"And that's just the reported deaths. We know the actual number is much higher."
In their latest meeting, WHO's International Health Regulations Emergency Committee concluded that "while eliminating this virus from human and animal reservoirs is highly unlikely, mitigation of its devastating impact on morbidity and mortality is achievable and should continue to be a prioritized goal."
The committee notes that health systems are struggling to cope with the current levels of COVID-19 on top of other diseases. The pandemic has only exacerbated global health workforce shortages.
"The jaded response would be 'well, obviously', from the forward-facing, acute health care responder's perspective," says Australian National University Emergency Consultant David Caldicott in response to the meeting.
"Emergency departments are full across the country, as a consequence of the downstream effects of the pandemic, both with increased demands, and a decreased capacity for flow, because of hospital bed occupancy."
But the reality that our healthcare workers are still facing is not reflected in the actions of the general population, with reductions in testing and reporting globally, highlighting one of the biggest current challenges: pandemic fatigue, which is hitting leaders and experts too.
"We have a worker shortage, including in our critical industries, and to neglect ways to prevent COVID spreading tears at the fabric of our society whether through excess deaths, no healthcare availability or difficulties in educating the next generation," says physician Karina Powers from Perth, Australia.
Despite these ongoing problems, many countries, including the US, have already – or are planning to soon – end their emergency health settings, which will expose patients to increasing costs for treatments. The US is currently experiencing around 500 known daily deaths from the virus.
"My message is clear: Do not underestimate this virus," Tedros warns. "It has and will continue to surprise us, and it will continue to kill unless we do more to get health tools to people that need them and to comprehensively tackle misinformation."
While not yet endemic, it's clear SARs-COV-2 has become permanently established in human and animal populations for the foreseeable future. This means it's all the more important to continue the momentum for vaccinations, particularly in the most vulnerable people, the committee urges.
However, both the population and governments' response are waning in this critical area, too, even in countries like Australia that had initial strong vaccination rates.
"Some people seeking new bivalent boosters for fourth and fifth doses are denied access," says Murdoch University immunologist Cassandra Berry. "Our protective immune responses need a boost after waning but also broader coverage to combat the diverse array of spike mutations on the viruses and avoid post-viral complications (long COVID)."
As well as continuing with vaccinations, the UN report calls for continued support research into the virus and treatments, continued surveillance, early antiviral use, boosting protection measures during surges, and fighting disinformation.
"It is clear more needs to be done to reduce the excess deaths from COVID," says Powers. "This includes higher levels of booster vaccinations, delivery of safe indoor air in public settings, the use of masks in poorly ventilated indoor areas, the return to free widely accessible testing, and review of mitigations used in high-risk settings such as aged care facilities.
Continuing to class the pandemic as an emergency doesn't mean it's as severe a situation as before. Hybrid immunity from vaccinations and natural infections, as well as antivirals, have reduced its severity.
The goal is to transition to a more sustainable, long-term phase of COVID-19 management. But neglecting measures to reduce infections risks the progress that we have made.
"We remain hopeful that in the coming year, the world will transition to a new phase, in which we reduce hospitalizations and deaths," says Tedros, where "health systems are able to manage COVID-19 in an integrated and sustainable way."
The complete statement from the 14th International Health Regulations Emergency Committee meeting can be found here.