The World Health Organization announced on Friday that it was ending the state of emergency it declared for Covid-19 more than three years ago, a milestone in the turbulent emergence of a pandemic that has killed millions around the world and disrupted daily life in has turned paths upside down in previously unimaginable ways.
“It is with great hope that I declare Covid-19 a global public health emergency,” said WHO Director-General Tedros Adhanom Ghebreyesus.
But WHO officials warned that the decision to lift the state of emergency does not mean an end to the pandemic and warned countries not to take it as a reason to dismantle Covid response systems. dr Maria Van Kerkhove, WHO’s technical lead on Covid, said the organization wanted to be as clear as possible and know that people would be wondering how to feel about the wider pandemic.
“The emergency phase is over, but Covid is not,” she said.
In practice, the decision to end the state of emergency actually changes little. Many countries have already ended their own Covid emergency states, moving away from nearly all public health restrictions put in place to combat the virus. The United States will lift its Covid emergency on May 11th. But the lifting of the WHO designation – officially declared a “public health emergency of international concern” – is a significant moment in the evolving human relationship with the novel coronavirus.
dr K. Srinath Reddy, who led India’s Public Health Foundation through the pandemic, said the decision to lift the emergency was appropriate given the high level of immunity to Covid caused by vaccination or infection, or both, around the world.
“It no longer possesses the same level of danger,” he said, adding that Covid “has reached an equilibrium, a certain kind of coexistence with the human host”.
dr Reddy said the end of the emergency should also be commemorated as a moment of human achievement and a “celebration of science.”
“It’s important to realize that it’s not just evolutionary biology that caused the virus to change its character,” he said, “but also the fact that we’ve actually made it less contagious, through vaccination, through.” Masks, through a number of people’s health measures.”
Globally, as of May 3, 765,222,932 confirmed cases of Covid have been reported to the WHO, including 6,921,614 deaths. However, these numbers are a gross understatement of the true toll of the pandemic. “We know the true toll is many times higher, at least 20 million,” said Dr. tedros
A year ago, the WHO said that in the first two years of the pandemic, 15 million more people had died than in normal times, a number that highlighted how severely under-counterfeited countries were. In Egypt, the number of deaths was about 12 times the official number of Covid-19; in Pakistan the number was eight times as high. Developing countries bore the brunt of the devastation, with nearly eight million more than expected deaths in lower-middle-income countries by the end of 2021.
“Covid-19 has been so much more than a health crisis: it has caused severe social upheaval,” said Dr. Tedros, describing crippled economies, closed borders, closed schools and millions of people suffering in isolation.
“Covid-19 has exposed and exacerbated political fault lines within and between nations,” he said. “It has eroded trust between people, governments and institutions, fueled by a tide of myth and misinformation. It has exposed the searing inequalities of our world, with the poorest and most vulnerable communities hardest hit and the last to have access to vaccines and other supplies.”
Addressing the media about the end of the emergency, WHO leaders described the moment as emotional. “It didn’t have to be like this,” said Dr. Van Kerkhove. “We cannot forget the images of hospital intensive care units crammed full, the images of medical gloves filled with warm water holding the hands of our loved ones who died, with healthcare workers making sure they did not die alone. We cannot forget the fire piles or the mass graves dug.”
Covid, she noted, continues to spread: WHO recorded 2.8 million new cases and more than 17,000 deaths worldwide from April 3-30, the latest figures available. As many countries have reduced their testing for Covid, these numbers also likely represent a significant undercount.
The WHO emergency declaration was crucial guidance when it was issued on January 30, 2020, when it was known that only 213 people had died from the virus. It signaled to the world that this new virus posed a threat outside of China, where it has emerged, and gave countries a critical nudge to impose potentially unpopular or disruptive public health measures.
The virus, which jumped to humans in late 2019, proved an unpredictable adversary, mutating rapidly and significantly, allowing it to resurface and ravage countries just when they thought the worst was over.
A brutal wave of the Delta variant devastated India just weeks after Prime Minister Narendra Modi boasted about how well the country had done in its Covid response. The Omicron variant, while less virulent, spread with a deceptive ease that made it the fourth leading killer in the United States in 2022 and a top killer in many other countries.
The first large-scale vaccinations began on December 8, 2020, less than a year after the first case of the disease was reported to the WHO, in an extraordinary triumph of science. But the collaborative process of vaccine development was followed by a dark period of hoarding and nationalism; a full year later, when people in developed countries received the second and third doses of the vaccine, only five percent of people in sub-Saharan Africa were vaccinated.
dr Githinji Gitahi, chief executive of Amref Health Africa, said it was time to lift the state of emergency. “The danger of keeping it forever is diluting the tool — you need it to keep its power,” he said.
The statement helped mobilize resources for Africa, he said, but did nothing to counter the grim experience of what he called “vaccination equity.” Amref continues to support vaccination in 35 African countries; continent-wide, coverage is now 52 percent.
The pandemic also has a positive legacy, said Dr. Gitahi for spurring the highest level of collaboration ever seen between African countries, including the creation of an African Union task force to coordinate vaccine procurement. The response to Covid has led to increased capacity and investment in areas such as genome sequencing and disease surveillance in many African countries.
The WHO decision was not welcomed by all health experts. dr Margareth Dalcolmo, respiratory medicine doctor and member of Brazil’s National Academy of Medicine, who has been one of the country’s most prominent experts guiding the public through Covid, said it was too early to lift the emergency as there were still urgent tasks such as research into Covid -Variants and development of multivalent vaccines. Declaring a global public health emergency also creates leverage for lower-income countries to access treatments and support, she said.
On May 3, WHO released an updated Covid Management Plan, which should provide guidance for countries on how to deal with Covid over the next two years as they move from emergency response to long-term Covid prevention and control.
dr Opening the Geneva meeting where WHO experts decided to end the emergency, Tedros told the committee that the number of weekly reported Covid deaths in each of the last 10 weeks was the lowest since March 2020. As a result, life has returned to normal in most countries and health systems are rebuilding, he said.
“At the same time, some critical uncertainties remain about the evolution of the virus, making it difficult to predict future transmission dynamics or seasonality,” he said. “Surveillance and genetic sequencing have declined sharply around the world, making it harder to track known variants and discover new ones.”
And access to life-saving Covid treatments remains grossly unequal around the world, he said.
dr Dalcolmo said the lifting of the global emergency should not be seen as a milestone but as a warning. “Think of this as an alarm, a time to prepare for the next pandemic,” she said, “because we know respiratory viruses are going to increase.”