MANILA — The novel coronavirus outbreak, or 2019-nCoV, that has infected over 800 people is an emergency in China, but not yet for the rest of the world, World Health Organization Director-General Tedros Adhanom Ghebreyesus said late Thursday as he announced his decision not to declare the outbreak a public health emergency of international concern.
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“I am not declaring a public health emergency of international concern today,” said the WHO chief. “Make no mistake. This is an emergency in China, but it has not yet become a global health emergency. It may yet become one.”
His decision follows two days of deliberation by experts forming the emergency committee on the outbreak. The experts were split on the decision to declare a PHEIC, citing limited information on disease severity and transmissibility.
One of the important points committee members wanted more information on is the fatality rate linked to the 2019-nCoV outbreak.
“If we refer to the previous coronavirus epidemics in 2003 and more recently with the MERS coronavirus, the fatality rate was much higher than it appears to be today. But this is one of the aspects for which we would like to have more information because it's of course one very important point to decide whether it is a major public health threat or not,” said Didier Houssin, emergency committee chair, during Wednesday’s press conference.
The committee said it’s ready to be called again in 10 days time, or sooner as the WHO aid chief deems necessary.
Tedros emphasized however that based on WHO’s risk assessment, the outbreak is at “very high risk” in China, regionally, and globally.
“It is likely that we will see more cases in other parts of China and other countries,” he said during Thursday’s press conference.
Currently, there are two emergencies classified as a public health emergency of international concern: the Ebola outbreak in the Democratic Republic of the Congo, and the international spread of poliovirus.
Experts are still grappling for information on the new coronavirus, which at time of print, has infected over 800 individuals within and outside China. The number includes a second confirmed case in Japan, 177 patients in severe conditions, and 25 deaths. Most of the patients who have died had underlying medical conditions and were of old age.
Efforts are underway to develop a vaccine against 2019-nCoV. The Coalition for Epidemic Preparedness Innovations on Thursday, for example, announced three programs targeted to advance the development of vaccines against the new coronavirus.
“Our intention with this work is to leverage our work on the MERS coronavirus and rapid response platforms to speed up vaccine development. There are no guarantees of success, but we hope this work could provide a significant and important step forward in developing a vaccine for this disease,” CEPI CEO Richard Hachett said.
China’s quarantine measures
WHO’s decision not to declare the outbreak a global health emergency has been overshadowed with questions over lockdowns in several Chinese cities, starting with Wuhan. On Thursday, the city suspended all public transportations, and closed the airport and railway stations.
As travel restrictions have been a point of contention in emergencies, journalists asked WHO for comment on the measures taken by city officials in China.
The world watches as China uncovers a new coronavirus as the source of the pneumonia-like symptoms that have affected 59 individuals in Wuhan province.
Tedros was short in his response: “China has taken measures it believes appropriate to contain the spread of coronavirus in Wuhan and other cities. We hope that they will be both effective and short in their duration.”
WHO does not recommend any more broader restrictions on travel and trade, he said.
Experts, however, have shared their concerns.
“Involuntary quarantines have a questionable track record and can often be counterproductive. A quarantine around a city larger than New York will be challenging to enforce, and past precedents suggest it could lead to more hiding of cases and less voluntary compliance with public health measures,” said Jeremy Konyndyk, senior fellow at the Center for Global Development. Konyndyk previously served as director of the U.S. Agency for International Development’s Office of US Foreign Disaster Assistance during the Obama administration.
Josh Michaud, associate director of global health at the Henry J. Kaiser Family Foundation and professor at the Johns Hopkins School of Advanced International Studies, meanwhile tackled the issue in a series of tweets.
During the SARS outbreak of 2003 and Ebola outbreak in West Africa between 2014-2016, several countries implemented quarantines, although with differing approaches, he said. Some proved to be effective, while others were costly.
Quarantines can be good options under certain conditions, he said, but noted how it can only work when effectively enforced. And in the case of Wuhan, a city reportedly home to over 11 million people, to enforce such quarantine would require a lot of manpower and logistics, he said.
“There is a balance between the political and social costs of quarantine and public health benefit. Quarantine of a whole city is a major imposition with many potential collateral costs, and may even bring more public health problems than it is trying to solve,” he tweeted. “Businesses and families must be ensured adequate access to food, supplies, medicines, social services and other supports.”
But with little information on the new coronavirus, he said “it’s hard to say whether a quarantine of this magnitude is advisable and the benefits outweigh the costs.”