The decision to lift Armenia’s social restriction measures has been made at a time of an increase of cases. – Dr Egor Zaitsev, WHO Representative in Armenia
WHO Representative Egor Zaitsev’s interview to 168.am
-Arsen Torosyan, the Minister of Healthcare, recently mentioned that about a month ago the WHO predicted up to 500,000 cases of coronavirus infection in Armenia, more than 10,000 hospitalizations and thousands of deaths. At the moment, taking into account the number and dynamics of the current events, what are the WHO’s forecasts for Armenia?
-Modeling for the epidemic progression has significant limitations since it cannot take into consideration different varying factors at the country level which greatly influence the course of the outbreak, and which in turn affect the results of the modeling. In fact, WHO has never recommended publishing any models on pandemic progression for any particular country due to these limitations as well as a multitude of factors (e.g. effect of physical distancing measures on the epidemic progression, cluster outbreaks among high-risk population groups etc.). For this reason, WHO’s position on modeling is very clear – it should only be used as a broad reference, for example in order to estimate the needs of the country based on the ‘worst case scenario’, or ‘community transmission’. This could be useful for development partners and donors to determine their level of support, or for the Ministry of Health to get a preliminary glimpse of potential needs and gaps in equipment, personnel or supplies.
Modelers estimate the effective reproductive number in Armenia to be 1.2 and a doubling time of 15 days. The aim is to make the effective reproductive number <1 for at least two weeks (prior to lifting social restriction measures / reopening).
-The total number of people infected with COVID-19 in Armenia exceeds 3,000 and the number of deaths is 40, there is a large number of infected people every day, however, the Armenian government decided to remove the restrictions. Is this a right approach and will it not lead to the collapse of the healthcare system? It should also be noted that it has been repeatedly stated that the hospital bed capacity in the country is not inexhaustible.
-The decision to lift Armenia’s social restriction measures has been made at a time of an increase of cases. There were 22 more new cases compared to the previous week. WHO advises countries to be very cautious when considering the lifting of social restrictions policies, and to ensure that each lifted measure is counterbalanced with risk mitigation measures. In other words, the risks associated with lifting certain measure should be reduced by introducing mitigating activities (e.g. opening the stores, but directing customers to que outside with 2 meter distance and to only allow entering the stores when wearing masks. WHO has developed guidance for governments to take into consideration when deciding whether to lift the restrictions. It is therefore very important for the government to consider the following six important criteria:
1. there should be clear evidence which shows that COVID-19 transmission in the country is controlled, which means that the number of newly identified cases each day should either steadily decline or stabilize at lower numbers;
2. public health and health system capacities should have been put in place to identify, isolate, test, trace contacts and quarantine them;
3. outbreak risks should have been minimized in high-vulnerability settings, particularly in homes for older people, mental health facilities and crowded places;
4. workplace preventive measures should have been established, including physical distancing, handwashing facilities and respiratory etiquette;
5. that importation risks associated with incoming travelers can be effectively managed; and
6. that communities have a voice and are aware, engaged, and participating in the transition.
Keeping in mind the abovementioned, as well as the fact that Armenia is one of the countries in the European Region with the highest growth of cumulative incidence, the government of Armenia should examine these criteria thoroughly and perhaps reconsider the current policy in favor of a phase-based plan whereas lifting restrictions would take place gradually. I would also underline the importance of clear communication with the general public in order to help people better understand the risks and to modify their behaviors.
On the 6 and 7 of May, WHO hosted a virtual mission in Armenia that included a discussion with the Ministry of Health about all aspects of COVID-19 response in the country, including a possible phase- based transition plan. The COVID-19 response in Armenia was also discussed by the Armenian Prime Minister and WHO Director General on the 6 of May.
-These days, many international organizations are providing support in the fight against Covid19. Will you present the WHO-supported programs in Armenia in this regard?
-It is important to emphasize that WHO serves as a global lead for the response to COVID-19 pandemic, being primarily responsible for providing technical guidance to the public health aspects of the response, such as surveillance and epidemiology, strengthening laboratory capacities, risk communication, clinical management, essential health services. From the first days of the pandemic, WHO has been ensuring that all the new protocols for COVID-19 in terms of diagnostics, laboratories, healthcare facilities, clinical management, surveillance, contact tracing, quarantine, etc. are put in place by the national authorities. In addition to this, WHO is providing technical leadership on the global Purchasing Consortia for the centralized global procurement of essential commodities required for the COVID-19 response at the country level. In light of the above, WHO should be seen as the technical lead for the consolidated efforts that UN agencies and various development partners are providing to the Government of Armenia in order to respond to the pandemic.
Zaruhi Dilanyan
