UN Geneva - Multimedia Newsroom : WHO Press Conference: New terminology for airborne pathogens

Hello, everybody. Welcome to this

special embargoed briefing

on the

document. Following extensive consultations on transmission through the air

I've got with me Dr

Jeremy Farrar,

our chief scientist and doctor, Lisa Asy, who has got a very long title

but is basically has basically been in charge

of the methodology and and and collating this,

ensuring that the science,

the evidence and all the work to achieve this has been done.

So they will both explain to you how things have what this document means,

what it's going to change

and also how

came about. And then, of course, I'll open it to your questions.

I'm sure you know, you should have received all the documents.

You should have received the document itself.

A draught press release.

The final press release will look a little different in a couple of sentences.

My apologies.

And, um, these are embargoed until 12 midday. Strictly today. So not far from now.

So without further ado, I'll hand over to Doctor Farrar.

So

just press that one,

uh, morning. All,

um, to those in the

in the room. I hope the microphone is working,

and I have no idea how many you are.

online, but wherever you are, whatever time of day it is. Very warm, warm Welcome.

My name's

Jeremy Farrow

to have met all of you. Um, I've been at

W

now as chief scientist for just over 10 months or so. Um,

but look forward to meeting

you.

Look forward to meeting you in

future.

Apologies for the microphone.

So

perhaps if I just open

the session with a little bit of the background of where this came from,

a little bit of a reflection of where I think we are now

and then a little bit of reflection of what this means going going forward.

I think if we split it into those three

perhaps most helpful in explaining the background beyond what I hope you've read

or you will read from the press releases and the document itself.

So

I take you back to

the end of 2021

and actually my my predecessor, who I who I'd like to

to pay tribute at the start to everybody that started this process back in in 2021

and at

the time, somebody before this was before I joined. At

the time somebody said, we're doing this because it's hard,

not because it's easy, but it needs to get done

and and I'll give a bit of a reflection

of why I think that was such an important thing to say.

So pay tribute to everybody that started it.

Uh, it wasn't an easy process getting it started,

and it hasn't been an easy process going through it.

And I think that reflects the importance of why why it was done.

Uh,

so I take you back through the starts and through

the first year or two of the of the pandemic.

Uh,

when If you do remember it as I'm sure you do,

it was an extraordinarily challenging time.

Uh

uh.

I've been working on emerging infections for most of my professional career,

and and this, of course, was something that none of us had witnessed at the scale.

It was at,

uh, and the novel, Uh uh, infection, Uh, SARS co V two.

that came to cause, uh, the pandemic

and in that period and I was working in the UK At that time,

the level of uncertainty was was huge

and the level of scientific knowledge was limited

and

there were a lot of different perspectives,

a lot of different opinions and a lot of different and

sometimes competing scientific evidence across a range of different issues,

including

mission, of course.

And some of those issues,

as you know through 2020 2021 became very polarised and very

contentious in the debates that happened both in the scientific world and in the,

uh, the public, the public debate.

So in the end of 2021

Dr

Tedros,

Mike Ryan, Maria van Kerkhoff, Suir

Sin,

my predecessor

and then John Reader

and many others thought the area of the debate around how this pathogen,

how this infection transmits through the air is one of the most contentious issues.

And we need to understand why it's so contentious and what we can help to do about it.

To move

the advice forward, to move the scientific community forward

and to bring people together.

And that was the genesis of why this report was commissioned in, I think,

November of 2021

and it's taken us through to the end of 2023 to bring everybody together

to have what at times were challenging

debates amongst a range of different experts.

But then finally to all agree

and there have been hundreds of different contributions to this report

which I took over the leadership of in May of 2023.

But I'm very proud to say

that here we are with the release of the report and everybody

that has contributed over that period of what is 18 months,

two years has agreed to be named in the report and be part

of the report and indeed not just from the World Health Organisation,

but with the strong support and agreement

and and commitment to go forward now from

the Europe Centre for Disease Control, Africa Centre, Disease Control,

China Centre for Disease Control and the United

States Centre for Disease Control and Prevention.

So

I think in a difficult situation, that's that is something of an achievement.

Uh, so that's where we are today. Uh, the terminology is agreed,

and the term terminology is not just about semantics of different words.

Uh, the challenge through 2020 2122

has been that the scientific community I'm a public health person and clinician,

that this involved people from physics from infection control,

from architecture, from engineering from very many different disciplines.

We're all using the same words to mean, subtly or importantly, different things.

And when that is true in a scientific debate,

it's extraordinarily difficult to bring it together

and understand that when I say the word airborne transmission

or aerosol or droplets or whatever the word is that somebody from the physics,

engineering, infection control, clinician, nurse, whatever,

whatever professional background

is making sure that we're saying the same thing.

So it's difficult to make scientific progress

unless we all agree with that terminology.

So what this report does is get us to base camp

to say this is the agreed terminology

from that diverse group of experts from different

disciplines from all around the world and that

we all agree with this new terminology,

and we can now move on.

And what that terminology does is, I think,

and I hope it simplifies the categorization

so that we no longer have what I think were to some

degree false dichotomies between it's all this or it's all that.

And the truth is, the world exists in some sort of continuum,

and so getting rid of things like size of particles being the determining factor

when there are so many other factors that drive transmission through the air,

humidity, temperature, environment, oxygen, air, airflow

in

immunity of the individual's risk and everything else.

I think the new terminology, which everybody's agreed with,

is a way now going forward

just 30 seconds or a minute on the future.

This is base camp,

and base camp is difficult to get to to anybody that's ever walked to base camp.

What we now need to do is keep this community of diverse experts together

and now work together in a multidisciplinary way,

an easy word to say and difficult to do

to make sure that we now conduct the science that tells us using this terminology

and the underpinning science of it.

How now do we make sure that for diseases and infections we

know about today and for those infections we may face tomorrow,

how can we ensure that infection control and the control of the pandemic,

for instance, can be best mitigated or prevented

in settings such as clinical facilities, hospitals, primary care,

but also in workplaces, schools, transport systems and others?

I don't think we could have done that two years ago with a diverse group of people.

I think we can now, because the terminology has been agreed.

So that's a long winded summary. Sorry of the genesis of it.

Why? It was done at the start where we've got to now and then what I think is the future.

And I'll hand over now to Lisa to talk us through

a little bit more of the background methodology for everything.

Thank

thanks very much, Jeremy. And, uh and, uh, good morning. Good evening.

Uh, good afternoon

to everyone.

Um, I'm Lisa Esky. I'm the, uh, scientist and methods lead within the, uh,

science division at WHO. HQ.

Um, so just a little bit more on, um, how we conducted the consultation,

uh, to give you that information.

Uh, it was as Jeremy said,

WHO led and convened, but very much supported by the four CDC S from Africa, China,

Europe and the USA, including them nominating, um,

representatives on the initial small working group

that was formed to to drive and direct,

uh, the process

out of that, uh, a panel of 41 global experts were chosen

to constitute the the full what we call the full technical con, uh,

consultation group.

and they were included because of their,

uh, for various reasons,

but predominantly because this was a

technical consultation for their technical expertise

and because they have had been were highly cited,

uh, in the scientific literature on these on this topic, they came from,

uh as, uh, Jeremy alluded to the A very wide range of disciplines.

So there were people from epidemiology, microbiology, clinical management,

infection prevention and control, engineering, physics,

air pollution, aerosol science, aerobiology,

public health and social measures and

social science amongst others.

So a wide

and diverse, uh, group

And we also needed to ensure, as this was a global consultation

both, uh, to the best extent possible. Uh, gender and geographic balance.

Uh, all the experts were, uh, declared and were assessed for conflicts of interest.

And no, uh, significant disclosed conflicts were were considered,

uh,

relevant with two chairs. Professor Kang

from India and Professor uh Lee from Hong Kong were

chosen as the chair and co-chair of the group.

The process was there was, uh, uh uh uh, four actual meetings.

Three virtual and one hybrid between, uh, May 2022 and November 2023.

So over about a year and a half,

Um, period

during those meetings and in particular in between, uh,

following very the the progressive draughts of the document.

There was, uh, extensive consultation

with, uh, the the experts and their, um, their constituencies Who

with whom? They shared the draught documents.

And we received,

uh, both verbal and written feedback. Uh,

a huge amount.

Over 500 separate pieces of individual feedback were were submitted and

were considered all of them as part of finalising the report.

It would be fair to say that, um,

that the the debate at times was robust, but I think, uh,

ultimately quite respectful.

But I I It is also true that there were very disparate views, uh, in the in the in

this group, not unexpectedly, given the the diversity of their

expertise. And there was debates at length.

Uh, which is, uh, you know, added to the length of the pro of the process,

but all very important and necessary.

Uh, finally, just to say that,

uh, this is a a document where everyone has agreed. I think it would be fair to say that

not every member of the of the technical working group

uh,

fully agreed with every single or was or

the every single term was their preferred term,

Uh, which is necessary when people had disparate views, But,

but all everyone agreed, in the end, that this was the the best, uh,

consensus and going forward, uh, they're all willing to put their names

to the document, including,

uh, very importantly, uh,

the statement of support you'll see on the

first page from the centres for Disease Control.

I think that's enough for me on the process. Over. Thank you.

Thank you both. Now I'm going to open the floor to questions.

I am not seeing any hands up.

Uh, aha. But there's a hand up in the room, so go ahead.

Uh, Christopher

a

francais.

I

have lots of questions, but, uh, because the memory of what we went through, all of us

are very fresh. And the debate and how harsh it was about droplets

or aerosols, uh, is still very,

uh,

in my mind also. Um,

so I was just wondering,

no, we go to IRPS if I understood that correctly and

and we size doesn't matter anymore.

My question is,

what does it mean from a practical point of

view when the tenants of the droplet theory,

when we go back to 2020 for example

put a lot of emphasis on washing our hands, cleaning surfaces, etc.

Where the aerosol people

were more for you. Open your window, Go out. Don't meet too many people, etc.

So

now we have one word for

those two realities. Um, so how do we practically fight if we

how do we do it? Practically, uh, from now on,

I

mean,

I'm not sure I'm quite clear, but what I mean is just that,

um because we only have one word to describe different realities now,

do we just apply all the preventive measures in one

go just to make sure or are we more selective?

And how do we do that?

I think the question is very clear and actually gets

to the heart of a lot of the debate.

A

few things to say.

I don't think there are two realities,

and I think that's a very important part of the report that comes out.

In other words, there's not

something that happens like this

and has no action like that. There is much more of a continuum,

which

I and I've run this past, um, uh, friends, family who had nothing to do with medicine,

science or public health or whatever.

and I have to say I think they feel that is more intuitive.

It feels more intuitive to me

because the factors depend on so many factors, much of which is in the report.

So, for instance,

let's take another infection. Doesn't matter what we call. Let's call it A,

which causes me to have a secondary infection.

The

particle sizes might be slightly bigger because it has a

lot of mucus that will fall quicker onto surfaces.

Somebody else may have much more immunity.

They may produce smaller particles, then go into the air.

So I think every infection in every person

is going to be subtly or importantly, different, depending on their immunity,

the humidity, the environment, the temperature,

the room they're in or the space they're in

the wind flow, et cetera, et cetera.

So rather than seeing it as two realities,

I would rather see it as I think the report talks about as a continuum

to your second point. Does this mean everything changes?

It does not change today, No, because it's critical now,

having agreed the terminology,

uh, that we now do the work that demonstrates where the greatest risks are

and what we can do to reduce or prevent or mitigate those risks.

Uh,

so, for instance, your comment about hand washing, um,

coming into December and January of 2019, 2020 20.

Uh, the evidence from many infections is the importance of hand washing.

Nobody should stop hand washing.

Hand washing should remain a critical part. It has importance in influenza.

It has importance in other respiratory infections.

It has importance, as we know in all sorts of other infectious diseases,

including waterborne infectious diseases and others.

So the message must never go out that hand washing

doesn't remain critically important and was important in SARS.

Cov

two.

The other thing to say is, Is that, um

uh, this this report is not just about covid,

although, of course,

maybe it was stimulated by covid and

the realisation that the scientific community was

very disparate and diverse with strong opinions

and needed to be convened and helped

in some ways to come to come together.

What I would hope now is having convened that scientific multidisciplinary group,

all of whom have agreed with the document

that

that group now stays together.

Uh,

and the physicists and the engineers and the infection control

people and the clinicians and all of those professions.

And my hope is that now the funders around the world and

my previous life I was a funder.

Now come together and support that work to allow us

to interrogate what this means for control of infectious diseases.

And I having watched this over the last 23 years,

I can see that already starting,

uh, with people coming together from different disciplines, Uh,

from physics from engineering from infection control and

doing work together that would never have done

before 2019.

Thank you. And I should point you to a report that came out through the magic of IT.

It was actually meant to come out after we had the definitions

on what to do with covid. An excellent report. Talk about the engineers.

It's been done with, uh, CERN,

uh so with the engineers, the scientists looking at, uh,

transmission and looking the dynamics on on mitigation

measures that you could use for,

um covid and there will be reports Looking

at all these different kinds of pathogens,

which will follow from this work.

Just as Dr

Farr said, we're at base camp now. The work to get to the specifics

is, is ongoing.

Um, there's a question, and I I'll that that reports publicly available,

but I'll send you the link.

Um, uh, there's quite a few questions online, so we'll go to Nina Larson first.

Um, Nina unmute yourself and ask your question.

Yes. Uh, thank you for taking my question. Um, I just wanted to go back to,

uh, early 2020

with covid and ask about, um

if there was any discussion around what the the consequences

were of the the false dichotomy that you mentioned,

um, between

in the two camps, Uh, between droplets and aerosols. Um, And

if if that sort of standoff is seen as because of, you know,

the advice that was given based on very sort of, uh

uh, rigid definitions.

If that, uh, is seen as having, uh, having contributed to not, uh,

sufficient advice for protection, for instance, actually costing lives.

Thank you.

Yeah. So I It's Jeremy far

here.

I can I can comment a not from from, uh,

from very similar debates where I was at the time,

which was which was in the UK and part of the scientific advisory group.

And,

um, I think at that time in, let's say, the first quarter, first half of of of 2020

uh,

the, uh, decisions that were made and and if you certainly in the UK that,

for instance,

as our previous question the the hand washing was

was a major feature of of the advice,

uh, was based on

prior knowledge going into 2020

much of it informed, of course, through influenza the most common, uh,

respiratory infection that that, uh, many of us, uh,

and still think would be the cause of a pandemic.

Uh, and that the strongest evidence in that And I remember being in a UK

sage meeting in early first few months of 2020 where

this was debated and where the the the the evidence,

including from influenza strongest was for indeed for for hand washing.

and that was the advice at the time,

Uh, over the course of the rest of, uh,

March, April May, June of 2020.

Of course, as as we started to learn more about covid itself, a novel pathogen,

that evidence changed and the weight of that evidence changed not just through

single opinions but through a collective sense

of what the collective evidence showed.

And as a result, through March and April, that advice changed.

I think one of the great challenges of the last three

years has been dealing with uncertainty dealing with imperfect information,

dealing with uncertain scientific evidence and that

that evidence evolves and changes dynamically.

Um, I think here now, speaking as a scientist,

but also somebody involved in policy work during that time,

What can you do in that space?

You can use the best available evidence you have at the time,

probably based on prior knowledge

to the event that's happening.

Uh,

do that in the best faith possible and have the

humility when that evidence changes to adapt that evidence and,

uh, and change the policy.

And I,

uh I think that is what happened, uh, during the first half of, uh, of 2020

including a WHO. But that was my experience as well. In, In in the UK.

Thank you very much for that. Uh, I ne.

You've still got your hand up, but I'm presuming that's finished for you.

Um, unless you've got a follow up.

No. OK, we'll go to

you have a follow

up. OK, I'll let you have your follow

up,

and then we go

to

I

just

wanted

to I.

I absolutely understand that about the shift

understanding of you know of this novel pathogen and that

the scientific understanding shifted over time.

So that's totally understandable. I was wondering if

if this, um, I guess rigid definition of what?

You know, droplets, Uh, the five micron,

uh, particles.

And and the fact that, uh,

this understanding that they wouldn't spread very far if that perhaps delayed,

uh,

may have delayed some of the the other advice that came later with with the masks and,

and more more distancing and more outdoor, uh, door to take activities outdoors,

for instance.

Thank you.

Yeah. II.

I think it's because the, um, evidence at that time, uh, as it was beyond this issue,

Uh, it was in different areas as well.

Um, including, for instance, care in intensive care units for people with

with with covid where in the early days, Uh,

intensive care units were treating in one way, and later in the pandemic,

they changed the way of treatment.

Um

uh,

And again, having been involved in many epidemics back to 1999 and N

a

virus in in Malaysia that that I'm afraid

when you face a novel pathogen is inevitable.

but what what can you do In those circumstances, you can you can say What does this?

What do we believe this to be the closest to and what strong evidence base do we have

that would help us offer that advice in those first critical 323 months?

And then as that situation evolves, we we we change our minds now,

going into the pandemic.

And again, as I say,

I remember vividly the conversations at this age in the

UK that that the the strongest evidence for an infection

that at that moment seemed most likely to to

guide us in terms of covid was from influenza.

And

the strongest evidence from influenza at that time

was felt to be the washing of hands,

and and closer proximity Now, with covid that subsequently changed. And, uh,

actually, I think the advice then changed pretty rapidly, both certainly in WHO.

But also, I think, in in the UK and around the world, Um,

what we need to do going forward because we will face new pandemics.

Of course,

we know that we're living in an era

of complex and more frequent epidemics and pandemics

is to be able to garner this sort of information in the

inter epidemic and pandemic time.

And that's why I hope that this report now giving everybody the same terminology,

will drive, uh,

an understanding in places like CERN that Margaret talked about a second ago.

But working with clinicians and infection control people to say,

If we face this type of pathogen,

let's say it was a SARS like, uh, pathogen.

Or if we paste another pathogen like this with these dynamics,

what would be the best advice?

But let's whether I'm a physicist, infection control person or or a

clinician.

Um, let's do that together, because otherwise,

when we come to a pandemic and the chaos and fear that

you're in in the midst of the start of a pandemic,

uh,

the danger is people will revert back to their types and not

stick together which is what I think we have to do.

Thank you very much for that. Uh, now I'll go to Maya Maya Plans from the UN.

Uh, UN brief. Um,

Maya unmute yourself and ask your question.

Thank you very much for taking my question, Doctor Harris.

My question, actually, is regarding the report. I have not received it.

Uh, could you send it to me? Because I, I didn't see the report beforehand.

I don't know if you send a copy around,

but if you could do it to my email

Sure.

My question is, uh, for Doctor, Uh uh, Jeremy Farrar.

Uh, I, um

how did you arrive to the idea that you needed to actually come to

to to redefine the terms or make them more precise or more encompassing?

What did you see?

Was lacking in the way that, uh, the conversation was conducted before

I think many, uh,

many areas of of science and II. I speak now as a scientist, um,

almost 20 years living in Vietnam.

I speak as 10 years as head of a major global philanthropy, the welcome trust.

And now I'm

in my role at WHO. So I've seen science from all angles.

Um, and and, uh,

scientists are wonderful,

but they often go back to their scientific disciplines.

and work within those disciplines and working across

disciplines and across sectors is is a challenge.

the terminology we use the language we use,

the culture of the way we work is different between different disciplines.

And, uh, uh,

we often force people into those disciplines very early in their careers.

I I'm a great believer in interfaces between disciplines,

and I'm a great belief in

people that can bridge disciplines polymaths that are able to respect

each other's skills and expertise but nevertheless bring communities together.

And I think this is an example where infection control clinicians,

I've mentioned them all.

Engineers, physicists, transport experts, architects

and the rest actually all have a role to play in this space because it is complicated.

it is complicated because it depends on my immunity. It depends on your immunity.

It depends on the humidity. It depends on the size of the room.

It depends on the airflow. It depends on the size of the particle.

It depends if you're coughing over me, for instance,

from a distance or close it depends.

Whether I've been vaccinated or whether I'm immune depends on my age.

Depends on whether I've got diabetes or I've got other conditions.

Uh, it's complicated.

And when often things are complicated,

people want to reduce it to the simplest possible dimension,

which often means working with your own discipline,

whereas the truth.

And there's a nice quote somewhere from, uh, Doc, Doctor Ted

or somewhere in one of these documents about

it. It's not who is right. It's what is right.

And that's where I think bringing teams together in a multidisciplinary

way and it is by no means limited to this issue.

Um, it's trick. It's a challenge to work across sectors and across disciplines.

But I think,

uh, the, uh,

pride, if you like or the success I think of this

is that, uh, everybody who was part of this has agreed to be named on it to be part of it.

And, uh, with the four centres of disease controls around the world

and the WHO coming together around a common terminology,

that is progress. Uh, it's progress to base camp.

Now we need to turn that into what it means for,

uh uh for the future.

I could add if you want.

Yes,

uh, and just to add,

we did, uh uh, we did

see that there was variation across disciplines, but to

ensure that that was a real, um, observation, we did undertake a, um a

large,

uh uh uh, scoping review of the existing literature on those terms and, uh uh,

by an internal.

An internal, uh, group of epidemiologists

and evidence specialists did that

and found EE Exactly that that we we There was a huge variation

in the in the termin

terminology used to describe the same phenomenon across quite a lot of, uh,

of disciplines.

Which

is

is exactly why we we felt we needed to bring those disciplines

together to resolve to try and resolve that.

Thank you. And we've got a question online from John

after. OK, so

we've got Jamie in the room too.

Uh, online from John Zara.

Costas John unmute yourself and ask a question.

Good morning, Margaret. I'll I'll wait.

Uh, my question is on, uh, an a another issue, so I'll wait.

Uh, because I've got a question for Doctor Farah on another item,

but I'll wait until this item is finished.

Thanks.

Ok, well,

I think we're about to wrap up because I'm going

to have to whisk them back to the main building.

They've got a very busy day. So ask your question.

And I think, Jamie, you've got one in the

room.

Jamie, go ahead.

I would

sympathise

with John's.

Having you present today is obviously a great

opportunity to ask other questions beyond this.

Um, Jamie, Associated Press.

Um, I just wanted to, um I'm sorry. I came in a little bit late.

I listened to some of it at the beginning. I had a call at 9. 30.

Um, the can you tell us a little bit about what these new definitions might mean

And how you've assessed the usefulness of mask wearing,

um, in connection with, um, these new definitions that you're laying out?

I mean,

what what is the science shown about the utility

of both in dealing with droplets and aerosols?

Yeah, the the

it's I think it's very important to to be clear

what this document tried to do and and I hope did

I think it's also very clear to have the

humility to say this is not what this document did

I. I would encourage everybody to both take this document.

So there's a lot of reading.

Take this document and the document that Margaret referred to earlier,

which was a joint,

Uh, maybe for the first time, I don't know.

Uh, WHO cern piece of work. Which folk? A, uh which from our side Maria Van

Kirkoff led.

Uh, it's very technical,

but Maria is great at explaining things. Um,

and CERN are

and it tries to bring the CERN physicists type world together with, uh,

with the public health people and address particularly covid.

I also know of work and I. I hope you won't mind me quoting the place.

I also know work, for instance,

now,

at Massachusetts Technology with five

or six different disciplines working together

in chambers that have been invented in the last year,

It's part because of this work

that are now looking at

how airflow and humidity and temperature,

for instance, impact on the on the

EE

when covid is

put into the atmosphere either experimentally or even indeed

from individuals that are known to be infected.

And I'll give you another example of work that's now going on again.

Catalysed by this report

is I don't Sorry, I don't I

don't know if the Big Brother programme translates

around the world where you put a whole pile

of people into a into a house and they live together for a period of time.

That sort of work is now going on with people known to

to have infections to look at where infections are in the air,

on surfaces on their hands on their, uh, mucosal surfaces.

And also quantify those and then change the airflow, the temperatures blah, blah.

So, I, I don't think that work would have happened at that scale and quality prior to

covid and prior to this report. So

I think this. I think over the next one year you will see an explosion. I hope

of new scientific work that gets exactly at your question.

And I don't I would actually admit that at the moment,

apart from that CERN paper and this work I've mentioned to you, um,

we have we This has been a neglected area of science,

and I think covid has demonstrated just how important it is.

And now, John, you can have your extra special mystery question.

Oh,

yes, Uh, yes, it's a chance. Since we have the chief scientist,

I was wondering if you could bring us up to speed

on the state

player of the H five N one outbreak in various countries.

And given the high

case mortality rate of this, uh,

virus, what is the situation?

And how is WHO coordinating with all the regional officers and national

governments? Thank you.

I'm still learning. Who

protocol can I answer off the

Oh, yes. And it's relevant to this.

This document is basically base camp for that too.

So I'm I'm John. I'm I'm

I'm not happy to be able to be answered that question, but But,

uh um,

having been involved in 2004 with the, um, red

reoccurrence of H five M one when working in Vietnam, Uh,

and and being one of the few people around the world that's actually

treated patients with H five M one during that epidemic in in Vietnam,

Um, this this remains a I think an enormous concern.

uh, if you if I've got a few minutes to explain, um

and I and I do hope as a group, as a community of professionals,

this remains on your agenda because,

uh, we know that H five M one is a influenza infection.

Predominantly, uh, started in poultry and ducks

and has spread effectively over the course of the last

one or two years to become a global zoonotic animal.

Um, pandemic.

Uh, the great concern, of course,

is that in doing so and infecting ducks and chickens, but now, increasingly,

mammals,

that that virus now evolves and develops the ability to infect humans and then,

critically, the ability to go from human to human transmission.

Uh, and we know that in the rare cases, uh,

I think off the top of my head four or 500 cases so far of humans,

the mortality rate is extraordinarily high.

Uh, so to me, this is a major concern.

And, uh, obviously, Maria Van Kirkoff is is focus is the lead on this, uh,

within within WHO and has enormous experience in all of this.

And I know even this week, there was a convening,

uh, on vaccine development for H five M one, for, uh, therapeutics, uh,

for influenza, which we are.

We are not where we need to be and ensuring that, uh,

regional offices and country offices and public health

authorities around the world have got the cap

cap

capability to diagnose H five, N one.

The current out outbreak for want of a better word

in America amongst cows is really concerning as well,

and also talks to this issue of of transmission.

We have to understand in those cow, uh, settings, uh,

sheds how H five M one is transmitting because

Because it may be learning, not learning,

evolving into transmitting in different ways.

Uh,

do the milking structures of cows create aerosols? Is

it the the environment which they're living in?

Is it the transport system that is spreading this around the country? So,

uh, this this is a huge concern, and I think

we have to watch more than watch.

We have to make sure that if H five M

one did come across to humans with human to human transmission

that we were in a position to

immediately respond with access equitably to vaccines,

therapeutics and diagnostics.

So,

uh, John, I'm really happy you've brought that up.

I think it is a continues to be a major concern.

And of course, it's not the only influenza virus that we We have to watch.

We have the human mostly human influenza viruses every year with seasonal.

Uh, but I know there's been a a new case of a novel novel, uh,

avian virus just in the last week or two, reported in Vietnam.

Uh uh,

Which we also have to watch. So

whilst we worry about covid, quite rightly, we worry about monkey pox.

We worry about a cholera, and we have to keep an eye on influenza

impact.

Thank you very much. And a highly relevant question, John,

Uh, I think we certainly have run out of time.

Uh, I just ask Lisa and, uh, Jeremy, if they've got any final remarks,

Anything further?

No, just thank you to I don't know how many are online, but thank you.

Also to the huge audience here in the room. Um,

and it's my first time down at the pally doing one of these.

Um, and of course, we're always available if you need us. So thank you.

So thank you all.

And I'll I'll send the link to that CERN report as well, so that you can find that,

um to all of you and and Mayer, I'll send the report specifically to your

email.

And as I said, the embargo is 12. Noon.

Uh uh, Which is? Soon We've got an hour and a half.

WHO Press Conference: New terminology for airborne pathogens - 18 April 2024