*** Note, this article was updated after publication on 17 August with a response from the Department of Health and Aged Care ***
Alison Barrett writes:
Australia and other member states of the United Nations have been urged to update their national COVID-19 plans, according to standing recommendations issued by the World Health Organization (WHO) last week.
The standing recommendations are to replace temporary recommendations issued under the International Health Regulations (2005) during the public health emergency of international concern associated with the COVID-19 pandemic from January 2020 to May 2023.
They are issued to guide countries’ transitions from emergency response to a “sustainable comprehensive management of COVID-19 within broader disease prevention and control programs”.
“Standing recommendations should stimulate States Parties to keep up their interest and vigilance around COVID-19 so that the disease burden can be reduced and the evolution of the virus and changes in the epidemiology can be rapidly identified and globally shared,” said the Review Committee tasked with developing the standing recommendations.
Croakey asked the Federal Department of Health and Aged Care and the office of Health Minister Mark Butler whether Australia would update our national COVID-19 plan, as recommended. No response was received by the time of publication.
*** Update ***
The below response was received from the Department of Health and Aged Care on 17 August.
In December 2022, Minister Butler released the Government’s ‘National COVID-19 Health Management Plan for 2023’ which outlines what the Government is doing in 2023 to manage COVID-19.
The Australian Government’s response to COVID-19 continues to be informed by leading experts, including the Australian Health Protection Principal Committee (AHPPC) and the Australian Technical Advisory Group on Immunisation.
The Department is aware of the recent publication of recommendations by the World Health Organization for COVID-19. Consistent with the approach taken throughout the pandemic, we will continue to monitor international and domestic developments and adjust our response measures accordingly.
In relation to international activities, Australia is actively engaged in negotiations to:
- develop an international instrument on pandemic prevention, preparedness, and response (PPR) through the Intergovernmental Negotiating Body (INB), and
- consider amendments to the International Health Regulations (2005)(IHR) through the Working Group on Amendments to the IHR (WGIHR).
High risk continues
While disease severity and deaths are lower than last year, “WHO continues to assess the risk of COVID-19 to global public health as high,” WHO Director-General Dr Tedros said at a media briefing last week.
“The virus continues to circulate in all countries. It continues to kill, and it continues to change.”
Tedros said the standing recommendations are important for protecting against COVID-19, as well as helping countries prevent and respond to other diseases.
“We cannot predict the future, but we can prepare for the future,” he said.
Tedros also added that “many people and governments view COVID-19 as a thing of the past” but it is important not to forget the people who have died and the people who continue to be at risk of severe disease or death.
Dr Preben Aavitsland, the WHO Secretariat to the Review Committee tasked with developing the standing recommendations, wrote in the preface: “although it may no longer be feasible, nor desirable, to suppress the spread of the virus, much can still be done to reduce burden from COVID-19.”
While the long-term risk assessment for COVID-19 conducted by the Review Committee found the impact to the health and wellbeing of the “aggregate human population” to no longer be considered “dire”, the global public health risk remains high.
This is based on potential disease burden by transmission of the virus and influence of emerging variants, waning immunity and reduction or elimination of public health and social measures.
In addition, the Committee considered the impact on health, particularly regarding the severity of disease if the virus evolves with new variants that may evade current diagnostics and therapeutics.
The Review Committee said that “standing recommendations, applying to all States Parties, are necessary, at least for the coming years, to stimulate efforts in all countries to reduce burden and maintain preparedness against an uncertain future”.
Sustainable management
In transitioning to sustainable management of COVID-19, countries are recommended to follow WHO’s COVID-19 Strategic Preparedness and Response Plan. Underlying goals of the Plan include:
- reducing and controlling incidence of SARS-CoV-2 variants with increased growth rates, with a strong focus on reducing infection in high-risk populations
- preventing, diagnosing and treating COVID-19 to reduce mortality, morbidity and long-term sequelae.
The main tools recommended to achieve these goals include vaccinating, treating and clinical care particularly in at-risk populations, integration of COVID-19 vaccination and disease management into existing primary health services, protecting health workers and other priority groups and strong surveillance and monitoring of SARS-CoV-2 variants.
The Review Committee noted that if a new variant emerges that causes more severe disease, the risk assessment may alter.
Additionally, they said several unknowns still exist regarding COVID-19, including the magnitude of long-lasting symptoms after infection, health consequences of repeated infections and duration of immunity following infection, vaccination or both.
As well as the recommendation for Member States to revise and implement national COVID-19 plans, other standing recommendations are:
- to sustain collaborative surveillance for COVID-19, integrating with surveillance for other respiratory infections and incorporating different types of monitoring systems including genomic sequencing, wastewater surveillance and serosurveillance
- continue reporting COVID-19 data to WHO, particularly relating to mortality and morbidity, vaccine effectiveness and SARS-CoV-2 genetic sequences
- continue to offer COVID-19 vaccination based on both the recommendations by the WHO Strategic Advisory Group of Experts on Immunisation (SAGE) and national prioritisation informed by cost-benefit reviews
- continue to initiate, support and collaborate on research to generate evidence for COVID-19 prevention and control with a view to reduce the burden of disease
- continue to deliver optimal clinical care for COVID-19, appropriately integrated into all levels of health services
- continue work towards ensuring equitable access to safe, effective and quality-assured medical countermeasures for COVID-19.
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