Re: Taiwan:
April 17 /
source:
“Gabriela Sotomayor: (
45:23)
Thank you very much. Thank you for giving me the question. And it’s very nice to see you all. And I have a question. I want to come back to the issue of Taiwan. We hear more criticism on Taiwan being excluded from COVID-19. They have very few cases and they can offer their experience to the world. So I would like to have your comments on this. And well, it’s just that. Thank you.
Maria Van Kerkhove: (
45:57)
So, I will start. So just to say, I will repeat what I said the other day. We have been working with colleagues from Taiwan on the technical side throughout this pandemic. And you’re right, it is important that we learn from all countries who are dealing with COVID-19. I’ve personally, myself and Steve, have briefed members from Taiwan CDC, public health professionals and scientists. We had an exchange of information about what is happening at the global level in different regions and also from Taiwan as well.
And we have a number of people who are serving in our clinical networks and our infection prevention and control networks. And again, it’s an opportunity where we regularly meet through teleconferences where there’s the opportunity to exchange information peer-to-peer. And this is invaluable to be able to have firsthand experience with patients to say how are they, how are they developing disease, how can we treat them, how do we prevent onward transmission? And so there has been a regular and open dialogue throughout the pandemic.
Dr. Steven A. Solomon: (
47:11)
Thank you. Thank you for the question and thank you Maria. Just to add, as we’ve said before, there’s two parts to this. There’s the participation within the WHO governance process, within for example, the World Health Assembly. And that’s an issue that member States of the organization decide. The WHO staff does not have the mandate to decide those issues. WHO staff works technically and operationally to fulfill the mandate of WHO to coordinate, to convene, to provide advice, to furnish assistance for the response.
That’s the work of WHO staff. The decisions about participation in the governance processes, in the membership, in the health assembly, is a decision that is and belongs to member States. But within the technical work that we do, as Maria has made clear, there are a range of areas that we cooperate, work with, engage with Taiwanese experts, both within the context of this current pandemic and generally. And we listed those, and they’re available on our website.
I think just again to remind of three of the key ones for the response now. There is a point of contact within Taiwan CDC that has access to the international health regulations event information site. This is the key platform for exchanging information among all the parties and stakeholders in the international health regulations. There are two of the key clinical networks that Taiwanese experts participate in. The Clinical Management Network and the Infection Prevention and Control Network. These networks meet at least once a week, sometimes twice a week.
And there is the direct contact between WHO at a technical level, Maria just mentioned these, and Taiwan CDC. These are very important to ensure an exchange. We are looking at other ways to do so as well as this evolve and as the expertise from wherever can contribute to the response efforts. So I hope that answers the question about the technical work that is ongoing and the area that is really in the hands of member States. The formal participation of in WHO governance bodies, like the World Health Assembly.
Michael J. Ryan: (
50:09)
Maybe I could just add to this, because I think it is important, the health authorities in Taiwan and Taiwan CDC deserve praise. They’ve mounted a very good public health response in Taiwan. And you can see that in the numbers. And we have praised that. And we’ve seen similar approaches taken in Hong Kong, SAR and across China. And we are observing and we are watching and we are bringing Taiwanese colleagues into the networks, the technical network, so they can share their experience. And they can both contribute their knowledge, but also seek new knowledge from outside. And I do believe that the health experts from Taiwan CDC were involved in one of the initial missions in China with colleagues from Hong Kong, SAR, as a joint mission to Wuhan by the National Health Commission in Beijing. So, that there is-
In Beijing. So that there, as Steve has said, these kinds of scientific collaborations within, without China are extremely important. But you know, Taiwan health authorities, Taiwan, CDC, professionals and health workers in Taiwan have stood on the front line. They’ve served and they have done service to their populations and as many others have around the world. And from our perspective we all stand with our professional scientific and health colleagues everywhere.”
—
Apr 20/
source
Tarik: (
15:34)
[French 00:16:02]. And so quick translation of that. Marie is asking about an email that has been sent by Taiwanese health officials to WHO on 31st December. So the question was when this email arrived, when we had the first announcement by Chinese authorities of cases of a unknown pneumonia, and how do we answer to claims that WHO was not acting on warning from Taiwan? Thank you.
Dr. Michael J. Ryan: (
16:43)
On the 31st of December, information on our epidemic intelligence from open source platform partners, ProMED was received, indicating a signal of a cluster of pneumonia cases in China. That was from open sources from Wuhan. On the same day, we had a request from health authorities in Taiwan and the message referred to new sources indicated at least seven atypical pneumonia cases reported in Wuhan media. That the cases were not believed to be SARS, however, that the samples were still under investigation. The message requested with great appreciation if we had relevant information to share, with a thank you in advance for our attention to the matter. There was no reference made in that query to anything other than what had been previously reported in news media and actually referred to a response from the Wuhan health authorities clarifying and confirming that the cases existed, the cluster existed, and obviously it turned out not to be SARS. So any SARS test on at that time would have been negative, as would have been influenza samples. Clusters of atypical pneumonia are not uncommon. There are millions of cases of atypical pneumonia around the world in any given year, and certainly in the middle of an influenza season. Negative influenza tests may also have been found at that time.
So from the perspective of the request we received from Taiwan, it was in line with other information that we had received from other sources, and the message through the iOS platform from ProMED had actually had a lot more detail in it based on the news media report, and that request was actually sent immediately on the same day to our country office for followup with Chinese authorities, and on the 1st of January we formally requested verification of the event under the IHR, which is a formal process beyond any informal verification, which requires a response and requires an interaction from the member state.
Under the IHR, member states are required to respond within 24 to 48 hours of any requests from the WHO for clarification or verification of an event or a signal that we believe may be significant. That process continued, and on the 4th of January WHO tweeted the existence of the event, and on the 5th of January provided a detailed information on our epidemic or emergencies information site, which is a site for all national focal points around the world, and every member state has a focal point for IHR, usually within the National Health Service, and all would have received a detailed report from WHO giving details on the event, and that would have included an IHR contact point for Taiwan. Taiwan has access to that site, as have other focal points and contact points around the world.
On the same day, we would have actually put out our first disease outbreak news, which was a public explanation or a public report on the event, and the process continues after that. So we would obviously like to thank our colleagues in Taiwan for having shared an interesting report for which we were receiving similar reports from other sources. At no point in the process of communication, in this email that’s been received, was there any reference to human to human transmission or any other issue. It was purely requesting relevant information and thanking us in advance for our attention to the matter. So I hope that clears up that confusion.
Dr. Tedros: (
21:04)
So I think Mike answered it very well, but I just wanted to summarize. In its email on 31st December, one thing that has to be clear is the first email was not from Taiwan. Many other countries already were asking for clarification. The first report came from Wuhan, from China itself, so Taiwan was only asking for clarification. And as some people were claiming, Taiwan didn’t report any human to human transmission. This has to be clear. They were asking for clarification, like any other entity who wanted clarification. So we didn’t receive the existence of human to human transmission from Taiwan on December 31. We have all the documentations, and the email we received from Taiwan is to get more clarification on the issue based on China’s report. So the report first came from China. That’s number one. In fact, from Wuhan itself. Second, the email from Taiwan, like other entities, was to ask for clarification. Nothing else.
Dr. Michael J. Ryan: (
22:47)
And I may also just add that for those of you who don’t know ProMED, ProMED has been existence for more than 20 years, and it’s actually a US based listserv that has provided a lot of early information on epidemics going back over decades. We work with them very closely and we have-
-epidemics going back over decades. We work with them very closely, and we have actually co-developed with ProMED with GPHIN which is a Canadian public health intelligence network. And many others around the world. The epidemic intelligence from Open Sources platform, which is an AI driven system which allows the automatic detection of these kinds of reports all over the world. Our system picks up 7,000 signals. And we pick up those 7,000 signals a month from all around the world.
And they all require verification and followup investigation. Up to 300 of them require investigations specifically by governments. And it’s a massive global process of picking up this information from around the world. And actually all of the G7 countries are now implementing EIOS as part of their core public health architecture and that system would have been live in all G7 countries at the time of these notifications.”
