The WHO declares COVID-19 is no longer a public health emergency of international concern: benefits, challenges, and necessary precautions to come back to normal life

Dear Editor,

The WHO designated the COVID-19 outbreak a global pandemic on 11 March 2020, as the number of cases swiftly increased across the globe¹. The pandemic has affected the global community, including public health, the economy, education, and mental health. The implementation of laws that prohibit gatherings and promote social distancing has also had an impact on our social lives². In addition, the pandemic has resulted in more than 765 million confirmed COVID-19 cases and more than 6.9 million associated deaths as of 3 May 2023³. The situation has changed. The impact of COVID-19 has begun to diminish, and the hospitalization rate and admission to intensive care units have decreased consistently. The WHO was receiving significantly fewer surveillance reports from countries. More people are now vaccinated worldwide which reduces the risk to global public health. In addition, the virulence of the currently circulating coronavirus is substantially more consistent than that of its predecessor. Despite the constant evolution of SARS-CoV-2, clinical case management has also made significant strides in recent years. The currently circulating mutations do not appear to be associated with a disease progression. As of 3 May 2023, 89% of health personnel and 82% of individuals over 60 have received vaccinations³. The WHO announced that after more than a year of analyzing data, International Health Regulations Emergency Committee (IHREC) recommended that they take initiatives to end the public health emergency of international concern (PHEIC) due to the COVID-19 pandemic. On 5 May 2023, the WHO declared that COVID-19 is no longer a PHEIC⁴. This does not imply that the virus is no longer a menace to global public health. The virus is still killing people around the globe, and there is always a chance that new variants will emerge and cause new cases and fatalities. The WHO will now transfer its focus from an emergency response to managing COVID-19 alongside other infectious diseases. The WHO will establish a review committee to create recommendations for countries on managing COVID-19 over the long term. In addition, WHO has published the fourth edition of the global strategic preparedness and response plan for COVID-19, which outlines actions for countries in five core areas: collaborative surveillance, community protection, safe and scalable care, access to countermeasures, and emergency coordination. We can say the pandemic phase of COVID-19 ended on 5 May 2023, after the declaration by WHO. However, the virus will continue to threaten global health, and the international healthcare systems should focus on managing COVID-19 alongside other infectious diseases⁴. To ensure the ongoing management of COVID-19, countries must transition from emergency mode to management mode and adhere to the recommendations enumerated in the global strategic preparedness and response plan.

The WHO’s declaration about COVID-19 is no longer as PHEIC has relieved many people worldwide⁴. It allows most countries to return to life as before COVID-19. However, this declaration may bring some new challenges and risks. It is crucial to remember that the virus is still widespread in many parts of the world. There is a possibility that the SARS-Cov-2 virus could mutate into a new variant that might be more dangerous than it is currently, which could increase the total number of people infected with the virus and the number of people who die from it the disease⁵. The discontinuation of global public health alertness may refuel the risk of the virus spreading. The public interest in receiving the vaccine, which is an essential instrument for preventing the progression of the disease⁶, may decrease as a result of the declaration. There is a possibility of a significant lack of interest in maintaining health safety guidelines for COVID-19. This situation might bring the COVID-19 outbreak again with any new coronavirus variants. Therefore, we should not lessen the safety and monitoring measures for COVID-19 although the pandemic phase of COVID-19 is officially over. The vaccine is a crucial instrument in preventing the passage of the disease. We assume that the authorities may now reduce the effort to mass vaccination programs, monitor infected patients, conduct testing, and track viral mutation after this declaration⁷. It is essential to be aware that infectious diseases cannot be eradicated overnight and that there is still a need for caution and monitoring. Because the declaration of the end of COVID-19 as a pandemic does not mean that the virus has been eradicated from the world, but it means this disease has been transited from the emergency phase to the monitoring phase⁴.

The decision about COVID-19 is no longer a global health emergency is suitable for the time. In agreement with this, we have already mentioned in our previous articles that it should be ended after analyzing the surrounding circumstances^8,9. The WHO has now declared that the pandemic phase of COVID-19 is over, but the coronavirus will continue affecting people worldwide⁴. Healthcare authorities across the countries should closely monitor the epidemiology of COVID-19. Researchers should conduct their research on the various variant of the coronavirus along with developing a vaccine able to fight the new variant. Countries should take awareness programs for the smooth transition of the COVID-19 pandemic phase to return to life before COVID-19. Because many people who have recovered from COVID-19 continue to experience lingering symptoms long after their initial infection^10,11, monitoring post-COVID symptoms have become an increasingly important aspect of the pandemic response. The severity of post-COVID symptoms can range from mild to severe and can impact various bodily systems, such as the respiratory, cardiovascular, and neurological systems. These symptoms can last for a long-time after the initial infection and sometimes lead to long-term health problems^12–14. To monitor post-COVID signs, healthcare providers may use various tools and techniques, including physical exams, blood tests, imaging studies, and questionnaires or surveys. They may also work with specialists from different fields, such as pulmonologists, cardiologists, and neurologists. Patients who have successfully recovered from COVID-19 and are now experiencing post-COVID symptoms can participate in rehabilitation programs offered by various healthcare providers. Patients who are experiencing post-COVID symptoms may find it beneficial to connect with others who are going through experiences that are similar to their own. Also, more research needs to perform on post-COVID symptoms, underlying causes, and management of these symptoms.

Ethical approval

Not required for this study.

Source of funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contribution

R.S., A.S.M.R., and M.J.H. conceptualization, data curation, writing—original draft. M.A.B. and M.R.I. supervision, validation, Writing—review and editing. All authors reviewed and approved the final submission.

Conflicts of interest disclosure

The author(s) of this work have nothing to disclose.

Research registration unique identifying number (UIN)

1. Name of the registry: Not applicable.

2. Unique Identifying number or registration ID: Not applicable.

3. Hyperlink to your specific registration (must be publicly accessible and will be checked): Not applicable.

Guarantor

Md. Rabiul Islam.

Data statement

Data not available/not applicable.