Journal live at seven eastern saturday morning. Join the discussion. At a Coronavirus Briefing in geneva, World Health Organization officials confirm theres more than one half a million positive cases. More than 20000 deaths from the virus worldwide. The director general also announce the first patients at historic drug trial to test treatments. Good evening, good morning, good afternoon. Welcome to the World Health Organization press briefing on covid19. We have with this, as always the who director general dr. Tedros. Doctor michael ryan and doctor maria technical lead for covid19. Dr. Tedros will give us an update and when he has finished remarks we will hear a message about the solidarity trial, after that, ill open the meeting to questions. If you have connected via zoom, please use the ratio hand icon to get in the queue to ask your question if you are connected by phone please hit star nine on your keypad to indicate you want to ask a question i apologize now who miss out as we have hundreds of people connecting already and asking questions for which we thank you all. So we need to keep this a briefing to under an hour so our speakers, who are all leading this response can get back to all of the other pressing jobs on their endless to do list. And right now there is a lot to do. And to hear more about where we are and what we are doing and what we need to do, i will now hand over to dr. Tedros. Thank you margaret. Good morning, good afternoon, good evening, wherever you are there are now then more half a million cases of covid19 and more than 20000 deaths. These are tragic numbers, but lets also remember that around the world, more than 100,000 people have recovered. Yesterday, i had the honor of addressing a meeting of leaders from the g20 countries. My message was threefold. We must fight, unites, and ignite. Fight to stop the virus with every resource at our disposal. Unite to work on the fight together. With one humanity and one common enemy. No country can fight alone. We can only fight together. And it ignites the mites and innovation of the g20 to protas and distribute the tools needed to save lives. We must also make a promise to future generations saying never again. Virus outbreaks are effective life. How much damage they do is something we can influence. I think the g20 countries for their commitment to fight the pandemic. Safeguard the global economy. Address International Trade disruptions, and enhance global cooperation. This is especially important for countries who are not part of the g20 but will be affected by decisions made by g20 countries. Earlier today we held a briefing with around 50 ministers of health around the world at which china, japan, the republic of korea, and singapore shared their experiences and the lessons they have learned. Things emerged about what has worked. The need for early protection and isolation of confirm cases, identification, followup and quarantine of context, the need to optimize care, and the need to communicate that, to build trust and engage communities in the fight. Countries also expressed several common challenges. The chronic global shortage of personal protective equipment is one of the most urgent threats to our collective ability to save lives. Who has shipped almost 2 million individual items of protective gear for 74 countries. I we are preparing to send a similar amount to a further 60 countries. But, much more is needed. This problem can only be solved with International Cooperation and international solidarity. Workers are at risk, we are all at risk. Health workers and low in mental Income Countries deserve the same protection of those in the wealthiest countries. To support our call on all countries to have aggressive case finding a testing we are also working urgently to increase the production and capacity for testing around the world. Why the most important areas is research. A vaccine is still at least 12 to 18 months away. In the meantime, we recognize there is an urgent need to treat patients and save lives. Today, we are delighted to announce that today to norway and spain, the first patients will be shortly enrolled on the solidarity trial. We will compare the safety and effectiveness of four different drugs or drug combinations against covid19. This is a historic trial. I will dramatically cut the time needed about what drugs work. More than 45 countries are contributing to the trial. The more countries who join the trial, the faster we will have the results. In the meantime, we call on all individuals and countries to refrain from using therapeutics that have not been demonstrated to be effective in the treatment of covid19. The history of medicine is strewn with examples of drugs that work on paper, or in a test tube. But, did not work in humans over actually harmful. During the most recent of bowl epidemic, some medicines that were thought to be effective were found not to be as effective as other medicines when they were compared during a Clinical Trial. We must follow the evidence. There are no shortcuts. We also need to ensure that using unproven drugs does not create a shortage of those medicines to treat illnesses for which they have proven effective. The pandemic evolved and more countries are affected, we are learning more and more lessons about what works and what does not. Who is continuing to support all countries in their response. We have published more than 14 guidance documents on our website providing detailed evidencebased accommodations for governments, hospitals, Health Workers, members of the public, and more. More than 1 Million Health workers have been trained through our courses on who. Org. Will continue to train more. Were also delighted to report the covid19 Solidarity Fund has now received donations of more than 108 million u. S. Dollars in just two weeks. From 200 to 3000 individuals and organizations. Thank you to each and every one of you. The English Version of our whatsapp has more than 12 million users globally. In the spanish versions were and arabica board launched today more languages will be added, russian, portuguese, somali, swahili, and more. I have said before that crisis like this bring out the best and worst in humanity. We have essentially seen an increase in Cyber Attacks and impressions using who, my name, and covid19. I am very grateful to those working in various National Organizations providing critical cybersecurity and intelligence to the who cybersecurity team. Thank you for your efforts to work with us to protect the health systems, Health Workers, and members of the general public who rely on our Information Systems and digital tools. Special thanks to microsoft for assisting on this. I would like to end with something that was said during todays briefing. We are only at the beginning of this fight. We need to stay calm. Stay united. Work together. We need to stay calm. Stay united. And work together. I thank you. Thank you very much dr. Tedros. And as dr. Tedros mentioned we have exciting news about the solidarity Clinical Trial from norway. We will hear more about that by the ministry of health and care services. I am honored to address you and this afternoons press conference. We are in the middle of a Global Health emergency. But we are also in the middle of a global quest for knowledge unlike anything we have ever seen. I find this happening in the midst of all of the bad news from around the globe. To find treatments that are safe we can save lives. We can protect Healthcare Professionals and other various groups from developing this disease. It is important that all countries pull together and show doctors and knowledge. This trial is an important piece into Global Research effort. Together, researchers from all around the world will assess four of the most promising treatments for covid19. This has jobs for patients today. Im very happy to be able to announce that the first patient included as a patient at Oslo University hospital. I would like to commend taking on the Global Leadership in this difficult situation for all of our countries. An Initiative Just setting up their solidarity trial. I would also like to thank as secretary director of the council for taking the responsibility of sharing for the trial. Will bring expertise and experience from ebola vaccine in west africa in 2015. This trial is in good hands under his leadership. I wish him good luck with the solidarity trial. Thank you. Following that message now we can open the floor to questions. Before we start i would like to give you a reminder, if you are an zoom please use the racer hand icon to get into the queue to ask your question. If you are connected by phone, please hit star nine on your keypad to indicate you want to ask a question. Please keep your questions short, and confine it to only one question for. Journalist. I will start with science. Are you on the line . Reporter we talked about this a couple of times and he wants to know theres an eu data, resell trying to nail down. [inaudible] can you say anything about the newest data you have with data from china . I will start with that. Yes this is something very important to us into the rest of the world to really understand what the results will be from the studies that are currently underway. What we can say is that there are more than a dozen countries who are conducting studies that epidemiological studies. These countries are focusing on what we call the ff expo which is looking at cases and controls. Involves Molecular Testing and thera logic testing we are working with these countries to evaluate which they are actually using. It will be a combination of a screening as well as confirmatory testing involving microneutralization. In addition to that there are number of countries that are conducting age stratified general population surveys. Who has a protocol that we put out online which is a core protocol which we want countries to use so we can compare results across these countries. At present there is at least four studies we are aware of that are ongoing and in different countries. Which involves the collection or the use of specimens that have already been collected. These may be clinical specimens for people who have been hospitalized for other reasons. We dont have results yet. We are eagerly anticipating these results so that we can better understand what is the prevalence are one of the antibody levels amongst people at different age groups, in different parts of the world. As is critical for us to really understand what level of circulation this virus may have had. For in people who may have a subclinical infection, an infection that has had mild disease and maybe they did not seek care, or they werent picked up to the current surveillance system. These are ongoing. In addition to that, we know there are another of others that have been developed. We working at a number of countries for the evaluation of these to see how well they perform. That needs to be done with well characterized samples. We have really great partnerships across the globe to be able to do this. Were trying to accelerate this just as quickly as we can. As soon we have these results, we will share them. But the really critical for planning purposes going forward. A number of these International Studies are grouped around solidarity to platform. So in effect, the organization on our partners have prioritized Different Research strands. Obviously establishing which therapeutics is effective as a major major priority. But in addition to many of the studies going on across the world, there is a wide group of researchers who have come together as maria has said to implement a common protocol which will be known as solidarity two. Solidarity three will look at prophylactics of intervention of Health Workers spread were trying to line all of our work, to bring together as many as possible. That is not to say other large trials of other efforts around the world are not important, they are. But for some of the answers that are complex, we are going to need to prove data for going to need to collect data in a consistent collaborative way. Appia logical data, Clinical Data data on the protection of prophylactics. These are answers we need and we need the right answers to drive policy. Thank you doctor ryan. The next question please go ahead. Thank you so much for taking my question. Seem younger people are affected in the u. S. And china, wondering how you explain this in the concern that the date he got from china and the first place might not be as reliable as you thought . This virus, this covid19 virus is capable of causing infection, severe disease of people of all ages. What we know from data across a number of countries including data from china, and the u. S. , italy, iran, korea, japan, and others, is that this virus can cause mild disease can cause moderate disease, which is described as people who still have pneumonia but dont need oxygen support. Who can cause severe disease, critical disease and can also kill some people. Amongst children, the data we have seen from a number of countries is that the majority of children that are infected are experiencing mild disease. We do have reports now some publications now that describes severe disease in children. We have reports of deaths in children there is one in china and one in the United States as well. We do need more well described around the age group so we can better summarize what we know about this in the different age groups. Ideally what would like to see is the use of a clinical characterization protocol. Its another data capture platform at w witchel has launched which involves systematic Data Collection in terms of scientific and regular sampling. And thats of hospitalized patients we can better characterize the history of this disease in people who are in hospitals. There is data thats coming out from a number of countries. And we welcome the rigorous Data Collection that is occurring in very difficult situations. In hospitals, whether its Clinical Data or epidemiological data across a number of countries. We have been reporting for quite a while now the spectrum of disease does not the elderly and the underlying conditions have been affected much more than other age groups. Weve certainly spoken here before about the age profile of patients, affected in korea, 20 of the deaths were people under 60 years of age. And in italy the fact that up to 15 of intensive care were under 50 years of age. I think we will find in germany and other countries ten to 15 of people with disease, people under 50 without disease will have moderate or severe infection. They may not progress in a critical but ten to 15 under 50 will have a moderate to severe infection. This is for most people a very mild infection, but for significant minority, people between the age of 20 and 60, this is a significant infection and if you listen to people who are interviewed on the media, the one thing ive seen again, again, again our people, adults and young adults they keep looking at the camera saying this is not flu was really emerging is a perception that this disease wont may not be fatal and critical and a Younger Age Group it is causing severe illness and many people. I just want to add the points we have made a few times is that young people are not invincible. Its not just the disease this virus is because in people comments every infection of covid19 presents an opportunity for onward transmission. So even in younger populations if you do have mild disease and you think its no big deal, with the big deal is you may transmit to somebody else who may be part of that vulnerable population who may advance to severe disease and him a die. So every Single Person has a role to play in this outbreak, and preventing themselves from getting infected pretty listed a number of ways in which you can do that which is physical distancing, washing hands, etiquette, adhering to what the National Government is saying by following those rules, adhering to that youre preventing yourself from getting infected and you are preventing the opportunity for onward transmission to someone who baby more vulnerable. Thank you doctor van kerkhove. Can you hear me . So very well please go ahead. Thank you for taking my question regarding the way of counting some cases, the chinese said last month they dont count cases who dont have symptoms. There is a huge number of adult symptom cases. [inaudible] [inaudible question] so i can start with that. We have case definitions we are using which include a Laboratory Confirmation regardless of the development of the symptom. What we know from case reports from several countries is that on the date of report, some patients may not have yet to develop symptoms. And so they may be presymptomatic. We need to be very careful in our language here. The use of asymptomatic globally as i think not appropriate. In some people, most people who identified as asymptomatic, because they were identified as part of contract racing that means they are already being medically followed. Therefore they are being tested early. Many of this individuals who are listed as asymptomatic are indeed presymptomatic and they go on to develop symptoms a day or two later. What is really important for us in terms of understanding epidemiology is when this transition taken place and what are the drivers of the transmission. From the apple logical data we have we know that the majority of transmission for covid19 are people who are symptomatic. That includes people who are in the very early stages of symptoms. In the viral shedding date is showing in the early stage of disease and people are having a little bit unwell, they havent yet had pneumonia and they certainly are not hospitalized yet, those individuals are the ones driving transmission. So it is really important we follow all of these members were keep our physical distance, transmission of covid19 is through droplets it is not airborne. Therefore, someone who has these small liquid particles that come out of their mouth, they travel a certain distance and they fall. Thats why we recommend the physical distance to be separated so you remove the opportunity for that virus to actually pass from one person to the other. So thank you doctor van kerkhove. Now we have anna from coral away croatia. Are you on the line customer so yes please go ahead. So as you could hear these experts said that they have most the trick measures when it comes to the number of cases. I can see this is changing our lives so i wonder if you have any idea how long this academic can last . And is there any proof that the higher temperatures can stop or slow down the spread of this rotavirus . Thank you at this point no one can predict how long this epidemic is going to last. And there are a number of scenarios that take us forward in time. I think the other question people are asking beyond how long is the pandemic is going to last is how long are the shutdowns . How long are the lockdowns, how long are all the measures going to last and will these measures be changed or be different . We are entering, moving to an uncertain future. You see many countries around the world are just starting this epidemic some have been through the cycle of the epidemic like singapore in china i know desperately are trying not to have the disease reemerged and caused another wave of infections because of disease importations. So each country is in a different position. Croatia is probably in a different position to many other countries in europe right now. The real trick for countries is to look at the national situation. Look at the subnational information to see if you know where the virus is. If you know where the virus is, you can break the chain. If you know who has the virus, if you know who the contacts are, you can break the chain. If you have that knowledge, and if you have that knowledge in a National Level you can anoint take action at the level of which you can measure. If you know its happening in every town, if you know its in every municipality, you can adapter measures for the situation in that particular area. In all of us want to see the measures that we are using for Public Health at the Community Level to be adapted to the maximum control of the disease , but to the minimum on life. In order to do that, in order to transition from the current measures in place, countries simply have to have in place a system to detect, isolate, contact trayce, and corn team. As well as to continue appropriate hygiene and physical distancing measures. They must be in a position to do that on different parts of the country at different times, and they must be in a position to reimplement measures should the situation deteriorate. That takes a very surf sophisticated system of very Strong Health system to absorb the surge of cases in any particular area. But we need to now is get measures that have been designed to suppress and just take the heat out of this pandemic to much more precise directed measures that will allow us, the very least, to live with this virus until we can develop a vaccine to get rid of it. Thank you doctor ryan. I now have thomas can you hear me thomas . Hello this is thomas from bloomberg news, i was just wondering as the rates of infection increases so dramatically, is there a point that it is no longer controllable . So i will start with that and maybe the others would like to answer to. I think you are saying the more we test, the more we are going to find. And that one aspect its an overwhelming thing to see these case numbers increase and in some cases, in many countries the case numbers are going to increase. But you need to test to be able to find with the virus is. That means this case numbers are going to increase. What we have seen from another of countries now is that this virus can be controlled what we have seen is that through the aggressive measures of case finding, testing your cases, isolating new cases, caring for them, depending on the severity that they have, making sure they have adequate care they dont progress with the disease if that is possible. To find all of their context, to follow them for 14 days. If you quarantine your contacts, or remove them from the family home will remove them from the community so they dont have the possibility of transmitting to other people, to having strong leadership, Strong Political leadership repurpose and your government to having this whole of government approach to engaging your population, communing with your population regularly so they can go through this with you as you adapt your measures. You implement certain control measures you may lift other control members. Empowering your population said they know what they have to do and this fight against covid19. We have seen in number of countries and the director general had a very important meeting today with many ministers who shared what works and what works is this. What works is case finding. Its Contact Tracing its immobilizing your copulation and communicating with your population. Making sure you have arrangements in place so that people who need to be cared for can be so that healthcare workers are protected, so that ppe is used appropriately and they are saved for frontline workers and utilized by those who need it most. See your answer to can this be controlled is yes. But it takes a lot of aggressive measures its a comprehensive approach we have an outline and countries will see improvements. As they moved to the different transmission scenarios. And so we need to apply what works to show that there can be suppression that can happen with this virus. So if i could add, is really important at this moment, that we dont create a perverse disincentives to detect cases. We should commend countries that are tested. We should not punish countries forgetting larger numbers. We should recognize the countries recognize reality. We should reward countries and governments are looking. We create a situation where we overreact to the daily number, then there is a disincentive to actually test. Countries are testifying cases and do lots of testing, secondly, we need to look at rates of things, we compare raw numbers and its helpful at times. We need to look at what is the number of cases as proportionate of the whole population what is the number of tests as a proportion of the whole population. What is the Positivity Rate of tests, how many tests have been done and out of them how many are positive . They give you much better idea than only of the impact of the disease but of the effort being made by the public authority. It is important that we look at these numbers rising part of that rise in numbers is increased detection due to better testing. And we need to be careful that we dont punish people for testing. Having a larger number means i know where the virus is better. Thank you very much doctor ryan. We now have caller from nigeria. Please go ahead with your question. Is there any concern about information about human. [inaudible] for covid19 . [inaudible question] im sorry could you repeat that question weve lost you a little bit the second part of your question was not clear. Reporter [inaudible question] so i think your question was about medication, is there any medication that works and what other issues with cases in nigeria . Thank you for the two questions. With regard to medication, and trent as the director general outlined in his speech shaded there currently no specific medications that have been approved for covid19. However, there are a number of Clinical Trials that are ongoing and theres a solidarity trial thats currently starting. Which is just enrolling patients now which is looking at therapeutics in controlled Clinical Trials. Whats very important as these medications are evaluated appropriately so we know what works and that we have the right data to support what works. With regard to the number of cases in nigeria, i dont know the exact number,. 46. 46. Doing to take that one . So the number of cases in nigeria remain quite low despite nigeria having a reasonable capacity to protect and tempered it does viruses but the risk is nonetheless there. Weve seen diseased, covid19 almost every country in africa at this stage. So the risks are certainly rising. But the numbers are still low. Again, we need to ensure we have a very strong Public Health response on the african government thats built from the community up. We need to try to avoid the worst impacts of lockdown slowdowns and minimize the necessity of measures like that which will have a very hard impact on peoples lives and livelihoods from which they may not recover as quickly as people in other countries. We also need to look at the very vulnerable populations we have in africa refugees in some cases people who are living with hiv and children with malnourishment. Africa is a very young consonant and there may be an advantage right now. There many, many other people in africa for whom we must provide maximum protection. Africa again, has demonstrated with polio and cholera response of bola response, african countries have capacity to response epidemics. The resilience to live through epidemics, and to recover from them. But what we need to do is bring our communities on board, we need to leverage the power of Community Based surveillance, we need to engage with civil societies, with local government, and then all of government approach as dr. Tedros continues to say. Its even more important in the context of nigeria in the context of africa that those approaches be taken. In terms of i think he said medications, i think its really important that we say quite plainly right now, there are no proven effective therapies or drugs in the fight against covid19. Those are the answers we are trying to find. Good, supportive care, Early Admission to hospitals for those have underlying conditions are developing severe disease, oxygen and the provision of oxygen is life saving it in certain small number of patients the ability to ventilate patients in order to get them through the worst of the infection. We have things that work in terms of clinical management. We do not have effective drugs. That is why this solidarity trial is so important in so many of the other trials around the world are so important to answer these questions. So thank you doctor ryan. Thank you. Just one point to add. When we had a small number of cases like we had in nigeria and other countries in africa, that is when you can also be able to do the public interventions effectively to test cases to followup contacts and isolate the cases. The problem does not grow meaning from the sporadic cases they will not grow into Community Transmission. The problem comes when Community Transmission starts with the number of cases builds. When that happens, doing the public held solutions was saying the quarantine and so on will be difficult if not impossible. But at the same time, the growing number of cases means the health system, the Healthcare System could be overwhelmed. That is why, for nigeria, the best option is to really cut it from the bud and while you have the small number of cases to invest more in the other interventions and do the things that we have been always been staying on who becoming a Community Transmission. Thank you dr. Tedros we now have the bbc on the line. Hi kenny here he okay . Very well go ahead. So primarily this question is for dr. Tedros. First developed is an incredibly difficult time and you are showing what all countries need. Im sure you are aware that you are advising things like progressive measures, sophisticated surveillance theres talk of identifying people and removing them from the community. What do you think about the human Rights Groups that say this could set precedents in some countries where steep measures will stay and be used for other purposes. Does that can concern you at all . On, especially social distancing or staying at home unless travel, we know this actually influences the individual human rights, but this is a choice that we should make. Meaning, and order to have collective security, to be a Better Society and to fight the virus, we give our freedom for a while. And this can be arranged by governments. There are many ways they can use this to have provisions for short, short. People will agree as long as it brings the collective security they will agree. And people will understand to limit their individual freedom, if it is for the betterment of society. When it is for a short period so it should continue between the government and the community. And that is what we are seeing. And without that, i dont think this virus could be stopped. And something we have been saying to government is one, you need to have the whole of government approach and also cites. [inaudible] there should be regular communication increasing awareness and in a way actually that creates trust in the community prayed with theirs Community Trust and trust in the government and cooperation, what the community is being asked can happen. You can ensure community ownership. We say it many times, this is everybodys business. This is our collective security and it can only be assured when each and every one of us contributes to that. So if i could just supplement that we take the issues of personal data, Data Protection and intrusion, very, very seriously. Our chief Information Officer is working with our information director and many others on ensuring all the initiatives we are involved with while aiming to determine good Public Information in no way interfere with the individual rights to privacy. And protections under the law. It is important when we talk about surveillance, and the Surveillance Society that indicates Public Health gathering of information about individuals, their movements, must be done with the consent of the community. In many cases of the individual themselves. There are serious issues here that have to be addressed. That is not just for Public Health that is across society and so many other sectors. There are times when the good of community and the good of population is something where we are in a crisis. It is much better through trust and community engagement, individuals are prepared to offer a little piece of individual sovereignty in order to support the community but that must be a temporary gift. That must be an explicit gift. That must be something that is not taken for granted. That is a gift of the individual to society, not to demand it upon the individual. And i think this is really important points that guides us in our work inside who and dr. Tedros is constantly reminding us of our responsibilities in that regard. Also in addition to that weve been working very closely with unicef, with the red cross and other groups truly furthering strengthening and launching a Major Initiative for covid19. Joining together with unicef, with the Red Cross Movement on scaling up our ability to engage with pride of participation and ownership in the fight against covid. It is through Strong Communities that we avoid the worst outcomes of this disease. And it is through Strong Community ownership of participation we will avoid any abuses of human rights that may emerge as they fight a deadly foe. Thank you very much doctor ryan. We are coming up to the hour so weve only got time for one question. I apologize very much to everyone else, you can send your questions and inquires will make sure we get them answered. The last question for antonio. Antonio are you on the line . So thank you for taking my question. Dr. Tedros you said today we must unite against coronavirus. But in the union we had a lot of to coordinate a united response it looks like countries like germany and the netherlands are showing some you have a message the European Union regarding this problem . From what i know, what you say it is, new information to me what we have been advocating and what we know is there working together for reform of the European Union. The ecd c is at the center through our Regional Office and headquarters also working with them. I think a coordinated effort in europe is important. That is what i know. As far as the important information. I havent heard. Me i just add that we are extremely grateful for the European Union, commission, and our colleagues who have been providing outstanding support to countries outside of europe, two countries affected by crisis. It is wonderful to see that even in the midst of crisis in europe, europe can still reach out to those who are even more vulnerable and more at risk. We spoke today at length with his team. We will work with our colleagues at is impressive to see that while in crisis and trying to support each other, europe is still willing, ready, able to reach out and support those in the south who neither help as well. If i could just add we are seeing the world uniting in this. We are seeing the solidarity that weve been talking about since day one. We are seeing the sharing of information. We are all connected, one country success is another country success. One countrys failure is another countrys failure are all in this together. Under the solidarity through europe, through north america, through asia, through the entire globe, is how we are going to beat this. So this is a pathogen circulates. We know so many countries are affected. The only way we are going to beat this is together. We will wrap up this press conference for today. We will reconvene on monday. I will send you a Media Advisory with all the details on monday during the day. If you have a question you want answered, please send it to Media Inquiries and we will do the best answer questions as quickly as possible. Thank you very much. Thank you. Okay, we will see you on monday.