Coronavirus Outbreak COVID 19 WHO Update 3 April 2020

hello to everyone from Geneva from WTO headquarters welcome to this regular covered 19 press briefing welcome to everyone who is watching us on number of WTO platforms there's more than 400 journalists watching us on zoom as well with the number of questions waiting for our guests today and today we have special guest that's Chris Kristalina Georgieva the managing director of the International Monetary Fund she will join this briefing to update about the economic impact of the covered 19 pandemic and the response of the International Monetary Fund for journalists who are online and which to ask questions please click raise and we will start with dr. Ted Rose who is joined by dr. Maggie Ivanka Cove and dr. Mike Ryan doctor tell us please Thank You Tarek and good morning good afternoon and good evening our static said we are delighted to be joined today by Kristalina Georgieva the managing director of the International Monetary Fund welcome my sister Kristalina will say more in few minutes about the economic impact of the pandemic and what the IMF is doing to support countries and the global economy more than 1 million confirmed cases of copied 19 have now been reported to whu-oh including more than 50,000 deaths but we know that this is much more than health crisis we are all aware of the profound social and economic consequences of the pandemic the restrictions many countries have put in place to protect health are taking heavy toll on the income of individuals and families and the economies of communities and nations we're in shared struggle to protect both lives and livelihoods in the short term countries can is the burden on their populations through social welfare programs to ensure people have food and other life essentials for some countries debt relief is essential to enable them to take care of their people and avoid economy collapse this is an area of cooperation between WH the IMF and the World Bank but ultimately the best way for countries to end restrictions and is their economic effects is to attack the virus with the aggressive and comprehensive package of measures that we have spoken about many times before fine tests isolate and treat every case and trace every contact if countries rush to lift restrictions too quickly the virus could research and the economic impact could be even more severe and prolonged financing the health response is therefore an essential investment not just in saving lives but in the longer term social and economic recovery there are three main areas for countries to focus on first we call on all countries to ensure core public health measures are fully funded including case-finding testing contact tracing collecting data and communication and information campaigns second we also call on countries and partners to strengthen the foundations of health systems that means health workers must be paid their salaries and health facilities need reliable supply of funding to purchase essential medical supplies sir we call on all countries to remove financial barriers to care if people delay or forgo care because they can't afford it they not only harm themselves they make the pandemic harder to and put society at risk several countries are suspending user fees and providing free testing and care for copy 19 regardless of person's insurance citizenship or residence status we encourage these measures this is an unprecedented crisis which demands an unprecedented response suspending user fees should be supported with measures to compensate providers for the loss of revenues government should also consider using cash transfers to the most vulnerable households to overcome barriers to access this may be particularly important for refugees internally displaced persons migrants and the homeless the pandemic is also having an effect on the fight against other disease like polio as you know in recent years we have driven polio to the brink of eradication this has been massive global effort started by rotary supported by many other partners and led by thousands of health workers vaccinating children in some very difficult and dangerous areas many of the health workers are now supporting the Kabat 19 response they're tracing contacts finding cases and providing public health information to communities to reduce the risk of increasing transmission of Kogut 19 the polio oversight board has made the hard decision to suspend house-to-house vaccination campaigns knowing that this may lead to an increase in polio cases to reduce this risk we will support countries to maintain essential immunization for all vaccine preventable diseases whu-oh has published guidance for countries on how to maintain essential health services even while responding to this crisis the Global Polio Eradication Initiative is working to ensure that once it's safe to do so countries can be supported to rapidly restart polio vaccination campaigns while all our energy may be focused on kovat 19 now our commitment to eradicating polio is unshakeable sadly there are reports from some countries of an increase in domestic violence since the cogut 19 outbreak began as people are asked to stay at home the risk of intimate partner violence is likely to increase women in abusive relationships are more likely to be exposed to violence as are their children as family members spend more time in close contact and families cope with additional stress and potential economic or job losses women may have less contact with family and friends who may provide support and protection from violence we call on countries to include services for addressing domestic violence as an essential service that must continue during the kovat 19 response if you are experiencing or at risk of domestic violence speak to supportive family and friends seek support from hotline or seek out local services for survivors make plan to protect yourself and your children any way you can this could include having neighbor friend relative or shelter identified to go to should you need to leave the house immediately there is never any excuse for violence we abhor all violence of all forms at all times finally the global response to commit 19 would not be possible without the generosity of countries and partners two months ago issued its strategic preparedness and response plan with an initial ask of 675 million dollars to support the response I'm delighted to say that almost six hundred ninety million dollars has now been pledged or received of this amount three hundred million has been given to support tablatures work and the rest has been given on bilateral basis or to other organizations involved in the response would like to thank the state of quad which today is becoming one of the largest donors with total of six hundred mil sixty million u.s. dollars separately WH of solidarity response fund has now raised more than 127 million dollars from more than two hundred nineteen thousand individuals and organizations would like to time Tencent for its contribution of ten million u.s. dollars I'm also pleased to announce that have invited UNICEF to join the Solidarity response Fund UNICEF has extensive experience both in fundraising and implementing programs and our partnership will help us to work together closely to save lives and thank you so much my sister Henrietta for accepting my invitation we still have long way to go in this fight is working every single day with all countries and partners to save lives and to mitigate the social and economic impact of the pandemic the IMF is key partner and would now like to hand the floor to my sister Kristalina to make few remarks and thank you so much for joining us Kristalina thank you thank you very much dr. Tadros for the invitation but most importantly for the work you and your staff do and want to express from the bottom of my heart gratitude to all health workers that are on the front line to save lives sometimes risking their own ID outset would like to make three points first this is crisis like no other never in the history of the IMF we have witnessed the world economy coming to stand still we are now in recession it is way worse than the global financial crisis and it is crisis that requires all of us to come together wuh-oh is there to protect the health of people the IMF is there to protect the health of the world economy they both are under said and only United we can do our duties want to stress the message that you and have sent to the world that saving lives and protective livelihoods ought to go hand in hand we cannot do one without the other and in that spirit we at the IMF are concentrated on making sure that there is strong response to the health crisis as well as protecting the straight strength of the economy my second point is about emerging markets and developing economies they are hard-hit and they have very often less resources to protect themselves against this dual crisis help an economic crisis we know that in many countries health systems are weak we know that in fight in in flight to safety lot of capital has left emerging economies the developing world nearly ninety billion dollars have flown out this is way more than during the global financial crisis and some countries are highly dependent on commodity experts with prices collapsing they're hit yet again it is paramount for us to place these countries and especially the weakest among them in the center of our attention the same way the virus hits vulnerable people with medical preconditions hardest the economic crisis hits vulnerable economies the hardest and that takes me to my third point we at the IMF are mobilizing strongly working together with the World Bank and other international financial institutions bringing the world together to provide protection against this crisis we have one trillion dollars war chest and we are determined to use as much as necessary in that protecting the economy from the scarring of this crisis we are mobilizing emergency financing assistance to countries and can tell you we have never seen ever such growing demand for emergency financing already over ninety third countries have been placing request to the IMF for it and this emergency financing is to underpin the appeal that you and are putting out and it is please prioritize health expenditures use money to pay doctors and nurses make sure hospitals function that they are makeshift clinics where necessary and protect your economy the most vulnerable people firms so they can hold on their workers because the highest risk we see is wave of bankruptcies and layoffs that would make the recovery from this crisis are harder third we in this line of financial support we have the big one one trillion we have the emergency financing we are also taking strong action for the poorest of our members by mobilizing grandfa funds to serve their duties to the IMF so they don't have to use scarce resources today for that purpose and together with the president of the World Bank we put out an appeal to official bilateral creditors for the time the economy's standing still to have debt service obligations also in stand still moratorium on that service for either countries let me finish by saying that this is in my lifetime humanity's darkest hour big threat to the whole world and it requires from us to stand tall be united and protect the most vulnerable of our fellow citizens on this planet thank you Thank You Ted Rose for having me thank you very much miss yogya for this very remarkable speech thank you dr. Ted rest we will now open the floor to questions would ask journalists to ask only one question and if it's possible to spy if to whom this question goes so we will start first with the CNBC and dawn from CNBC don't can you hear us hi yes can you hear me yes please go ahead okay thank you for taking my question am calling from quarantine in New York City my question is that the fatality rates in Italy and and the United States especially Italy are significantly higher than in Asia and it appears that that may be the case in the next few weeks leaks in the US I've seen research reports on ACE inhibitors and ibuprofen affecting this disease is there anything in the diet the lifestyle the typical drug protocols that Americans or Europeans views that make this virus more severe yeah can begin on Maria can follow up certainly the the experience in in Italy and large number of patients were were were questioned on their use for example of ACE inhibitors and there was absolutely no association on the use of those ACE inhibitors on having disease or not for having severe disease more importantly so obviously we need to gather more evidence but the evidence thus far would indicate that the that these antihypertensive drugs that are used many people are on do not appear to have any impact on the severity of disease with regard to the reasons why we have different mortality in different countries lot of it's mediated by two factors one the age profile in those communities populations that have older populations or higher percentage of people in the older population it may not be that the overall case fatality is different it's just that case fatality is higher in that older age group equally the presence of underlying conditions in those individuals and the incidence of underlying conditions and those individuals can also lead to worse outcome so you have lot of issues that have to be factored in when you try to because why one country's mortality rate is higher or lower than another's the and obviously as well and you this has to be taken into account that systems that come under huge pressure systems that are overloaded with fatigued doctors and nurses with many many sick patients at one time clearly the outcomes for those patients can be worse that's what we've been saying and many countries are trying to do we need to take the pressure off the healthcare system we need to reduce the tsunami of patients coming through the door to give doctors nurses and other carers the opportunity to save more lives we can only do that if we pressure the virus and put it under pressure reduce the incidence and get back to situation where we can deal with this this virus within the healthcare system in an effective way yeah thanks Mike the the other reason why it's challenging to compare mortality rates is because indeed it is rate which you are calculating on any given day which means you are looking at the numbers of people who have died divided by the number of people who have been reported in that country and so there are significant differences at in terms of the activities that areas are doing to identify cases based on the epidemiology based on the transmission scenario that they're in and in many situations where systems are overwhelmed they're focusing on severe cases and those are the cases that are being detected and you're missing mild cases or unrecognized cases that may be in the community and so that could lead to higher number of mortality rate at the same time you have individuals who are still in hospital that are developing either progressing to more severe disease and some people who are who are experiencing severe disease will have advanced treatments they could be on ventilation they could be on ECMO and it will take some time for them to either recover or to die and so it is very difficult and misleading to be comparing mortality rates what we really need to be focusing on right now are what is the age profile of people who are in ICU we've talked about this before we're seeing more and more individuals who are of the younger age group in their 30s in their 40s in their 50s who are in ICU and who are dying overwhelmingly we do see trend across countries that people who are older people who have underlying conditions will have more advanced disease so if the population that is affected have those characteristics then you'll have higher risk of death but we have some time to go before we can really understand what mortality looks like across different countries so would urge you to - to take those mortality rates with caution when comparing across countries thank you very much dr. Anand dr. Bergman care cover we will now go to Simon atiba from today News Africa Simon can you hear us yes can hear you can you hear me yes please good please go ahead thank you for taking my question my name is Simon atiba from today news Africa and Washington DC and my question goes to the managing director of the IMF miss Kristalina Georgieva from Lagos in Algeria to join us Berg in South Africa and even to Kinshasa in the Democratic Republic of Congo Africans who have been forced to stay home are complaining about hunger many of them said hunger May 1st may kill them faster than even the coronavirus the w-h-o director-general recently said the IMF and the World Bank granted relief to developing countries including African countries to provide food to their cities and curb the spread of the coronavirus can you guarantee here today d'you pay special attention to African nation to contain this pandemic by granting them relief to African nation before it's too late thank you but want to thank very much for this question it is the continent we at the IMF worry lot about there has been momentum built in Africa Africa has been growing and many countries have done really well in recent years and we are risking to lose this momentum and even worse to reverse it and therefore it is hugely important to provide substantial financial support to Africa and we do it in two ways one we are scaling up emergency financing and can tell you that yesterday our board approved emergency financing for random and today two more African countries are going to be in discussion for approval our objective is to double what normally is being provided as emergency financing and we do that in very highly concessional terms with big component of this financing being de facto grant component we do so because we recognize that many governments are faced with this dilemma do they provide support to people to simply survive do they fight the virus and we want this to be false dilemma we want them to have for the next month substantial financial resources so they can step up their support for people against the pandemic and their support for the for the economy in many cases in formal economy that requires social safety nets to be to be strengthened to help people - we do see the issue of debt as one that has to be addressed urgently for us at the IMF what it means is that for our poorest members we are raising grant financing to cover their dues to the IMF it is called cut of containment relief trust and we have been getting support from the UK Japan and others so we can do what you're saying provide that relief visibly our own obligations beyond that we are also calling on official creditors two countries either countries many of the hosel are countries in Africa to provide much-needed space for countries to address their immediate priorities by standstill on that service artificial creditors for period of one year and can tell you that have been in touch with many of the leaders in Africa know how important it is right now to stand up and support Africa built bridge over what is such dramatic drop in their economic performance thank you very much giver and thanks Simon for this question we will go now to Randy from al-jazeera Randy can you hear us yeah can hear you now please don't you often goes to miss Kristalina Georgieva of the IMF I'd like to ask you something more specific on the economic impact in Southeast Asia because I'm wondering mean based on the IMF's assessment what has been the economic impact of the endemic on Indonesia's of these engines largest economy I'd like and what does prevent meningococcal the capital city need to do more in order to overcome the issue thank you thank you thank you very much for this question Indonesia over the last years has done lot to build very strong macroeconomic fundamentals and buffers exactly in case of crisis and what is happening today is Indonesia is taking set of measures that are significant they're large and they're well targeted to support the economy to go through this very difficult time like many other emerging market economies Indonesia is experiencing significant outflow of capital and that makes it so much more difficult for the country because there is drop in production and that is to say drop in revenues and at the same time the needs of supporting the population in this crisis are growing what we see Indonesia doing very well is to have coordinated response between the Ministry of Finance and the central bank so measures that are taken are impactful they're strong and impactful we are also fully aware that edition of dollar liquidity is one that that many countries including Indonesia needs to to wrestle with and this is where we are very strongly supporting central banks of advanced economies and especially the Federal Reserve in the United States to do more of what they have started doing and it is to offer swap lines to banks in emerging market economies on outside at the IMF we have been very much encouraged by Indonesia among many other countries to look into whether we can offer more in terms of instruments that are fitting for emerging market and market economies and address the issue of liquidity and our our body is going to review proposal in the next days on creating short-term liquidity line that is exactly to countries with strong fundamental strong macroeconomic fundamentals that may be experiencing short-term liquidity constraints actually if may if may add what what is very impressive is to see how much attention Indonesia is paying exactly on this issue of protecting firms especially SMEs in this period that that would allow them when the recovery comes for for the country to step up it's very well thought through targeted fiscal measure thank you very much miss Gill here and now we will go to Italy to do leage an area who tried couple of occasions to request so we will try this yes and you hear me yes go ahead okay so can ask you what's the what sir whas stance on antibodies testing have you already approved some of them and is that good practice that we widely use test for antibodies before the lockdown is actually over and of course the immunity passport also is that good good idea that comes from germinating is it is that feasible for countries such as Italy thank you so thank you for the testing there's there's very large number of molecular tests and serologic tests that are now available for use some of which have gone through approvals in their in their countries regulatory approvals we are working with number of countries right now that are looking at the use of serologic assays in the form of research where they are looking to estimate the SERO prevalence or the antibody levels in populations in their countries there's number of countries across Europe and across Asia that are currently doing this and they're looking at different types of tests they're looking at screening assays which are eliza's but they're also looking at micro neutral microphone neutralization assays which are more confirmatory testing we there there is large amount of work right now and we're working with find and we're working with other groups that are trying to evaluate these against well-characterized panel of ceará from infected individuals and non infected individuals or controls and though that work is still underway what we would like to be able to do in the form of research is to be able to compare some of those serologic assays with individuals who are known to have been infected so identified through molecular testing but all of this work is underway but there are number of tests that are available and this is very positive in terms of being four months into early four months into pandemic where they were rapidly developed because full genome sequences were shared very quickly by the by China just add the tests that are currently being used the our PCR type tests that the tests detect the virus and usually in the nose nasal cavities of individuals so if someone is symptomatic and they get tested you test for the virus the serologic tests don't test for the virus they test for the immune response to the virus and they say you've had recent infection or maybe not so recent infection and there are different parts of that test for IgM which tells you if you've had very recent infection or some infectious and IgG which says you've had an infection at some time in the past so we have to be careful in using these tests that they may diagnose you as having had the infection but they're not necessarily used in the active diagnosis of an active case you can be sick and infected with the virus and you may not have yet developed serial ajik response to the virus so how these tests are used has to be very carefully calibrated we welcome all the innovation and we need comprehensive set of testing tools but they need to be rolled out with the careful objectives of what they're actually supposed to achieve we do welcome the innovation we welcome the private-sector innovation and we welcome government's introducing these testing into their national policies in the appropriate way thank you very much we'll go now to onions our colleague based here in Geneva from AFP onions can you hear us yes hello Tarek can hear you and want you to have question to something that Maria kerkoff's said before she said if understood well that more and more it appeals that more and more young adults are in intensive care if she can give us some figures about that and if she has any explanation thank you so thank you for that question yes indeed we are seeing more and more younger individuals who are experiencing severe disease should say overall most of the people who are experiencing severe disease and ice in ending up in ICU and needing advanced care are people of older age and are people who have underlying conditions but what we are seeing in some countries is that there are individuals who are in their 30s who are in their 40s who are in their 50s who are in ICU and who and who have died we've seen some data from Italy we've seen some data from China we've seen some data from number of countries across Europe where people of younger age have died some of those individuals have had underlying conditions but some have not and so what we need to better understand is why there are young people who are dying from this infection there there are still many unknowns at the present time so can't give you complete answer on that but what is important is that people who are infected with this even if they have mild disease what is classified as mild disease or moderate disease moderate disease still includes pneumonia and if you hear anyone who has been infected who explains the kind of disease that they've had this isn't this it's still pretty significant even if you don't require hospitalization but what we need to better understand and these will come through these natural history studies which are being conducted of why are some people progressing from moderate disease to severe these two critical disease why are some people progressing backwards from very very severe disease to more moderate disease and recover so these are really fundamental questions that we need to better understand so that we can improve our standard of care for anyone who is infected with this there's also large number of clinical trials that are underway that you're aware of that are looking specifically at therapeutics for kovat 19:00 and those are currently being conducted and we're hoping for results of those in the coming months so again we can have more specific options for people for treatment for Cova 19 but sorry if understood well you you are saying that at the beginning of the epidemic there was more older people and that now there are more young people infected and in intensive care you need to change so it's not change but with more countries affected and more virus circulating we're going to see maybe some slight differences in epidemiology in different countries it's too early to conclude one way or another if this will be the same in all countries as we mentioned before it depends on the populations that are affected that are infected but what is important is that everyone needs to do what they can to prevent themselves from getting infected and by preventing themselves from getting infected and taking those measures will prevent the onward transmission to someone else who could perhaps be more vulnerable Mike and if may add there was tendency at the beginning in the last number of months for almost dismissive attitude to say well this is you know this disease is severe and older people and and and and it's fine and younger people and maybe that was way of people assuring themselves that younger people were not going to be so badly affected but we've been saying again and again in this forum and with our data in in in in Korea even in Korea who have managed to control the disease one in six deaths of million people 160 in Italy over the last five six weeks at least 10 to 15 percent of people in intensive care have been under 50 it's not that anything has changed it's that we collectively have have been living in world where we've tried to convince ourselves that this disease is mild in the young people and it's more severe in older people and that's where the problem is and think the evidence has been there all along that there is spectrum of severity and it is definitely more severe in older age groups but there is spectrum of severity in younger people as well and and and sometimes in younger people with underlying conditions and sometimes not so don't think there's been significant change as the numbers grow as the clinical data is collected we begin to see that this disease has an impact on the young as well as the old but again younger people tend to have milder course of disease but that is also younger people and that is not to scare young people to sale or you need to be careful because you may become very sick in the main younger people still have milder course of disease but we've also been saying is milder people who get sick can transmit the disease to people who are even more vulnerable so there are two reasons here for younger people to avoid infection one it is not always mild disease in your age group and two if you get sick and you start to transmit that virus you may infect someone who's in an older age group who was who is vulnerable and therefore you need to try and do whatever you can to protect yourself and protect others thank you maybe would like to add in order to remind young people said several weeks ago that two young people in my message in our presser in one of our pressors that you are not invincible and because we had cases actually how the virus was affecting young people to still older people are more vulnerable and people with underlying conditions are more vulnerable but we have even now more evidence that it affects younger people too and that's what we are saying today but if you compare that to still the senior citizens are the most affected but we have now more and more cases also from the younger population thank you very much Sean we will go now to lot in finance Network and Joe Joe can you hear us one second we connected yes please go ahead yes thank you there's these circumstances are for World Bank or the IMF I'm sorry so this is the question is I'm sorry there's been this in this situation there's probably been lot of work on trying to do institutional innovation the role of the IMF has been very active investing funds you have porter company but there's also been talk about expanded quantitative easing from central banks in Europe global level and was wondering the role that if the IMF is considering role new kind of role there in sort of screen as guarantor or intermediary in the final global level of quantitative easing or central banks or open west by bonds from markets was yep but thank you this is very interesting question let me first say that we have seen unprecedented stepping up of action of central banks and also of ministries of Finance in advanced economies that has been done in very short period of time with tremendous significance because we had seen as result of this determined action some stabilization in markets and most importantly financing going to protect people protect firms protect jobs that could have not been done by central banks alone on their own only it does require the monetary side and the fiscal side to come together so just want to recognize that what has been done is unprecedented the problem with we face is gigantic but also the actions that are taken are very significant very big when it comes down to the role of the IMF our main preoccupation in this crisis is one to very rapidly step up financing for countries especially emerging market developing countries that are faced with very significant and growing needs and to to think of what may be needed but it's not there in the defence system of the world and in that context what we have done is on one side to encourage central banks in advanced economies to do more for the emerging for liquidity in the emerging markets and actually must say think that they have recognized that need on their own and we have seen both stepping up of swap operations with emerging markets by the Fed we have said we'll have seen operations that are directed towards this stabilization of emerging markets and then too we looked at our own instruments and what we have identified is that we are short of one particular instrument and it is to provide short-term liquid two countries that are basically strong but may find themselves in tight place we have not been pursuing anything beyond the mandate of the fund that traditionally we have been exercising we have been asked by some of our members on something that de facto goes into if you wish quantitative easing for the world and it is whether or not what was done in 2009 by the allocation of additional SDRs this is tool to boost liquidity mostly useful for emerging markets and developing countries the Special Drawing right this is what what the fund offers as addition in the in offer that as an addition during that crisis many of our members are saying we should look into this again at this point however our membership our shareholders are saying use everything you can use right now fast and that is the focus of our attention to to step up double emergency financing from fifty to hundred billion that order of magnitude and then make sure that we are ready to to deploy the one trillion we have slanting capacity as this crisis continues to evolve but as you said we do need to think beyond what we have and in that context the question the questions around what more we can do are always very welcome so really appreciate you bringing up that question thank you very much miss Gere gira we will go to Bloomberg now - no me no me can you hear us hi can thanks for taking my question actually have one for each organization and first of whu-oh and we saw some countries in Asia tightening restrictions on public life today after virus infections popped up again just wonder if you can help us understand how this sort of rolling raising and lowering of as restrictions might work throughout the world and if this would be the new normal for the next year maybe the next 18 months what should we anticipate and second and ironmouth question and do we have any assurances that China supports the postponement on official bilateral debt repayment on the issue of measures think many countries around the world have have been climbing very tragic and dangerous mountain of disease and we need to be also extremely careful under descent we need to be watchful be aware we we want this disease to go away we want the numbers to drop but as they drop and as we try to come up with transition strategies to allow economies and social life to re-emerge and nobody wants that more than then than us here at whu-oh and all our medical nursing colleagues around the world our health care professionals but what we need to absolutely ensure that as we if we want to transition back to steady-state with the virus we want to reach point to disease control we need to put in place the Public Health architecture we need massive investment in our capacity to do surveillance contact tracing isolation and Quarantine we need very good information systems we need highly educated engaged and empowered communities around the world who understand what to do if they're sick where to go have access to doctor to nurse to testing to isolation to quarantine if we and at the same time we strengthen our health care system to deal with those who are racing and all the while developing new therapies and vaccines to solve this problem once and for all if we want to reach that that situation where we can with this virus and have our economies back on track we must make those other investments as we do that there will always be the chance as we lift as government's lift shutdowns lock downs as people go back to school we have to have in place to protect almost safety net the other things in the system that can trigger and may be in and may happen we may have to modulate that we may have to decide which are the measures we can put back in place if necessary to create more physical distance and we don't want to end up in cycle of lockdown followed by release followed by another lockdown followed by release that that's not the way forward and the way to avoid that is we need transit strategy transition strategy that gets us back into more control of the wires we need to get ahead of the virus and then if we are in control we can protect our economies but if we lurch from lockdown to poor control and back to lock down and back to poor control that is not what anybody needs right now so the investment we need to make the lock downs have given some time they've taken the pressure out of the epidemic you see that this is precious time not only to strengthen the healthcare system as the VG has said but precious time to put in place the public health architecture the testing the community education and build this response from the community of that's the challenge and if we do that we have chance of transitioning back into life an economic and social life that may in some senses not be the same again maybe more caring engaged society with better health care system with better universal access to health care with more social social justice and more care for each other and that won't be bad Society to go back to so from my perspective we need to work hard now to put in place the comprehensive architecture of Public Health and health care if we're going to unlock safely from the economic measures or from the societal measures and population measures that are affecting and impacting people's social and economic future thank you very much you miss Gilly would like to answer the question please yep yes thank you thank you for your question Chinese constructively engaged on this issue of dead standstill for poor countries so they can weather the tremendous difficulties they're faced with during this crisis week at g20 ministers of finance call earlier this week this topic of potentially having debt relief for either countries for poor countries was on the agenda and China addressed that issue by framing set of principles they would be interested to see being integrated in that process and it is also important to point out to China's decision to contribute to the catastrophic on tainment relief trust that the IMF has been mobilizing to make sure that poor countries do not have to serve their debt obligations to the IMF that this would be taken over by grant provision and China is one of the countries that are making commitments to that fund to that to the em to that trust catastrophic containment relief trust we will be we will be obviously working with that with everybody in the next day's the g20 the Paris Club IMF World Bank by the time of our spring meetings we look forward to advancing this discussion thank you very much chef miss Virgie Evan to Dhaka in Bangladesh mr. malroux photography can you hear us yes please go thank thank you thank you very much would like to address mr. director general and wo headquarters just want question have any your special observation in Bangladesh testing policy or testing system on COBIT 19 its run to right or wrong anything wrong or say no observation could take that DG think your mic is still on thank you for your question dr. Poonam Singh Regional Director for the Southeast Asia region myself actually spoke with the Minister of Health in Bangladesh yesterday as part of ministerial meeting with all ministers of Southeast Asia and we spoke about laboratory testing and our support to beef up that testing in Bangladesh and what is interesting is that Bangladesh has already implemented very wide network of testing based on the gene expert platform this was put in place for TB and HIV and other diseases and there's real opportunity for us to be able to use an existing platform that has been invested as part of health development and health systems development and to leverage that platform in order to scale up the testing in Bangladesh and we see that as as way forward in doing this think Bangladesh is taking the issue of testing very seriously in the minister was extremely keen to broaden the testing availability in the country to improve and drive surveillance using polio surveillance and other avenues so think there's strong focus on good surveillance in Bangladesh and we will do everything in our power to support Bangladesh in their efforts to beef up surveillance and to ensure that there's adequate lab testing available thank you very much we'll go now to cell China Morning Post if we can connect to think it's and Mary Stewart Stewart from South China Morning Post hi can you hear me yes please go ahead hi I'm dr. Ted Rose and the team have question about the use of masts because throughout the last 48 hours we've seen lot of media reports suggesting that the whu-oh is considering revision on the advice of the use of masks on the public level may check with you guys whether there is any plan undergoing about you know potential changes to encouraging the public or at least not you know dissuading the public from wearing surgical masks and public clays and also have you guys unseen the report from team of Hong Kong scientists on the nature magazine about the potential effectiveness of using masks in preventing coronavirus thank you well III can start and maybe Maria and will will follow up on the issue of masses those are very important and very healthy debate at the moment looking at how masks are used in this response first and foremost surgical and medical masks and masks like n95 and FFP - and FFP three respirators are for the medical system and we must prioritize their use to protect our workers in the frontline and that's what we're working on with all our partners around the world with all governments with our colleagues in the UN system and with governments to try and ensure that we get the best possible protective gear to our frontline health workers with that in mind Joe already advises the use of medical masks for for people who are ill and at home or people who are caring for people who are sick at home the debate regarding using masks in general public is base is built not on the paradigm of protecting yourself it the evidence is quite clear that the wearing of mask in public doesn't necessarily protect you but if sick person wears mask then it is less likely that they may in fact others at the moment and from whu-oh perspective people who are sick with kovat 19 should be in isolation and we need to make sure that people are in isolation but there are circumstances and we need to be open on this this is new epidemic it is challenging everything we know it is challenging systems so there are particular context circumstances in which it may not be possible to do physical distancing in which people may not have access to all of the services that may be available in other countries and there may be situations where the wearing of masks may reduce the rate at which infected individuals may infect others it is not the ideal solution in this sense but it is very it should be considered in the context of the comprehensive strategy to control the disease it should be considered in terms of the types of transmission that are happening how intense transmission is at community level what the circumstances and context of that transmission is and what the resources are to deal with that and we we must preserve medical surgical and respirator masks for our frontline workers but the idea of using respiratory coverings or mouth coverings to prevent coughing and sneezing projecting disease into the environment or towards others that's mechanical process and and that in itself is not bad idea but that doesn't negate the need for hand-washing it doesn't negate the need for physical distancing it doesn't negate the need for people to stay at home if there's stay at home order in place it doesn't negate the need for everyone to protect themselves and try to protect others so we can certainly see circumstances in which the use of masks but homemade or cloth masks at community level may help in an overall comprehensive response to this disease and we will support government's in making those decisions based on the situation they find themselves in in terms of transmission based on the context in which they're dealing and the resources that they have at their disposal but but above all we must ensure that our frontline health workers are the ones who are most exposed they're the ones that need the the high performance protection in order for them to stay healthy do their jobs and save lives there are the there are many articles coming out at the moment on types of transmission and pre-symptomatic transmission i've seen one recently from think Singapore where there was an estimation that about 6% of pre-symptomatic people or 6% of cases may have been caused by people who are pre symptomatic and that's and I'm not here to question that there are many different estimates but the corollary of that the opposite of that is clearly that 94% of infections are caused by people who are symptomatic so we have to look at what's driving this epidemic there are always and always the possibility of asymptomatic transmission there's always the possibility that we can have some element of airborne transmission but we have to look at is what is the main driver of this pandemic and in this case we still believe the main driver this pandemic is symptomatic individuals coughing or sneezing or contaminating surfaces are contaminating other individuals breaking that chain means ensuring that infected individuals are diagnosed and isolated their contacts are traced and tracked and quarantined and that people are cared for very quickly in the system having said all of that as said we're having very open very healthy debate we had long meeting today with our strategic and technical advisory group on infectious hazards from all over the world know our our expert group on infection prevention and Control has been talking about this in very very intensely over the the last days we will look at all that evidence we will reave we will every single paper we will engage aged with every single researcher and we will see what place can be found for this intervention in this overall response and we will support governments who wish to have measured approach to the use of masks and who include that as part of comprehensive strategy to control this disease Bria thank you very much dr. Anna we will have to conclude here maybe TG would have one last word maybe to thank our guests yeah first if you would like to have Kristalina few few words as closing and thank you so much for joining us but please thank you thank you very much dr. Ted Rose for inviting me do believe that bringing together epidemiology and economics is absolutely crucial my closing message is that we will get through this but how fast and how effectively would depend lot on the actions we take and on making sure that in these actions we bring the world together the commitment of my institution of the IMF is to play our part thank you again very much for all you do thank you thank you my sister it's because as we have agreed in our op-ed both lives and livelihoods matter and that's why we join forces today and thank you so much for this very important cooperation and we have now our plan together that we need to implement and we agree on how to handle this pandemic and not only that we also agree that together we can defeat this virus this is new virus new corona virus and the first ever corona virus also to cause pandemic there are many unknowns and we should learn everyday and while learning the united force is really really key so together as you said fully agree we will overcome this and thank you so much again for joining and look forward to working with you very very closely thank you thank you very much dr. Taylor thank you thank you thank you visa your gira dr. Van Kirk Kove and dr. Ryan we will have audio file sent very soon and transcript as well will be posted tomorrow we will also send you some of the news from our regional and country offices in their activities against kovat 19th wish you very nice weekend