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Current global situation CASES REPORTED TO WHO AS OF 10 DECEMBER 2021 • Cases: > 262 million 750,000 500,000 250,000 • Deaths: > 5.2 million 0 z 20,000 15,000 10,000 5,000 3 CHECK our THE LATEST GLOBAL SITUA WHO Coronavirus Disease (COVID-19) Dashboard Jun Region of the Americas European Region African Region Apr Date of report sep Western Pacific Region Eastern Mediterranean Region South-East Asia Region data smoothed with 7•day moving — Deaths • are Current week. depæted by &OthS depicted by.

All viruses evolve over time • The more the virus circulates, the more the virus will evolve • Most changes have little to no impact on the virus's properties or behaviour • However, some changes to SARS-CoV-2 lead to the emergence of variants that may affect: virus transmissibility disease severity and presentation effectiveness of vaccines, therapeutics, diagnostic tools or public health and social measures • Several SARS-CoV-2 variants have been identified and some have been characterized by WHO as variants of interest (VOI) or variants of concern (VOC) Spikes. used by the virus to attach to human cens SARS.Cov-2 Chaves to the spike protein may result in changes in virus transmissibility the virus may inmunny.

SARS-CoV-2 variants of interest and variants of concern SARS-CoV-2 variant of interest (VOI) • A variant with genetic changes that are predicted or known to affect virus characteristics such as transmissibility, disease severity, immune escape, diagnostic or therapeutic escape; AND • Causes community transmission or multiple COVID-19 cases/clusters in multiple countries with increasing relative prevalence or other epidemiological impacts to suggest an emerging risk to global public health SARS-CoV-2 variant of concern (VOC) • Meets the definition of a VOI and, through a comparative assessment, has been associated with one or more of the following changes at a degree of global public health significance: increase in transmissibility or detrimental change in COVID-19 epidemiology; OR increase in virulence or change in clinical disease presentation; OR decrease in effectiveness of public health and social measures or available diagnostics, vaccines, therapeutics.

Omicron designated a variant of concern (VOC) by WHO Fig: Delta compared to Omicron with mutations in the Sl domain of the spike proteo • On 26 November WHO designated B.1.1.529 a variant of concern (VOC) because of preliminary evidence of a detrimental change in COVID-19 epidemiology. As a VOC, it was named Omicron • Omicron has a large number of mutations including more than 30 genetic mutations of the spike protein • The spike protein of SARS-CoV-2 is targeted by some of the currently approved COVID-19 vaccines; mutations in the spike protein therefore need to be closely monitored • Some mutations have previously been associated with increasing transmissibility and making it easier for the virus to bind and attach to cells Spike of SARS-COV-2 Areas w€th mutations Mere man 70% 40 to 15 b e 5t015% Image: AFP.

Current knowledge about Omicron Transmissibility: It is not yet clear whether Omicron is more transmissible, causes more or less severe disease compared to other variants, or impacts the effectiveness of current COVID-19 vaccines Reinfection: Preliminary evidence suggests there may be an increased risk of reinfection with Omicron, however information is limited* Detection: Diagnostic tests, including PCR and antigen detection tests, continue to detect infection with Omicron Clinical management: Corticosteroids and IL-6 receptor blockers do not target the spike protein and are still effective for managing patients with severe COVID-19 While characteristics of Omicron are being studied, evidence shows that COVID-19 vaccines are still effective to protect against severe disease due to current circulating SARS-CoV-2 variants, including Delta.

Three key properties of a variant are likely to influence the overall threat from it Its transmissibility (relative to circulating variants) Its virulence (ability to cause severe disease) Its ability to evade immune responses (prior infection and vaccines & therape tics).

A global approach to monitor and assess SARS-CoV-2 variants, including Omicron WHO has set up a multidisciplinary mechanism of external experts for decision making Monitoring & surveillance Technical Advisory Group for Virus Evolution (TAG-VE) assesses whether variants • Alter trmsmission or disease characteristics • Impact vaccines, therapeutics and diagnostics, or • effectiveness of PHSM Evidence & assessment The R&D Blueprint for Epidemics convenes researchers to identify knowledge gaps, studies to answer questions TAG for COVID-19 Vaccine Composition (TAG-CO-VAC) assesses • mpæt of VOCs on current vaccines • determines whether changes to fre composition of vaccines are needed Policy Strategic Advisory Group of Experts (SAGE) for vaccines Advises on vaccine use and implementation.

Additional processes to gather information on SARS- CoV-2 variants, including Omicron Multidisciplinary mechanism of extemal experts for information gathering Working Group (WG) for Clinical Management Networks assessing impacts of VOCs on current vaccines The Joint Advisory Group on Therapeutics Prioritization analysing the pssible effects on treatment of hospitalized patients WG on outpatient platform trials reviewing trial &signs and chalEnges WG on vaccines Target Product Profiles reviewing current desirable and minirnum criteria for vaccines.

Preventive measures effectively reduce the risk of COVID-19, including Delta and Omicron Preventive measures continue to be effective and should continue to be implemented to reduce the spread of COVID-19 1m Keep a physical distance of at least 1 metre from others o Wash hands frequently Wear a well-fitting mask Open windows to improve ventilation O x Avoid poorly ventilated or crowded spaces Cough or sneeze into a bent elbow or tissue Get vaccinated, when it is your turn.

Robust response to Delta helps response to Omicron and other SARS-CoV-2 variants Advice for all countries: • Continue to implement effective public health and social measures to reduce COVID-19 circulation • Increase vaccination coverage in at-risk populations in all countries Identify those populations who are not yet vaccinated Target the most vulnerable populations • Enhance surveillance and sequencing efforts to better understand circulating SARS-CoV-2 variants, including Omicron Submit complete genome sequences to a publicly available database, such as Global Initiative on Sharinq Avian Influenza Data (GISAID) Report initial cases or clusters associated with VOC infections to WHO Where capacity exists, perform field investigations and laboratory assessments to improve understanding of the potential impacts of VOCs.

Risk-based approach to international travel in the context of SARS-CoV-2 variants • In response to the emergence of Omicron, many countries have reintroduced travel-related health measures, including travel bans • Travel bans will not prevent international spread, will place a heavy burden on lives and livelihoods, and may disincentivize countries to report and share epidemiological data • An evidence-informed and risk-based approach to international travel should be applied in the context of COVID-19, in line with the IHR (2005) • Travel for essential purposes should continue to be prioritised, including emergency and humanitarian missions, travel of essential personnel, repatriations and cargo transport of essential supplies • https//www_who.int/ne - to- Risk assessment should consider: The local epidemiological situation in departure and destination countries The risk of importing and exporting SARS-COV-2 (including variants) Vaccine-induced and natural immunity Health system capacities Volume of travel and arrangements for follow-up of incoming travellers who test positive Public health and social measures in departure and destination countries Contextual factors, including economic impact, feasibility of applying measures.

Travel risk mitigation measures that may be implemented Travel advice: • National authorities may apply a multi-layered risk mitigation approach to potentially delay and/or reduce exportation or importation of the new variant • Such measures may include exit/entry screening of passengers, including via the use of SARS-CoV-2 testing, or the quarantine of travellers • All measures should be defined though a risk assessment and be commensurate with the risk, time- limited and applied with respect to traveller' dignity, human rights and fundamental freedoms, as per the IHR (2005) • Travellers should remain vigilant for any signs or symptoms of COVID-19, follow recommendations and continue to adhere to protective measures such as the use of masks and physical distancing both during travel and at point of entry • Persons who have not been fully vaccinated or do not have proof of previous SARS-CoV-2 infection and are at increased risk of developing severe disease, including people 60 years of age or older or those with comorbidities should be advised to postpone travel to areas with community transmission.

Protect yourself & others. We are #Inthistogether against COVID-19.