Caixin
Jan 30, 2020 09:25 PM
SOCIETY & CULTURE

WHO Mulls New Decision on Coronavirus Emergency

The WHO headquarters in Geneva, Switzerland. Photo: Li Zengxin/Caixin
The WHO headquarters in Geneva, Switzerland. Photo: Li Zengxin/Caixin
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The WHO is today poised to review its decision on whether a new virus that has taken 170 lives and spread to 16 countries constitutes an international health emergency.

While experts cautiously expect the group's Emergency Committee to overturn their ruling last week that the coronavirus was not a “public health emergency of international concern” (PHEIC), they’re divided on what doing so at this late stage will achieve.

As the tally of airlines canceling flights to China grows, many are watching for whether the body weighs in on the issue of travel restrictions with a “temporary recommendation, as it has during previous disease outbreaks.

Speaking in Beijing on Wednesday after meeting Chinese President Xi Jinping, WHO Director-General Tedros Adhanom Ghebreyesus said he would reconvene the coronavirus emergency committee because new signs of person-to-person transmission in three countries outside China were “deeply concerning.”

“Although the numbers outside China are still relatively small, they hold the potential for a much larger outbreak,” he said.

He said about one in five cases of the virus were severe.

Raina MacIntyre, a professor of global biosecurity at the University of New South Wales in Australia, said she expected the committee to change its position because of the revelation that people without symptoms could spread the virus.

“That makes it more difficult to track and gives it greater epidemic potential,” she told Caixin.

MacIntyre said the odds were also shortened by the fact the outbreak had “shown no signs of slowing down despite all the measures taken in China.” But since last week’s meetings resulted in a 50-50 split decision, the outcome was unclear.

Theoretically, calling a PHEIC would give the WHO greater powers over disease surveillance, detection and reporting, and the ability to better coordinate the response, MacIntyre said. But she pointed out that like most international regulations, it is not enforceable.

Sanjaya Senanayake, a virus expert at the Australian National University, said the committee should have declared an emergency last week and doing so now would have little effect because “most member states are on the same page.”

“It certainly won’t raise alarm or awareness because everyone’s already alarmed and aware. This is really storming across the world in terms of the panic it’s causing.”

There has been much speculation about why the WHO chose not to declare a global emergency when they convened last week. Speaking to Caixin between those meetings, Professor John MacKenzie, one of the members of the committee, said that in his opinion there was simply too little known about the disease’s severity and transmissibility.

Senanayake said the WHO had previously held off calling global emergencies because of concern doing so could create a panic and lead to travel restrictions which could effectively penalize nations for being transparent about outbreaks.

Professor MacIntyre said international health regulations were “designed to strike a balance between the interests of trade and business with public health.”

The current wave of travel restrictions is likely to be on the agenda in today in Geneva after more than a dozen airlines suspended or cancelled flights to China, she said.

Under WHO regulations, temporary recommendations should not be more restrictive of international traffic and trade than

“reasonably available alternatives that would achieve the appropriate level of health protection.”

There were also questions about whether declaring an international health crisis would make China appear to have lost control of the situation.

Tedros, who is known by his first name, appeared to play down such concerns on Wednesday, when he said he would seek the emergency committee’s recommendations “on how best to protect people all over the world — while recognizing what China is doing.”

He also announced that Xi had invited the WHO to bring a team of international experts to China to work with the government and guide global response efforts. A report by the Chinese state newswire said he also recommended against the evacuation of foreign nationals.

MacIntyre said it was “unusual” to see the WHO issue such advice. “Countries have an obligation to their citizens, and citizens are petitioning their governments asking for help to get out,” she said. “It’s just natural that countries would do what they could to get their citizens out.”

She said it was hard to argue it was a disease control measure, because nations with the means to evacuate their citizens also had the means to quarantine them.

Marylouise McLaws, an infection control expert who worked with the WHO to review China’s response to the SARS crisis, said an international health emergency should have been called “much earlier” this time around.

She said the UN health watchdog may have deferred the decision so far to avoid being accused of crying wolf, after a perceived misstep over the 2009 swine flu outbreak.

“They were really unfairly criticized for their response to the influenza where people said they had called it much too early,” McLaws told Caixin.

Swine flu never became the crisis it might have been because of sheer luck, McLaws said — it dissipated due to humidity and temperature changes. “And yet the community and the media gave WHO a lot of grief, and I think perhaps they want to keep their reputation.”

“But if you call it too late you can lose your reputation as well.”

Contact reporter Flynn Murphy (flynnmurphy@caixin.com)

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