ATHENS — All of the COVID-19 vaccines that have been authorised for use meet the standards requirements for safety, efficacy and quality, WHO Regional Director for Europe, Dr Hans Kluge, said in an interview with the Athens-Macedonian News Agency (ANA) released on Monday.

"Vaccination is one of the key tools to preventing COVID-19 and to ending the pandemic," he underlined.

In the European Region, we are seeing signs that the number of cases is plateauing, but there are still close to 1.6 million new cases of COVID-19 every week, he said and added:

"So the situation is serious, we are not out of the woods, and must live with the virus for some time to come. However, what is important to note is that we have powerful tools at our disposal to combat the virus, and, by now, we know how to use them. Physical distancing works, masks work, hand hygiene works, ventilation works. Surveillance, testing, contact tracing, isolation, supportive quarantine and compassionate care – they all work to stop infections and save lives. Public health and social measures break the chains of transmission, and these must be combined with the longer-term strategy of vaccination. It is only by using all these weapons that we can stop the virus."

The full interview follows:

Can we assume that, since the pandemic can be put under control, we get closer to its end? Taking into account all we know about the virus and the weapons we have developed to fight against it, can there still be overturns and epidemic rages?

This pandemic is not yet over. Globally, cases have been rising over the past six weeks, and in the European Region, we are seeing signs that the number of cases is plateauing, but there are still close to 1.6 million new cases of COVID-19 every week. So the situation is serious, we are not out of the woods, and must live with the virus for some time to come. However, what is important to note is that we have powerful tools at our disposal to combat the virus, and, by now, we know how to use them. Physical distancing works, masks work, hand hygiene works, ventilation works. Surveillance, testing, contact tracing, isolation, supportive quarantine and compassionate care – they all work to stop infections and save lives. Public health and social measures break the chains of transmission, and these must be combined with the longer-term strategy of vaccination. It is only by using all these weapons that we can stop the virus.

May we have today effective measures on the public health that can respond realistically to the problem of the loosening and the complacency, that is obvious in many countries as the result of the tiredness of the people due to the longstanding restrictions?

Decision-makers across the globe are facing challenging decisions when it comes to balancing public health against the significant economic and mental health consequences of prolonged public health and social measures. Controlling this virus relies on population behaviours, and people across the world have been tremendously responsive and shown great responsibility – and they should be commended for this.

In WHO we are very aware of the fatigue – or even frustration – that many people feel, and our recommendation remains that any measure should be implemented with concerns for the context:

Social, economic, mental, behavioural implications may affect whether and how any measure should be implemented. Supporting and supplementing our recommendations on public health and social measures which can control transmission, we have suggested four key strategies for governments to address fatigue: understanding; engaging; allowing space to live; acknowledging and addressing hardship.

Even as countries are lifting some of their restrictions and allowing the operation of various social and economic activities, we should continue to bear in mind that the virus is still around and try to tailor our activities accordingly. It is important, however, that any sort of measures be taken in a dynamic way and be applied in a specific time frame and in as localized a context as possible.

Which European countries are today the source of your concerns on the pandemic? Is the slowness you have noted on the vaccination procedure connected with the distribution of the vaccines or the vaccination programmes of the governments?

We are witnessing a mixed epidemiological situation across the WHO European Region. There are some encouraging signs that cases are plateauing in some countries, but incidence remains high. And tragically, we have now surpassed the grim milestone of over 1 million deaths in the European Region. It is very concerning that hospitalizations remain at high levels, with critical strain documented from several countries including Greece, and France, Poland, Bosnia and Herzegovina, and Ukraine.

With regards to COVID-19 vaccine roll out, the most critical issue is ensuring equity in access for all countries in the Region, and beyond. The demand for vaccines is far from being proportionate to the availability during this early stage. The sheer scale of vaccine rollout is enormous – and so are the challenges. Frustration due to an inconsistent flow of vaccines, is understandable. Vaccine production and roll-out will take time.

Through the COVAX mechanism, WHO is working with all actors to ensure equitable access to all people. We recognize that countries are responsible to their populations and are working in their interest, however, in a supply limited environment, which it will be for 2021, a global approach to distribute vaccines fairly and equitably is the best approach.

To speed up vaccine rollout, we need to dramatically increase the production of vaccines. Now is the time to use every tool to scale up production including licensing and technology and where necessary intellectual property waivers.

Taking into account the current epidemic data, can Greece hope for a good touristic season?

We still have a long way to go before we are able to put this pandemic behind us. As the weather is improving, allowing people to interact more in outdoor spaces, as opposed to indoors and as the vaccination roll-out is progressing, we can hope for an improving situation in the Region. The gradual lifting of measures must always be based on epidemiological and behavioural criteria, and we all acknowledge it is important to allow for the resumption of critical areas of the economic sector, which will ensure that the negative economic effects of the pandemic to be somewhat mitigated. We cannot forget that the pandemic is far from over – and we should continue to be cautious and maintain public health and social measures. It is when we allow ourselves to let our guards down that the virus could find the opportunity to resurge.

Nowadays all countries fight for the least losses in human lives so that their health systems endure and their economies survive. Could in this text rivalries be avoided and solidarity be displayed to the countries lacking access to the tools to face the pandemic? Are you satisfied with the contribution of EU on COVAX?

It is a fact that this pandemic has really put people and countries to a profound test when it comes to solidarity and compassion. However, in many instances throughout the past months, we have seen the best of people prevail and important displays of solidarity manifesting around the world.

The pace of delivery of COVID19 vaccine doses in the European Region is increasing, and so far over 171 million doses have already been administered.

COVAX deliveries have been received in many countries, and are accelerating, with additional countries due to receive shipments in the coming period. However, equitable distribution that reaches all people, in all countries across the globe is a serious challenge, one which will take time and collective effort to realize.

The EU is one of the biggest COVAX supporters/funders, and as part of the EU, Greece has demonstrated solidarity in supporting COVAX.

Is there an explanation why the side effects of all the available vaccines avert people from being vaccinated despite the fact that there is documented proof that they (the side effects) can affect them less than the possible consequences of getting contaminated with COVID19?

It is important to highlight that all of the COVID-19 vaccines that have been authorized for use meet the standards requirements for safety, efficacy and quality. Vaccination is one of the key tools to preventing COVID-19 and to ending the pandemic. Serious side effects may occur from any vaccine but they are extremely rare. It is important to remember that we are witnessing the largest mass vaccination campaign in history, and some rare reactions are to be expected.

Vaccine hesitancy can be expected in circumstances in which much is still unknown about which vaccine or vaccines will be available to each person. In the absence of this information, speculation and misinformation has had ample opportunity to spread.

WHO has been carefully monitoring the rollout of all COVID-19 vaccines. We will continue to work closely with countries to manage potential risks, and to use science and data to drive our response and recommendations.

How well do we know COVID-19? Can we estimate possible long- term consequences on the population that suffered the disease? Will these people need continuous specialized support?

As part of learning the behaviour of the virus better, scientists have also been investigating cases where people infected with COVID-19 display persistent symptoms, lasting more than 12 weeks. We call these “post-COVID conditions”. Current estimates approximate that about one in four people who test positive for COVID-19 continue to experience symptoms 4-5 weeks following their diagnosis, while about one in ten people experience symptoms past 12 weeks. These symptoms can often be debilitating, with significant effects on people’s ability to work, grapple with their future, and actively participate in social life. There can also be a significant impact on the mental health of those affected. Continued research is required in order for us to understand the virus, and most importantly devise better strategies and support mechanisms for individuals suffering from these symptoms.

Do you share the view that the pandemic strengthened the popular confidence to WHO? How can such an organization in such a framework face political pressures and not get involved in political and state antagonism?

As the UN specialized agency, responsible for international public health, WHO has gained special prominence during this crisis. Our role is to guide, advise and support countries based on the best evidence available, so that they can adapt and apply these recommendations to their unique contexts. It is a specialized agency, not a political entity and, as such, its decisions are led by the insights provided by experts, in the interest of public health globally. In the European Region, our work is guided by the European Programme of Work (EPW), that was approved by our 53 Member States last year. The EPW has set health priorities for the next 5 years – working on effective protection against health emergencies, moving towards universal health coverage, and promoting health and well-being – delivering what citizens legitimately expect from their health authorities.

As we proceed to exit the pandemic, will we be more ready to face next challenges? Has keeping the hygiene protocol already been a culture in our societies, or perhaps we will forget them after the end and till the next pandemic?

This pandemic has given us a lot to think about in terms of how we approach public health and has taught us a lot of valuable lessons that, hopefully, the world holds on to past the end of the current crisis. We all understand the importance of hand hygiene, proper ventilation of spaces, building trust in healthcare authorities and vaccinations, and so on.

It is also clear that we need to harness the political momentum to strengthen preparedness for future health emergencies, and ensure that the world is ready to respond to the next pandemic. In the European Region, I have convened the Pan-European Commission on Health and Sustainable Development, an independent and interdisciplinary group of leaders brought together to rethink policy priorities in the light of pandemics. The Commission’s work will culminate in a report to be published in September 2021 with recommendations on investments and reforms to improve health and social care systems.

Can we assess the long-term consequences of the pandemic on the mental health of the people? Has our life changed in a permanent manner?

Everyone’s mental health has been affected in some way by this pandemic, whether as a result of the worry about becoming infected, or the stress brought about by measures such as lock-down, self-isolation and quarantine, or challenges linked with lost employment, income, education or social participation. In some ways, you could call this a parallel pandemic.

What we need to do now is manage the challenge of addressing people’s increased psychosocial needs when service availability or continuity has been disrupted.

WHO has set up a Technical Advisory Group on the mental health impacts of COVID-19, whose purpose it is to support and inform Member States on how to best respond to the mental health effects of the COVID-19 pandemic on their people. Moreover, the Mental Health Coalition, one of the flagship initiatives of WHO’s European Programme of Work 2020-2025, will further facilitate the flow of information between Member States with regards to addressing mental health needs, and will provide a collaborative framework in which they can work together to achieve common solutions.

We now have an opportunity to ‘build back better’ through the scaled-up delivery of accessible and innovative approaches to the prevention and care of mental health conditions as well as the promotion of mental health as a human right.

What does your award by Aristotle University of Thessaloniki mean to you?

It is an incredible honour to have been awarded the Gold Medal of Aristotle. I see this as a recognition of WHO’s work on mental health in the Region in the past year – in challenging times, urging us to do more.

It is clear that your Government places great importance on addressing mental health needs, and even in the middle of a pandemic, we have seen bold initiatives, such as the establishment of a mental health support line and a considerable increase in the mental health budget.

The award symbolizes the strengthening of ties between the WHO Regional Office for Europe and Greek authorities and academia, and building future collaborations within the framework of the Mental Health Coalition. I guarantee you that both WHO/Europe, and I personally, will continue to place mental health at the top of our agenda.

What was the moment that marked you personally while performing your duties during this pandemic?

I have had the privilege to meet many of those working on the frontlines to care for and keep people safe during this pandemic. In the last few weeks, for example, I have been honoured to speak to vaccinators at the Helexpo centre in Athens, community outreach workers on the streets of Romania, and health professionals keeping tuberculosis treatment going in Kyrgyzstan. The dedication, compassion, professionalism and sacrifice of all those working to keep services going and protect the health of all of us is truly inspiring, and is what I carry with me as a motivation in my daily work.

Back in February, I shared a few words with Sister Andre, who had just recovered from COVID-19, and at 117, is the oldest person in Europe. Her wisdom and advice from a lifetime of helping people has stayed with me in these difficult times – “Be patient, be kind and encourage others”.