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INTERVIEW. End of the global health emergency: “The non-vaccinated no longer have too much to worry about,” says this epidemiologist



Do you, like the WHO, consider that Covid is no longer a global health emergency?

Yes, it is clear, everywhere in the world, that the Covid is no longer the public health emergency that it was once in our lives. There are no longer any countries that resort to confinements, quarantines, or impose sanitary controls at the borders vis-à-vis the Covid. The global health emergency lasted three years, which was particularly long. It is estimated that the Covid will have claimed nearly 27 million lives during this period, which is considerable. Fortunately, the vaccine changed the game, and this is one of the reasons that today we can get out of this pandemic.

Is the situation the same on all continents?

The situation has become much more homogenized with the arrival of Omicron at the end of 2021 and its myriad of sub-variants since. Currently the XBB-series sub-variants are dominating all over the world, and continue to cause waves of infections. But the vaccine immunity and that left by the repeated waves greatly limit the serious forms which led to saturation of hospitals and sometimes also morgues. The epidemiological situation is, however, less precise today because most governments have lifted their health surveillance guards and the collapse of tests no longer makes it possible to compare the current viral circulation with that of previous waves.

Would you say the pandemic is over, or not?

The notion of a pandemic, even if it may come as a surprise, is not in the official vocabulary of the International Health Regulations, the very one that governed the public health emergency of international concern which has just been lifted by the Director General of WHO in Geneva. Dr. Tedros had however, without any real legal basis, decided to declare a state of pandemic on March 11, 2020, in particular because he noticed that the international community was not mobilizing enough against the pandemic wave that started in China. The WHO could have taken advantage of the end of the state of emergency to declare the end of the pandemic, but decided against it, probably so as not to suggest that the virus was eliminated or that it no longer posed a threat to humanity. The message from the WHO is also very clear, if we have come out of the state of emergency, on the other hand we are entering a post-pandemic phase which should not be likened to the end of the problem caused by the SARS-CoV-2.

Some doctors see in the decision of the WHO a bad signal sent to the population in terms of prevention. And you?

On the contrary, this decision represents a signal that should encourage us to implement more effective prevention, to tackle the improvement of indoor air quality in particular. I will allow myself an analogy. Take a person who has just had a myocardial infarction. We hospitalize her in intensive care and after a few days, she is doing quite well. Some of the cells in his heart suffered, others necrosed, that is to say died, but the body is functioning, the patient is then transferred to the cardiology department, then to follow-up care. During this time, we analyze the situation, we try to better understand what happened. The patient was overweight, smoked, and had high blood pressure. The doctors decide to sign the discharge from the hospital and recommend preventive measures to the patient, i.e. a healthy lifestyle, a healthier diet, moderate physical activity, stopping smoking, and treatment for high blood pressure. The family complains about this too quick exit. She thinks that all these measures should be implemented in a hospital environment, better supervised, she thinks that the patient will not follow this advice. Perhaps the family is right because they know the patient, but do you believe that the hospital is the ideal place for prevention? Of course, all this advice and these measures will have been initiated during the hospital stay, but it is more in the very context of resuming a normal life that this prevention must now be considered. Well, for the pandemic it’s a bit the same thing, it’s outside the framework of the health emergency that we have to think about and implement long-term prevention measures, even if we know the patient, we know that our societies here are reluctant to learn the lessons of the past and to commit to the preventive investments necessary to reduce future risks.

How is vaccination coverage today?

The immune protection of the population against serious forms is excellent thanks to vaccination and the immunity conferred by previous infections, for those who have been able to escape serious forms. The question that now arises is to know how long this protection will last, with the arrival, which we know is inevitable, of new variants, because the answer will condition the need for new reminders.

Should the unvaccinated still be worried?

The non-vaccinated don’t have too much to worry about, if they are not immunocompromised or very old. The non-vaccinated who today have escaped the serious forms of Covid-19 are in fact protected against them by the immunity left by the different variants of the coronavirus. As almost the entire population has had Covid now and often several times, there is no longer a big difference between the vaccinated and the non-vaccinated with regard to the risk of serious forms today.

Does the mixing of populations during the holidays constitute a risk for the population in general and the non-vaccinated in particular?

The holidays paradoxically play a rather protective role vis-à-vis respiratory viruses. They spread more in closed and poorly ventilated places, yet we spend more of our time outdoors on vacation. We take less crowded public transport, we don’t go to work, the children don’t go to school, and university students, many businesses are closing. Thus, even if the Covid has shown that it can still circulate widely during the summer holidays, this is neither its period nor its preferred season.

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