID-19. WHO has worked with UNICEF and the International Federation of Red Cross and Red Crescent Societies on a guide to preventing and addressing the social stigma associated with the disease. It's vital to fight stigma because it can drive people to hide the illness, not seek health care immediately, and discourage them from adopting healthy behaviors. This guide includes some tips and messages, as well as do's and don't's on language when talking about COVID-19.
26 February 2020 - WHO has issued new COVID_19 guidance for businesses and employers, which outlines simple ways to prevent the spread of the virus, things to consider when employees travel, and how to get your business ready in case COVID-19 arrives in your community.
There is also a new video - Watch Dr. Maria Van Kerkhove, WHO's technical leader on the new coronavirus, answer questions from the public about COVID-19. She begins by explaining how the virus spreads and how to protect yourself from it. Dr. Van Kerkhove was a member of the recent joint mission of experts to China to learn more about the outbreak.
27 February 2020 - In discussing preparedness for COVID-19, the WHO Director General listed questions every health minister (or the head of Health & Human Services in the US) should be able to answer. The questions are:
1. Are we ready for the first case?
2. Do we have enough medical oxygen, ventilators and other vital equipment?
3. How will we know if there are cases in other areas of the country?
4. Do our health workers have the training and equipment they need to stay safe?
5. Do we have the right measures at airports and border crossings to test people who are sick?
6. Do our labs have the right chemicals that allow them to test samples?
7. Are we ready to treat patients with severe or critical disease?
8. Do our hospitals and clinics have the right procedures to prevent and control infections?
9. Do our people have the right information? Do they know what the disease looks like?
28 February 2020 - In a daily COVID-19 press briefing the WHO Director General said that more than 20 vaccines are in development globally, and several therapeutics are in clinical trials. But we don't need to wit for vaccines and therapeutics. There are things that every individual can do to protect themselves and others. Wash your hands. Don't touch others. Use social distancing. Do not congregate in large numbers.
1 March 2020 - United Nations Humanitarian Chief Mark Lowcock released $15 million (US $) from the Central Emergency Response Fund to WHO and UNICEF to help fund global efforts to contain the COVID-19 virus. This grant will help countries with fragile health systems boost their detection and response operations. It will fund essential activities including monitoring the spread of the virus, investigating cases, and the operation of national laboratories.
2 March 2020 - A WHO team visits Iran, landing in Tehran. The experts aim to identify transmission dynamics and at-risk populations, as well as provide guidance on strengthening and scaling up the response and readiness efforts. The mission arrived along with a shipment containing medical supplies and protective equipment to support over 15,000 health care workers and enough laboratory kits to test and diagnose nearly 100,000 people. The mission will build on COVID-19 preparedness and response work already underway by WHO's country office in the Islamic Republic of Iran.
Dr. Tedros, the Secretary General of WHO said, "There is no choice but to act now." Speaking at the COVID-19 media briefing, Dr. Tedros emphasized that the virus is capable of community transmission, but can be contained with the right measures. He Tweeted: "Containment of #COVID19 is feasible and must remain the top priority for all countries. There is no one-size fits all approach. @WHO is advising countries on actions they can take for each of the scenarios - first case, first cluster, first evidence of community transmission."
3 March 2020 - WHO has shipped nearly half a million sets of personal protective equipment to 47 countries, but the global supply is rapidly depleting. Shortages are leaving doctors, nurses, and other front line workers dangerously ill-equipped to care for COVID-19 patients due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns and aprons. To meet rising global demand, WHO estimates that the industry must increase manufacturing by 40 %.
Each month, front line health responders around the world need - at the very least - these supplies to protect themselves and others from infectious diseases - including COVID-19:
Face masks - 89 million
Gowns - 30 million
Goggles - 1.59 million
Pairs of gloves - 76 million
Hand sanitizer - 2.9 million liters (766,099 gallons)
4 March 2020 - "This is unprecedented," says Dr. Maria Van Kerkhove, WHO's technical leader for COVID-19. She Tweeted: " We are eight weeks into this #COVID19 outbreak: yet we have identified the virus, we have the genetic sequence, PCR & serological assay in use. This wealth of knowledge is unprecedented for a new disease."
5 March 2020 - Speaking at the COVID-19 media briefing, the WHO Secretary General, Dr. Tedros, emphasized that the epidemic "can be pushed back, but only with a collective coordinated and comprehensive approach that engages the entire machinery of government." In three Tweets, he said: "The #COVID19 epidemic is a threat for every country, rich & poor. We are calling on every country to act with speed, scale & clear-minded determination. We call on countries to activate their emergency plans through the whole-government approach. - We are concerned that in some countries the level of political commitment and the actions that demonstrate that commitment do not match the level of the threat we all face. - Leadership from the top: We call on country leaders to mobilize their plans, coordinating every part of government, not just the health ministry - security, diplomacy, finance, commerce, transport, trade, information and more - the whole government should be involved."
Also today, WHO launches a new social media campaign called Be Ready for COVID-19, which urges people to be safe, smart, and kind. "Be Ready" was launched because everyone can prepare for COVID-19, including individuals, governments, and businesses.
We're calling on people to Be Safe by remembering tried & tested public health measures, like regular hand washing & staying at least 3 feet away from anyone coughing or sneezing. These ordinary measures are extraordinarily effective at fighting COVID-19.
We're asking people to Be Smart about COVID-19 by rejecting rumors & taking care to only share information from trusted sources. Everyone should keep informed about what is happening in their area and follow the recommendations of local authorities.
We're reminding people toBe Kind through addressing stigma and looking out for one another -especially the most vulnerable and those in isolation. Compassion can combat COVID-19.
6 March 2020 - "Research - implemented as policy and practice - can save lives and needs to be integrated into the response from the start." A Research & Development road map for COVID-19 outlines research priorities in 9 key areas. These include the natural history of the virus, epidemiology, diagnostics, clinical management, ethical considerations, and social sciences, as well as longer-term goals for therapeutics and vaccines.
7 March 2020 - Tweet from Dr. Tedros, WHO Secretary General: "Today for the first time 100 countries are reporting #COVID19 cases. This comes after the world reached 100,000 cases yesterday. While very serious, this should not discourage us. There are many things everyone, everywhere, can and should do now. #coronavirusbit.ly/3azVPDK "
Marking this somber moment, WHO reminded all countries and communities that the spread of this virus can be significantly slowed or even reversed through the implementation of robust containment and control activities.
Every effort to contain the virus and slow the spread saves lives. These efforts give health systems and all of society much needed time to prepare, and researchers more time to identify effective treatments and develop vaccines.
Allowing uncontrolled spread should not be a choice of any government, as it will harm not only the citizens of that country, but affect other countries as well.
We must stop, contain, control, delay and reduce the impact of this virus at every opportunity. Every person has the capacity to contribute, to protect themselves, to protect others, whether in the home, the community, the healthcare system, the workplace, or the transport system.
8 March 2020 - Every country should urgently take all necessary measures to slow further spread and to protect health systems from becoming overwhelmed with patients seriously ill with COVID-19.
Interim Guidance is issued from WHO: Drawing on existing materials, this guidance describes the preparedness, readiness, and response actions for four different transmission scenarios:
1. No cases
2. Sporadic cases: 1 or more cases, imported or locally detected
3. Clusters of cases in time, geographic location and/or common exposure
4. Community transmission: larger outbreaks of local transmission
9 March 2020 - Tweet from Dr. Tedros of WHO: "Now that the #coronavirus has a foothold in so many countries, the threat of a pandemic has become very real. But it would be the first pandemic in history that could be controlled. The bottom line is: We are not at the mercy of this virus."
Dr. Tedros also said the above in his daily media briefing. All countries must aim to stop transmission and prevent the spread of COVID-19, whether they face no cases, sporadic cases, clusters, or community transmission. "Let hope be an antidote to fear. Let solidarity be the antidote to blame. Let our shared humanity be the antidote to our shared threat."
10 March 2020 - WHO, UNICEF and the International Federation of Red Cross and Red Crescent Societies outline critical considerations and practical check lists to keep schools safe, with helpful tips for parents and caregivers, as well as children and students.
11 March 2020 - Speaking at the daily COVID-19 media briefing, Dr. Tedros, of WHO, said:
"WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction. We have, therefore, made the assessment that COVID-19 can be characterized as a pandemic.
Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.
Describing the situation as a pandemic does not change WHO's assessment of the threat posed by this virus. It doesn't change what WHO is doing, and it doesn't change what countries should do.
We have never before seen a pandemic sparked by a coronavirus. This is the first pandemic caused by a coronavirus.
And we have never before seen a pandemic that can be controlled, at the same time."
12 March 2020 - Reports from 5-day missions to Azerbaijan and Iran were given.
During it's 5-day mission to Azerbaijan, a team of WHO experts worked with the national response committee on developing a national preparedness and response plan for COVID-19. The government of Azerbaijan is contributing to global efforts to address the virus, coordinating with neighboring countries, and has pledged $5 million (US $) to WHO's strategic preparedness and response plan.
A 5-day expert mission to Iran with experts from WHO, GOARN partners, Robert Koch Institute in Berlin, and the Chinese Center for Disease Control has concluded. "Everybody in the country is engaged in this response. The right and timely public health measures implemented on an adequate scale will make a difference," said Dr. Richard Brennan, WHO Regional Emergency Director of the Eastern Mediterranean Region and mission team lead. Looking forward, Dr. Brennan said more work needs to be done to protect health workers. The mission also held constructive discussions on ways to advance epidemiological data collection and analysis.
13 March 2020 - A new coronavirus disease (COVID-19) Solidarity Response Fund will raise money from a wide range of donors to support the work of the World Health Organization and partners to help countries respond to the COVID-19 pandemic. The fund, the first of its kind, enables private individuals, corporations, and institutions anywhere in the world to come together to directly contribute to global response efforts, and has been created by the United Nations Foundation and the Swiss Philanthropy Foundation, together with WHO.
*Europe now has more reported cases and deaths than the rest of the world combined, apart from China.
More cases are now being reported every day than were reported in China at the height of its epidemic. *
WHO launched a #SafeHands Challenge to promote the power of clean hands to fight the coronavirus. To support the challenge to encourage people to clean their hands with soap or an alcohol-based hand rub, Twitter created a new hand-washing emoji. Heads of state, footballers, singers, and more have already taken part, with more people nominated to join the challenge every day.
15 March 2020 - A WHO mission in Iraq, which comprised of experts from the Eastern Mediterranean Regional Office and from WHO headquarters in Geneva, held a series of meetings with national health authorities to identify the disease detection dynamics and at-risk populations, in addition to providing guidance on strengthening response and control measures.
The mission also reviewed the Ministry's overall readiness to deal with a potential increase in case reporting and the priority of establishing an Emergency Operation Center to speed up action now that the disease has been announced as a global pandemic.
16 March 2020 - "You cannot fight a fire blindfolded." - Countries should test every suspected case of COVID-19. If people test positive, they should be isolated, and the people they have been in close contact with up to 2 days before they developed symptoms should be sought out, and those people should also be tested if they show any symptoms of COVID-19.
WHO also advises that all confirmed cases, even mild cases, should be isolated in health facilities, to prevent transmission and provide adequate care.
But we recognize that many countries have already exceeded their capacity to care for mild cases in dedicated health facilities. In that situation, countries should prioritize older patients and those with underlying conditions.
Chris Martin played a mini-gig at home to kick off #TogetherAtHome, a virtual no-contact concert series that aims to promote physical distancing and taking action for global health, presented by WHO and Global Citizen. More Solidarity Sessions are being planned to promote health, to show support for people who are staying at home to protect themselves and others from COVID-19, and to encourage donations to the COVID-19 Solidarity Response Fund.
17 March 2020 - The World Health Organization today called on member states in the South-East Asia Region to urgently scale-up aggressive measures to combat COVID-19, as confirmed cases cross 480, and the disease claims 8 lives.
18 March 2020 - Take real-time training during our current pandemic. Real-time training during global emergencies is critical for effective preparedness and response.
The OpenWHO (at OpenWHO.org) Massive Online OPen Courses for COVID-19 provide learning resources for health professionals, decision-makers, and the public. More than 320,000 people have already enrolled.
As the pandemic continues to evolve, new resources will be added, additional language versions will continue to be rolled out, and existing courses will be updated to best reflect the changing context.
Courses include:
1. Operational Planning Guidelines to Support Country Preparedness and Response
2. Infection Prevention and Control
3. Acute Respiratory Infections (ARIs) and basic hygiene measures to protect against infection
4. Clinical Care Severe Acute Respiratory Infection
5. Emerging Respiratory Viruses, including COVID-19; Methods for detection, prevention, response and control
