The World Health Organisation announced on Friday that it was ending the emergency it declared for Covid-19 more than three years ago, a milestone in the fitful emergence from a pandemic that has killed millions of people around the world and upended daily life in previously unimaginable ways.

“With great hope, I declare Covid-19 over as a global health emergency,” said the WHO director general, Dr Tedros Adhanom Ghebreyesus.

In practical terms, the decision changes little: Many countries have already ended their states of emergency for Covid, and have moved away from almost all public health restrictions implemented to control the virus. The United States will lift its Covid emergency on May 11. The virus will continue to have pandemic status according to the WHO, much as HIV does.

But the lifting of the WHO designation — officially called a “public health emergency of international concern” — is a significant moment in the evolving human relationship with the novel coronavirus.

Dr K. Srinath Reddy, who led India’s Public Health Foundation through the pandemic, said the decision to lift the emergency was appropriate, because of the high levels globally of immunity to Covid, induced by vaccination or infection, or both.

“It no longer possesses the same level of danger,” he said, adding that Covid “has achieved a level of equilibrium, a certain type of coexistence with the human host.”

Dr Reddy said the end of the emergency status should also be appreciated as a moment of human achievement and a “celebration of science”.

“It’s important to recognise that what made the virus change its character is not only evolutionary biology,” he said, “but also the fact that we have induced it to actually become less virulent, by vaccination, by masks, by a number of public health measures.”

Globally, there have been 765,222,932 confirmed cases of Covid, including 6,921,614 deaths, reported to the WHO as of May 3. But these figures are a vast undercount of the pandemic’s true toll. Independent researchers have estimated the real death tally of the virus to be many times higher.

A year ago the WHO said that 15 million more people had died in the first two years of the pandemic than would have in normal times, a figure that laid bare how vastly countries had undercounted victims. In Egypt, excess deaths were roughly 12 times as great as the official Covid toll; in Pakistan, the figure was eight times as high. Developing nations bore the brunt of the devastation, with nearly eight million more people than expected dying in lower-middle-income nations by the end of 2021.

And Covid continues to spread: The WHO recorded 2.8 million new cases globally, and more than 17,000 deaths, from April 3 to 30, the most recent numbers available. As many countries have reduced their testing for Covid, these numbers also probably represent a significant undercount.

The WHO’s emergency declaration was a crucial piece of guidance when it was made on January 30, 2020, when just 213 people were known to have died of the virus. It signalled to the world that this new virus posed a threat outside of China, where it emerged, and gave countries critical buttressing to impose potentially unpopular or disruptive public health measures.

The virus that jumped into humans in late 2019 proved to be an unpredictable adversary, mutating swiftly and significantly in ways that allowed it to resurge and devastate countries just as they thought the worst was past. A brutal wave of the Delta variant ravaged India just weeks after Prime Minister Narendra Modi bragged about how well the country had done in its Covid response. The Omicron variant, while less virulent, spread with a deceptive ease that made it the fourth-leading cause of death in the US in 2022, and a major killer in many other countries.

The first large-scale vaccinations began on December 8, 2020, less than a year after the first case of the disease was reported to the WHO, an extraordinary triumph of science.

But the collaborative process of vaccine development was followed by a grim period of hoarding and nationalism; a full year later, when people in industrialised countries were receiving second and third doses of the vaccine, just five per cent of people in sub-Saharan Africa had been vaccinated.

Dr Githinji Gitahi, executive director of Amref Health Africa, said it was time to lift the emergency. “The danger of keeping it forever is diluting the tool — you need it to retain its force,” he said.

The declaration helped to mobilise resources for Africa, he said, but did nothing to counter the bleak experience of what he called “vaccine injustice”.

Amref continues to work on supporting vaccination in 35 African countries; continent-wide, coverage now stands at 52 per cent.

The pandemic also has a positive legacy, Dr Gitahi said, because it spurred the highest level of cooperation ever seen among African countries, including the creation of an African Union task force to coordinate the procurement of vaccines.

The WHO decision was not welcomed by all health experts.

Dr Margareth Dalcolmo, a respiratory physician and member of Brazil’s National Academy of Medicine who was one of that country’s most prominent experts guiding the public through Covid, said it was too soon to lift the emergency.

On May 3, the WHO issued an updated Covid management plan, which it said was intended to guide countries on how to manage Covid over the next two years as they transition from emergency response to long-term Covid prevention and control.

Opening a meeting of WHO experts in Geneva on Thursday, Dr Ghebreysus told the committee that for each of the past 10 weeks, the number of weekly reported Covid deaths had been the lowest since March 2020.

As a consequence, life has returned to normal in most countries and health systems are rebuilding, he said.

New York Times News Service