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Health Emergencies Newsletter
Issue No.32: 02.11.2023
TOP STORY
"The WHO European Region is no longer the disaster-resilient region that we believed it was. Yes, we learned a lot of lessons from the COVID-19 pandemic, from successfully controlling mpox and moving towards elimination, from swiftly controlling the polio outbreaks thanks to the political commitment of the governments of Tajikistan, Israel and Ukraine – but we just cannot let our guard go down."
CONFLICT IN ISRAEL AND OCCUPIED PALESTINIAN TERRITORY
Dr Michel Thieren, WHO Special Representative in Israel, spent almost 2 weeks travelling across the country to see how the health system is responding in the aftermath of the attacks led by Hamas on 7 October. This is his account of what he saw and heard.
Note: Some readers may find the content of this article distressing.
ARMENIAN REFUGEE CRISIS
On Monday 25 September, as thousands of refugees were moving towards Armenia from Karabakh region, a powerful explosion at a fuel storage depot killed more than 200 people and seriously injured more than 300. To support the ongoing care of burns survivors, WHO/Europe activated an Emergency Medical Teams Coordination Cell (EMTCC) under the leadership of the Ministry of Health of Armenia. Care teams specializing in burns management from several countries were quick to arrive and have been working alongside Armenian medical staff to care for the exceptionally high number of burns patients, from the early treatment stages through to rehabilitation.
The health needs are immense for the more than 100 000 refugees that have entered Armenia since 20 September 2023.
The United Nations High Commissioner for Refugees (UNHCR) has assessed that close to 42 000 refugees require health assistance. In addition to the overall health needs of the refugee population, more than 200 people died and over 300 were injured following the explosion on 25 September 2023 at a fuel depot, as thousands of people were on the move. Such a high number of severe burns patients would place immense strain on any health system, due to the intensive care and pain management required, along with the risk of secondary infections.
While nearly half of Ukraine’s primary health-care (PHC) facilities have experienced staff absences due to the war, the majority have continued to provide essential health services with the available workforce, according to a recent WHO assessment on continuity of essential health services during the war in Ukraine.
The volume of services changed in 2/3 of facilities due to decreased patients’ attendance in some regions with simultaneous increase in other regions. An increased volume of services was mainly linked to caring for non-registered patients or changes in patients’ needs due to hostilities.
Poland has just launched the WHO Mental Health Gap Action Programme (mhGAP), an evidence-based approach to scaling up capacity and services for mental health conditions, under its National Health Programme, in a major step towards addressing the unmet mental health needs of the population.
Poland, like other countries in the WHO European Region, has significant challenges when it comes to ensuring access to mental health services. 60% of patients who have reported needing mental health support say they do not seek help due to stigma. There are just 9 psychiatrists per 100 000 population in the country and waiting times are long. 3.7% of the Polish national health budget is spent on mental health care, which is low compared to some other European countries. A survey conducted by Statistics Poland and the WHO Country Office in Poland found that at least 1 in 10 Ukrainian refugees reported significant mental health issues, and of those who reported issues, more than half would benefit from treatment.
The ongoing war continues to bring daily destruction and loss of life in Ukraine. The protracted crisis has severely impacted the country’s health-care sector, resulting in the disruption of essential primary health care services for frontline communities. Health-care facilities have been gravely affected, with over 1200 attacks on health care recorded by WHO since 24 February 2022. To ensure continued access to primary health care services in areas where facilities have been destroyed or become irreparable, WHO is installing modular primary care facilities in partnership with the Ministry of Health of Ukraine.
WHO/Europe and the European Centre for Disease Prevention and Control (ECDC) have launched the weekly European Respiratory Virus Surveillance Summary (ERVISS). The new online platform displays integrated surveillance data for influenza, COVID-19 and RSV in the WHO European Region, including the European Union/European Economic Area.
ERVISS will also contribute to the new WHO/Europe COVID-19 Information and Data Hub, a comprehensive resource that provides links to the most current health information, datasets and products related to COVID-19.
A new study in Albania brings fresh evidence that the COVID-19 vaccine booster provides excellent protection against SARS-CoV-2 infection in health-care workers.
The study was conducted by the Albanian Institute of Public Health, the Southeast European Center for Surveillance and Control of Infectious Diseases, the WHO Regional Office for Europe, and the United States Centers for Disease Control and Prevention, with support from the Task Force for Global Health, and published this week in Open Forum Infectious Diseases. It found that health workers who received a COVID-19 booster during the Omicron wave were 88% less likely to become ill with COVID-19 than unvaccinated health workers.
As we transition out of the acute phase of the COVID-19 pandemic, the perplexing shadow pandemic of long COVID continues. Diagnosis of long COVID in children can be particularly difficult, as other childhood illnesses and conditions with similar symptoms must be ruled out. There is a long way to go before the mechanisms of the virus are understood and broad-ranging treatments can be applied.
Over the course of the COVID-19 emergency, WHO/Europe has shared the experiences of a wide range of people, including children like Jay (pictured) whose lives have changed since contracting the virus. Here we review what we know about long COVID in children and adolescents, and why scientists are still struggling to fill the glaring gaps in our understanding of the condition.
EMERGENCY PREPAREDNESS
Speaking at the session on Preparedness 2.0 at the Regional Committee in Astana, WHO Regional Emergency Director for Europe Dr Gerald Rockenschaub called on countries to actively engage in further consultations to collectively develop the priorities for a new 2023–2029 Strategy and Action plan on health emergency preparedness, response and resilience in the WHO European Region. Known as Preparedness 2.0, it will support countries to develop fit-for-purpose national health emergency preparedness and response plans through an all-hazards and One Health approach.
The Preparedness 2.0 strategy builds on a broad range of recommendations, experiences and lessons learned from the COVID-19 pandemic and other emergencies across the Region. In support of the WHO Secretariat, a Preparedness 2.0 Technical Advisory Group (TAG) has been established to provide evidence-based guidance on priority areas for consideration by the WHO European Region Member States.
WHO PUBLICATIONS
COVID-19
European Respiratory Virus Surveillance Summary
COVID-19 Epidemiological Update - 27 October 2023
COVID-19 Vaccination Insights Report - 30 October 2023
MPOX (MONKEYPOX)
Multi-country outbreak of mpox, External situation report #29 -20 October 2023
UKRAINE EMERGENCY
War in Ukraine: situation report from WHO Ukraine country office -18 October 2023
ARMENIA REFUGEE RESPONSE
Armenia refugee response: situation report No.1, 5 October 2023
