explainer

Coronavirus has been declared a global health emergency. Here's what that means.

With AAP.

On Thursday afternoon in Geneva, the World Health Organisation’s Emergency Committee reached a decision with global consequences. It declared the current outbreak of Novel coronavirus to be a ‘Public Health Emergency of International Concern’.

As it stands, more than 7,830 people have contracted the virus globally, though close to 99 per cent of those cases occurred in China. It was there, in an illegal wildlife market in the transport hub of Wuhan, that the virus originated.

It was first reported on December 31, 2019, after a number of workers and customers began to experience respiratory illness similar to a cold or flu.

Watch: WHO declares a global health emergency.

Video by World Health Organisation

Some 60 million people are living under virtual lockdown as China seeks to contain the outbreak, but already 98 cases have been detected in 18 other countries, including nine in Australia.

So, what exactly does a Public Health Emergency of International Concern mean? Has it happened before? And what does it say about the seriousness of this outbreak?

Here’s what you need to know about the WHO’s decision.

What is a Public Health Emergency of International Concern?

A PHEIC is a formal declaration made by the World Health Organisation in response to the international spread of a disease that may endanger global public health.

As the WHO explains, a PHEIC declaration “implies a situation that: is serious, unusual or unexpected; carries implications for public health beyond the affected state’s national border; and may require immediate international action.”

Declaring a PHEIC requires the convening of a group of experts called the International Health Regulations Emergency Committee, but ultimately it’s up to the WHO Director-General to make the final call.

When the declaration is made, he or she advises countries on how to respond to the public health risk in ways that avoid unnecessary interference with international travel and trade. (More on what that looks like later.) These recommendations are non-binding, however, the WHO can hold governments to account if they go overboard in their response, for example, needlessly stopping trade or closing borders.

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Why wasn’t a PHEIC declared in response to Novel coronavirus sooner?

Because of a change in understanding about how it’s spreading and where it could end up.

Most of the cases of Novel coronavirus have been associated with travel to Wuhan. However, four countries have now reported instances of infection in people who haven’t been to the region.

The latest such case was recorded in the United States on Thursday. Officials from the US Centers for Disease Control and Prevention said the flu-like virus was confirmed in a man living in the state of Illinois, bringing the total number of US cases to six. The man’s wife, who was also infected, had previously travelled to China, but he had not.

It’s that person-to-person transmission that has experts worried, as it suggests greater potential for the virus to spread further. Potentially, to countries that don’t have the resources to deal with it.

Speaking at a news conference in Geneva on Thursday, WHO Director-General Tedros Adhanom Ghebreyesus explained: “The main reason for this declaration is not because of what is happening in China but because of what is happening in other countries. Our greatest concern is the potential for the virus to spread to countries with weaker health systems.

“Let me be clear, this declaration is not a vote of no confidence in China. On the contrary, WHO continues to have confidence in China’s capacity to control the outbreak.”

Listen: How worried should Australians be about Novel coronavirus? The Quicky chats to experts. (Post continues below.)

What do countries have to do now that a PHEIC has been declared?

In a statement, the WHO said the IHR Committee “believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures”.

It, therefore, suggested temporary measures to achieve that.

It gave specific instructions to China, which included recommendations to enhance efforts to contain the virus, implement a public communication strategy to keep its people updated and conduct “exit screening” at international ports to identify outgoing travellers who may have symptoms of the virus (e.g. a high temperature).

As for other countries… No travel or trade restrictions were recommended, but countries were urged to “be prepared for containment, including active surveillance, early detection, isolation and case management”. As well as placing emphasis on stopping the spread of the disease, they were also told to focus on collaborating with other countries in that effort and on “active participation in increasing knowledge on the virus and the disease, as well as advancing research”.

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Countries were also reminded that they are legally obligated to report all cases of the disease to the WHO and were cautioned against taking action that promotes “stigma or discrimination”.

Has a PHEIC been declared before?

Yes. Prior to the Novel coronavirus declaration this week, there had been five PHIEC declarations since the International Health Regulations were established in 2005 in response to the SARS epidemic. SARS (severe acute respiratory syndrome) was another type of coronavirus that originated in China in 2002 and, over the course of several months, spread to two dozen countries, infected at least 8,000 people and led to 774 deaths.

The first PHEIC declaration came on April 26, 2009, in response to the H1N1 Swine Flu pandemic, which spread to 241 countries and is estimated by WHO to have claimed between 105,000 and 395,000 lives. At the stage of the declaration, however, the virus was only present in three countries and there was criticism that the PHEIC may have caused unnecessary global panic — the WHO website received almost two million visits in three hours on the day of the announcement.

The second PHEIC came in May 2014 when more than 300 cases of polio — a disease thought to have been almost eradicated — sprung up in Afghanistan (the PHEIC declaration remains in place). The same year a declaration was made for the outbreak of Ebola in Western Africa.

The next came in February 2016 in response to the mosquito-borne Zika virus that emerged in the Americas. And most recently, the July 2019 declaration for the Kivu Ebola epidemic that emerged in the Democratic Republic of Congo the previous year. The epidemic is ongoing and that PHEIC remains in place; so far 2,242 deaths have been recorded in the DRC and another four in Uganda.

And now, Novel coronavirus — or 2019-nCoV, as it’s formally known.

Despite the declaration, experts are urging people not to panic. Especially those who have not travelled to the Wuhan region.

Most people who contract Novel coronavirus experience mild to moderate symptoms, including fever, dry cough, shortness of breath, and the fatality rate (roughly 2 per cent) is relatively low compared to other major epidemics. Also, of the 170 coronavirus deaths in China, most involved elderly patients or those with underlying health conditions that increased their risk of developing pneumonia.

As Dr Sanjaya Senanayake, Professor of Medicine at Canberra’s Australian National University, told Mamamia‘s daily news podcast, The Quicky:

“For a lot of infections, people who’ve got other illnesses tend to be more susceptible to a severe illness and a really bad outcome, and that’s just because they haven’t got as much reserve. And at this early stage that seems to be the case with this coronavirus,” he said. “Otherwise the mortality from it seems to be relatively low compared to other coronaviruses, like SARS, for instance.”

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