The World Health Organization is pleading with countries not to reduce COVID-19 testing amid a rise of new infections even as their latest report suggests that cases have fallen globally.
According to the WHO’s weekly epidemiological report released on Tuesday, the number of new cases reported worldwide between March 21 and March 27 declined by 14 per cent compared to the previous week. Every single region recorded a decline, including the Americas and Eastern Mediterranean, which saw declines of 14 per cent and 32 per cent.
While that may sound like positive news, the report notes that the decrease in cases should be “interpreted with caution” because numerous countries have reduced testing capacity.
“Several countries are progressively changing their COVID-19 testing strategies, resulting in lower overall numbers of tests performed and consequently lower numbers of cases detected. Despite a generalized decline in the rate of SARS-CoV-2 testing observed across the six WHO regions, the number of new weekly cases increased again in early to mid-March, indicating that the virus is currently circulating at very high levels.”
The report expressed concerns about a “significant reduction” of COVID-19 testing in several unnamed countries and said the data is becoming “progressively” less representative, less timely, and less robust.
“This inhibits our collective ability to track where the virus is, how it is spreading and how it is evolving: information and analyses that remain critical to effectively end the acute phase of the pandemic.”
COVID-19 testing has been on the decline in Canada since the beginning of the year and is now back to 2020 levels. The nation’s seven-day moving average for tests performed was 41,548 as of March 28, a figure that it hasn’t been at since July 2020.
In B.C., laboratory testing has decreased steadily since December. Since early February, the number of lab tests performed in a single day in B.C. has not exceeded more than 10,000. Furthermore, the number of new cases in B.C. each day is likely far higher than what is reported by the provincial government due to restricted access to PCR testing — the only method included in the province’s official case reports.
WHO’s report also warned countries against reducing testing and other surveillance measures, saying that it is too early, reduces their ability to detect new variants, and impairs response efforts.
“The uncertainty around the characteristics of emerging variants limits our ability to confidently predict the behaviour of this disease, as the evolution rate and risk of emerging variants are still high, which could undermine prevention and mitigation measures,” the report states, adding. “Until we reach the end of the acute phase of the pandemic, countries must maintain sufficient epidemiologic surveillance.”
Reducing transmission is key, say WHO officials
During a press conference on Wednesday, Dr. Maria Van Kerkhove, technical lead for WHO's COVID-19 response, said countries must continue to focus on reducing transmission.
"If we don't continue to focus on reducing the spread as well, we will continue to see further virus evolution and the future of future variants is uncertain. It could be more severe, it could be less severe and we need to prepare for all those eventualities," she said.
Numerous countries are struggling to "get themselves out" of their current situations, said Van Kerkhove. She also said that COVID-19, especially its variant BA.2, continues to circulate at a rapid rate despite changes in testing and surveillance.
"We are in the third year of this pandemic and this virus has a lot of energy left. It is circulating at such an intense level," she said. "There are at least 10 to 11 million new cases being reported each week and we know that is an underestimate because surveillance has changed and testing has stopped or reduced significantly in a number of countries."
Dr. Mike Ryan, WHO's health emergencies program director, said COVID's reproductive number has risen above one in many countries causing a spike in new cases. He also said that when countries open up and remove the majority of restrictions, there is almost always a rebound in new COVID-19 cases.
"Opening up rapidly and removing almost all restrictions almost definitely results in a rebound in infections, the question is what impact that rebound will have," said Ryan. "We have seen the impact the sublineage BA.2 has had in Asia and its increased transmissibility. We are seeing now some increased pressure in Europe because of that virus, having that extra degree of transmissibility and a lot of reinfections."
While the virus may be "milder" due to more people being vaccinated, Ryan said there is still a reasonable chance that increased transmission could result in added pressure on the healthcare system.
"Each and every government has to look at that. They have to make some choices around that and what they advise people to do," he said. "What we hope governments are not doing is passing that back that individual responsibility onto individuals and not supporting people who want to continue taking precautions, particularly people themselves who may be vulnerable."
Nevertheless, Ryan said everyone will need to make their own choice about their risk.
"I will continue to wear my mask on the number eight bus when I am coming to work and I think each and every person has to make their own decision regarding their risk and their chance of exposing others."
WHO’s director-general, Dr. Tedros Adhanom Ghebreyesus, said it appears that the best-case scenario in the future is a situation where there are less severe variants emerging that don't require the use of booster shots or new vaccines. A worst-case scenario, he said, would be a situation where a more virulent and highly transmissible variant emerges that evades vaccines and kills people.
"Addressing this situation would require significantly altering the current vaccines and making sure they get to the people who are most vulnerable to severe disease," he said.
In order for the world to move forward and "end the acute phase" of the pandemic this year, Dr. Tedros said countries will need to invest in key areas such as surveillance, laboratories and public health intelligence, as well as research and development. He also said basic tools such as wearing masks and hand washing must also continue if the world wants out of the pandemic.
"We have all the tools we need to bring this pandemic under control," he said. "We can prevent transmission with masks, hand hygiene and ventilation, and we can save lives by ensuring everyone has access to tests, treatments and vaccines."
Nicholas Pescod
