Further to the WHO announcement (see last update) on COVID-19, the IATA response to the end to the PHEIC status is here: https://www.iata.org/en/pressroom/2023-releases/2023-05-06-01/ Also, here is the commentary in Nature: https://www.nature.com/articles/d41586-023-01559-z
Current trends with COVID are the usual mixed picture, as illustrated by rates continuing to decline in India, but trebled over the past month in China (both trends probably related to XBB.1.16 which is now at 10% of new sequences globally) and rising in Indonesia.
As the pandemic transitions to something that has been termed a “permademic” (an extended health threat before it settles into “background” or endemic), the threat of highly pathogenic avian flu (H5N1) is on the horizon at an unknown distance.
An analysis by BlueDot assesses the overall risk to humans as low but increasing. It points to an exponential increase in wild birds rather than domestic poultry and a series of “unusual mortality events” amongst mammals since 2022 (in USA, Spain and Peru), with genetic adaptations for mammals. It notes that CDC assesses the current H5N1 vaccine candidate, and existing antivirals, as likely to provide good protection/efficacy. (Source: BlueDot).
It is worth noting that with the decline in COVID deaths over the last few months globally, tuberculosis has become the number one killer amongst infectious diseases globally, claiming over 4000 lives daily (Source: Stop TB Partnership).
The WHO Emergency Committee on mpox has also just met and, similarly to the COVID-19 committee last week, determined that it should transition from a PHEIC (public health emergency of international concern) to mechanisms geared to a long-term response. The statement of the committee is here: https://www.who.int/news/item/11-05-2023-fifth-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-on-the-multi-country-outbreak-of-monkeypox-(mpox) In the last two weeks there was an increase of only 0.3% in cases, and 10 new deaths, globally.
An updated situation report on Marburg in both Equatorial Guinea is here:
https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON467
In Tanzania there have been 9 cases (probable or confirmed) and 6 deaths. But from 10-30 April the only case was a mother whose baby had been a case, and both were quarantined from March. In Equatorial Guinea there were 40 probable or confirmed cases, and either 35 or 36 deaths (the outcome is unknown in one case). From 10 April to 1 May the only new cases were linked to known cases. (Source: WHO).
A note on Lassa fever in Nigeria, which numbered around 5000 suspected cases and 900 confirmed (with 150 deaths in the confirmed cases, representing a case fatality rate of 17%) as of late April. There were also reported spill-over cases in nearby countries, of this rodent-borne haemorrhagic fever.
Of note, a 2016 study investigated the medical costs of treating Lassa fever in Nigeria, and found that while costs are subsidised, the average cost to treat is 18% of the gross national income (GNI) per capita, largely due to the high cost of medications and diagnostics. Along with improvements in cost efficiencies in health services, a reduction in the Lassa disease burden is therefore crucial to breaking the cycle of poverty in Nigeria. (Source: Airfinity).
David Powell
IATA Medical Advisor