FULL TRANSCRIPT: World Health Organization (WHO) Press Briefing – March 18, 2020

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Tarik Jasarevic :
We'll have a questions for other guests. Before you applaud to Dr. Tedros, just to remark that we've had some issues, technical issues with sending media advisories. We had a we had some meetings just as just few hours ago. And hopefully this will be sorted.

Tarik Jasarevic :
And everyone who is on our lists will be getting the notes from W.H.O., including media advisories, press releases and all the other notifications. We will have an audio file, as we always do, and hopefully a transcript will be available tomorrow. Dr. Tedros, please.

Dr. Tedros:
Thank you. Thank you, Terry. And good morning and good afternoon, everybody. It's now more than a month since the last case of Ebola in DRC. If it stays that way, the outbreak will be declared over in less than a month's time.

Dr. Tedros:
We would like to thank all our partners for their solidarity in staying the course in the service of the people of DRC and my special appreciation, especially to the government and people of the Democratic Republic of Congo. That same spirit of solidarity must be at the center of our efforts to defeat Coheed, 19.

Dr. Tedros:
More than two hundred thousand cases of Cobbett 19 have been reported to W.H.O. and more than 8000 people have lost their lives.

Dr. Tedros:
And more than 80 percent of all cases are from two regions the Western Pacific and Europe. We know that many countries now face escalating epidemics and are feeling overwhelmed. We hear you. We know the tremendous difficulties you face and the enormous burden you are under. We understand the heart-wrenching choices you are having to make. We understand that different countries and communities are in different situations with different levels of transmission. Every day. W.H.O. is talking to ministers of held heads of states, health workers, hospital managers, industry leaders, CEOs and more to help them prepare and prioritize according to their specific situation. Don't assume your community want to be affected. Prepare as if it will be. Don't assume you won't be infected. Prepare as if you will be. But there is hope. There are many things that all countries can do. Physical distancing measures like canceling sporting events, concerts and other large gatherings can help to slow transmission of the virus. They can reduce the burden on the health system and they can help to make epidemics manageable. Allowing targeted and focused measures but to suppress and control the epidemics. Countries must isolate, test, treat and trace. If they don't. Transmission chains can continue at a low level, then resurge once physical distancing measures are lifted. W.H.O. continues to recommend that isolating testing and treating every suspected case and tracing every contact must be the backbone of the response in every country. This is the best hope of preventing widespread community transmission. Most countries with sporadic cases or clusters of cases are still in the position to do this. Many countries are listening to our call and finding solutions to increase their ability to implement the full package of measures that have turned the tide in several countries. But we know that some countries are experiencing intense epidemics with extensive community transmission.

We understand the effort required to suppress transmission in these situations, but it can be done.

A month ago, the Republic of Korea was faced with accelerating community transmission, but it didn't surrender. It educated, empowered and engaged communities.

It developed an innovative testing strategy and expanded lab capacity iteration ration the use of masks. It did exhaustive contact tracing and testing in selected areas, and it isolated suspected cases in these designated facilities rather than hospitals or at home.

As a result, cases have been declining for weeks at the peak. There were more than 800 cases. And yesterday the report was only 90 cases. W.H.O. is working in solidarity with other countries, with community transmission. To apply the lessons learned in Korea and elsewhere and adapt them to the local contexts. Likewise, W.H.O. continues to recommend that wherever possible, confirmed mild cases should be isolated in health facilities, where trained professionals can provide good medical care and prevent clinical progression and onward transmission. If that's not possible. Countries can use community facilities to isolate and care for mild cases and refer them for specialized care quickly if needed. If health facilities are at risk of being overwhelmed, people with mild disease can be cared of or cared for at home. Although this is not the ideal situation, W.H.O. has advice on our Web site for how homecare can be provided as safely as possible.

W.h.o. continues to call on all countries to implement a comprehensive approach with the aim of slowing down transmission and flattening the curve. This approach is saving lives and buying time for the development of vaccines and treatments. As you know, the first vaccine trial has begun just 60 days after the genetic sequence of the virus was shared by China. This is an incredible achievement. We commend the researchers around the world who have come together to systematically evil Lloyd experimental therapeutics, multiple small trials with different methodologies may not give us the clear, strong evidence we need about which treatments help to save lives. W.H.O. and its partners are therefore organizing a study in many countries in which some of these untested treatments are compared with each other. This large international study is designed to generate the robust data we need to show which treatments are the most effective. We have called this study the Solidarity Trial. The Solidarity trial provide simplified procedures to enable even hospitals that have been overloaded to participate.

Many countries have already confirmed that they will join the solidarity trial and these countries.

Ah, Argentina Bukharin, Canada, France, Iran, Norway, South Africa, Spain, Switzerland and Thailand and I trust many more will join.

I continue to be inspired by the many demonstrations of solidarity from all over the world. The coveted 19 Solidarity Response Fund has now raised more than 43 million US dollars from more than one hundred seventy three thousand individuals and organizations. Few days since we launched it, I would especially like to thank FIFA for its contribution of 10 million U.S. dollars. This and other efforts give me hope that together we can and will prevail. This virus is presenting us with an unprecedented threat, but it's also an unprecedented opportunity to come together as one against a common enemy, an enemy against humanity.

I thank you.

Thank you very much for these remarks, so we will start with the questions. I will just remind once again, if it's possible to has only one question per person so we can get as many questions as possible.

So if we are ready, we can start with father'll from Boland's. Hold it. His Bible. Can you hear us? Yeah.

Can you hear me? Hello?

Hello? Yes, we hear you. Go ahead, please. Pappalardo.

Up to today, Paul on the run. Nine thousand test on a population of thirty eight million, which many consider as far too few. Do you have any recommendation on a hat on how much testing is advisable for our country in containment phase like Poland? And when can we expect cheaper version of diagnostic tests to be available in Europe?

Thank you.

If I understood well, the question is about how much testing should be done in a country of a size of bowling.

Yes. Yes.

And when the tests would be available in Poland, no one when the cheaper version of diagnostic tests be available in Europe.

When when? When cheaper tests would be available in Europe.

First of all, the value of testing is clearly determined by the number of suspected cases that you that you have.

So I think the focus here is not how much testing it needs to be done to reach a certain number. Though the answer there, the real challenges, are you testing every single suspect case? Every suspect case should be tested, their contacts identified. If those contacts are sick or showing symptoms, they should be tested. That requires a scale up because many countries have not been systematically testing all suspect cases. And that's one of the reasons why we're behind in this epidemic. So we need that to happen. Secondly, there are many manufacturers producing tests. W.H.O. has contracted with a manufacturer of production of tests mainly aimed at supporting developing countries. I am sure that Poland and through the European Union and others has access to too many companies who are producing tests either in the academic or in the private sector. But if if there is a need, any country may contact W.H.O. and we will either point them to a manufacturer or if needed, provide them with emergency testing capacities.

Thank you very much. Hope this answers question from Butler.

If if we can go now to Seeman at caber from today's News Africa. Simon, can you hear us?

Yes, you can. Can you hear me?

We will try to level up the sound a little bit.

Please go ahead. So send.

Ok. Thank you for taking my question. My name is Simon. I step back from today's News Africa. Washington, D.C. I know that Corona virus is spreading in Africa is largely over 30 countries and almost 600 people have been affected. But there's a problem. You still have big gassings.

You still have big religious gods and you still have people waiting. Speak with, for instance, a popular pastor in Nigeria. So TB Joshua has told his followers that the virus will be defeated on the 27 of March and he's not the only one. So my question is, do you think this is the time to avoid a two star big religion gods in big wedding and all the things that bring us together in Africa and be naming sounds for the first time?

But I will just repeat question for everyone. The question is about a big religious gatherings in Africa. And is this a risky thing for spreading the virus on the continent?

First of all, congratulations to you, to many of our member states in Africa reacted very quickly to put in place the necessary surveillance, the laboratory testing and other measures. Africa is a resilient continent with a resilient population who've dealt with and deal with epidemics every day of every year or every year, unfortunately.

At the moment, the incidence of Corbitt, 19 in Africa is low. It may be higher due to lack of detection, but within reason, Africa still has a major opportunity to avoid some of the worst impacts of the epidemic and to prepare prepare its public health system and its health system for this. With this in mind. African countries are looking at all of the different options. And I'm sure they're looking at their experience in Asia. They experience in Europe and looking at what options work best for them. Certainly at this moment in time, all countries that have a disease inside their borders need to examine the appropriate measures to limit contact between individuals, particularly large mass gatherings that have the potential to amplify disease. But we fully understand that. Depending on where countries are in the disease development or in the evolution of the epidemic, those decisions are based on different risk management factors. But in principle, W-A Jal's view at this moment is that all countries with with community transmission are clusters of cases inside the country. In order to avoid disease, amplification should be seriously considering delaying or reducing mass gatherings that bring people together in an intense way and have the potential to amplify and spread disease, particularly in large religious type gatherings that bring people from very far away into very close contact.

Maybe you'd like to add to what Mike said.

You know, as of today, the number of cases reported from sub-Saharan Africa is 233 cases in four days, and it's actually in terms of confirmed cases. It's the lowest region. But as Mike said, we we have we cannot take this number, as you know, the amount of or the number of cases we have in Africa, probably we have undetected cases or unreported cases. But in addition to that, even if we take this, 233 cases are true. We have to prepare for the worst in other countries.

We have seen how the virus actually accelerates at after a certain tipping, tipping point.

So the best advice for Africa is to prepare for the worst and prepare today.

It's actually better if these numbers are really true to cut it from the bad. And that's why we're saying we have to do the testing, we have to do the contact tracing, we have to do that isolating isolation and cut it from the blood.

And with regard to mass gathering and so on, it will help if we avoid that. And W.H.O. is recommendation is actually mass gatherings should be avoided and we should do all we can.

Look at it from from. From that.

But expecting that the worst could happen because we have seen how the virus really speeds up and accelerates in other continents or or countries. So that's our advise. And I think Africa should wake up. My continent should wake up. Thank you.

Thank you so much. The terrorists end up to run. Let's try to get to myself from my iodine, sir.

I understand.

Sir, can you hear us?

We were just left out of his day on Monday, but the Met again. He did? Oh, I guess not with me. It's a mixed blessing for him. We're on medication.

Let's go over to a larger idea. In case you think Sonix. Let's see what comes up.

So our friend from from magazine is asking about a sanctions to Iran and how sanctions on Iran have impacted the capacity of the country to to respond to this outbreak.

We've been working very closely with the authorities in any round and with many, many countries around the world now who have worked with us to ensure that Iran gets the assistance and help that it needs.

We've again said right the way through this epidemic that we want to avoid politicization of these events and we thank those member states. And there are a wide range of member states from different political and different persuasions and ideologies who have agreed to act in solidarity together to support Iran's situation. And we are focused as we have been on providing lab supplies and reagents in supplying PPE and ensuring that Iran has access to the markets. It needs to do that. And we've been working at a very detailed level, not only through the sanctions, but through the banking system and others to free up the necessary resources and to free up and provide the necessary assurances to companies and others that they can without with comfort and without fear of any consequence, supply Iran with essential medical equipment and supplies for the purposes of the control of Corbitt 90. The DG may wish to speak on some of his political engagements that have successfully ensured that the circumstance has come to pass. We are in solidarity with our brothers and sisters in Iran and all over the world and will ensure that every citizen in every country has the opportunity to access a global goods.

At this point in time, let us know. Thanks. Thank you very much.

The only thing I would like to add to that is we have already we are already in contact with senior officials from Iran. I had spoken to the minister of health yesterday and also had a chance to speak to Secretary Pompeo yesterday. And we have underlined the need for full solidarity. And I remind all of us the statement that the United States and especially Secretary Pompeo issued some weeks ago and we have discussed on how best that can be implemented. And as Mike said, some of the process, especially with with banking and so on. But in emergency situations, the sanctions can be addressed. And this is, you know, already agreed from the US side. And that's why we heard the statement. And we hope that we will have the needed solidarity to fight this enemy together. At the same time, I would like to use this opportunity to thank the crown prince. He sent the second round of support to Iran the day before yesterday. Two aircraft chartered shipping materials needed.

And that's what we're calling for, to for the whole world to know for the time.

I think we are in the most important solution in fighting an enemy like this by a dangerous virus is solidarity. And we hope this spirit will will continue.

Thank you very much and really sorry myself. We'll try to take your second question next time and just to say that we all miss our Geneva press corps.

So speaking about let's go to Jamie. We missed Jamie as well. Jamie. Please go ahead and ask your question. One question.

Candy, can you hear me, Terek? Yes, please go ahead.

Ok, great. Hi, Jimmy. Associated Press. We're wondering why might the death rates across Europe is so variable? Italy's death rate is at about 11 percent and they will soon overtake Hubei Province in terms of numbers of deaths, while other countries like Germany, France, Spain and the UK have reported far lower death rates closer to one to two percent. What might explain that discrepancy? Thanks.

Hi. Jamie here. I almost miss you as well.

The the.

It's a good question and there are a number of factors that might explain that.

But certainly one of them is testing. If you look at the Germany we had we had some very good communication with Germany today. They've had a very aggressive testing process. They've they've tested and confirmed over 6000 cases with just 13 deaths. But that may reflect the fact that they're really aggressive in their testing strategy. So the number of tests and the number of confirmed cases may be detecting more mild cases as a proportion of all cases. That's an important determination. The second issue is the the evolution of the time of evolution in the outbreak. What we do see is a pattern of long hospital admission. So Italy being having experienced the first wave of major transmission much earlier than other European countries is now experiencing those deaths because a lot of people reach a point where they can no longer be saved in the clinical system. So therefore, the deaths occur sometimes two to three to four weeks after the infection starts. So, again, it's you have to look at where each country is in the epidemic cycle. The other factor may be to do with the age profile of populations. For example, Italy has a very or a much older age profile and has a higher proportion of people in the very elderly category. And in some ways, Italy has been a poster child for healthy people living into old age.

And we've always asked ourselves the question, you know, why Italians and people living on the Mediterranean are healthier and live longer lives and. And.

But unfortunately, in this case, having that older population may mean that the fatality rate appears higher because of the actual age distribution of the end of the population underneath. There may be technical reasons as well in terms of the ability to provide standard of care. We saw this in China. We saw this in Hu Bay. When you looked at the case, fatalities inside Hubei, an outside Hubei. There were significant differences in case fatality. And anyone who's ever worked in the frontline of an emergency, when patient numbers begin to overwhelm, it becomes a simple factor of your ability to provide adequate care and react to every change in the patient's condition in the intensive care environment. So I think there are circumstances in which the standard of care cannot be maintained when patients are being overwhelmed and appointed to the tremendously courageous and brave physicians, nurses and intensivist in Italy who haven't been dealing with one or two patients in intensive care, for example, in northern Italy, over twelve hundred patients in intensive care at the same time. It's an astonishing number. The fact that they're saving so many is a miracle in itself. So I think there are many factors Jamie. And they all play into the the actual numbers. Maria May for more technical advice on that.

The only thing to add is, is exactly where the virus is, is is circulating in each country. And so you have to look at the demographics of where those where it is circulating in Korea. We had these clusters, these very large clusters related to a church and that the age distribution of those cases was much younger than what we're seeing in northern Italy, for example. You may see outbreaks in long term care facilities where the age is much higher. And so it's important where those clusters are occurring and where you're capturing your cases from. But we do need to be very careful when we look at mortality rates and we compare mortality rates. It's it's not right to compare them yet. What we need to do is find out why we're seeing differences and what that actually means in terms of our understanding of this virus and how it impacts different populations. We've said previously that we need to we need to be very careful when we compare a calculation of the number of deaths over the number of cases that are reported per country. And Mike has outlined the reasons why that is difficult. But we have not seen the way this virus will behave in other vulnerable populations. We have not seen how this virus will behave if and when we see it in vulnerable populations of high prevalence. HIV, for example, or malnutrition, children, for example. And that's what we need to prepare for. So every death is significant regardless of where this takes place. And we need to ensure that all of the measures that we take are preventing transmission because every step that we take there will prevent death.

Suppliment here on the issue severity, if you look at the case series that reduced and published from Korea, almost 20 percent of their deaths have occurred in people under 60. So the idea that this is purely a disease that causes death in very in older people, we need to be very, very careful with physicians again, initially will attest to this. And in Korea, this isn't just a disease of the elderly. There is no question that younger, healthier people experience a much overall less severe disease. But a significant number of otherwise healthy adults can develop a more severe form of the disease. And that's why we need to be ever vigilant in ensuring that we observe everyone. Even the mild cases for any signs of clinical progression to a more serious disease.

Thank you very much. Be good. Next question, that should be Diego from Brazil. Diego, can you hear us?

Yes, I can't. Can you hear me? Yes, please go ahead.

Yes. There are a lot of speculation about cases regarding children. So if you could please clarify, what is the data right now about the symptoms on children and how fast they can spread? The virus can spread on children.

Thank you, Diego, so I can start with that. So, yes, we know that children are susceptible to infection.

We know that children are infected with this virus. But in terms of the reporting of cases across a large number of countries now where we have data, the number of cases of reported cases in children is lower than adults. We know that children can have to develop disease. And the disease that they develop in terms of the signs and the symptoms are similar to what we're seeing in adults, which include fever, which include dry cough, which include fatigue and muscle pain. There are a overall the majority of children that are infected will experience mild disease, but that is not universal. There is a recent study that came out in China that showed that a number of children have developed severe disease in critical disease. And in China, one child has died. And so what we what we need to prepare for is the possibility that children can also experience severe disease. But the evidence so far is that children have mild disease. And only one death reported in China so far.

Thank you very much. Thank you. We will take one question from from journalists who are for some reason unable to get on the line.

So here is Camilla Hudson from Financial Times asking, is there a shortage of tests and or test processing centers in Europe? Is that the reason that more testing isn't being done in countries like the United Kingdom?

I think countries in Europe have been scaling up their capacity to do testing over the last number of weeks. There are different options for countries. One is not lab testing kits which do a small number of tests per kit. The other are automated machines that allow you to test a number of samples at one time. And then there are high throughput machines that allow up to 5000 samples to be processed per day. And many European countries are moving through to to put in place those more high throughput mechanisms to be able to test more and more cases. So, yes, I think there's a scale up going on and testing, but I don't believe that the ability to test has been the reason for the not testing. I don't think that's been this step in the limitation. I think it comes down to what the strategy of an individual country is. If you're going to make an attempt to detect every suspect case and test every suspect case, then I believe countries in Europe do have the capacity to do that. The tough part is then when you get those cases being able to identify context and follow those contacts and quarantine contacts, then you need to leverage a much larger public health response that comes in behind that lab testing and allows you then to suppress the virus through those individual isolation mechanisms.

Isolating individuals or quarantining contacts is about removing people who are potentially infectious from the community. What in balance with that and in line with that social distancing or physical distancing measures, in a sense, ask everybody to separate themselves from everybody else on the basis that we're not quite sure where the virus is. A combination of those two allows you to really suppress the virus if you really focus on individual measures to try and take people who are known to have the virus or could have the virus out of the general population for a period of time and at the same time you create some physical separation at the population level. Those two combined can be very effective at suppressing transmission of the virus in order for that strategy to work. You must have the capacity to do more extensive lab testing as you really tried to search for and identify all of those suspect cases.

And countries are coming up with different strategies to meet the testing demands. And maybe Maria can explain a little more on what those strategies are.

Yes. So there's there's three major areas in which countries are working on to increase their testing capacity. The first is the kits themselves that Mike has has described the sheer number of available tests and companies they're developing tests in countries that have developed test is incredible considering where 12 weeks into this outbreak, this pandemic. The second area is increasing the number of labs that can actually run these tests. So in every country, there are national labs that can do PCR work there. They're building on a flu national influenza system that has been in existence for decades. But increasing the number of labs that can actually run those tests is an important part of the strategy. Whether you're using public health labs or using private labs or academic labs, whatever it may be, the number of labs that can do those tests needs to be increased. And the third area is the number of people, the workforce who are actually going to run these tests. So this three pronged approach of being able to have more labs that can do these and run these assays, more people who can run this and have more tests available are really critical. We've also seen in the D.G. gave a good example in Korea, where countries not only in Korea, but countries are finding innovative ways to test people. So finding individuals, how can we run these tests? We saw this drive through system, for example. But countries need to be creative in the way they use the fundamentals of public health in terms of tackling this virus. But think of innovative ways and creative ways in which you can find people that fit your transmission scenario.

Thank you very much. Let's go to next question, Helen branswell, Helen.

Hi. Thanks for taking my question. I was hoping you could give us some more information about the Solidarity trial. Could you please tell us what drugs have been prioritized?

Hi, Helen. Annamaria. I know Restrepo will join us to give you the specifics on the trial, but it's a multi it's a multi armed trial and countries are able to choose between any one, I think, or more or five therapeutics that are currently being evaluated. But it may be more some. Anna-Marie, it will speak to this and give you the details.

Good afternoon, Helen. Is is that the design? Initially, we have five arms. The first arm is the standard of care. They're useful care that is provided to the patients in the country. The second arm is round NCB. The said arm is lapping that weird routine every year. Therefore, arm is lapine. We had royalty navvy with interferon beta and their fifth arm. It was chloroquine. The good thing about the trial is, as Mike indicated, that the randomization could be adjusted to the drugs available in each individual hospital over time. The other good thing about adaptive design is that we can include additional arms or drop arms as our Global Data Safety Monitoring Committee advises we should do. Finally, Dr. tetras mentioned that this is a very simple trial and we think that is very important, that other research goes on that will contribute to our understanding of this disease. But this trial focus on the key priority questions for public health. Does any of these drugs reduce the mortality that any of these drugs that reduce the time a patient is in hospital and whether another patient is receiving any of the drugs needed, ventilation or intensive care unit?

Very much. Dr. Hanno.

If needed, we will provide the exact title of Dr. No.

But now we will go to next question to South Africa.

We have Stephen from Hot's 9 1 9. Stephen, can you hear us?

Yes, I can. Thanks very much for taking my question. I was gonna ask Stephen.

Stephen, we don't hear you very well. Can you speak a little bit?

I can't speak, right. How is it that you got it? Yeah. OK.

I wanted to ask. We've seen some schizophrenic government activity, I have to say, looking at the way our government here in South Africa has responded.

I have been fairly impressed as the journalist and the response you've been potent factor for the government to be unified on this. Opposition politicians have come out and said they support government. We are to be on the same page. I don't know what sort of interaction that W.H.O. has had with South Africans. Maybe your with is not they interact to communicate out. I'd like to get an insight from you.

Again, as as the director general has said many times, an all of government approach is in absolutely underpins success in fighting any emergency. But in this particular case, all the more so, I think that has been the case in many countries, including South Africa. Another point to make here is that African countries have been dealing with emergencies, climate disasters, natural disasters, epidemics for a very long time. South Africa has had to deal with a terrible HIV epidemic over many, many decades. So the ability to create coherent responses to what our biologic threat is is not easy for governments because these are threats you can see and sometimes can't quantify. So having been through that kind of a crisis already prepares government for that leadership role when when the time comes. Building trust with communities is tough at a time when many citizens have lost faith in government and all around the world. This is not easy. This is both an opportunity for governments to rebuild trust with their citizens, to rebuild that confidence that's needed to manage adversity and to reach out and create a nonpartizan all of government. All of society approach to dealing with disease. But again, the idea here and I say this with caution. Many countries in sub-Saharan Africa and there are many countries in the world that are fragile health systems. That is correct. But they are not helpless. And I have worked with with an African colleagues in Africa for many, many years. And what I see is a story of resilience, a story of coping and an ability to overcome adversity through communities by building on community intervention, building on community acceptance. If we can match community participation with good governance, then I believe that Africa can succeed. It has demonstrated that time and time again. But it does require strong, united governance to deliver for citizens. And I think we're we're seeing that in Africa and I hope we continue to do so.

Thank you very much. Dr. Tedros, as you can see, has left.

But I'm sure our our speakers will be able to answer one or two more questions. Let's go to Emma Farge from Reuters. Can you hear us?

I can hear you. Hopefully you can hear me. I had a question about the strategy for the supply crunch. You think that the only way to demand for equipment such as ventilators and people is for medical factories to be retooled to make this.

And are you calling for that on a large scale? Thank you.

There you are. Correct. Or there is a real pressure in the market for personal protective equipment, for essential medical supplies, for providing care for people. Most countries are are still in reasonable shape, but there are great disruption and there's great distortion in the market and many would characterize that as a market failure.

We're working very, very closely with governments and in particular with our colleagues in the United Nations system, with the World Food Programme, who have are working extremely closely with us, like we have World Food Programme staff here with us. No better logistics organisation and the whole world in terms of supply chain management. We're working with UNICEF. We're working with other agencies in order to maximize our ability to access those materials on the global market. We also have some fantastic support from from governments in trying to prioritize supplies for us so we can provide them to to to all countries the most basic needs. China being the lead in driving that approach of prioritizing our supply chains. In order to do that, there is a scramble on the market and we do need order and discipline in that. And I do believe that the institutions like the European Union and others are trying very hard to bring that order and coherence to the process of procurement and ordering and prioritization.

It's like any rush.

We've seen this in the supermarkets of the shops. If everybody rushes to to buy everything they think they need for the foreseeable future, then many people lose out. That is the same if it's a if it's toilet roll or if it's a personal protective equipment. But, you know, we can afford maybe to run out of time. A robot help. Workers can't afford to run out of PPE. And it is a huge responsibility for governments around the world to ensure that not only their health workers, not only their health workers, but all health workers have a fair opportunity to. Excess PPE. That is a responsibility of industry. That is the responsibility of governments. That is a responsibility of the U.N. system. We're trying to do our bit. Working very hard across the U.N. to make that an easy process for governments. Governments who wished prioritize giving help to others can use W.H.O. use the U.N. platforms to do that. I know they're very busy and may not be able to do that themselves, but we would welcome any contributions, donations to an international system to supply PPE to those most in need. And in addition, other essential supplies like oxygen concentrators and the rest in terms of them. We've seen some positive moves. For example, some countries in Asia are really looking at self production of PPE. And we do again look and again, there are some companies around the world part of our pandemic supply chain network who are actively working to license their production capacities to local producers for Masks for Peepee in order to be able to produce that at local level. That's a fantastic development to transfer technology license that so that local manufacturers can come into the game. Ventilators and other sophisticated equipment is another scale of production and another scale of safety and ISO standards that are needed to meet that. We have to be very, very careful in scaling up production of sophisticated technology like that. But countries like China and others have immense capacities for ramping up production. And we're working with them to see how that can be achieved and with other large scale producers of such equipment.

I yeah, if I could supplement that. So in addition to everything that Mike said, it's important that every individual knows what their role is in to ensuring that the supply that is needed is being used for in the most appropriate way. So what is what what countries are doing in terms of what is their strategy for dealing with mild patients? What is their strategy for dealing with with severe patients? Individuals need to know what their role is in terms of how they can prevent overburdening a health care health system. For example, if you're feeling unwell, you know, if you're feeling unwell, you generally stay home. You don't rush to a health care facility. You contact the either the hotline number that is available in your country or you call your health care provider. And you and you say, these are my symptoms. Do I need to come in? And in most cases, you will not need to go in. You will not need. But if you do have the symptoms that we worry about for Cauvin 19, which include fever, which include dry cough, which include shortness of breath, then you will need to seek care. And so it's important that that processes in place in countries so people that they know where they can go and when they should go seek health care. It's about the rational use of masks. We have provided guidance about using a medical mask in the community. And if you're not sick, you shouldn't be wearing a medical mask. But if you are, then you should.

Those decisions that are being made on an individual level impact the global supply for all of these materials. So please know that each individual has a role to play in this global supply issue.

Thank you very much. Sure. Next question will go to we will have two more questions and then we will let you go.

Next year will be KACL fresh meat. But before that, I just need to see what's Anna-Maria title because it has been asked.

So Anna-Maria now and I will spell the name A and a Maria is a high H now as HP and a OAP.

Maria is a unit head for research and development blueprints as Health Emergencies program here at W.H.O.. Keiko Fishman's. How are you?

Thanks for taking my question. So maybe if I can, just a quick clarification on the Maria, the fifth arm of you're trying to win Portwenn, plus something else. And then the question I wanted to ask you, keep talking about testing, of course, and you know, a lot of discussions, but there also seems to be a problem with the supply of reagents, some of the testing. And I'm curious whether W O is working on addressing that in some way or whether you have some thoughts on that.

Ok. You are very good friend of W.H.O., but I have to enforce the policy of one question. So it was a question and the clarifications. OK. So what you please.

It's clear Kim alone. So we are going to test in some countries chloroquine and in some countries in dose of chloroquine. And we are looking into the equivalence between the two doses. And we have an independent expert panel who help us with the proteasome process. And this is how we arrive to this selection. Over.

Them on the lab side. Right. Might actually, Anna-Maria, bring Mac to the table there? Mac Perkins leads ah ah ah lab portfolio under marías coordination. There are lots of questions being asked about his lab supplies and and all of that.

And again, as Maria said, there are different manufacturers producing tests on different platforms. So there could be a shortage in one area and nothing. Another. So it's very hard to do a global evaluation.

We've seen, for example, in some of the high throughput systems in the last few weeks, they haven't run out of the testing reagents. They've actually run out of of equipment and supplies to support the high throughput system. So it's very easy to extrapolate a single problem in a single testing system to the whole system. But I will let Mark as we close off our thanks to Mark and the team, because they've worked really hard over the last number of weeks and within days of of of of this virus been sequenced. We were working with scientists and collaborating centers and with manufacturers to produce highly qualified, validated tests that have actually been distributed to 120 countries. They're operating at a very high level of quality and quality assurance. And we're very, very pleased at the way in which they have performed throughout the world over the last number of weeks. And we thank Mark. We also thank all of those in the laboratory networks who've been working on this, all of the scientists, all of the manufacturers, all of the collaborating centers and those who've worked to validate these tests in the fields. It's been a huge success and something that we are proud of. We continue then to work with others to make sure that they're able to scale up at the same level. So, Mark, maybe a word or two on some of the issues around reagents, supplies, assays, concerns around this?

Yes, there have been shortages of some of the materials on the ancillary materials, as Mike mentioned, used in PCR reactions, which are the most common way to diagnose coronavirus. These are sometimes important chemistries that you can't find any place else other than a diagnostic manufacturer. Some of the diagnostic manufacturing, a lot of it has been done in China and with the outbreak in China. It decimated the workforce, at least made them unable to work and make some of those reagents and made it difficult to procure the vast number of diagnostic companies are scaling up their own capacity to generate those reagents. And I think we'll get over that hump. There are more than 200 companies now working, already declared sometimes already finished working on diagnostics for coronavirus. And so we have a plethora of choices and sorting out which ones work and which ones meet, whose needs is really the next step for the future.

Thank you.

Thank you very much. That was Mark Perkinson.

I was trying to find the exact title maybe. Can you just say the exact title for those who would like to use?

I'm the lead of laboratory networks in infectious hazard management.

Thank you very much, Mark. And we will go to last question and then we'll go to South China Morning Post.

Did we have anyone from South China? Morning Post, Yeganeh.

Amy.

Hopefully we will hear you better try again.

Yes. Yes. Great. Thanks so much for taking my question. Doctor Tenderize mentioned the importance of international unity on this. And I just wondered whether anyone there at W.H.O. had comments about the US president, Donald Trump's continued usage of the Chinese choir as recent as this morning to refer to it. You know, given that there continue to be reports of racism and xenophobia, attacks against ethnic Chinese people around the world, not wondered whether you had any black made me or distract from the international community's opinion on this.

You very much. I think we've been very clear right since the beginning of this event that the viruses know no borders and they don't care your ethnicity, the color of your skin or how much money you have in the bank.

So it's really important that we be careful in the language we use, lest it lead to profiling of individuals associated with the virus. This is just something we need to all avoid it. It's easy.

You know, in in in situations to summarize or to make comments that are not intended to do that, but ultimately end up having that outcome. And I'm sure anyone would regret profiling a virus along ethnic lines.

That's not something anybody would would want. We need solidarity. We need to work together.

There are many different origins. I've said it before in these press conferences that the pandemic of influenza in 2009 originated in North America. We didn't call it the North American flu. So it's very important that we have the same approach when it comes to two other other viruses to avoid that.

And we ask for for that to be the intent and that everybody that everybody has. This is a time for solidarity. This is a time for facts. This is a time to move forward together, to fight this virus together. There is no blame in this.

All we need now is to be able to identify the things we need to do to move forward quickly with speed, with certainty, and to avoid any indication of ethnic or other associations of this virus.

To say something on international unity, we've seen overwhelming international unity and solidarity for this pandemic. And I think every single instance that we can highlight that we should we see this in not only support for countries, verbal support for countries that are dealing with horrible outbreaks.

We see this through donations, whether it's through PPE or whether I, you know, eyes. I see children drawing pictures for health care workers. Every single one of those acts of kindness is an act of international unity. And we'd like to see more of that. We see this through through donations to the Solidarity Fund, which we're so grateful for, which will be used towards fighting this response. We see this through acts of kindness, of people helping older people in their neighborhoods, of doing grocery shopping, delivering care, packaging, of helping your parents and grandparents set up your their phone so that they can talk to each other over over different platforms. All of that is international unity. And we every single one of us has a responsibility to contribute to that. And every single reporter that's out there that's covering this has a responsibility to cover that, too. It's really incredible that these are very tough times. And in many countries, this is going to get a lot worse before it gets better. But this will be temporary and we will get through this and we will get through this together.

Thank you very much for this important message. We will conclude today's press briefing. Will have all your files on to our very shortly and transcript tomorrow.

And next press conference is scheduled for Friday. We sure. A nice evening.

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