Why does the WHO say the worst is yet to come?

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The worst is yet to come. The phrase is from Tedros Adhanom Ghebreyesus, the general director of the World Health Organization (WHO), and it was pronounced the past June 29, six months after the WHO received the first notification of the emergence of a new virus causing atypical pneumonia in Wuhan (China). Six months that left more than 10 million cases confirmed, half a million dead and touched the economies of practically all countries. Just one week later, confirmed cases have increased by more than a million, and the deceased total an additional 25,000 people.

The worst is yet to come. Probably there was no lack of drama for the CEO of the WHO. The pandemic is raging in the Latin American and Caribbean region, which has gone from 40,000 cases daily in early June to more than 60,000 in early July. With Brazil, Mexico and, at a great distance, Peru and Chile as the countries that contribute the most confirmed cases. Only Brazil and Mexico accumulated –at the beginning of July– 1.8 million confirmed cases and almost 92,000 deaths. And the numbers grow as both countries start de-escalation.

U.S, which seemed to slowly bend the contagion curve during the month of May and the beginning of June (from 32,000 cases a day in the beginning of May to 21,000 in the beginning of June), experienced a new and rapid rebound in June and exceeded 45.000 daily cases in the last days.

New confirmed daily cases and evolution of the 10 most affected countries currently. Johns Hopkins University – The Conversation

Not surprising that United States and Brasil, two countries with emblematic presidencies “Denialists” which represent 7% of the world population, have contributed 36% of all confirmed cases and the 39% of the deceased of the planet.

It is also not surprising that they are embarking on the rise of the epidemic curve in contradictory de-escalation processes. In his speech on June 29, and even without specifically naming them. Tedros It made a good part of that “worst” gravitate in the erratic strategies for coping with the pandemic by these and some other countries.

In other regions of the world, and still far from the figures of United States and Brazil, confirmed cases also grow. Asia now exceeds 50,000 new cases daily, dragged mainly by India (more than 20,000 cases daily). RussiaOn the way to the 700,000 cases accumulated, it seems to have started a decrease in the contagion curve and its declared mortality –as also happens in Asia– is much lower than those registered in western Europe or the United States. Also in the Persian Gulf the numbers are increasing.

“We all look with great unease at the great African unknown, with transmission figures still low but constantly increasing”

And last but not least, we all look with enormous unease the great African unknown, with transmission figures still low but constantly increasing. To the scarcity of health resources and the obvious difficulties for confinement in Africa, an expansion of the pandemic in this continent would divert public health and health care resources from other health problems and other equally serious epidemics.

Europe also watches with suspicious next winter. Despite the fact that – with some exceptions – the European countries have controlled the first wave, health services continue to be in constant tension due to the successive local outbreaks, some of great magnitude. If they will have the capacity to contain a second wave without the need for resort to general confinement is another great unknown.

Live and be able to live. Tedros did not refer in his speech to the impact of the economic crisis on the health of populations. But it’s there and it promises to be devastating. Especially serious in a Africa highly indebted and already facing a significant depreciation of raw materials due to the worldwide drop in industrial production. Nor will it be easy in developed countries. Less easy if they increase, as it seems, the struggles between United States, China, Russia and Europe.

The worst is yet to come. Apparently a prophecy that perhaps does not require great prophets. But the phrase was not so much the prediction of an inescapable future as an appeal to work to avoid or at least reduce that worst. A call not to let your guard down and to do even more to control the pandemic. The worst is yet to come, but it can be a lot “Less worse” with effort and solidarity. Much less worse the less we are.

This article is published in The Conversation

Author: Salvador Peiró. Director of the Health Services Research area FISABIO, Fisabio.



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