Panel details failures that unleashed pandemic, urges bold steps


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An independent review panel tasked with evaluating the world's response to the COVID-19 pandemic issued its scathing findings today, outlining failures at every level, recommending steps to end the pandemic, and suggesting overhauls to better prepare for future threats.

In other global developments, European officials weighed in with new assessments of the B1617 SARS-CoV-2 variant first detected in India, which they say may be more transmissible than the B117 variant first found in the United Kingdom.

Panel: System unfit for preventing another pandemic

Today's report on the global pandemic response came from the Independent Panel for Pandemic Preparedness and Response (IPPR) based on a resolution passed by the World Health Assembly (WHA) last May. The panel was headed by Helen Clark, New Zealand's former prime minister, and Ellen Johnson Sirleaf, Liberia's former president. It included 11 experts spanning a range of backgrounds and countries, including China and the United States. Panel members were asked to represent their institutions rather than their countries.

The group started its investigation in September and was asked to present its full report ahead of the WHA's meeting this month. It posted its findings today in an 86-page main report that came with an evidence-based narrative that spelled out 13 defining moment that have steered the pandemic's course.

One of the group's criticisms was that the World Health Organization (WHO) took too long to declare a Public Health Emergency of International Concern (PHEIC), and that for many countries, February 2020 was a lost month, when they could have launched measures to contain the spread of the virus and prevent a catastrophe. "The Panel finds that the system as it stands now is clearly unfit to prevent another novel and highly infectious pathogen, which could emerge at any time, from developing into a pandemic," the group wrote, noting that the world didn't heed warnings from earlier pandemics.

For ending the current pandemic, they urged developed countries to quickly share large vaccine quantities—1 billion doses by September, followed by another 1 billion by mid-2022. They also called for steps to ease intellectual property restrictions for COVID-19 vaccines with an automatic waiver if a voluntary agreement can't be reached through World Trade Organization negotiations.

To address future threats, the group proposed several bold steps, which include giving the WHO more financial resources and power to investigate the source of outbreaks. The group called for an International Pandemic Financing Facility funded mainly with $5 to $10 billion from richer countries to support pandemic preparedness, such building up supplies of personal protective equipment. Other recommendations include establishing a Global Health Threats Council to maintain the political commitment for pandemic preparedness and a new global surveillance system that would speed early warnings about outbreaks.

In response to the group's report, Lawrence Gostin, JD, of the O'Neill Institute for National and Global Health Law and Georgetown University Law Center, said today in an expert column that international health regulations were much too slow to curb a fast-moving virus and though the review panel did a great job detailing shortcomings and failures, they didn't single out any government, agency, or actor.

"In particular, despite marked delays in China’s reporting of a novel outbreak in Wuhan and its impeding WHO in finding the pandemic’s origins, the IPPR did not seek to hold the government accountable," he wrote.

He said the group's recommendations are bold, covering the immediate crisis and addressing future pandemics, but he said without enforcement and compliance measures, similar threats will persist.

B1617.2 more transmissible than B117?

Yesterday, the WHO fleshed out more details about B1617 in its weekly situation report, including that B1617 has three lineages that may have important differences. So far, B1617.2 seems to show higher transmissibility, less response to one of the monoclonal antibodies, and slightly reduced susceptibility to neutralizing antibodies.

So far, the variant has spread to nearly 50 countries, according to the WHO.

The European Centre for Disease Prevention and Control (ECDC) said yesterday in a risk assessment that the United Kingdom has experienced a sharp increase in B1617.2 and, to a lesser extent, B1617.1, mainly related to India travel with onward transmission. The group also noted that the variant is being detected more often in Europe as a whole.

In a related development, the UK's Scientific Advisory Group for Emergencies (SAGE) discussed the variant last week and published their findings on May 10. The group said that B1617.2 prevalence has significantly increased, including some community transmission. It said early indications suggest that it may be more transmissible than B117, while adding that confidence in the assessment is currently low.

SAGE warned that a variant that substantially escapes immunity or is more transmissible than B117 could lead to a wave of infections eclipsing the one from January 2021 without interventions. "Reducing the number of variant infections should be a priority for policy," it said.

India accounts for 50% of world's cases

The WHO said in its situation report that global cases dropped slightly last week and that India made up 50% of the world's cases, with worrying trends seen in some neighboring countries. Though overall cases declined in Europe and the Middle East, some countries saw double-digit increases last week, including Nepal (79%), South Africa (41%), and Malaysia (19%).

At a briefing today from the WHO's Pan American Health Organization (PAHO), its director Carissa Etienne, MBBS, MSc, said a number of Americas countries are still experiencing surges, putting pressure on health systems and oxygen supplies. For example, intensive care unit beds in Chile and Peru are at 95% capacity, and some parts of Brazil have waiting lists.

She also warned that cases are surging in some border areas, such as parts of Guyana and Bolivia that border Brazil. Also, Colombia's cases have steadily risen over several weeks, which could worsen following a week of protests.

In other developments:

  • Norway said it won't resume using the AstraZeneca-Oxford vaccine, and Brazil halted use of the vaccine after a pregnant woman died of a stroke after immunization.

  • The United States issued a level 4 "do not travel" advisory for Nepal, where most of the country is under partial or full lockdown.

  • The global total today edged close to 160 million cases and is at 159,899,053, and 3,322,008 people have died from their infections, according to the Johns Hopkins online dashboard.

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