The virus, which is similar to the fatal severe respiratory syndrome (SARS), first emerged in Wuhan, China, which has a population greater than New York City. More than 1,900 people have already been infected, and more than 55 people have died. To contain the virus during the Lunar New Year, which marks the largest annual human migration in the world, the Chinese government placed a lockdown on 12 cities, affecting about 35 million people. On Saturday, China said it would halt all outbound international tour groups starting Monday.
Although authorities in Wuhan initially cracked down on people accused of spreading "rumors" about the illness, the Chinese government has since taken rapid and strict measures to contain the virus. Their efforts are laudable but may not be sufficient given the movement of people who may have been infected in the weeks before the lockdown was ordered.
While Chinese officials have a responsibility to limit the spread of the outbreak, global health officials in Geneva need to take quick action. By declaring a global emergency, WHO would set in motion coordination efforts among various countries and encourage UN member states to institute strict surveillance measures. While some initial panic could result, WHO's leadership would jolt passive governments into action.
In making its decision not to declare a global public health emergency, WHO officials cited a limited number of cases abroad, and strong, preventative containment measures in China. "While this outbreak is an emergency in China, it has not yet become a global health emergency," WHO spokesman Tarik Jasarevic told me.
However, the number of overseas cases are growing rapidly. There are more than 35 cases in more than a dozen countries and territories outside mainland China, including two in the United States. On Friday, the first European cases were confirmed in France. As for the number of cases in China, some experts suggest the total could be far higher than what is currently being reported.
By WHO's own definition, an international public health emergency is "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." Given what we've seen of the Wuhan coronavirus so far, the threshold for the declaration has surely been met.
In a public statement, the organization said, "the Committee members agreed on the urgency of the situation and suggested that the Committee should be reconvened in a matter of days to examine the situation further."
In a 2018 report analyzing the responses to the earlier Ebola, Zika and H1N1 public health emergencies, public health researchers Steven Hoffman and Sarah Silverberg wrote, "When the systems for recognizing and responding to disease outbreaks act too slowly, the result is unnecessary delay, greater disease spread, additional people affected, and more lives lost."
The WHO, a mainline UN agency which is heavily influenced by members states, has used the international public health emergency declaration sparingly, has come under fire for being too slow to act. We saw that when WHO finally declared Ebola a public health emergency of international concern in 2014, eight months after the outbreak first emerged. By that time, the outbreak had already spread to three countries, and the virus ultimately killed more than 11,000 people.
"Ebola exposed WHO as unable to meet its responsibility for responding to such situations and alerting the global community," said an independent panel of experts in 2015 that included members from the Harvard Global Health Institute and the London School of Hygiene and Tropical Medicine.
The panel went further, suggesting the establishment of a new global health committee within the UN Security Council to declare outbreaks and international emergencies for more timely responses.
A perfect storm for authorities in Beijing?
Placing cities on lockdown, especially when tens of millions of Chinese people planned to travel and celebrate the Lunar New Year holidays, has already sparked panic and created a headache for the Chinese Communist Party. Long lines have been reported at local hospitals, tourist attractions like the Forbidden City in Beijing and Shanghai Disneyland have been closed, and large public gatherings are now forbidden around China. Public criticism of authorities has increased dramatically on social media, although many of the posts were later taken down.
What happens next in terms of public reaction may be of a magnitude not seen by Beijing authorities for some time. After all, far more minor events have sparked protests in China — including protests over a waste incineration plant near Wuhan last year in which riot police had to be deployed.
Let's be clear. The Wuhan coronavirus is spreading rapidly, including to other continents outside of Asia. There is no known vaccine. Tens of millions of people who live in China or recently traveled to the Hubei province are still on the move.
In the absence of a declaration of a global public health emergency, governments or regional bodies such as the Association of Southeast Asian Nations (ASEAN) are free to coordinate action themselves.
Out of an abundance of caution, the UN should act immediately to raise the international alarm to prevent further infections and deaths. So far, cities like Vancouver, which has an international airport hosting numerous Chinese airlines, haven't instituted thermal screening for incoming passengers. In Toronto, Ontario's chief medical officer of health announced on Saturday the first "presumptive" case of the coronavirus in Canada.
While the declaration of a global public health emergency could stoke widespread fear and would by no means bring the outbreak under control, it will push countries around the world to take preventative action and encourage them to step up surveillance. If there is one thing that we have learned from previous outbreaks, viruses do not respect borders and thrive when there is a lack of urgent and coordinated human action. Time is of the essence.
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