Beating Covid-19 with public health measures
- Author(s):
- Parliamentary Assembly
- Origin
- Assembly
debate on 27 January 2022 (7th sitting) (see Doc. 15444, report of the Committee on Social Affairs, Health and
Sustainable Development, rapporteur: Mr Stefan Schennach). Text adopted by the Assembly on
27 January 2022 (7th sitting).See also Recommendation 2222 (2022).
1. More than 332 million confirmed
cases of Covid-19, including more than 5.5 million deaths, had been reported
to the World Health Organization (WHO) by 19 January 2022. These
figures are alarming, in particular since they are bound to be largely
underestimated in many parts of the world. Currently, the European
and Americas regions of WHO are recording the most cases, as the
fast-growing Omicron variant displaces the previously dominant Delta
variant. Nearly 9 million cases and over 21 000 deaths were recorded
in a seven-day period in the European region alone.
2. At the same time, nearly 10 billion vaccine doses have so
far been administered, an amazing feat only two years after the
virus was first discovered. The vaccines approved by WHO have been
proven safe and very effective in reducing disease severity. However,
global vaccine distribution and uptake have been neither equitable
nor sufficient: in the European region, 57 out of 100 persons are
fully vaccinated, but only 7 out of 100 persons in the African region.
Despite the work of the COVAX mechanism, which won the Council of Europe
North-South Prize in 2021, in lower-income countries only 5 out
of 100 persons are fully vaccinated, while upper middle-income and
high-income countries have already fully vaccinated 68 out of 100 persons. Widespread
vaccine misinformation and hesitancy needs to be urgently addressed
in all countries.
3. Additional Covid-19 vaccines are in the making, using different
techniques with a view to addressing “immune evasion”, reaching
sterilising immunity and developing a general vaccine against all
Covid-19 variants. The first specific treatments for Covid-19, surprisingly
effective if taken shortly after infection, are also starting to
be authorised. To fulfil their promise, these treatments necessitate
effective and accessible testing and contact-tracing systems, as
well as the removal of obstacles to global equitable production
and distribution throughout the world.
4. The Assembly welcomes the global initiatives promoting solidarity
in the fight against the pandemic, including the efforts of countries
that have supplied Covid-19 vaccines, and the holding of the 31st
special session of the United Nations General Assembly, in response
to the Covid-19 pandemic, which took place on 3 and 4 December 2020.
It stresses the importance of international co-operation and effective
multilateralism in ensuring that all States, in particular developing
States, have affordable, timely, equitable and universal access
to Covid-19 vaccines in order to minimise negative effects in all
affected States and to beat the pandemic. In this regard, the Assembly
recalls the relevant resolutions adopted by the United Nations General Assembly
and the United Nations Human Rights Council.
5. Unfortunately, a significant percentage of survivors of Covid-19
infections will have persistent symptoms (“long Covid”), some severe.
Research so far indicates that about 10% to 20% of all adults infected
by the virus are affected, putting a considerable strain on healthcare
systems and economies, not to mention on the quality of life of
these new chronic disease sufferers, many of whom are comparatively
young, and were healthy and active before infection. Governments
must make this a public health priority and urgently allocate the necessary
resources for research on the condition and treatment of persons
suffering with post-Covid-19 symptoms, in order to uphold the right
to health.
6. The mental health situation has deteriorated across the globe
due to the chronic stress and uncertainty of living through a pandemic,
adding to the general disease burden. With the virus evolving into
new and more infectious variants, some evading immunity provided
by vaccines and prior infection, successive waves of Covid-19 infection
have led to long waiting lists in most countries for treatment of
other diseases, further deepening the general health crisis. Moreover,
the pandemic has laid bare inequities in our health systems and the
lack of sufficient funding, resulting, inter
alia, in overworked healthcare staff and insufficient
hospital beds. This needs to be addressed urgently.
7. However, the Covid-19 pandemic is far more than a health crisis
as it affects societies and economies at their core with the increase
of poverty and inequalities both within member States and globally,
thus also resulting in a setback for the achievement of the United
Nations Sustainable Development Goals. Once again, working people,
parents, children, women, vulnerable persons and marginalised individuals
are disproportionately affected.
8. It is thus urgent that all countries learn the lessons of
the pandemic so far, starting with the implementation of the necessary
public health and social measures to get the pandemic under control. High infection
rates cannot be tolerated anywhere, since every infection gives
the virus a new chance to mutate, and thus become more infectious,
virulent and/or able to evade immunity – creating a seemingly never-ending
cycle of waves of disease. These cycles push decision makers into
making stark choices between “living with the virus” and the large
burden of disease and death the virus brings on the one hand and,
on the other hand, taking harsh public health and social measures
to protect health systems from collapse, with the disruption to
our economies, our education systems and our societies these measures
bring.
9. As has been pointed out several times during the pandemic,
“no one is safe until everyone is safe”. The Parliamentary Assembly
thus recommends that governments and parliaments, in Council of
Europe member States and worldwide, make the necessary paradigm
shift to beat Covid-19 once and for all, with public health measures
and in a human rights-compliant way:
9.1 at all times:
9.1.1 by following WHO and expert
advice, and adjusting pandemic control measures to the evolving
local situation and in line with evolving scientific knowledge;
9.1.2 when it is necessary to impose public health measures
which interfere with fundamental rights, by ensuring that decisions
are made and communicated in a clear and transparent manner, that
they are as far as possible evidence based, fulfil a legitimate
aim and are proportionate. Parliaments, the judiciary and, when
appropriate, external experts should be able to assess and review
the measures. Moreover, continued assessments are needed to ensure that
measures are not in place for longer than necessary, but also to
consider other measures that may be more appropriate;
9.1.3 by encouraging vaccinations, mask wearing, maintaining
physical distancing, hand hygiene, avoiding crowded and closed spaces
and ensuring proper ventilation in schools, healthcare and social-care
settings and public buildings, with a view to preventing the spread
of Covid-19 without having to shut down large parts of society;
9.2 with regard to bringing down infection rates:
9.2.1 by
putting in place a timely and staggered response to rising infection
rates in accordance with WHO guidance, adapted to the local circumstances
in pandemic hotspots, while implementing appropriate measures to
offset any negative impact and respecting the principle of proportionality,
in particular:
9.2.1.1 developing production capacity, distribution
and considering mandating the use of high-quality masks (progressively
moving to masks of FFP2 standard if possible) in high-risk situations
(such as on public transport, in crowded spaces inside and outside and
in schools); and providing such masks free of charge for vulnerable
groups if possible;
9.2.1.2 making appropriate Covid-19 testing available free of
charge to users, in particular for healthcare and social-care personnel,
children and school personnel, essential workers, contact cases
and persons with symptoms;
9.2.1.3 using vaccination certificates only for their designated
purpose of monitoring vaccine efficacy, potential side effects and
adverse events, as called for by the Assembly in its
Resolution 2361 (2021) “Covid-19
vaccines: ethical, legal and practical considerations”, when appropriate;
9.2.1.4 encouraging working from home where possible and when
necessary;
9.2.1.5 considering putting in place other proven infection control
measures as and when necessary when infection rates spike (such
as placing maximum capacity limits on businesses and events where
the risk of infection is high), while keeping schools, universities
and businesses open as long as possible;
9.2.2 by ensuring that infection chains are broken and that
vulnerable persons are shielded from infection:
9.2.2.1 putting
in place effective, accessible and affordable testing systems, as
well as contact-tracing systems;
9.2.2.2 mandating a sufficiently long isolation period for those
infected and a sufficiently long quarantine for contact cases (based
on recommendations from WHO and public health experts), and ensuring
that the necessary financial, logistical and other support is in
place for those affected to actually comply with the guidance given,
and that their economic and social rights enshrined in the European
Social Charter (ETS No. 35) are guaranteed;
9.2.2.3 shielding highly vulnerable persons from infection, including
by legislating for vaccination mandates for healthcare or social-care
personnel in contact with them, and ensuring that the necessary
financial, logistical and other support is in place for the measures
to be effective, and that their economic and social rights enshrined
in the European Social Charter are guaranteed;
9.3 with regard to ensuring the equitable distribution of
vaccines and treatments worldwide:
9.3.1 by ensuring that
market conditions no longer disadvantage countries with less economic power:
9.3.1.1 showing a stronger commitment to funding a global response,
including via the COVAX mechanism;
9.3.1.2 reaffirming the Assembly’s call in its
Resolution 2361 (2021) and
overcoming obstacles to global equitable production and distribution,
including through supporting the World Trade Organization Agreement
on Trade-Related Aspects of Intellectual Property Rights (TRIPS)
waiver for vaccines and treatments during the pandemic, technology
transfer and increasing local production capacity;
9.3.2 by avoiding discrimination between and within countries:
9.3.2.1 mutually recognising vaccination certificates issued by
Council of Europe member States, as well as vaccination certificates
of all WHO-authorised vaccines;
9.3.2.2 following the advice of WHO and avoiding instituting ineffectual
blanket travel bans when new variants emerge;
9.3.2.3 following the advice of independent national, European
and international bioethics committees and institutions, as well
as of WHO, when devising and implementing strategies for the equitable
distribution of Covid-19 vaccines and treatments within States;
9.4 with regard to sufficient vaccine uptake:
9.4.1 by
ensuring free, effective and easy access to vaccination for all
for whom vaccine use is authorised, with respect for the principle
of equitable access to healthcare, as laid down in Article 3 of
the Convention for the Protection of Human Rights and Dignity of
the Human Being with regard to the Application of Biology and Medicine:
Convention on Human Rights and Biomedicine (ETS No. 164, Oviedo
Convention);
9.4.2 by taking effective measures to counter misinformation,
disinformation and hesitancy regarding Covid-19 vaccines:
9.4.2.1 investing in strong vaccine education campaigns, and distributing transparent
information on the safety and possible side effects of vaccines,
working with and regulating social media platforms to prevent the
spread of misinformation;
9.4.2.2 collaborating with non-governmental organisations and/or
other local initiatives to reach out to marginalised groups, and
engaging with local communities in developing and implementing tailored
strategies to support vaccine uptake;
9.4.3 starting a public debate on possible legislation to impose
vaccination mandates for specific groups or the general population;
such vaccination mandates should, however, not cover persons who
for medical reasons cannot be vaccinated, nor should it cover children
unless and until the complete safety and efficacy of all vaccines
made available to children are ensured, with a focus on the best
interests of the child, in accordance with the United Nations Convention
on the Rights of the Child;
9.4.4 by keeping records of vaccination side effects and providing
support to people with possible complications from vaccination;
9.5 with regard to addressing “long Covid”:
9.5.1 by
making research into the condition a priority and allocating the
necessary funds to research and treatment, with a view to ultimately
introducing unified treatment guidelines;
9.5.2 by setting up screening programmes to gain a better understanding
of how many people are affected by the condition and the kind of
support they would need, and how this support can best be provided;
9.5.3 by focusing efforts on the development and widespread
use of comprehensive rehabilitation programmes for patients with
“long Covid”;
9.5.4 by ensuring that sufferers are not discriminated against;
9.6 with regard to building stronger health systems nationally,
at European level and globally:
9.6.1 by ensuring the necessary
funds are made available to national health systems, in particular
with regard to appropriate pay for healthcare and social-care personnel,
and appropriate, affordable and accessible mental healthcare (in
particular for children and young people);
9.6.2 by applying the recommendations contained in
Resolution 2329 (2020) “Lessons
for the future from an effective and rights-based response to the
Covid-19 pandemic” as regards:
9.6.2.1 public health and
pandemic preparedness, global health security and the “One Health”
approach, also by supporting the drafting and negotiating of a convention, agreement
or other international instrument under the Constitution of the
World Health Organization to strengthen pandemic prevention, preparedness
and response;
9.6.2.2 WHO reform;
9.6.2.3 the development of a regional European system capable
of assisting the relevant international institutions in their endeavours
to ensure effective preparedness for and reaction to pandemics;
9.6.2.4 the establishment of a permanent system of inspection
at the United Nations for current and future biological events with
serious consequences, international oversight and accountability
for pandemic preparedness through an independent external entity;
9.7 with regard to addressing the socio-economic issues that
have arisen due to the pandemic:
9.7.1 by applying the
recommendations contained in
Resolution
2384 (2021) “Overcoming the socio-economic crisis sparked
by the Covid-19 pandemic”,
Resolution
2385 (2021) “Impact of the Covid-19 pandemic on children’s
rights” and
Resolution
2393 (2021) “Socio-economic inequalities in Europe: time
to restore social trust by strengthening social rights”;
9.7.2 by upholding the fundamental social and economic rights
enshrined in the European Social Charter.
10. The Covid-19 pandemic is not over, nor is it likely to be
the last pandemic of its kind. It is paramount to avoid the politicisation
of pandemics – and of public health measures to contain them. To
mitigate the impact of future coronavirus variants and other health
threats which may soon emerge, the world needs to urgently establish
and strengthen pathogen monitoring and surveillance systems. The
divides between countries and within societies need to be bridged,
with politicians leading by example, so that Covid-19 can be beaten
once and for all, and future threats can be faced in a more unified
manner, with more solidarity.
