1 February 2022

o   More than 370 million cases and 5.6 million deaths had been reported – numbers were an underestimate [543]

o   Omicron was first identified almost 10 weeks ago and since then, almost 90 million cases were reported (more than in the whole of 2020) [543]

9 February 2022

o   The ACT Accelerator Advocacy Event was held [544]:

• The ACT Accelerator required U.S. $23 billion

11 February 2022

o   The WHO Director-General spoke at the mRNA technology transfer hub [545]:

• Last week, Afrigen announced that an mRNA vaccine was produced – based on the publicly available information of an existing vaccine (the mRNA technology is also for malaria, tuberculosis, and human immunodeficiency virus)

• It was expected that clinical trials would start in the fourth quarter of the year and that the vaccine would receive approval in 2024

o   The FDA issued an EUA to a new monoclonal antibody that has activity against Omicron - bebtelovimab (mild to moderate COVID-19 in adult and paediatric patients aged 12 year and older, weighing at least 40 kg) - must have tested positive or be at high risk for progressing to severe COVID-19 (where other treatment options are not accessible or clinically appropriate) [546]

14 February 2022

o   The WHO hosted the COVID-19 Global Action Meeting [547]:

• 116 countries were off-track for the target of vaccinating 70% of the population by the middle of this year

• The WHO Director-General made three requests - countries need to support the target of 70%, fund the ACT Accelerator, and support the mRNA technology transfer hub in South Africa 

18 February 2022

o   The WHO Director-General announced that Egypt, Kenya, Nigeria, Senegal, South Africa, and Tunisia would be the first six African countries to receive technology from the mRNA hub to produce their own vaccines [548]

23 February 2022

o   In a media briefing, the WHO Director-General raised the following points:

• In addition to the six African countries that will receive technology to produce mRNA vaccines, another five will be added to the list (13 in total so far) - Egypt, Kenya, Nigeria, Senegal, South Africa and Tunisia [549]

24 February 2022

o   The first meeting of the Intergovernmental Negotiating Body was held [550]:

• The aim was to develop a draft of a WHO convention, agreement, or other international instrument that addresses pandemic prevention, preparedness, and response - strengthen global structures and systems

o   The COVID-19 Global Research and Innovation Forum was held [551]

28 February 2022

o   The 9th meeting of the ACT Accelerator Facilitation Council was held [552]:

• There was an urgent financing gap of U.S. $16 billion

2 March 2022

o   In a media briefing, the WHO Director-General raised the following points [553]:

• Deaths were declining globally in most regions – it was too early to declare victory

• The threat of a more dangerous variant remained real 

• 56% of the world’s population had been fully vaccinated (only 9% of the population of low-income countries)

• The importance of prioritising mental health was highlighted - in a WHO report, it was estimated that the global prevalence of anxiety and depression increased by more than 25% in the first year of the pandemic  

8 March 2022

o   The Global Pandemic Preparedness Summit took place [554]:

• CEPI announced the 100 Days Mission - the aims were to have safe, effective, and accessible vaccines against emerging pathogens in 100 days

• The progress that has been made on COVID-19 was discussed and the gaps/weaknesses were highlighted

9 March 2022

o   In a media briefing, the following points were highlighted [555]:

• Reported cases and deaths were declining globally – several countries lifted restrictions

• One of the major issues was a reduction in testing – important for monitoring the spread and evolution of the virus

• The WHO published new guidance recommending the use of self-tests in addition to professionally-administered test services

o   The Alpha, Beta, and Gamma variants were designated as previous VOCs [268]

o   The Lambda and Mu variants were designated as previous VOIs [268]

17 March 2022

o   At the WHO Member State Information Session, the following points were raised [556]:

• The reported cases were beginning to increase globally again – despite reduction in testing in some countries

• All Member States were encouraged to continue vaccinating with a focus on health workers, elderly individuals, and other vulnerable groups

23 March 2022

o   At the WHO press conference, the following points were raised [557]:

• The increase was mainly being driven by outbreaks in Asia and Europe (fresh wave) – the death rates were also increasing in several countries

• Infections would continue to occur if high vaccination coverage was not reached and it was likely that new variants that had the ability to evade the vaccine would emerge

25 March 2022

o   The FDA announced that sotrovimab was no longer authorised in the U.S. Health and Human Services regions 1 and 2 - due to the circulation/high frequency of the Omicron BA.2 subvariant and evidence demonstrating the ineffectiveness of the antibody [558]

29 March 2022

o   The FDA authorised a second booster dose of either the Pfizer/BioNTech or the Moderna vaccines for older individuals and those who may be immunocompromised [559]

30 March 2022

o   In a media briefing, the following points were discussed [560]:

• The WHO released the updated Strategic Preparedness, Readiness, and Response Plan for COVID-19 - outlined three possible scenarios for how the pandemic could evolve

  • Despite the continuous evolution of the virus, vaccinations and immunity from infections may result in the reduction of disease severity

  • As immunity wanes, there may be surges in the number of cases and deaths (booster doses will be important for this)

  • Best-case scenario - less severe variants may emerge, and boosters or new formulations won’t be required

  • Worst-case scenario - a more virulent and highly transmissible variant may emerge

5 April 2022

o   The FDA announced that sotrovimab was no longer authorised for use as a treatment for COVID-19 - unlikely to be effective against the BA.2 subvariant [561]

11 April 2022

o   The 11th meeting of the IHR Emergency Committee was held [562]:

• Although there had been a reduction in reported deaths, there were still challenges - transmission remained very high, vaccination rates were very low in several countries, and public health/social measures had been relaxed (driving transmission)

• People were becoming fatigued, the duration of immunity from vaccination or infection remained unclear, and it was difficult to predict how the virus would evolve

• Pros - systems had been put in place to help us better understand the virus, we had access to vaccines and therapeutic agents, and the ability to implement public health/social measures

12 April 2022

o   A Public Hearing was held by the WHO to discuss a new international instrument to strengthen pandemic prevention, preparedness, and response [563]

13 April 2022

o   In a media briefing, the WHO Director-General raised the following points [564]:

• The lowest number of deaths was recorded last week (since the early days) – spikes were being recorded in some countries

• The significant reduction in testing made it difficult to monitor trends

• The IHR Emergency Committee agreed that the pandemic was still a public health emergency

• There were a number of Omicron sublineages being tracked - BA.2, BA.4 and BA.5, as well as a recombinant made up of BA.1 and BA.2

14 April 2022

o   The FDA issued an EUA for the first COVID-19 diagnostic test that detects chemical compounds in breath samples [565]

19 April 2022

o   The ceremony for the WHO Global Centre for Traditional Medicine was held [566]:

• There were five main areas of work: leadership and partnership; evidence and learning; data and analytics; sustainability and equity; innovation and technology

• They highlighted the importance of considering where traditional medicine can be tied into modern health systems (holistic efforts to promote wellbeing)

• They stated that more than 40% of pharmaceutical formulations are based on natural products - plays an important role for COVID-19 research

22 April 2022

o   The WHO recommended Paxlovid (nirmatrelvir and ritonavir) for patients with mild or moderate COVID-19 and are at high risk of being hospitalised [567]

26 April 2022

o   In a media briefing, the WHO Director-General raised the following points [568]:

• The WHO released an update over the weekend about cases of hepatitis of unknown origin being reported in children - from 11 countries in Europe, and in the U.S.  

  • • • Symptoms include abdominal pain, diarrhoea, vomiting, jaundice, severe acute hepatitis, and increased levels of liver enzymes

• Globally, the number of cases and deaths were decreasing  

• The long-term consequences of infections required further investigation

27 April 2022

o   The 10th meeting of the ACT Accelerator Facilitation Council was held [569]:  

• Omicron’s subvariants had been driving surges in some countries

• 1.8 billion individuals in low- and middle- income countries were yet to receive their first vaccination dose + antivirals were inaccessible in many of these countries

• Testing rates had declined

4 May 2022

o   In a media briefing, the following points were raised [570]:

• The data showed that the number of reported cases and deaths were declining globally

• In certain regions, the Omicron subvariants were driving the increase in the number of cases (Americas and Africa) - BA.4 and BA.5 contributed to the spike in cases in South Africa (the severity of the variants was unknown however, early data suggested that vaccinations provided protection against severe disease and death)

o   The 9th meeting of the Working Group on Strengthening WHO Preparedness and Response to Health Emergencies was held [571]

5 May 2022

o   The FDA limited the use of the Janssen COVID-19 vaccine to individuals aged 18 and older - where other vaccines are not available or clinically appropriate; and to those who elect to receive the vaccine [572]

10 May 2022

o   In a media briefing, the following points were raised [573]:

• There was an increase in COVID-19 cases in more than 50 countries - mainly due to subvariants (hospitalisations and deaths were not rising at the same rate as previous waves – the immunity from vaccinations and previous infection may have been a contributing factor)

• BA.4 and BA.5 - were driving the wave in South Africa

• BA.2 - was dominant worldwide

• There were concerns that there could be a variant that evades current immunity, has a high transmission rate, and causes greater mortality

• South African scientists were urging further vaccinations to prevent the next wave

• Long COVID was discussed and it was recommended that systems be put in place to help patients

• The WHO Director-General called for Pfizer to increase the geographical scope on the licensing with the Medicines Patent Pool, make prices more affordable, stop any additional contractual requirements that might delay access, and continue to increase generic manufacturing around the world - increase access to antivirals

o   The FDA approved a new indication for baricitinib (immunomodulatory treatment) - for the treatment of hospitalised adults requiring supplemental oxygen, ventilation (invasive and non-invasive), or extracorporeal membrane oxygenation (ECMO) [574]

12 May 2022

o   The second Global COVID Summit was held [575]:

• Cases were increasing in more than 70 countries, while testing rates were decreasing

• Although vaccine supply improved, more needed to be done for vaccine delivery and absorption

• The ACT Accelerator required U.S. $15 billion - the Strategic Preparedness, Readiness and Response Plan required U.S. $1 billion

16 May 2022

o   The FDA authorised the first test (no prescription required) to detect COVID-19, the flu, and respiratory syncytial virus (RSV) [576]

17 May 2022

o   In a media briefing, the WHO Director-General raised the following points [577]:

• Over a period of week, cases increased in four of the six WHO regions - due to the reduction in testing and sequencing levels, it was difficult to keep track of how the virus is mutating

• The Democratic People’s Republic of Korea reported their first outbreak of COVID-19 (over 1.4 million cases suspected since late April) - the WHO had concerns for the country of Eritrea (no vaccines had been administered)

• In addition to COVID-19, the following outbreaks were of concern:

  • Ebola in the Democratic Republic of the Congo

  • Hepatitis (unknown) affecting children globally

  • Monkeypox

o   The FDA expanded the EUA for the Pfizer/BioNTech vaccine - the use of a single booster dose for individuals aged 5 to 11 (at least five months after the primary course has been completed) [578]

20 May 2022

o   The G7 Health Minister’s meeting was held [579]:

• The support from G7 countries allowed for 1.5 billion vaccines, 159 million tests, more than $200 million worth of treatments and oxygen, and more than $550 million of PPE to be delivered (through WHO and ACT-A partners)

• Vaccine supply improved however, absorption was the main issue  

• Insufficient funds and access were the main problems for tests and new therapeutics

22-28 May 2022

o   The 75th World Health Assembly was held [217]:

• Over 6 million deaths had been reported and the new estimates of mortality were at almost 15 million – cases had significantly declined since the Omicron wave in January (reported deaths were the lowest since March 2020)

• 60% of the world’s population had been vaccinated

• Cases were rising in almost 70 countries

• 57 countries had vaccinated 70% of their population (mostly high-income countries)

• In addition to the COVID-19, Ebola, monkeypox, and hepatitis outbreaks, there were humanitarian crises in Afghanistan, Ethiopia, Somalia, South Sudan, the Syrian Arab Republic, Ukraine, and Yemen

30 May 2022

o   The 151st session of the Executive Board was held [580]

1 June 2022

o   In a media briefing, the following points were raised [581]:

• During the World Health Assembly, the International Health Regulations were amended – to strengthen the response to pandemics and preparedness

• Although the reported cases and deaths from COVID-19 were decreasing globally, there were concerning trends in several regions

• Update on monkeypox

  • Over 550 confirmed cases had been reported to the WHO – 30 countries

  • Most cases had been reported among men who have sex with men (presentations at sexual health clinics) – could be spread via physical contact

  • Countries were encouraged to broaden their surveillance

o   The first in-person meeting of SAGO took place [582]

7 June 2022

o   The Delta variant was designated as a previous VOC [268]

8 June 2022

o   In a media briefing, the following points were raised [583]:

• The WHO Director-General emphasised the need for caution to be taken with the declining number of cases and deaths – increasing vaccinations were saving lives however, the testing rates were decreasing

• 68 countries were yet to achieve the goal of 40% coverage

• In terms of the hepatitis cases, more than 700 had been reported from 34 countries – 112 were still under investigation

  • • • At least 38 children required a liver transplant and 10 died

      • The cause was still under investigation – not due to the five viruses that commonly cause hepatitis (had not been detected)

• In terms of monkeypox, over 1000 confirmed cases had been reported to the WHO from 29 countries (non-endemic countries) – no deaths had been reported

  • • • There was evidence of community transmission – not just in men who have sex with men

      • The WHO released guidelines on surveillance, contact tracing, and testing/diagnostic measures that can be implemented

      • There was a limited supply of antivirals and vaccines approved for monkeypox - the WHO did not recommend mass vaccination

9 June 2022

o   The first preliminary report was released from SAGO – made recommendations on the studies that were required to better understand the origins of SARS-CoV-2 [584]

o   In a media briefing, the WHO Director-General mentioned that the origins of SARS-CoV-2 and how it entered the human population were still being investigated [585]

10 June 2022

o   The FDA issued an EUA for the first COVID-19 NGS test that can identify and differentiate SARS-CoV-2 PANGO lineages [586]

14 June 2022

o   In a media briefing, the WHO Director-General raised the following points [587]:

• The number of reported COVID-19 cases and deaths decreased by more than 90% from their peaks earlier in the year (numbers were under-reported)

• In the past week, more than 3 million cases and 8737 deaths were reported

• Monkeypox

  • • • Over 1,600 confirmed cases and almost 1,500 suspected cases had been reported to the WHO from 39 countries (32 countries where monkeypox is non-endemic and 7 countries where it has been detected for years)

      • There had been 72 deaths from previously-affected countries so far and no deaths from newly-affected countries (statistics were still being verified)

      • The importance of raising awareness to reduce stigma and reduce transmission was highlighted

      • The WHO published guidance on the use of smallpox vaccines for monkeypox – did not recommend mass vaccination

17 June 2022

o   The FDA amended the EUA for the Moderna and Pfizer/BioNTech vaccines - for use in children down to 6 months of age [588]

20 June 2022

o   The G20 Health Ministers Meeting was held [589]:

• Globally, the number of reported cases and deaths from COVID-19 had declined - transmission was increasing in several countries and in many, all restrictions had been lifted

• 40% of the world’s population remained unvaccinated

• Due to the disruptions caused by the COVID-19 pandemic, tuberculosis deaths rose

23 June 2022

o   An announcement was made about BioNTech developing a manufacturing facility in Rwanda – would assist with the manufacturing and distribution of vaccines in low- and -middle income countries (mRNA-vaccine technology) [590]

o   The WHO Director-General made the following comments at the IHR (2005) Emergency Committee regarding monkeypox [591]:

• The meeting was held to determine whether the monkeypox outbreak in multiple countries constituted a public health emergency of international concern

• The WHO was notified of three cases of monkeypox (family cluster) just over six weeks ago - without recent travel outside of the U.K

• More than 3200 confirmed cases and one death had been reported since then – 48 countries

• In newly-affected countries, monkeypox was primarily being spread among men who have sex with men, and who have reported recent sex with new or multiple partners

25 June 2022

o   The WHO Director-General advised that although there was concern over the spread of monkeypox, the Emergency Committee did not consider it to be a Public Health Emergency of International Concern - an evolving health treat [592]

o   The WHO learnt about the monkeypox outbreak on 7 May 2022 [592]

26-28 June 2022

o   The G7 Leaders Summit took place [593]

• Along with the COVID-19 pandemic, other global crises were discussed 

29 June 2022

o   In a media briefing, the WHO Director-General raised the following points [594]: 

• The BA.4 and BA.5 variants of COVID-19 were driving the increase in cases – on the rise in 110 countries

• Global cases increased by 20% and deaths had risen in three of the WHO regions (global figure remained stable)

• Tracking the virus had become a challenge

• In the past 18 months:

  • 12 billion vaccines had been distributed globally

  • 75% of health workers and individuals aged over 60 had been vaccinated

  • In low-income countries, hundreds of millions of people remained unvaccinated

  • 58 countries had hit the 70% vaccination target

• A pan-coronavirus vaccine would be the ideal solution (covers all variants)

• Monkeypox had been identified in more than 50 new countries - there was concern and evidence that it could spread to high-risk groups including children, the immunocompromised, and pregnant women

30 June 2022

o   The FDA advised vaccine manufacturers to develop modified vaccines (to create a bivalent booster for Omicron BA.4/BA.5) [595]

6 July 2022

o   In a media briefing, the following points were raised [596]:

• COVID-19

  • The number of reported cases of COVID-19 had increased by 30% over the past two weeks (included four out of the six WHO regions)

  • BA.4 and BA.5 were driving the waves in Europe and America, while a new sublineage had been detected in India (sublineage of BA.2.75)

  • Testing rates had reduced dramatically – the timing of treatments was impacted

  • Vaccine protection was found to wane as the virus evolved – still effective at preventing severe disease and death

  • More people were suffering from long-COVID or post-COVID condition

  • The WHO developed an allocation system to support access to antivirals (Molnupiravir and Paxlovid)

  • The establishment of the financial intermediary fund (FIF) would assist with pandemic prevention, preparedness, and response capacities

• Monkeypox

  • More than 6000 cases had been recorded in 58 countries

  • Europe was the epicenter of the outbreak

  • In Africa, previously non-affected countries were reporting cases + record numbers were being reported in countries that had previously experienced monkeypox

o   The 11th ACT-A Facilitation Council meeting was held [597]:

• A record number of countries had met the 10% and 40% vaccination coverage targets, while only 58 countries had reached the 70% target

• The issue for vaccines was one of demand and distribution

• Supply, demand, and distribution were challenges for tests and therapeutics

o   The FDA revised the EUA for Paxlovid - authorised state-licensed pharmacists to prescribe this antiviral to eligible patients (must be assessed before Paxlovid is prescribed) [598]

7 July 2022

o   A Member State Information Session on COVID-19 and other issues was held [599]:

• COVID-19 and the monkeypox outbreak were discussed

• Over 7000 cases of monkeypox had been reported in 60 countries – may be an underestimate

8 July 2022

o   The FDA announced that the COMIRNATY (Pfizer/BioNTech) vaccine would be approved for active immunisation to prevent COVID-19 in individuals aged 12 through to 15 [600]

9 July 2022

o   The WHO Health Emergency Hub was launched (in Kenya) + the new Centre of Excellence for workforce training [601]

12 July 2022

o   In a media briefing, the WHO Director-General raised the following points [602]:

• COVID-19 cases and deaths continued to increase – the Emergency Committee concluded that COVID-19 remained a Public Health Emergency of International Concern

• Subvariants of Omicron continued to drive the cases

• Surveillance, including testing and sequencing, had significantly reduced

• Diagnostics, treatments, and vaccines had not been deployed effectively

• Monkeypox - 9,200 cases had been reported in 63 countries

13 July 2022

o   The FDA issued an EUA for the Novavax COVID-19 vaccine - in individuals aged 18 and older [603]

20 July 2022

o   In a media briefing, the following points were raised [604]:

• Over the past six weeks, the number of weekly COVID-19 cases (globally) had almost doubled – deaths were also increasing but not as rapidly as cases

• Thus far, BA.5 was the most transmissible Omicron subvariant

• In terms of monkeypox, close to 14,000 confirmed cases had been reported from over 70 countries and territories + 5 deaths (all in Africa) - the community needed to be informed of the risks and equipped with the information to be able to protect themselves

21 July 2022

o   The second meeting of the IHR Emergency Committee regarding the multi-country outbreak of monkeypox was held [605]

o   The following key points were raised at the Member State Information Session on COVID-19 and other issues [606]:

• New and dangerous variants were continuing to emerge (some that reduce vaccine efficacy)

• Vaccination coverage had increased by more than 40% since October 2021 in lower-middle income countries, and by 15% in lower-income countries

• Updates had been made to the Global COVID-19 Vaccination Strategy – emphasised the need to vaccinate at-risk groups (including 100% of health and care workers, older people, and those at highest risk)

• Different vaccine delivery methods needed to be investigated – nasal sprays or drops

• In collaboration with UNICEF, the Global Immunization Coverage Values for 2021 report was released last week – showed that there had been an unprecedented and sustained decrease in the rates of immunisation for diseases such as measles, pneumonia, polio, diarrhoea, and cervical cancer

 23 July 2022

o   The WHO Director-General stated that the Emergency Committee was unable to reach a consensus on whether the monkeypox outbreak constituted a Public Health Emergency of International Concern [607]

• Based on five elements, the WHO Director-General determined the monkeypox outbreak to be a Public Health Emergency of International Concern

• A set of recommendations was made for four groups of countries

27 July 2022

o   In a media briefing, the following key points were raised [608]:

• Monkeypox

  • Over 18,000 cases of monkeypox had been reported from 78 countries (70% from the European Region and 25% from the Region of the Americas)

  • ~10% of cases required hospitalisation to deal with the pain caused by the disease

  • Although most cases had been reported in men who have sex with men, anyone exposed could get monkeypox – countries were advised to reduce the risk of transmission to children, pregnant women, and those who were immunocompromised

  • Targeted vaccination was recommended – the MVA-BN smallpox vaccine had been approved in Canada, the European Union, and the U.S. for use against monkeypox + LC16 and ACAM2000 were under investigation (vaccines)  

• COVID-19

  • COVID-19 deaths had been on the rise for the past five weeks – hospitalisations had also increased in several countries

17 August 2022

o   More than 35,000 cases of monkeypox had been reported and 12 deaths had been recorded – from more than 92 countries and territories - there had been a 20% increase over the previous week (most cases were from Europe and the Americas) [609]

• The Congo Basin or Central African clade was being referred to as clade I

• The West African clade was clade II

o   The number of COVID-19 deaths had increased by 35% worldwide (over a four week period) [609]

• The Omicron BA.5 subvariant represented more than 90% of sequences

19 August 2022

o   The FDA authorised the emergency use of the Novavax vaccine (adjuvanted) for use in individuals aged 12 through to 17 years of age [610]

25 August 2022

o   In a media briefing, the following points were raised [611]:

• COVID-19:

  • 1 million deaths from COVID-19 had been reported so far (the milestone was crossed this week)

  • Vaccine coverage of high-priority groups was improving

• Monkeypox

  • The global weekly reported cases declined by 20% last week – new cases had been reported in the Americas

  • Less than 40% of cases were in Europe and 60% in the Americas - the outbreak seemed to be slowing in Europe

  • Bavarian Nordic signed an agreement with WHO’s Regional Office for the Americas to provide Latin America and the Caribbean with access to the vaccine

31 August 2022

o   In a media briefing, the WHO Director-General raised the following points [612]:

• Hospitalisations and deaths from COVID-19 were expected to rise as winter approached in the northern hemisphere

• A decline in deaths from COVID-19 had been reported globally

• In the Americas, the number of monkeypox infections had increased in several countries (accounted for more than half of reported cases) – a decline had been seen in some European countries

o   The FDA amended the EUAs of the Moderna and Pfizer/BioNTech vaccines to authorise bivalent formulations for use as a booster dose at least two months after primary or booster vaccination [613]

1 September 2022

o   At the Member State Information Session on COVID-19 and other issues, the establishment of the Financial Intermediary Fund (FIF) was discussed - the core mission was to ensure that gaps in preparedness, prevention, and response were addressed [614]

2 September 2022

o   The following points were raised at a virtual dialogue about the monkeypox outbreak [615]:

• • Over 50,000 cases and 16 deaths had been reported to the WHO thus far

  • In some regions such as Europe and North America, the cases were declining (due to the measures that had been implemented)

  • PCR tests were available however, a number of countries couldn’t access them – the WHO also had a small reserve of tecovirimat

7 September 2022

o   In a media briefing, the following points were raised [616]:

• The decline in global COVID-19 cases and deaths continued – did not mean that the pandemic was over

• In terms of monkeypox, some countries in the Americas were reporting an increase in the number of cases – may have been an underestimate (stigma and discrimination) – a downward trend was being seen in Europe

14 September 2022

o   In a media briefing, the WHO Director-General raised the following points [617]:

• In the last week, the number of COVID-19 deaths was the lowest since March 2020

• The WHO released six policy briefs that countries could use as a guide to manage testing, vaccination, infection prevention/control etc.

15 September 2022

o   The WHO Director-General discussed the Lancet COVID-19 Commission’s final report - the report was published on 14 September 2022 and the response to the pandemic was assessed [618, 619]

18 September 2022     

o   In a 60 minutes interview, Biden stated that he believed the pandemic was over [620]

22 September 2022

o   The WHO Director-General raised the following points in a media briefing [621]:

• The United Nations General Assembly was being held from the 21st to the 23rd of September 2022

• The number of weekly COVID-19 deaths being reported continued to decline

• Two-thirds of the global population had been vaccinated – restrictions had been lifted in majority of countries

• In low- and middle- income countries, there were still vaccination gaps

• In addition to vaccines, distancing, masks, and ventilation were still crucial measures that could help prevent the transmission of COVID-19

• The Global Fund announced that Pfizer had signed an agreement to allow Paxlovid to be accessed through the ACT Accelerator

• Ebola (Uganda) and monkeypox were also outbreaks of concern

23 September 2022

o   The WHO Director-General raised the following points at the UNGA UNSG-hosted event - “Ending the pandemic through equitable access to COVID-19 vaccines, tests, and treatments” [622]

• The number of deaths from COVID-19 was the near the lowest since the start of the pandemic

• The ACT Accelerator Council published a report that provided evidence about the falling testing rates and difficulty in accessing antiviral treatments

• 75% of the population in high-income countries had been vaccinated compared to 19% of the population in low-income countries

• Antivirals need to be more accessible

30 September 2022

o   The meeting of the Global Preparedness Monitoring Board (GPMB) was held [623]

5 October 2022

o   In a media briefing, the following points were raised by the WHO Director-General [624]:

• In several European countries, a rise in COVID-19 cases, hospitalisations, and deaths had been reported (expected due to more people staying inside as the weather cools)

• Omicron was still the dominant variant globally (more than 300 subvariants)

• The reduction in surveillance, testing, and sequencing remained issues

• In addition to COVID-19, the influenza season was beginning in the Northern hemisphere + outbreaks of Ebola, cholera, and monkeypox

3-6 October 2022

o   The meeting of SAGE took place – to provide guidance on immunisations and outbreaks (COVID-19, monkeypox, RSV, polio, and Ebola) [625]

7 October 2022

o   The FDA issued an EUA for the first commercial test kit that could be used to detect monkeypox [626]

12 October 2022

o   In a media briefing, the WHO Director-General raised the following points [627]:

• In Uganda, 54 confirmed and 20 probable cases of Ebola had been reported – 39 deaths and 14 recovered - measures were implemented to reduce the spread

• There was an outbreak of cholera in Haiti + disease outbreaks in Pakistan from the floods (eg. malaria, cholera, dengue, measles, and diphtheria)

• Over 70,000 cases of monkeypox and 26 deaths had been reported so far to the WHO – cases were continuing to decline globally - in some regions of the Americas, cases were on the rise

o   The FDA amended the EUAs of the Moderna and Pfizer/BioNTech vaccines (bivalent) to authorise their use as a single booster dose in younger age groups [628]

13 October 2022

o   The 13th meeting of the IHR Committee on the COVID-19 pandemic was held [629]:

• The number of weekly reported deaths was declining – in some European countries, the number of cases/hospitalisations/deaths were on the rise (as winter approached)

• Three quarters of individuals in low-income countries were yet to receive a single dose of a vaccine

• Our ability to evaluate the evolution of the virus was being made difficult by low testing rates and inadequate surveillance

• Countries needed to ensure that they were using resources available and that people had access to therapeutic agents

16-18 October 2022

o   The World Health Summit took place [630]

18 October 2022

o   The FDA issued an EUA for the first over-the-counter molecular test for COVID-19 (for use with saliva specimens) [631]

19 October 2022

o   In a media briefing, the WHO Director-General raised the following points [632]:

• In terms of COVID-19, the Emergency Committee considered the pandemic to still be a Public Health Emergency of International Concern

  • The committee urged the need for surveillance systems and access to treatments/vaccines to be strengthened

• Ebola, cholera, and monkeypox were still of concern

o   The FDA revised the EUA for the Novavax vaccine (adjuvanted) - as a first booster dose to individuals aged 18 and over - for use when an FDA authorised mRNA bivalent booster is not accessible or clinically appropriate; or for use when an individual elects to receive the vaccine [633]

20 October 2022

o   The third meeting of the IHR Emergency Committee on the monkeypox outbreak was held [634]  

• The number of reported cases continued to decline (decreased for eight weeks straight) - progress was slower in the Americas (accounted for 90% of cases) [634]

25-26 October 2022

o   The World Bio Summit 2022 was held [635]:

• The development of vaccines, therapeutics, and tests during the COVID-19 pandemic occurred in record time

• Despite the progress, inequitable access to these tools remained a major challenge

• There was a need to expand the production and manufacturing of vaccines (included next-generation vaccines)

• The WHO announced that they were establishing a Global Training Hub in the Republic of Korea (global biomanufacturing initiative) - for the production of vaccines and biologics

27 October 2022

o   At the Member State Information Session on COVID-19 and other issues, the following points were discussed [636]: 

• Ebola

  • • • The rising cases in new geographical locations were of concern (109 confirmed cases, 31 deaths, 20 suspected deaths, 34 recoveries)

• Cholera

  • • • Outbreaks had been reported in 29 countries - last week, the WHO announced a temporary suspension of the two-dose course of cholera vaccines

• Monkeypox

  • • • Over 76,000 cases in 109 countries had been reported and there had been 36 deaths

• COVID-19

  • • • In the last week, there were over 2,600,000 cases reported and 8,562 new deaths

• The WHO Director-General highlighted the urgency of preparing for the next influenza pandemic (a near certainty)

28 October 2022

o   The 12th ACT Accelerator Facilitation Council meeting took place [637]:

• The WHO Director-General stated that although the end of the pandemic was in sight, the threat of COVID-19 remained

• The ACT-A would continue to deliver vaccines, antivirals, therapeutic agents, PPE, and diagnostics to countries

• The ACT-A launched a six-month transition plan to develop arrangements that could help countries with COVID-19 tools in the long-term 

2 November 2022

o   There was no mention of the COVID-19 pandemic in the media briefing (see a shift in the events) [638]

o   An update on Ebola was provided - 130 confirmed cases, 21 probable cases, 43 confirmed deaths, and 21 probable deaths [638]

8 November 2022

o   Latin America and the Caribbean (LAC) and Africa launched a communiqué on the development of pharmaceuticals for global public health – aimed to expand local production of medicines and vaccines [639]

9 November 2022

o   In a media briefing, the WHO Director-General raised the following points [640]:

• Several disease outbreaks were discussed

  • Cholera - the first case was confirmed just over a month ago (Lebanon was the latest country to be affected)

  • Ebola (Uganda) – 135 confirmed cases and 53 confirmed deaths (62 have recovered)

  • COVID-19 - just over 9,400 deaths were reported in the last week (almost 90% less than in February) - testing and sequencing rates were low, vaccine inequity remained a challenge, and new variants were arising

  • Monkeypox - WHO signed an agreement with SIGA Technologies for a donation of 2,500 courses of tecovirimat (TPOXX) – this treatment was not approved in most countries however, the WHO published a protocol that could be used to design and conduct clinical trials

o   The Optimmunize Conference was held [641]:

• The COVID-19 pandemic had caused disruptions to health services, including vaccinations

• Last year, 25 million children missed out on routine vaccinations - disruptive outbreaks of vaccine-preventable diseases had occurred

13 November 2022

o   The Pandemic Fund was launched - G20 Joint Finance Health Ministers Meeting [642]

• As part of the 75th World Health Assembly in May, the WHO published a white paper outlining 10 proposals that aimed to strengthen the global architecture for health emergency preparedness, response, and resilience

• One of these was funding – to establish a new fund for pandemic prevention, preparedness, and response

16 November 2022

o   In a media briefing, the following points were raised [643]:

• The G20 leaders reaffirmed their commitment to prioritise global health, economies, and health security – remained committed to achieving/sustaining universal health coverage

• The WHO also signed an agreement on the 15th of November to establish a training hub to prepare medical teams for emergencies

• Ebola - total of 55 confirmed and 22 probable deaths, 73 patients had recovered

  • Three candidate vaccines had been evaluated by a committee of external experts and would be included in the trial in Uganda + two investigational therapeutics had been selected for a trial by a separate group (a trial design was also being submitted for approval)

• Measures had been taken to reduce the spread of disease at the World Cup in Qatar

2 December 2022

o   In a media briefing, the WHO Director-General raised the following points [644]:

• The European Union’s Global Health Strategy was launched on November 30 - 125 million euros had also been contributed by the European Union to support WHO’s UHC Partnership

• Last Saturday marked a year since the announcement of the Omicron variant – over 500 sublineages of Omicron circulating (replicate in the upper respiratory tract and tend to cause less severe disease)

• The WHO estimated that at least 90% of the global population had some level of immunity against SARS-CoV-2, either from prior infection or vaccination

• We were not yet in a position to declare that the emergency phase was over – still gaps in surveillance, testing, sequencing, and vaccination

• Monkeypox would now be known as “mpox” – the outbreak continued to decline

 8 December 2022

o   The FDA amended the EUA for the bivalent Moderna and Pfizer/BioNTech vaccines to include children down to 6 months of age [645]

12 December 2022

o   The WHO Director-General made the following key remarks at the Standing Committee on Health Emergency Prevention, Preparedness, and Response [646, 647]:

• To address the gaps that were identified from the COVID-19 pandemic, changes were being made:

  • Member States were negotiating an international accord

  • International Health Regulations were being amended

  • The Pandemic Fund was established

  • The Universal Health and Preparedness Review was being piloted in four countries

  • The WHO Hub for Pandemic and Epidemic Intelligence was established 

14 December 2022

o   In a media briefing, the following points were raised [648]:

• Last week, the WHO Member States agreed to develop the first draft of a legally binding accord on pandemic prevention, preparedness, and response

• WHO was responding to 53 graded emergencies – there were more than 200 outbreaks in the past year

• With mpox, over 82,000 cases had been reported from 110 countries (the mortality rate was low)

• In terms of Ebola, there had been no new cases in more than two weeks and no patients were being treated - if there were no cases being detected, the outbreak would be declared over on January 10, 2023 (the first batch of vaccines had also arrived in Uganda)

• Cholera outbreaks were still occurring in 29 countries - Haiti had received almost 1.2 million vaccines

16 December 2022

o   The WHO, WIPO, WTO Joint Technical Symposium on the COVID-19 pandemic (response, preparedness and resilience) was held - trilateral collaboration [649]

• Progress had been made in the past three years however, inequities were still apparent - low vaccination rates in low-income countries, difficulty in being able to access diagnostics and life-saving treatments, increases in the burden of long-COVID or the post-COVID-19 condition, and large gaps in surveillance

• Local production/manufacturing of vaccines, diagnostics, and therapeutics was needed + the WHO mRNA Hub required companies to expand the geographical scope of voluntary licenses

• Cooperation was needed to meet the targets

21 December 2022

o   In a media briefing, the WHO Director-General raised the following points [650]:

• Although there were still challenges, there were also reasons for hope

• The COVID-19 pandemic, monkeypox emergency (over 83,000 cases and 66 deaths), and Ebola outbreak were continuing to decline (may be declared over on the 11th of January) - there was hope that each of these emergencies would be declared over in 2023

• We were not at the point where we could say that the pandemic was over yet - there were too many uncertainties and gaps

• The WHO was also concerned about the situation in China (COVID-19 cases were rising and there were increasing reports of severe disease) - more information is required à China eased COVID-19 restrictions on the 7th of December

• Cholera outbreaks were still occurring in 30 countries, including Haiti

o   The FDA amended the EUA for tocilizumab to include adult patients hospitalised with COVID-19 à receiving systemic corticosteroids and require supplemental oxygen, mechanical ventilation (non-invasive or invasive), or ECMO [651]

25 December 2022

o   The WHO announced that the antiviral drugs Nirmatrelvir and Ritonavir had been prequalified for production by an Indian manufacturer [652]

30 December 2022

o   The WHO held a high-level meeting with China to gain insight into the surge in COVID-19 cases and offer support - encouraged to share data [653]