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China’s mystery virus prompts emergency WHO meeting

‘In the early moments of SARS, there was concealment in China. This must not be repeated.’

A notice masks are sold out at a pharmacy. Koki Kataoka/REUTERS
A notice stating that protective face masks are sold out at a pharmacy in Beijing, China.

The mysterious new coronavirus that has infected hundreds of people in China is fuelling concerns about a wider epidemic, pushing global health officials to schedule an emergency meeting to discuss possible responses.

A World Health Organisation panel is meeting for a second day on Thursday to examine whether the outbreak is “a public health emergency of international concern” – and to devise possible ways to manage it. An initial day of discussions on Wednesday produced no decision.

Declaring such an emergency, often known by its abbreviation, PHEIC, would be a rare step: there have only been five declarations in the last decade, including for the ongoing response to an Ebola epidemic – the second deadliest ever – in the Democratic Republic of Congo.

Chinese authorities first publicly reported the emergence of a new respiratory illness with pneumonia-like symptoms in the central city of Wuhan on 31 December.

There were at least 570 confirmed cases and 17 deaths in China as of 23 January.* Chinese health authorities have confirmed the coronavirus can spread from person to person.

The United StatesThailand, JapanSouth Korea, and Taiwan have identified cases involving people who had travelled to Wuhan. The Philippines was also reportedly investigating a possible case. In Australia's Queensland, a man suspected of having the virus was later cleared.

Within China, there’s particular concern the virus could spread more easily during the upcoming Lunar New Year celebrations, when hundreds of millions of people usually travel.

What is the coronavirus?

The WHO says the as-yet-unnamed coronavirus appears to have emerged at a market in Wuhan, which was shut down on 1 January. But cases have also been found among people who said they never went to the market, suggesting transmission may be taking place elsewhere.

Coronaviruses are part of a family of viruses that includes everything from the common cold to more severe illnesses like Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). 

In 2002 and 2003, the SARS outbreak originating in southern China spread to at least 26 countries, infecting more than 8,000 people. Some 774 people died. 

The MERS virus was first confirmed in Saudi Arabia in 2012. It reached at least 27 countries and killed at least 861 people out of nearly 2,500 cases, according to the WHO.

Both SARS and MERS have been ruled out during the current outbreak.

What is a PHEIC?

The WHO emergency committee is debating whether to recommend declaring the outbreak a “public health emergency of international concern”, or PHEIC.

A PHEIC declaration may trigger measures such as limits on international travel or health screening for travellers.

Under international health regulations, a PHEIC can be considered during “an extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response.”

These declarations are meant to balance public health risks and “avoid unnecessary interference with international traffic and trade”, according to the WHO.

This has led to claims of politicisation, not least last year when the WHO’s emergency committee met three times before finally declaring Congo’s Ebola outbreak a PHEIC in July. 

The medical journal The Lancet called an earlier decision not to declare an international public health emergency “a mistake” that appeared to be “more political than technical”. 

There have been five PHEIC declarations including last year’s Ebola outbreak: the 2009 swine flu pandemic, declarations in 2014 for the re-emergence of polio and the West Africa Ebola outbreak, and the spread of the Zika virus in 2016.

Notably, the WHO’s emergency committee did not declare an international public health emergency during the MERS outbreak. There are still transmissions of MERS, including five new cases in Saudi Arabia and the United Arab Emirates in December. 

What are China and the WHO saying?

China was accused of covering up the magnitude of the SARS outbreak until it was too late. During the current coronavirus outbreak, Chinese authorities have repeatedly stressed that they’ve alerted the WHO and shared information “as soon as possible”.

“China has taken proactive measures to handle the situation, formulated strict prevention and control schemes, spared no effort to treat the patients, properly managed close contacts, and carried out in-depth epidemiological investigations,” Geng Shuang, a foreign ministry spokesman, said on Monday.

This week, an editorial in the pro-government Global Times called the coronavirus a test of China’s disease-control capabilities.

“In the early moments of SARS, there was concealment in China. This must not be repeated,” the paper stated.

Takeshi Kasai, the WHO director for its Western Pacific region, which includes China and parts of Asia as well as the Pacific Islands, called the emerging coronavirus “a wake-up call”.

“We are not completely safe,” he said. “Our surveillance teams identify, on average, two disease outbreak events every week, and the context in which these events occur is far more complex than before.”

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* Statistics in this story were updated on 23 January 2020.

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