Professor Piot is the Director of the London School of Hygiene & Tropical Medicine and Handa Professor of Global Health. At the age of 27, he co-discovered the Ebola virus and went on to lead the world’s fight against HIV/AIDS. Professor Piot has been advising numerous institutions on the coronavirus response and is the Special Adviser to the President of the European Commission on research and innovation for COVID-19.
Professor Zeltner is currently Chairman of the WHO Foundation. From 1991 to 2009, he served as Secretary of Health for Switzerland and Director-General of the Swiss National Health Authority. More recently he worked as a Special Envoy for the World Health Organisation.
On October 3, they joined Salman Mahdi, Vice Chairman of Deutsche Bank International Private Bank, for an update on the global pandemic. Both scientists shared their views on the months ahead, the search for a vaccine and answered questions from our clients around the world.
The COVID prognosis: what can we expect this winter?
With the northern hemisphere moving into winter, Professor Piot began with a sobering reality, “We’re only at the beginning of this pandemic.” Although many people anticipated an increase in new infections when the seasons changed, it has happened earlier than expected. In Europe, he explained, this has been driven by young people and it’s predominantly the elderly, who are far more vulnerable, that are becoming infected.
“In theory, if everybody were to respect the rules of the game and the restrictions – wearing a mask, hand washing and avoiding crowds and closed spaces – I think we wouldn’t have this big problem. But the reality is, it’s not happening. And so, we are up, I think, for some trouble.”
Following this warning, Professor Piot then went on to explain why a nationwide lockdown would be disastrous for the economy and also lead to excess deaths for other reasons, such as delayed cancer treatments and misdiagnosed cardiovascular diseases.
“If we act now, we can avoid a totally out-of-hand epidemic in the months to come.”
How concerning is Europe’s Autumn surge?
As an adviser to the President of the European Union, Professor Piot was then able to provide a unique perspective on the rise in infection rates. “Fairly regardless of the overall policy countries have taken, there is a major increase in new infections.”
He then went on to explain that the virus is not following the same pattern as previously, “although we will likely see an increase in hospitalisations and mortality rates, it won’t be to the same extent as we saw earlier this year”.
This is for several reasons, Professor Piot explained. First, the average age of infection has gone down. The younger you are, the less likely you are to be hospitalised. Although he was keen to remind the audience that the risk is not zero. “There are very healthy, 40-year-old football players who have died from COVID.”
Second, health services are now more experienced in treating the virus. “Let’s not forget that we’ve never been confronted with this kind of epidemic and in contrast to what we originally thought – a respiratory virus means the lungs are infected – we are now learning it also affects the heart, the kidneys, the brain.”
Necessary next steps in the fight against COVID
Professor Zeltner began by exploring three elements that must be taken into consideration when planning the next steps in the fight against COVID-19.
The first point he discussed was exhaustion. “When we talk about a crisis, we somehow have in our brains the idea it will last one month, two months or something… But that the crisis actually lasts and will last one year, two years. We are just not used to it and we get tired.”
Workers in the healthcare sector are exhausted, he continued. Ministries of health are close to burnout. No one is used to this kind of continuous stress and uncertainty. So it’s important to spend time thinking about how we deal with our staff and look after these people so they can survive this long, difficult period.
The second point Professor Zeltner raised was the effect of social media. “This is really the first pandemic in the age of social media, and apart from the government, anyone can make any kind of statement.” It has made it harder for the public to decipher the facts, generating distrust and confusion.
This doubt and scepticism led Professor Zeltner on to his third point, “How can the global health community keep the trust of the population?” He expressed concern that there are organised political movements across the globe trying to profit from and undermine these policies.
What can we expect from a COVID vaccine?
Professor Piot began by stating, “Without a vaccine I don’t really see how we can end this kind of long-term emergency.” He then continued with the good news that, “biologically it should be possible.”
There are three important factors that cannot be forgotten when trialling a vaccine, he explained. First, the clinical trials. It’s not enough to just test healthy adults. You need to know for certain that it will work and protect the elderly as well. Scientists already know that the influenza vaccine can be less effective in older people. So testing must be rigorous and thorough. It’s not possible to shortcut anything at this stage.
Second, if doctors are going to inject biological material into billions of people, we need to make absolutely sure it’s safe. “Again, we need large numbers of people that have been tested under observation. And even once it’s on the market, we’ll need very careful monitoring.”
Third, “we need enough of the dose. Manufacturing capacity to produce billions of vaccines is simply not there yet.” Fortunately, there is massive investment to support this. But it’s not just the actual vaccine that needs to be considered, we also need billions of glass vials and the correct distribution systems in place.
Professor Piot then raised the important question of who will benefit from the vaccine first. “There seems to be unanimity that the ones who will get it first are healthcare workers and workers in homes for the elderly,” he said. But afterwards there is “quite a debate” about which individuals, or even countries, are next in line.
How the WHO Foundation aims to help in a post-COVID world
Professor Zeltner then talked in more detail about the vision and mission of the WHO Foundation.
He explained that the foundation is not part of the World Health Organisation (WHO) but an independent grant-making entity set up to complement and strengthen its work. The foundation’s mission is to “support critical global health needs by funding high-impact initiatives and through strategies of innovation, effectiveness and rapid response to acute health needs globally.”
Until now, it has not been possible for the general public to support the work of the WHO. By setting up the tax-exempt foundation, Professor Piot hopes to find new collaborations between health professionals, philanthropists, and corporates, along with the WHO and its partners on the ground. Working as a “global village” to bring better health to the world.
While the idea to create the foundation started long before the COVID-19 pandemic, the impact of the virus reinforces the urgent need for investment in global health. The foundation hopes to reach $1 billion of funding in the next three years.
Professor Zeltner explained that they are in the process of creating a funding circle of forward-thinking supporters. People from around the world who share a common commitment to advance global health. He urged passionate and committed philanthropists, families, and businesses to join them on this crucial mission. “Together we can achieve so much. The lives of future generations are in our hands.”