GENEVA — As nations ease up on coronavirus lockdowns, World Health Organization officials cautioned on Monday the first wave of the pandemic has not ended and a “second peak” may occur with global infections and deaths still increasing.
The number of confirmed coronavirus cases surpassed 5 million just four days ago, and continues to rise globally as infections keep increasing in Africa, Central and South America, and South Asia. Areas with dense populations, including poor, urban hubs and refugee settlements, remain particularly vulnerable.
“It depends where you are in the world. Right now, we’re not in a second wave. We’re right in the middle of the first wave globally,” said Dr. Mike Ryan, executive director of WHO’s health emergencies program.
“And for many other countries, we’re still very much in a phase where the disease is actually on the way up,” he told the U.N. health agency’s regular online press briefing. “We congratulate countries, like Spain, who’ve managed to contain and suppress the disease transmission.”
Ryan noted the actual number of people who have been infected in each nation remains relatively low, however, which means health authorities cannot make any assumptions about what will happen next.
In the United States, for example, which has recorded 1.6 million of the world’s more than 5 million confirmed cases, around 5,000 out of every 1 million people have become infected. China, where COVID-19 was first detected late last year, has reported 83,000 infections — about 60 of every 1 million people.
“So when we speak about a second wave classically, what we often mean is that there will be a first wave — the disease by itself effectively goes to a very low level — and then it curves a number of months later,” Ryan explained.
“The disease can jump up at any time. We cannot make assumptions that just because the disease is on the way down now, that it’s going to keep going down and we’re going to get a number of months to get ready for a second wave,” he said. “We may get a second peak in this wave.”
That happened with past pandemics — a second peak to the first wave; not necessarily a second wave — including the flu pandemic from 1918 to 1919. It remains the deadliest pandemic in recorded history, killing an estimated 50 million worldwide.
As a result, Ryan recommended that Europe, North America and Southeast Asia keeping implementing public health and social distancing measures, along with surveillance and testing, so that an “immediate second peak” might be avoided before the possibility of a second wave of infections later in the year.
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Experimental trial narrows focus
WHO officials also announced there would be a “temporary pause” on the use of an anti-malarial drug, hydroxychloroquine, in a global trial of potential treatments for the coronavirus. U.S. President Donald Trump had said he was taking the drug, but decided to stop experimenting with it this week.
The U.N. health agency initiated the trial more than two months ago t0 evaluate the safety and efficacy of four drugs and drug combinations against COVID-19, including hydroxychloroquine. More than 400 hospitals in 35 countries have recruited patients, and nearly 3,500 have been enrolled from 17 countries.
WHO Director-General Tedros Adhanom Ghebreyesus told the press briefing that an executive group overseeing the trial met on Saturday and agreed more review is needed before continuing with the drug.
“The executive group has implemented a temporary pause of the hydroxychloroquine arm within the Solidarity Trial while the safety data is reviewed by the Data Safety Monitoring Board,” said Tedros.
“The other arms of the trial are continuing,” he said, referring to other potential treatments such as the experimental drug remdesivir and an HIV combination therapy. “This concern relates to the use of hydroxychloroquine and chloroquine in COVID-19. I wish to reiterate that these drugs are accepted as generally safe for use in patients with autoimmune diseases or malaria.”