COVID-19 Global Risk Assessment

Overview

WHO regularly conducts risk assessments for graded emergencies in accordance with the WHO Emergency Response Framework. Since January 2020, WHO conducted global risk assessments for COVID-19 every three months. With the lifting of the public health emergency of international concern, WHO has shifted to producing COVID-19 risk assessments every six months.  

Under the current risk assessment, the global public health risk associated with COVID-19 remains high. There has been evidence of decreasing impact on human health throughout 2023 and 2024, driven mainly by: 1) high levels of population immunity, achieved through infection, vaccination, or both; 2) similar virulence of currently circulating JN.1 sublineages of the SARS-CoV-2 virus as compared with previously circulating Omicron sublineages; and 3) the availability of diagnostic tests and improved clinical case management. SARS-CoV-2 circulation continues at significant levels, however, as indicated by percent test positivity from sentinel sites and wastewater sampling. 

Since February 2022, SARS-CoV-2 Omicron sublineages have accounted for 97% of all publicly shared sequences globally. As at the end of October 2024, JN.1 and descendent lineages represented 99.5% of all circulating SARS-CoV-2 variants. Currently circulating BA.2.86 and JN.1 sublineages feature immune escape properties but do not appear to be associated with increased severity of infection. Most patients who contract COVID-19 fully recover, however, approximately 6% of symptomatic infections are estimated to develop post COVID-19 condition (PCC) with long-term effects on several body systems. Available data indicate a reduced risk of developing PCC in people who have received two doses of a COVID-19 vaccine. The impact of the emerging variants on PCC rates and relative risk of post-acute and long-term health effects of SARS-CoV-2 infection remain unclear, though recent data suggests that PCC rates following acute infection are lower than earlier in the pandemic.

Progress in reaching high-risk groups, as defined by WHO Strategic Advisory Group of Experts on Immunization (SAGE) recommendations, with COVID-19 vaccines remains a challenge globally. Among older adults, 19.7 million individuals were reported as having received a dose as of 30 September 2024 across the 75 Member States reporting on uptake in this group, corresponding to an uptake of 1.68%. Among health and care workers, 1.3 million individuals were reported as having received a dose so far this year, across the 54 Member States reporting on uptake in this group, corresponding to an uptake of 0.96%. Strong variations continue to be observed across regions and income strata in all population groups. At present, COVID-19 vaccines with WHO Emergency Use Listing (EUL) / Pre-qualification (PQ) maintain reasonably high vaccine effectiveness (VE) against severe disease and death. WHO recommends a simplified single-dose regimen for most COVID-19 vaccines for individuals in high and medium priority groups who have not yet received a COVID-19 vaccine, as well as periodic re-vaccination of most high priority-use groups and sub-populations with special considerations at an interval of 6-12 months.  

Confidence in the available information on the global public health risk is mixed. Overall, it remains low to moderate due to various factors. The de-prioritization, defunding, and scale down of SARS-CoV-2 surveillance activities continues, despite consistent advice by WHO.  These difficulties are exacerbated by the ongoing reduction in the number of sequences submitted to publicly accessible databases. Both trends make it increasingly difficult to accurately assess the scale of community transmission and burden, as well as ongoing evolution of the SARS-CoV-2 virus.