OTTAWA — The World Health Organization decided Monday not to end to the COVID-19 global public health emergency it declared three years ago, even though the pandemic has reached what the international body calls an "inflection point."
Tedros Adhanom Ghebreyesus, the director-general of the WHO, said Monday "there is no doubt that we're in a far better situation now" than a year ago, when the highly transmissible Omicron variant was at its peak.
But Tedros warned that in the last eight weeks, at least 170,000 people have died around the world in connection with the SARS-CoV-2 virus. He called for at-risk groups to be fully vaccinated, an increase in testing and early use of antivirals, an expansion of lab networks, and a fight against "misinformation" about the pandemic.
"We remain hopeful that in the coming year, the world will transition to a new phase in which we reduce hospitalizations and deaths to the lowest possible level," he said.
Why is COVID-19 still considered an emergency when life is starting to get back to normal?
By declaring a global emergency, the WHO essentially sounded the alarm on a serious worldwide health risk that required international co-operation.
It triggered a legally binding response among WHO member countries, including Canada, and allowed the organization to make temporary recommendations to those countries to prevent or deal with the threat.
But in the three years since COVID-19 was designated an emergency, workers have begun to go back to the office, public health restrictions have lifted and masks are no longer mandatory in most places. Life is starting to resemble the pre-pandemic reality.
In Canada, public health officials credit this slow return to normalcy to the high rate of vaccination among Canadians, and the availability of therapeutic drugs to prevent and treat serious cases of infection.
Those life-saving therapies are not available everywhere in the world, Tedros reminded the WHO's COVID-19 emergency committee before they began their meeting Friday.
"The global response remains hobbled because in too many countries, these powerful, life-saving tools are still not getting to the populations that need them most — especially older people and health workers," he told them at the outset of the meeting.
The committee of global experts said in a statement Monday that they're still worried about "insufficient" vaccine uptake in low- and middle-income countries.
Even in countries with such tools at their disposal, public trust in those life-saving medicines has been undermined by disinformation campaigns. Health systems remain overwhelmed because of staff shortages and COVID-19 surveillance efforts have been massively scaled down.
What will it take to end the emergency?
The committee recommended the WHO come up with some other way to make sure countries stay focused on COVID-19 after the formal emergency designation is called off.
Moving past the emergency will require commitment from the WHO, member counties and international institutions to "developing and implementing sustainable, systematic, long-term prevention, surveillance, and control action plans," the committee said in a statement Monday.
That's because even when that designation is lifted, it won't mean the pandemic is over or that the threat has ended.
They suggest the international body issue recommendations to guide the long-term response to COVID-19 as it evolves.
The experts also want to know if calling off the emergency in the "coming months" will have implications for developing and authorizing vaccines, diagnostics, and treatments.
The committee will meet again in three months to reconsider ending the emergency designation.
What will Canada do differently once the WHO declares the emergency over?
Nothing much. At a press conference on Jan. 20, Canada's chief public health officer Dr. Theresa Tam said no matter what the WHO decided, Canada would continue to track cases, serious illnesses and deaths, as well as roll out vaccination campaigns.
Cases, hospitalizations and deaths associated with the virus spiked noticeably over Christmas and in early January, Tam said, but all now appear to be trending down.
"We mustn't, I think, let go of the gains that we've had in the last several years," she said.
"I think whatever the decision is made by the director-general of WHO, I think we just need to keep going with what we're doing now."
Whose decision was it not to end the emergency?
The final call was ultimately up to Tedros, but he was informed by the advice of the emergency committee.
The group was first struck in 2020 when the threat of COVID-19 first came to light, and have met every three months since to debate whether or not the emergency was still justified and to review temporary recommendations to member countries.
The committee voted Friday on whether or not to maintain the formal emergency designation, and Tedros announced his decision Monday.
When will the pandemic finally be over?
It's difficult to say because COVID-19 is still spreading around the world, and it's going to be around for a long time, the WHO's committee of experts said in their statement Monday.
"There is little doubt that this virus will remain a permanently established pathogen in humans and animals for the foreseeable future," the committee's statement said.
"While eliminating this virus from human and animal reservoirs is highly unlikely, mitigation of its devastating impact on morbidity and mortality is achievable and should continue to be a prioritized goal."
The WHO declared COVID-19 a pandemic a month and a half after designating it a global emergency, and at the time Tedros took pains to explain the two classifications are not one and the same.
"Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do," Tedros said on March 11, 2020.
Last fall he declared the end of the pandemic was "in sight," but it is difficult to say when it will fully come into view.
This report by The Canadian Press was first published Jan. 30, 2023.
— With files from The Associated Press.
Laura Osman, The Canadian Press