Coronavirus outbreak - Covid-19 pandemic (2020)

OMS global health emergency

With no indication that a new corona virus epidemic is fading, virologists are waiting around the world to get their hands on the virus ' physical samples. We are developing plans for testing drugs and vaccines, creating animal models of the infection and researching concerns about the virus ' nature such as how it spreads. The moment we heard about this outbreak, virologist started putting out their feelers to gain access to the isolates. At the epicenter of the outbreak was the first laboratory to isolate and study the virus, known provisionally as Covid-19: in Wuhan, China. A team led by virologist Zheng-Li Shi at the Wuhan Institute of Virology isolated the virus from a 49-year-old woman, who developed symptoms on 23 December 2019 before becoming critically ill. Shi's team found that the virus can destroy human cells that are cultured and enter them through the same molecular receptor as another corona virus: the one that causes SARS (severe acute respiratory syndrome). On 28 January a laboratory in Australia confirmed it had collected virus samples from an infected person who had returned from China. The team was getting ready to share these findings with other scientists. Laboratories in France, Germany and Hong Kong are also isolating and planning to exchange samples of viruses from local patients that they collected.

Nevertheless, at a news conference in Geneva the World Health Organization declared corona virus to be a public health emergency of international concern. It's only the sixth time such an emergency has been declared, with past examples including the Democratic Republic of Congo Ebola outbreak and the Zika virus. Through seeking to spread worldwide, the WHO reserves the designation for "extraordinary events" that present a public health risk. The step reversed the organization's decision to hold off such a statement just a week earlier. Since then, several other nations, including the United States, have seen thousands of new cases in China and clear evidence of human-to-human transmission. This all warranted reconsideration by the emergency committee of the W.H.O.

The statement "is not a vote of mistrust in China”. The W.H.O., on the contrary, appears to believe in China's ability to control the outbreak. The announcement now comes because of concerns that the corona virus could enter countries with poor health care systems where it could run amok, potentially infecting millions of people and killing thousands.

The State Department warned travelers to avoid China altogether following the declaration. The spokeswoman for China's foreign ministry, Hua Chunying, said “the country is fully confident and able to win the fight against this epidemic”. She added in a statement on the ministry's website that China is willing to continue collaborating with the W.H.O. and other countries to protect public health.

The announcement of the W.H.O. — officially called an "international public health emergency"— does not have the force of law. The department is governed by an annual meeting of all U.N. ministers of health. Countries and their function are merely to provide instruction. Governments will now make their own conclusions about how to protect themselves.

To Americans concerned about their health, the best advice are to follow good flu season hygiene, including regular hand washing, covering coughs and keeping up-to-date on new CDC details. The CDC does not suggest wearing a face mask to avoid corona virus. Our conclusion remains that there is low immediate risk for the American public.

The Illinois transmission is the sixth corona virus outbreak in the USA. Last week the WHO deliberated for two days before agreeing not to declare an emergency. Nevertheless, patients from Germany, Japan, Taiwan, Vietnam and the United States have since been infected with the new corona virus without visiting China. The new corona virus is within the same virus family as common cold and SARS.

A lot of uncertainty emerges from that human-to-human transmission outside China. At last count, the novel corona virus has sickened more than 7,700 people, and 170 have died from it. More than 90 percent, and every death, of those cases were in China. 20 percent of cases are considered serious, and 2 percent have been fatal, according to World health organization. The fatality rate of the latest corona virus is expected to decline as more cases are identified, as the sickest people tend to seek first medical treatment.

Emergency systems are "just instructions. Governments and even private firms "may or may not obey it." However, announcements of emergency signal that the situation is critical for the worlds top health advisory body. The decision had been accepted by many scientific experts. The emergency in public health "allows them to rely further on the role of global leadership for governments and the private sector."

The first aim should be to learn more about how the virus spreads — whether it's mostly in hospitals and clinics, what ages and sexes or occupations are most affected, how sick they are, and what risk factors are most harmful. Yet Amir Attaran, a law and epidemiology professor at the University of Ottawa and a frequent critic of W.H.O., called the announcement "inexcusably late." The committee's rationale that it lacked sufficient scientific evidence to declare an emergency last week was "balderdash," he said. W.H.O. is crippled with SARS, Ebola and Zika for the same political reasons that destroyed its scientific judgment, "he said. Borders are closed, planes are grounded and ships anchored like W.H.O. are quietly dithers about whether or not to declare an emergency. "Things have overtaken them greatly, proving their uselessness yet again," he said.

Declaring emergencies is always a tough decision to take. Border closures and cancelations of flights will cause misery for millions of healthy people close to the epicenter, and huge economic disruption. In the worst situations, food and medicine supplies can run short, and fear can spread, threatening to do more harm than the disease.

Experts at the W.H.O., however, have lavishly and consistently praised the response by China as exceptionally violent. In just two weeks, the nation has built two hospitals for the home of patients with corona virus. Chinese scientists deposited the corona virus genetic signature in public libraries, which greatly accelerated the production of diagnostic tests and, eventually, vaccines. The Chinese authorities cordoned off the major cities at the epicenter of the epidemic, Hubei Province, stranding over 50 million people at the height of New Year's Lunar holidays— a step that few other countries could have taken.

It remains to be seen whether that massive cordon can prove effective. Five million people were able to flee Wuhan, the city where the outbreak started, before it closed its train and bus stations and airports. The Chinese Government has set a new standard for response to the outbreak. Many countries should be thankful that only 98 of the nearly 10,000 cases reported so far have taken place outside of the borders of China, he said.

Notwithstanding the state of emergency, and notwithstanding the fact that the State Department is advising Americans to stay away from China, the W.H.O. is opposed to limits on travel to or trade with China. According to the president of the agency's emergency committee, steps the agency finds unwarranted include border closures, visa restrictions and the quarantining of apparently healthy travelers from affected regions.

Other countries have already taken many of those steps against China. That's not to say that there weren't missteps. Last week the W.H.O. described its outbreak risk assessment as "moderate" when it should have said "high." The mistake was added to the agency's report in a footnote. U.S. researchers have written about spotty epidemiological knowledge coming from China. The W.H.O., too, cannot share information with Taiwan, which now has eight patients with corona virus, as Taiwan is not a member of the UN.

The corporation "does not want its main stakeholders to get upset. China holds the political clout many countries don't have. Yet, along with its effects, the epidemic seems to be accelerating. On Friday China said another 43 people had died of the disease, bringing the total to 213. There have yet to be any fatalities outside China.

Russia sealed much of its 2,600-mile boundary with China and halted all of the country's train service except for a regular train between Moscow and Peking. Several airlines, like British Airways, stopped flying there; others reduced their service considerably. Some medical experts within China have challenged the response from their government, arguing that local officials should have implemented more stringent travel restrictions before the virus spills out of Wuhan. The country now has cases confirmed in every province and area.

People have argued that local authorities kept quiet about the extent of the outbreak— initially maintaining that there was no proof of transmission from person to person outside Wuhan— but admitted the truth after Hong Kong press reports. As the magnitudes of the outbreak became vivid, Wuhan's mayor offered resignation on Monday.

A delegation from the W.H.O. was authorized to visit Wuhan for only one day of rain; he said the visit was not intended to pass judgment. Everything is performed with a sense of strength, and good practice, to threes evaluation. You need to recognize the large scale and comprehensiveness of the project. "After the tour, China agreed to allow W.H.O.-coordinated international experts to collaborate with Chinese scientists to control the outbreak in the region. A team to join them is assembled by the C.D.C. Since its formation in 2005, the W.H.O. has made only five emergency declarations: for the 2009 pandemic influenza; for the 2014 polio resurgence; for the West African Ebola epidemic during that year; the Zika virus erupt in 2016; and an Ebola outbreak in the Democratic Republic of Congo last year.

The country has taken very strong steps including daily contact with WHO and robust multi-sector strategies to avoid further spread. In other cities and provinces, it has also taken public health measures; is conducting studies on the magnitude and transmissibility of the virus, and sharing data and biological content. The country has also agreed to work with other countries that require support from them. The steps that China has taken are positive for that country as well as the rest of the world. The Committee recognized WHO and its collaborators as leading role.

The Committee also noted that many unknowns remain, cases have now been identified in five WHO regions within one month, and human-to-human transmission has occurred outside of Wuhan and outside of China.

The Committee claims that it is still possible to prevent the spread of virus, if countries put in place effective measures to identify disease early, isolate and treat cases, monitor interactions and encourage risk-sensitive social distancing steps. It is important to note that as the situation continues to evolve, the strategic objectives and measures to prevent and reduce the spread of the infection will also evolve. The Committee concluded that the epidemic now meets the criteria for a globally concerned public health emergency, and offered the following advice to be given as Temporary Recommendations.

The Committee emphasized that a PHEIC's statement should be interpreted in a spirit of support and respect for China, its citizens, and China's actions on the front lines of this outbreak, with openness and, it is to be hoped, progress. In line with the need for global unity, the Committee felt a need for an internationally coordinated effort to improve preparedness in other parts of the world that might need additional support.

The Committee welcomed an upcoming multidisciplinary technical mission to China which included national and local experts from the WHO. The mission will examine and support efforts to investigate the animal source of the outbreak, the clinical scope and nature of the disease, the degree of human-to-human transmission within the population and in health care facilities, and efforts to control the outbreak. This mission will provide the international community with information to assist in understanding the situation and its effects and facilitate exchange of knowledge and effective action.

The Committee wished to re-emphasize the importance of researching the possible source, excluding secret transmission and informing steps for risk management. The Committee also underlined the need for enhanced surveillance in non-Hubei areas, including pathogen genomic sequencing, to understand whether local transmission cycles are occurring.

World health organization should continue to use its international specialist networks to determine how best to control the outbreak globally. WHO should provide enhanced preparatory and response support, especially in vulnerable countries and regions. Measures should be established to ensure rapid development and access for low-and middle-income countries to future vaccinations, medications, antiviral medicines and other therapies.

WHO should continue to provide all the technical and operational support necessary to respond to this outbreak, including with its broad networks of partners and collaborating organizations, to adopt a robust risk communication strategy, and to allow research and scientific advances in relation to this novel corona virus to be furthered.

The WHO will continue to explore the advisability of establishing an intermediate level of warning between the binary possibilities of PHEIC or no PHEIC, so that discussions on the IHR text do not need to be reopened (2005).

The WHO will review the situation with consistency in due time and update its recommendations based on evidence. The Committee does not propose any restrictions on travel or trade based on the current available information. The Director-General announced that the Covid-19 outbreak constitutes a PHEIC and acknowledged the advice of the Committee and released this advice as Temporary Recommendations under the IHR.

To the People's Republic of China:

Develop a systematic risk communication strategy to inform the public on a regular basis about the nature of the outbreak, the population's prevention and security measures, and the response measures taken for its containment.

Improve public health programs to curb the current outbreak.

Ensure health system stability and secure health-care workers.

Increase monitoring and successful case finding across China.

Collaborate with the WHO and its collaborators in carrying out studies to clarify the epidemiology and evolution of this epidemic and its control steps.

Partake of appropriate human case info.

Continue to identify the zoonotic source of the outbreak as soon as it becomes available, and in particular the potential for circulation with WHO;

Perform exit screening at international airports and ports with the goal of early detection for further assessment and treatment of symptomatic travelers while reducing interference with international traffic.

To all countries:

More foreign export of cases is expected to appear in any region. All countries should therefore be prepared for containment, including active monitoring, early detection, isolation and case management, communication tracking and prevention of further spread of Covid-19infection, and full data sharing with World health organization. Professional guidance can be found on the WHO web site.

Countries are reminded that they are legally obliged under the IHR to share information with the WHO.

Any identification of the Covid-19 in animals (including species information, diagnostic tests and relevant epidemiological information) should be reported as an emerging disease to the World Organization for Animal Health (OIE).

Countries should place particular emphasis on reducing human infection, preventing secondary transmission and international dissemination, and contribute to international response through multi-sector cooperation and collaboration and active participation in enhancing virus and disease awareness, as well as advancing research;

The Committee does not propose any restrictions on travel or trade based on the current available information.

Countries shall inform WHO, as required by the IHR, of travel measures taken. Countries are warned against acts encouraging stigma or prejudice, in accordance with the IHR's Article 3 principles.

In view of this rapidly evolving situation, the Committee requested the Director-General to provide further guidance on these matters and, if necessary, to make new case-by-case recommendations.

To the global community:

As this is a new corona virus and it has been shown previously those similar corona viruses require substantial efforts to allow routine information sharing and analysis, the global community will continue to show solidarity and cooperation in supporting each other in identifying the source of this new corona virus, in compliance with Article 44 of the IHR (2005).

Help low-and middle-income countries to respond to this incident and to promote access to diagnostics, possible vaccines and therapies.

Under Article 43 of the IHR, States Parties adopting additional health measures that substantially interfere with international traffic (refusal of entry or departure for more than 24 hours of international travelers, luggage, freight, containers, conveyances, goods and the like) are obliged to send to the WHO a rationale and justification for public health within 48 hours of their arrival. WHO will review the reasoning and may ask countries to rethink their steps. WHO is required to share information regarding interventions and the rationale obtained with other States Parties. The UN's health arm said the move was to protect countries with "weaker health systems," but the WHO also said there was no excuse for steps that would interfere excessively with international travel and trade.