Good evening, good morning, good afternoon. Welcome to the World Health Organization press briefing on covid19. We have with us, as always, the who director general, the executive director of our emergencies program, and the technical lead for covid19. You will first be given an update. When opening remarks are finished, we will hear a message about the solidarity trial. After that, i will open the meeting to questions. If you have connected via zoom, please use the raise your hand icon to get in the queue to ask your question. If you have joined by phone, please hit star nine to indicate you would like to ask a question. I apologize on those who miss out as we have hundreds of people connecting already and asking questions, for which we thank you all. We need to keep this briefing to under an hour, so our speakers who are all leading this response can get back to all the other pressing jobs on their endless to do list, and right now, there is a lot to do, and to hear more about where we are and what we are doing at what we need to do, i will now hand over to dr. Tedros. Thank you. Thank you, margaret. Good morning, good afternoon, good evening wherever you are. There are no more than half a now more than half a million confirmed cases of covid19 and more than 20,000 deaths. These are tragic numbers, but lets also remember that around the world, more than 100,000 people have recovered. Yesterday, i had the honor of addressing an extraordinary meeting of leaders from the g20 countries. My message was threefold we must fight, unite, and ignite. Fight to stop the virus with every resource at our disposal. Unite to fight the pandemic together. We are one humanity with one common enemy. No country can fight alone. We can only fight together. And ignite the industrial might and innovation of the g20 two to produce and distribute the tools needed to save lives. We must also make a promise to future generations saying never again. Viral outbreaks are a fact of life. How much damage they do is something we can influence. I thank the g20 countries for their commitment to fight the pandemic, safeguard the global economy, address International Trade disruptions, and enhance global cooperation. This is especially important for countries who are not part of the g20, but will be affected by decisions made by g20 countries. Earlier today, we held a briefing with around 50 ministers of health from around the world, at which china, japan, the republic of korea, and singapore shared their experiences and the lessons they have learned. Several common themes emerged about what has worked. The need for Early Detection of confirmed cases, identification, followup, and quarantine of contacts, the need to optimize care, and the need to communicate to build trust and engage communities in the fight. The countries also expressed several common challenges. The chronic global shortage of personal protective equipment is now one of the most urgent threats to our collective ability to save lives. W. H. O. Has shipped almost 2 million individual items of protective gear to 74 countries that need it most. We are preparing to send a similar amount to a further 60 countries, but much more is needed. This problem can only be solved with International Cooperation and international solidarity. When Health Workers are at risk, we are all at risk. Health workers in low and middle Income Countries deserve the same protection as those in the wealthiest countries. To support our goal for all countries to conduct aggressive case finding and testing, we are also working urgently to massively increase the production and capacity for testing around the world. One of the most important areas of International Cooperation is research and development. A vaccine is still at least 12 to 18 months away. In the meantime, we recognize that there is an urgent need to treat patients and save lives. Today, we are delighted to announce that norway and spain, the first patients will shortly be enrolled in the solidarity trial, which will compare the safety and effectiveness of 4 different drugs or drug combinations against covid19. This is an historic trial which will dramatically cut the time needed to generate evidence about what drugs work. More than 45 countries are contributing to the trial, and more have expressed interest. The more countries who join the trial, the faster we will have the results. In the meantime, we call on all individuals and countries to refrain from using methods that using therapeutics that have not been demonstrated to be effective in the treatment of covid19. The history of medicine is for is strewn with examples of drugs that have worked on paper or in a test tube but did not work in humans forward actually humans or were actually harmful. During the most recent ebola epidemic, for example, some medicines that were thought to be effective were found not to be as effective as other medicines when they were compared during a Clinical Trial. We must follow the evidence. There are no shortcuts. We also need to ensure that using unproven drugs does not create a shortage of those medicines to treat diseases for which they have proven effective, as the pandemic evolves and more countries are affected, we are learning more and more lessons about what works and what does not. W. H. O. Is continuing to support all countries in their response. We have published more than 40 guidance documents on our website providing detailed evidencebased recommendations for governments, hospitals, Health Workers, members of the public, and more. More than one million Health Workers have been trained through our courses on openwho. Org. We will continue to train more. Were also delighted to report that the covid19 Solidarity Fund has now received donations of more than 108 million u. S. Dollars in just two weeks. From 3000 individuals and organizations. Thank you to each and every one of you. The English Version of our whatsapp held dialogue now has more than 12 million users globally. The arabic, french, and spanish versions were launched today. More languages will be added including chinese, hindi, kurdish, portuguese, russian, somali, ordu, swahili, and more. I have said that crises like these ring out the best and i have said before that crises like these bring out the best and worst in humanity. We have seen an increase in Cyber Attacks and impressions using w. H. O. , my name, and covid19. Im grateful to those working in various National Organizations providing critical Cyber Security intelligence to the who w. H. O. Cybersecurity team. Thank you for your efforts to work with us to protect the health systems, Health Workers, and members of the general public who rely on our Information Systems and digital tools. Special thanks to microsoft for assisting on this. I would like to end with something singapores master of minister of health said during todays briefing. We are only at the beginning of this fight. We need to stay calm, stay united, and work together. I will repeat we need to stay calm, stay united, and work together. I thank you. Thank you very much. Weve got some exciting news about the solidarity Clinical Trial from norway and we will hear more about it via video intervention by norways minister of health and care services. Here colleagues, friends, dear all. Im honored to address you in this afternoons press conference. We are in the middle of a Global Health emergency, but we are also in the middle of a global quest for knowledge unlike anything we have ever seen. I find this happening in the midst of all the bad news from around the world. If we find treatments that are safe and effective, we can save lives and we can protect Health Care Professionals and other highrisk groups from developing disease. It is important that all countries pull together, share data and knowledge. The solidarity trial is an important piece in the Global Research effort. Together, researchers from all over the world will assess four of the most promising treatments for covid19. The solidarity trial starts including patients today. I am very happy to be able to announce that the first patient included is a patient at Oslo University hospital. I would like to commend w. H. O. In taking on the Global Leadership in this difficult situation for all our countries and its initiative in setting up the solidarity trial. I would also like to thank the secretary director for taking the responsibility of chairing the committee of the trial. He will bring expertise and experience from the ebola vaccine crisis in west africa in 2015. This trial is in good hands under his leadership. I wish us all good luck with the solidarity trial. Thank you. Following that message, now we can open the floor to questions. Before we start, i would like to give a reminder if you have connected via zoom, please use the raise your hand icon to get in the queue to ask your question. If you have connected by phone, please hit star nine on your keypad to indicate you want to ask a question. Please keep your question short, and confine it to only one question per journalist. Please. Are you on the line . We talked about this a couple of times, and i wanted to ask if there any new data on the serology. We are still trying to nail down the denominator. Can you say anything about the newest data you have . Is there any serology data from china . I will start with that. Yes, this is something that is very important to us and to the rest of the world to really understand what the results will be from the serologic studies that are currently under way. What we can say is that there are more than a dozen countries who are conducting studies epidemiology studies. These countries are focusing on what we call the sfx protocol, which is looking at cases and controls. It involves Molecular Testing and serologic testing. We are working with these countries to evaluate which assays they are using and it will be a combination of screening as well as confirmatory testing involving microneutralization. In addition to that, there are a number of countries conducting these agestratified general population surveys. W. H. O. Has a protocol that we put out online, which is a core protocol, which we want countries to use so we compare results across these countries. At present, theres at least four studies that we are aware of that are ongoing in different countries, which involve the collection or use of specimens that have already been collected, so these may be clinical specimens for people who have been hospitalized for other reasons. We do not have results yet. We are eagerly anticipating these results so that we can better understand what is the serology prevalence or what are the antibody levels amongst people at different age groups in different parts of the world. This is critical for us to really understand what level of circulation this virus may have or may have had in people that may have had a subclinical infection, so infection that had mild disease and maybe they did not seek care or they were not picked up during the current surveillance system. We know there are a number of serologic assays that have been developed. We are working with a number of countries to look at an evaluation of these to see how well they perform, and that needs to be done with wellcharacterized samples. We have really great partnerships across the globe to be able to do this. We are trying to accelerate this as quickly as we can. As soon as we have these results, we will share them, but they are really critical for our planning purposes going forward. If i might add, a number of serologic epidemiological studies are grouped around the solidarity platform, so the organization and our partners have prioritized Different Research strands, obviously establishing which therapeutics were effective has been a major priority, but in addition to many of the studies going on across the world, there is a wide group of researchers who have come together, as maria has said, to implement a common protocol, which will be known as solidarity two. Solidarity three will look at prophylaxis in other interventions in Health Workers. We are trying to align all of our work, to bring together as many partners as possible. That is not to say that other large trials and other efforts around the world are not important they are but for some of the answers that are complex, we will need to pool data. We are going to need to collect data in a consistent, collaborative way. Serial epidemiological data, Clinical Data, data on protection of prophylaxis. These are answers we need and we need the right answers to drive policy. Thank you, dr. Ryan. The next question. Are you there . Im here, can you hear me . Very well. Please go ahead. Thank you so much for taking my question. Weve seen young people being hospitalized in the u. S. And europe and china. We are wondering how you explain than in europe and china. We are wondering how you explain the discrepancy, and we are concerned data you have in the first case from china right not be as reliable as you thought. Might not be as reliable as you thought. Thank you. This virus, this covid19 virus is capable of causing infection and severe disease in people of all ages. What we know from data from all countries, including data from the u. S. , china, italy, iran, korea, japan, and others, is that this virus can cause mild disease, can cause moderate disease, which is described as people who still have pneumonia but do not need oxygen support, can cause severe disease, can cause critical disease, and can kill some people. Amongst children, the data we have seen from a number of countries is that the majority of children that are infected are experiencing mild disease, but we do have reports and there are some publications now that describe severe disease in children. We have reports of death in children. Theres one in china and i believe one in the United States as well. We do need more wellcharacterized descriptions of severity across the age groups so that we can better summarize what we know about this in the different age groups. Ideally, what we would like to see is the use of a clinical characterization protocol. This is another data capture platform that the who has that the w. H. O. Has launched, which involves systematic Data Collection in terms of assigning symptoms, in terms of regular sampling of hospitalized patients so we can better characterize the Natural History of this disease in people who are in hospitals, but there is data coming out from a number of countries, and we welcome the rigorous Data Collection that is occurring in very difficult situations, and in hospitals, if its Clinical Data or epidemiological data, across a number of countries. Maybe i could just add that we have been reporting for quite a while now a spectrum of disease. Theres no question the elderly and those with underlying conditions have been affected much more than other age groups, but we have certainly spoken here before about the age profile of patients, the fact that in korea, 20 of the deaths were people under 60 years of age. In italy, the fact that up to 15 of people in intensive care were under 50 years of age. I think we will find other countries, of people with disease, people under 50 who have disease will have moderate or severe infection. They may not progress into critical condition, but 10 to 15 of people under 50 will have a moderate to severe infection. This is for most people a very mild infection, most young people, but for a significant minority of people between the age of 20 and 60, this is a significant infection, and if you listen to people who are interviewed on the media, the one thing i have seen again and again and again from people adults who got this and young adults they keep looking at the camera and saying this is not flu. I think what is really emerging is a perception that this disease, while not fatal and not causing critical disease in a Younger Age Group is causing severe illness in many people. Thank you. I want to add the point we have made a few times is that young people are not invincible. It is not just the disease. Every infection of covid19 presents an opportunity for onward transmission. Even in the younger population if you do have mild disease and you think it is no big deal, what is a big deal is that you may transmit to somebody else who may be part of that vulnerable population, who may advance to severe disease and who may die. Every Single Person has a role to play in this outbreak in preventing themselves from getting infected, and we have listed a number of ways in which you can do that, which involve hand hygiene and respiratory etiquette, physical distancing, adhering to the recommendations of the national government. By following those rules, by adhering to that, your you are preventing yourself from getting infected and preventing the opportunity for onward transmission to someone who may be more vulnerable. Thank you. Are you on the line . Yes, can you hear me. Yes, very well. Please go ahead. Thank you very much for taking my question. Regarding the way of counting for some cases, the chinese authorities said last month they do not count cases who do not have symptoms, but currently, there is a huge number of such cases. [inaudible] thank you. I can start with that. We have case definitions that we are using which include a laboratory confirmation, for regardless of the development of symptoms. What we know from some countries is on the date of report, some patients may not have yet developed symptoms. They may be presymptomatic. We need to be very careful in our language. The use of the word a , iasymptomatic globally believe, is not appropriate. Many of the individuals who are listed as asymptomatic are indeed presymptomatic and go on to develop symptoms a day or two later. What is important for us in terms of our understanding of epidemiology is when is transition taking place, and what are the drivers in transmission . From the epidemiologic data that we have, we know that the majority of transmissions, the drivers of transmissions for covid19 are people who are symptomatic. That includes people in the very early stages. From the data we have now come of the majority of transmission for covid19 are people who are asymptomatic. That includes people who are in the very early stages of symptoms. In the viral shedding date is showing in the early stage of disease and people are having a little bit unwell, they havent yet had pneumonia and they certainly are not hospitalized yet. So its really important we follow all of these members were keep our physical distance, transmission of covid19 is through droplets, it is not airborne. Therefore, someone who has these small liquid particles that come out of their mouth, they travel a certain distance and they fall. So thats why we recommend the physical distance to be separated so that you remove the opportunity for that virus to actually pass from one person to the other. Thank you dr. Van kerkhove. Now we have anna from croatia. Are you on the line . Yes, im on the line. Can you hear me . Yes, please go ahead. So, as you could hear these experts said that they have most that croatia has some of the most strict measures when it comes to the number of cases. I can see this is changing our lives so i wonder if you have any idea how long this academic this covid 19 epidemic can last . And is there any proof that the higher temperatures can stop or slow down the spread of this novel virus . Thank you. So, at this point, no one can predict how long this epidemic is going to last. And there are a number of scenarios that take us forward in time. I think the other question people are asking beyond how long is the pandemic is going to last is how long are the shutdowns . How long are the lockdowns . How long are all the measures going to last and will these measures be changed or be different . We are entering, moving through an uncertain future. You see many countries around the world are just starting this epidemic. Some have been through the cycle of the epidemic, like singapore and china. They are desperately trying not to have the disease reemerged and caused another wave of infections because of disease importations. So, each country is in a different position. So croatia is probably in a different position to many other countries in europe right now. The real trick for countries is to look at the national situation. To look at the subnational situation. To see if you know where the virus is. If you know where the virus is, you can break the chain. If you know who has the virus, if you know who the contacts are, you can break the chain. If you have that knowledge, and if you have that knowledge at a subnational level, you can only take action at the level of which you can measure. If you know its happening in every town, if you know its in every unit penalty, county, province, you can begin to adapt your measures for the situation in that particular area. And all of us want to see the measures that were using for Public Health at the Community Level to be adapted to the maximum control of the disease, but to the minimum of economic minimum impact of economic and social life. In order to do that, in order to transition from the current measures in place, countries simply have to have in place a system to detect, isolate, contact trace, and quarantine, as well as to continue appropriate hygiene and physical distancing measures. They must be in a position to do that in different parts of the country at different times, and they must be in a position to reimplement measures should the situation deteriorate. That takes a very sophisticated surveillance system, it takes a very Strong Health system to absorb the surge of cases in any particular area. And what we need to do now is evolve and get measures that have been designed to suppress and just take the heat out of this pandemic to much more precise, targeted directed , measures that will allow us, at the very least, to live with this virus until we can develop a vaccine to get rid of it. Thank you, dr. Ryan. I now have thomas from bloomberg. Thomas, can you hear me . Hello, yes, this is thomas from bloomberg news. I was just wondering as the rate of infection increases so dramatically, is there a point that it is no longer controllable . Is this globally . Ill start with that. Maybe mike would like to answer. I think youre saying, where the rates start to increase . I think and one aspect, its an we test, the more we are going to find. I think and one aspect, its an overwhelming thing to see these case numbers increase. And in many countries, the case numbers are going to increase. But you need to test to be able to find with the virus is. Find where the virus is as , mike just said. That means this case numbers are going to increase. What weve seen from a number of countries now is that this virus can be controlled. What weve seen is that through the aggressive measures of case finding, testing your cases, isolating those cases, caring for them, depending on the severity that they have, making sure they have adequate care they dont progress with the disease, if thats possible. To find all of their context, to follow them for 14 days. If you quarantine your contacts, or remove them from the family home, or remove them from the community so they dont have the possibility of transmitting to other people, to having strong leadership, Strong Political leadership, repurposing your government to having this whole of government approach to engaging your population, communing with your population regularly so they can go through this with you as you adapt your measures. You implement certain control measures, you may lift other control members. Empowering your population said they know what they have to do and this fight against covid19. We have seen in a number of these countries, and the director general had a very important meeting today with many ministers who shared what works and what works is this. What works is case finding. What works is Contact Tracing your population and communicating with your population. Making sure you have arrangements in place so that people who need to be cared for can be so that healthcare workers are protected, so that ppe is used appropriately and they are saved for frontline workers and utilized by those who need it most. So your answer to can this be controlled is yes. But it takes a lot of aggressive measures, this comprehensive approach that we have been outlining and countries will see improvements as they move through the different transmission scenarios. And so we need to apply what works to show that there can be suppression that can happen with this virus. And if i could add, its and if i could add, it is really important at this moment that we dont create perverse disincentives to detect cases. We should commend countries testing, and we should not punish countries for getting larger numbers. Thehould recognize countries, recognize reality, reward countries and governments for looking. If we create a situation where we overreact to the daily number, then theres a disincentive to actually test. Countries who test and find cases and do lots of testing, should be commended. Testing should be commended. Secondly, we need to look at rates of things. We compare raw numbers and its very unhelpful at times. We need to look at what is the number of cases as proportionate of the whole population . What is the number of tests as a proportion of the whole population . Whats the Positivity Rate of tests . How many tests have been done and out of them how many are positive . They give you much better idea not only of the impact of the disease, but of the effort being made by the public authority. But, it is important that we look at these numbers rising, part of that rise in numbers is increased detection, due to better testing. And, we need to be careful that we dont punish people for testing. Having a larger number means i know where the virus is better. Thank you very much, dr. Ryan. We now have a caller from nigeria. Are you there . Yes, im here. Please, go ahead with your question. Any country that, now, you get specific information for about covid19 . Is that sequence of [indiscernible] thank you. Sorry, could you repeat that question . We lost you a little bit. Ok. So, i think your question was about medication. Is there any medication that works . And what other issues with cases in nigeria . So, thank you for these two questions. With regards to medication, and as the director general outlined in his speech today, there currently are no specific medications that have been approved for covid19. However, there are a number of Clinical Trials that are ongoing and theres a solidarity trial thats currently starting. It is just enrolling patients now, looking at therapeutics in controlled Clinical Trials. What is very important is that these medications are evaluated appropriately so we know it works, and that we have the right data to support what works. With regards to the number of cases in nigeria, i dont know the exact number 46. Do you want to take that one, mike . Yeah, the number of cases in nigeria remain quite low, despite nigeria having a reasonable capacity to protect and temper the virus, but the risk is nonetheless there. Weve seen diseased, covid19 almost every country in africa at this stage. So the risks are certainly rising, but the numbers are still low. Again, we need to ensure we have a very strong Public Health response on the african continent. From the response african government. Minimize the necessity of measures that will have a hard impact on peoples lives and livelihoods from which they may not recover as quickly as people in other countries. Shutdowns, slowdowns. We also need to look at the very vulnerable populations we have in africa, refugees in some cases, people who are living with hiv and children with malnourishment. While africa is a relatively young continent, and that may be an advantage for africa right now, there are many, many other Vulnerable People in africa for whom we must provide maximum protection. Africa, again, has demonstrated, with polio elimination, color response, ebola response, that african countries have capacity to respond to epidemics, the resilience to live through epidemics, and to recover from them. But what we need to do is bring our communities on board. We need to leverage the power of communitybased surveillance. We need to empower and engage with ngos, civil society, local then the all of government approach, as dr. Tedros continues to say, it is even more important in the context of nigeria and in the context of africa that those approaches be taken. In terms of, i think he said medications, i think its really important that we say quite plainly that there are no proven effective therapies or drugs in the fight against covid19. Theyre the answers were trying to find. Good, supportive care, Early Admission to hospitals for those who are with underlying conditions are developing severe disease, oxygen and the provision of oxygen to people is certainng, and, in a small number of patients, the ability to ventilate patients in order to get them through the worst of the infection. So, we have things that work in terms of clinical management. We do not have effective drugs. And that is why the solidarity trial is so important and that is why so many of the other trials around the world are so important to answer these questions. Thank you, dr. Ryan. Yeah, thank you. Just one point to add. When we had a small number of cases, like what we have in nigeria and like other countries in africa, thats when you can also be able to do the public interventions effectively, to test cases, to followup contacts, and isolate the cases. So the problem doesnt grow. Meaning from the sporadic cases, from the past cases, that it will not grow into Community Transmission. The problem comes when Community Transmission starts with the number of cases builds. When that happens, doing the public held solutions was saying the quarantine and so on will be difficult, if not impossible. But, at the same time, the growing number of cases means the health system, the Healthcare System could be overwhelmed. So thats why, for nigeria, the best option is to really cut it from the bud, and while you have the small number of cases, to invest more in the public interventions and do the things that we have always been staying from the start on who, like becoming or venting it from becoming a Community Transmission. We live this and take you to new york where Governor Cuomo is going to give an update on the coronavirus activity in his state. Director, will talk to you about the budget director will talk to you about where we are