 then kind of legislative agenda of the UN in regards to health is brought to a head and is usually preceded by our January executive board. Of course, this year we're not meeting in person. We had for the first time ever in our 73 year history, we had a digital gathering, we had to open the meeting with a whole bunch of procedural resolutions just in order to enable the digital gathering, but the director general had a really clear message that this is not the COVID-19, which was the only agenda item we held on the normally kind of full week agenda. It's not just an emergency, it's a demonstration that there's no health security without resilient systems and that we have to also address the social, economic and commercial as well as environmental determinants of health that his point was really that we're learning health is not a luxury and many national governments, the way that health is put is at a basically a cost center for a country. It's not a reward for development, it's not something you graduate into because you've got higher GDP per capita, but it's a prerequisite for development and investment both in prosperity and peace but also in security. And I think that this is one of the main points that we've talked about this past two days here. Next slide. So I'll go through just a quick update which I think is useful as a WHO representative in these days you're semi practically legally bound to present some epidemiologic information every time you speak, but I'll then just give a quick update on some of the health services and health systems guidance that's coming and some of the issues we're really wrestling with and it'd be great to follow up with people afterwards around some of the questions and some of the issues that you may be able to help us with. Next slide. So again, part of the benefit of this is not for me to read it all but for you to be able to have it afterwards but this is the latest data that we have from today or it's from last night at six o'clock is when we closed the books on this but we have unfortunately crossed the very sad thresholds of over 4.5 million cases and over 300,000 deaths globally. And we have a number of countries that they're big countries that are leading the charge unfortunately still in terms of the number of cases and the number of deaths but they're also very high per capita especially in the US, very high per capita number of cases and also quite high in the number of deaths in the last 24 hours but also cumulatively. Next slide please. Here you can see the global curve. It's nicely now summarized them with the different colors across different regions and you can see the very kind of large contribution of the Americas and Europe in the global epidemic curve. Definite slowing within Europe with some of the Eastern European states still struggling but number of Western countries some anyway who've got things more under control. There is still increasing cases or still cases anyway over nights in the US but now sort of the attention has shifted to some of the South American countries and an increasing numbers in Southeast Asia as well as some in particular in several African countries. The unfortunate issue is that this, we've kind of hit a plateau globally. Things look different across the different regions but obviously one of the lessons we have on this is that we won't be out of this until everybody is out of this. So the fact that certain regions are doing better you know, it's starting to know what to think of that until really the curve changes for all of us. Next slide please. So just to summarize a few key points related to health systems challenges and this is something we're seeing in France, the UK and Spain and the US but also in Peru, in Chile, in Ghana and South Africa. There has been obviously an increased demand for the related, the services that are related to COVID which are intensive care and ventilation and these types of hospital based services but there's been major disruption of routine essential services. And we now are seeing big difficulties around medical supplies and equipment and infrastructure partially because of the supply chain interruptions and travel and trade restrictions but also partially because of the additional burden of personal protective equipment in routine essential services that we wouldn't normally have had. There's been a big burden on healthcare workers and major infection prevention and control challenges. Next slide. Just some of the things that WHO has been working on there's been an update to the strategic preparedness and response plan that's the worlds, I mean it's shepherded by WHO but it's the world's plan for dealing with COVID and that update has been taken on board to look at some of the changing of the public health measures and their applications globally meaning the change in the quote unquote the so-called lockdown. There's been update guidance on maintaining essential services and operational guidance that we've been working on that I'll come back to. There's been new work that we've just been working more on today. We had a very good webinar with our colleagues from CDC we're happy to pass along that information on long-term care facilities and I think that's a big concern in the US as much and probably more than a third of deaths in the US or in long-term care facilities. And we started some recent work that we would really be very interested to talk to with folks more about about a sort of virtual help desk for countries virtual place to provide real-time support for WHO country offices and our ministry colleagues. Next slide, please. We have the hand hygiene recommendations to member states and one of the issues that we continue to come back to is the need for increasing availability of hand hygiene facilities everywhere. And this is something that's as relevant in Manhattan as it is in sort of rural Niger where I did a lot of work at one point in my career that public facilities, it's quite clear that many countries have very limited ability to be in sort of lockdown situations and that living with the virus and a sort of new approach to our everyday activities has to be what is going to get us through this next phase of the outbreak and hand hygiene is really going to be key there. This has to be the responsibility and interest of decision makers at national levels but at state, provincial and local levels. Next slide, please. The work that WHO has done also is not just about and I think we need to remember this it's not just about what happens in health facilities but it's also about what happens when health teams head out into the community and this is a photo from West Africa but this is the kind of scene that is going on in downtown LA in terms of community health workers providing outreach social services and these types of essential services which are very much like police like firemen, like others, services that go out in the community need to be thinking about how they can do that safely, what things should be stopped and how they could be the things that really need to go on how do they keep going on and this is particularly relevant in many parts of the world around immunization which has both facility based and outreach services but also it's crucial for other services such as malaria and other considerations. So this is some guidance we've worked on and it's been rolling out just this past week and again, we're looking to evaluate its impact as we go forward, next slide. The bottom line is that the overall impact of COVID will be much, much broader than just the health impact. I mean, it's obviously had a massive impact on jobs, on the economy and on really all sectors of society. The UN has laid it out in terms of this framework for addressing the immediate socioeconomic response to COVID and it takes a health first approach. Unfortunately, we've seen, in some countries rather than see the wider socioeconomic response as being a continuum of health first and then these other areas such as looking at social protection and basic services, protecting jobs, fiscal and financial stimulus packages and macroeconomic policies and then the issue of social cohesion and community resilience rather it's put as a either or situation. And I think it's gonna be very difficult for those countries to really work through a holistic response to this particular outbreak while we're waiting for the vaccine to come. And I think if I can just comment on that before moving on, we'd have to remember that just getting to the vaccine is one thing, getting beyond that and getting it to people will be a final one and I'll close with that before we finish. But we've been looking on the next slide at some of the national plans that are based on this work, the strategic preparedness and response plan as well as the UN framework. But trying to ask where are governments putting their points of emphasis and where are they trying to put resources? Are they aligned with the strategic, the SPRP? Are they aligned with the GHRP which is the Global Humanitarian Response Plan? So that's the plan that looks at this work in a number of FCV, fragile conflict affected and states as well and vulnerable states as well as other vulnerable populations. And do they focus on this systems issue and preparedness approach? And you can see that some of the results that we've got here show some gaps. There's a number of countries that do have multiple plans. There's not all of the countries and we were only looking at a sample, a small sample, only about half of the country is actually aligned with all of the pillars. Only half of them had this piece on essential health services. And I think there's clearly some gaps that in terms of having a health systems approach overall. Next slide. The issue that this creates is then, it's not that having a plan means that something happens, but if you don't have a plan, something definitely will not happen. And so this issue of ensuring that essential health services are maintained and are emphasized and that there is a considered and strategic approach to how that's done is very concerning I think for a lot of us. And I think we're gonna be looking at a wider examination of this and collecting data on how COVID has impacted the delivery of essential health services at country level. We've been fielding data collection across initially five of our six regions, but to all countries. And we hope within about a week's time to start to get some of that data back. So I'll just finish with this last slide here before we take some questions. But the whole idea of our work going forward is that there's the immediate response that the areas in blue, there's the humanitarian response for those countries that are really highly affected when humanitarian settings, the Yemen, the Venezuelans of the world, there's, and then there's the longer term economic recovery plan. And really the linchpin on this is this health first approach. The idea that essential health services and systems need to keep running, that that is going to be a key element in terms of ensuring that the recovery efforts can be actually even begun. And the idea that we've had here, it's speaking to the UN principles just a little bit at the end of last week, from some of the serology studies that we're seeing, only about five to 10% of our populations. And this is even in countries that have been very affected by COVID, Spain, France, the US, only about five to 10% of the population, the world's population has been exposed to COVID, which means that the vast majority of the world is still very vulnerable to infection with this virus. And the idea that we are all tired about being cooped up and about being at home and not being able to work to the virus, it does not matter that it will, if we go back too quickly and without enough preparation, come roaring back. And we've shown that we can control the virus. In many countries, there's been good efforts at controlling it, but the virus has also shown that it can control us. And the promise of a vaccine, things are moving very quickly in some countries. There's hope that we can get to a certain point in early 2021, but there's also a talk in certain government circles about earlier than that. But just to remind, at the beginning of or at the end of December of last year in Samoa, for instance, a country with very limited capacity in terms of intensive care beds and ventilators, it had 15 intensive care beds for the whole country with ventilators. All of them on December 31st of 2019 were filled, but not obviously with COVID patients. It was filled with young children under fives who were suffering from measles. And we have had a measles vaccine since 1946. So the idea that the creation of this vaccine will suddenly solve all our problems is not the case. We will need to think of health systems approaches and vaccination approaches that innovative ways of delivering the vaccine, packaging and delivering, and innovative ways of ensuring that health systems support that, both between now and then and then following the creation of the vaccine. So I'll close with that, with the encouragement to stay vigilant and to keep working together and happy to take some questions, Donna. Thank you. That's great. Thank you, Rad. We do have a few questions. The first question is related to the slide that we were just looking at. What does SPRT mean on that slide and HRT? Yeah, yeah. Thank you so much. WHO, just like you're required to use numbers in your presentations, you're also required to only speak in acronyms that nobody understands. So anyway, SPRP, if you turn your head sideways, it means the strategic preparedness and response plan. So that's the WHO, the global response plans for COVID. And the GHRP is the, again, turning your head sideways is the global humanitarian response plan. So both of those are UN roadmaps for addressing COVID. One, the second one addresses it in the official humanitarian countries of which there's about 28 of them. Wonderful. Excellent. Well, we'll be sure to send out this PowerPoint with all of these great links that you have, but we'll also make sure that we link to it on our website as well so that people can have access to everything. Another question that came in was related to academic studies. We're learning an awful lot through this. Is the World Health Organization looking to partner with academic institutions to better improve training for upcoming healthcare workers? Yeah, that is something that we have been definitely working on. And actually the Director General and our Health Workforce Department have launched a very, very exciting new initiative, the WHO Academy, that will bring together all of WHO's work and training into, because of course, as you might imagine, capacity building is one of the core jobs of WHO around the world in providing the technical content for that. We're not always the best at delivering that. And so often we depend on our collaborating centers and academic institutions. So there's a whole global network of WHO collaborating centers on that, but the WHO Academy has recently created and afterwards we will share the link to the Academy and it's got a new WHO Academy app that takes all of the COVID material, all of the guidance and training and has organized it in this very easy to use app. So we'll provide the link on that. That's probably what one of your listeners had referred to in one of the questions that came. That's great, thank you. Yes, we'll definitely post that as well. Another question comes from a patient advocate. Here at the Patient Safety Movement Foundation, we're very focused on helping to eliminate medical errors. We know at least here in the United States that between 250 and 400,000 people die every year because of that. So the question is there is a lot of focus right now on COVID, but why aren't medical errors, preventable medical errors, do you think getting the same attention? Getting the same attention as COVID, meaning? Right, yeah, knowing that hundreds of thousands of people are dying every year, but yet when you've talked to most people, they are not aware that this is a problem. Yeah, I think that's a very, very interesting point and great point to bring up here with the Patient Safety Movement Foundation. Obviously we in peacetime and in wartime are working a lot with the Foundation and I started at WHO to work on the World Alliance for Patient Safety. I think that it has to do with sort of the nature of that outbreak and the controllability or at least the perceived controllability that is out there, that in the same way that an airplane crash gets much more, gets big news, but the drip, drip, drip of car road safety deaths does not. I think it's that aspect that is principally behind it. I think also there's a perception that COVID there is or will be sort of a magic bullet around it and it'll be, you know, the vaccine will come and we'll be able to kind of start working on eliminating it or something like that, like smallpox or something, but whereas the solutions for preventable deaths in healthcare are sort of multifold and systems related, here we can blame it on one virus. So probably those two, that's probably not the full answer, but I think that's part of it. And I think if we can try and see one of the lessons for our future work for the patient safety would be to say, look, this is all about patient safety. Getting back to safe provision of healthcare will be the key to this and we should take some of the lessons on infection prevention and then what we're gonna need to do in this context of COVID and translate those into other areas of safety issues. So I think we have a big opportunity here. I think you're right, I think you're right. And I think that this is gonna provide us with an opportunity to really understand how systems impact care. As you mentioned, systems are usually the root cause of patient errors. Another question for you is related to who webinars, the World Health Organization. Do you do any kind of webinars for the public that people may be able to share with family and patients? Yes, definitely. We have, they're on the website itself, there's a whole for the public section of the website that has a set of videos for things like it's putting on and taking off masks and please, please go to that website. I cannot tell you, living in France, there's just been the request for people to wear masks and publish transportation and in stores and that kind of thing. And WTO, as people probably know, has been quite clear to say that the evidence from previous outbreaks and H1N1, et cetera, shows that the whole, the wearing of masks by people who aren't sick doesn't really prevent. Obviously does not do any harm, but it does do harm if you don't know how to put them on or take them off and you wear them in crazy ways and the minute you come out of the store, you touch your face, taking off and put your phone on and all that kind of stuff. So please go and watch that before you start wearing your mask everywhere. But so there's a bunch of videos but then WTO does have its EpiWin team, the sort of the infodemic fighters has, have regular EpiWin seminar webinars and I'll just, we'll have our colleague, my colleague Zandili who's here who can make sure to put the link in the chat box so we can also provide it afterwards. Great, excellent. In terms of workers who are having to go back to work this month, I know you've talked a lot about hand hygiene, but there may be some concern for those who don't feel like it is safe yet to go to work but yet they're required to. Any recommendations on what they can do to keep themselves safe? Yeah, I think that's, you know, that's, it's a big issue. We have a health worker protection and occupational health team here that's really working on some of that. It's a joint piece of work with the health workforce team, the occupational health team and the international labor organization, ILO. I mean, first and foremost, obviously it's to express, you know, through the appropriate channels, your concerns about return to work and, you know, in theory, no one should be forced to work in unsafe conditions. And that's sort of one of the principles that the ILO has globally. And so that's one issue. But when workers do go back and things open up and you're not able to, the biggest issue is trying to maintain appropriate distance and trying to maintain a workplace that is only as dense as, you know, safety allows. So to allow a meter between workers, WHO, is getting itself gradually ready by looking at workflow, at looking at flow along our very long hallways. So we have arrows, like it's a bike path now. So one direction you're supposed to go this way and one direction you're supposed to go that way rather than people crossing each other in the hallways, looking at doors and how, you know, people coming in and out of doors, looking at elevator spaces so that you create enough space for people getting on and off, make sure that only a certain number of people appropriate can ride up and down on the elevators, making sure all that is signposted of all very helpful issues, installing extra hand hygiene spots with, we've just even installed here extra on-the-wall bottles with little framings of how to hand rub, using alcohol-based hand rub. So all of those things can help. It can help if you are, if you have to be in more crowded situations for shorter periods of time to if it makes you feel better also to wear a mask on occasion. And I think the main thing is to really look and work with your decision makers within your workspace about making sure that the flow, particularly workflow is that way. And for healthcare workers, one of the additional things that many, this depends on testing strategy that a lot of healthcare providers are moving into is to have a very clear testing strategy for healthcare workers coming back to work and a very clear screening and triage approach. And those are two different things that as all of your people on this call should know about. Very clear screening and triage approach for patients coming in for regular health services and all, we have guidance on that. And I think that could be very useful. WHO has also guidance in terms of returning to work and for schools and other workplace institutions that that's in Dillisa posted up there. Great. And I think we have time for just one more quick question. There's been a lot of talk about vaccines. We talked earlier about that here. There are a lot of folks in the world who are not necessarily in favor of vaccinating their children. So does the World Health Organization have anything that a practitioner could share with patients to help explain the purposes of vaccinations and the safety? Yes, definitely. This is of course an issue that has existed for a while in peacetime and has been, unfortunately, the reason why we've seen measles outbreaks in European and certain countries in Europe and in parts of the US from a disease that can be very deadly for young children but is completely preventable. And we have had this whole vaccine reticence movement sort of what we've termed from a technical side the demand side of vaccine or lack thereof has been an issue for us for a while and we have several good publications that are around both explaining the benefits of vaccines, the explaining the safety issues, busting some myths that have unfortunately cropped up anyway around vaccines and vaccine safety. So we'll be sure to share that and there's good Q and A on vaccine safety that's available that also just pasted in the chat. Great. Well, we will add all of those to our resource pages and I think that's about all the time that we have. So Ed, thank you again. Thank you always for joining us and giving us some such great information about what's happening across the world. It's really very helpful. We really appreciate your time. Thank you so much, Anand. It's really always a pleasure to be with the foundation and just get a great group of people here and so we're just thankful to have a moment to talk to them. Great. Well, hopefully we will see you again in a few weeks. Good, sounds good. Thanks. Thank you so much, Ed. Have a great day.