From Our Bureau    

3RD JUNE 2020

The Corona Virus (CPVID-19) pandemic situation remained grim globally, with the confirmed cases across the world soaring to 62,87,771 and the death toll reaching 3,79,941 in the 216 affected countries and territories, according to the latest update from the World Health Organization (WHO).

Globally, European region continued to be the worst-hit in terms of fatalities with 21,91,614 confirmed cases and 1,83,313 deaths. American region came next with 29,49,455 confirmed cases and 1,65,311 deaths. Eastern Mediterranean region reported 5,52,497 confirmed cases and 13,181 deaths.

Western Pacific region’s tally stood at 1,85,358 confirmed cases and 7,057 deaths. South-East Asia region recorded 2,96,620 confirmed cases and 8,277 deaths and African region witnessed 1,11,486 confirmed cases and 2,789 deaths. WHO Risk Assessment at global level remained very high.

Basic psychosocial support skills are at the core of any mental health and psycho-social support intervention. To assist all those involved in the COVID-19 response, WHO has published guidance on basic psychosocial skills.

At the Yemen High-level Pledging Conference, Dr Mike Ryan, Executive Director, WHO Health Emergencies Programme emphasized that COVID-19 was placing a major burden on the health system, already on the verge of collapse , and that despite the considerable efforts of WHO and partners in Yemen, ‘we need a massive scale-up of our COVID and non-COVID health operations to assist some of the most vulnerable populations in the world’.

On 29th May 2020, WHO and the International Labour Organization (ILO) hosted a webinar on returning to work in the context of COVID-19.

A record number of countries have contributed data revealing disturbing rates of antimicrobial resistance. WHO is concerned that the trend would further be fueled by the inappropriate use of antibiotics during the COVID-19 pandemic.

Subject in Focus:

Returning to work in the context of COVID-19

On 29 May 2020, WHO and the International Labour Organization (ILO) hosted a webinar on “returning to work” in the context of COVID-19. The webinar focused on how businesses and societies can adapt to ensure the safety of workers, their families and communities, and the sustainability of business operations as national restrictions are eased.

It was attended remotely by over 1,000 participants from across all six WHO Regions.

As businesses are restarted, workers and employees must confront a range of occupational safety and health hazards not limited to the risk of COVID-19 transmission, including psychosocial risks related to fear, stigma and job insecurity.

Safety measures to reduce transmission of COVID-19will be necessary, ranging from enhanced hygiene and physical distancing, to mandatory use of personal protective equipment (PPE) in higher-risk settings where measures based on prevention of exposure cannot sufficiently reduce risk.

Risk mitigation measures must reflect the features of, and risks related to, each specific job. To ensure they can be properly implemented and are working as intended, individual businesses must develop prevention and mitigation action plans in consultation with workers and their representatives based on assessment of occupational health risks and epidemiological situation; return to work should take place in a phased and controlled manner; sufficient resources must be put in place; and policies should be revisited and adapted as the situation changes.

Existing labour standards provide a normative framework for countries and employers to develop policies and guidance. Many of the issues raised by COVID-19 are already covered in a general manner by ILO conventions and recommendations such as the Occupational Safety and Health Recommendation 164 and Occupational Safety and Health Convention C155which provide an overall framework for managing hazards in the workplace, in addition to sector-specific labour standards.

During the COVID-19 pandemic, WHO and the ILO have been working to meet the demand from stakeholders for reliable information to inform safe back-to-work strategies. The ILO has also launched a portal which brings together the latest news and recommendations related to COVID-19, including specific guidance for different sectors.

The ILO’s recently-released guidance note on safe and healthy return to work aims to assist governments, as well as employers’ and workers’ organizations,in developing national policy guidance for a phased and safe return to work, and provide guidelines for workplace -level risk assessments and implementation of preventive and protective measures—which are summarized in the ILO’s ten action points tool. WHO has produced a scientific brief on modes of transmission of COVID-19.

The Department of Health from South Africa shared current policy perspectives on easing restrictions and restarting the economy; touching upon many of the issues raised by the other speakers. Despite the continuing risk of COVID-19 transmission, the South African government recognised that the current policy of lockdowns and closure of businesses is not viable in the long term.

To balance the two priorities of preventing a new wave of COVID-19 cases that could overwhelm the health system and safeguarding livelihoods, the government has adopted a phased approach to reopening with five alert levels, tailored to different provinces of the country, with different public health measures and restrictions on activities based on the current risk of COVID-19 transmission.

Different sectors, including mining and the public sector, have been given guidelines for return to work at each alert level, along with restrictions that should remain after the lockdown, regardless of the alert level. Activity will be resumed in each sector using a phased approach, with no more than one third of workers returning to work at once. At the same time, safety measures will account for risks to workers as they commute, work, and interact with clients, consumers and the wider community. These efforts must be supported by the timely availability of high-quality data to identify potential cases, and inspections of workplaces to ensure measures are being implemented.

Social partners on the webinar emphasized that every worker is essential and must be protected from COVID-19, and that safe and healthy work conditions are a fundamental right. In the context of the COVID-19 pandemic, enhancing workplace safety is not just a concern for individual workers, but is vital to overall public health. The risks faced by workers do not just depend on their job role, but also on the type of relationship between workers and their employers.

Policy-makers and businesses are called on to pay particular attention to protecting contract workers, migrant workers, and those in the informal economy. Return to work must also be accompanied by ‘social protection’ measures, particularly paid sick leave and protection against discrimination and harassment, to ensure no group of workers is unfairly disadvantaged.

As the world economy restarts and begins its recovery, the opportunity to take stock of lessons presented by the pandemic on the relationship between work, human health and environmental sustainability should not be lost. For its part, WHO has developed a manifesto for a healthy and green recovery from COVID-19, with six prescriptions including protecting nature, investing in essential services, ensuring a quick healthy energy transition, promoting healthy and sustainable food systems, building healthy, liveable cities, and ending taxpayer subsidies for polluting activities.

Meanwhile, at the media briefing, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that “WHO is continuing to respond to the new Ebola outbreak in the city of Mbandaka, in the Equateur province of the Democratic Republic of the Congo. So far, 8 cases have been detected. Four of those have died and the other 4 are receiving care. To be clear, this outbreak is in the same area as a previous outbreak in 2018, which was stopped in just 3 months.”

“However, it is on the other side of the country to the Ebola outbreak that WHO and partners have been fighting for almost 2 years in the provinces of North Kivu and Ituri, in eastern DRC. The latest person confirmed with Ebola attended the burial of one of the first cases, but was detected in the town of Bikoro, 150 kilometres away from Mbandaka. This means that two health zones are now affected,” he pointed out. 

“Today almost 50 responders from WHO and partners arrived in Mbandaka, plus 3600   doses of Ebola vaccine and 2000 cartridges for lab testing. The government is now sequencing the virus to see whether or not it is related to a previous outbreak. This is an important reminder that even as WHO focuses on responding to the COVID-19 pandemic, we continue to monitor and respond to many other health emergencies,” he added.

“More than 100,000 cases of COVID-19 have been reported to WHO for each of the past 5 days. The Americas continues to account for the most cases. For several weeks, the number of cases reported each day in the Americas has been more than the rest of the world put together. We are especially worried about Central and South America, where many countries are witnessing accelerating epidemics.

“We also see increasing numbers of cases in the Eastern Mediterranean, South-East Asia and Africa, although the numbers are much smaller. Meanwhile, the number of cases in Europe continues to decline. Yesterday saw the fewest cases reported in Europe since the 22nd of March. 

“WHO continues to work through our regional and country offices to monitor the pandemic, to support countries to respond, and to adapt our guidance for every situation.

WHO continues to provide the world with new and updated technical guidance, based on the most up-to-date evidence.

“Just in the past week, WHO has released a new case report form for suspected cases of multisystem inflammatory syndrome in children; Operational guidance on maintaining essential health services; Guidance on controlling the spread of COVID-19 at ground crossings;  Planning recommendations for mass gatherings; A protocol for surveillance of infections among health workers;  Ethical considerations for the use of digital technologies in tracking COVID-19; And updated guidelines on the clinical management of patients with COVID-19.

“This is an update of the guidance we published in March. It includes a COVID-19 care pathway, which describes the steps followed by a patient from screening to discharge, to ensure delivery of safe and quality care, while stopping onward transmission. 

“WHO continues to train millions of health workers all over the world to apply our guidance. Our online learning platform has now registered 3 million enrolments for our courses on COVID-19.  And we have added two new courses: one on decontamination and sterilization of medical devices, and another on environmental cleaning and disinfection. In total, we’re now offering 12 courses in 27 languages. In the past week, we launched COVID-19 courses in Amharic, Arabic, French, Hausa, Macedonian, Odia, Spanish and Vietnamese.

“As you know, last week the Executive Group of the Solidarity Trial decided to implement a temporary pause of the hydroxychloroquine arm of the trial, because of concerns raised about the safety of the drug. This decision was taken as a precaution while the safety data were reviewed. The Data Safety and Monitoring Committee of the Solidarity Trial has been reviewing the data. 

“On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol. The Executive Group received this recommendation and endorsed the continuation of all arms of the Solidarity Trial, including hydroxychloroquine. The Executive Group will communicate with the principal investigators in the trial about resuming the hydroxychloroquine arm. 

“The Data Safety and Monitoring Committee will continue to closely monitor the safety of all therapeutics being tested in the Solidarity Trial. So far, more than 3500 patients have been recruited in 35 countries. WHO is committed to accelerating the development of effective therapeutics, vaccines and diagnostics as part of our commitment to serving the world with science, solutions and solidarity,” he observed. (eom)

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