The World Health Organization (WHO) Emergency Committee held a meeting Friday, 30th January 2020 under the International Health Regulations (IHR) (2005). This was the second meeting of the committee since the outbreak of the Coronavirus in December 2019. This meeting took place in view of significant increases in numbers of cases and additional countries reporting confirmed cases.
22 January 2020
The committee had previously met on 22 January, the members of the Emergency Committee expressed divergent views on whether this event constitutes a Public Health Emergency of International Concern (PHEIC) or not. At that time, the advice was that the event did not constitute a PHEIC, but the Committee members agreed on the urgency of the situation.
Dr. Tedros said the potential for the further global spread was one of the reasons he had called on the W.H.O.’s emergency committee to meet again on Thursday to decide whether to declare the epidemic a PHEIC.
The outbreak now meets criteria for a Public Health Emergency of International Concern
As of 30 January, the Committee agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.
The 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 commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce the spread of the infection.
The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency, and, it is to be hoped, with success.
Representatives of the Ministry of Health of the People’s Republic of China reported on the current situation and the public health measures being taken. There are now 7711 confirmed and 12167 suspected cases throughout the country. Of the confirmed cases, 1370 are severe and 170 people have died. 124 people have recovered and been discharged from hospital.
Around the world
There are now 83 cases in 18 countries, which is a rise of 15 cases since 29 January.
Of the cases from other countries, only 7 had no history of travel in China. There has been human-to-human transmission in 3 countries outside China. One of these cases is severe and to date, there were no deaths.
Dr. Tedros Adhanom Ghebreyesus previously said at a news briefing on Wednesday 29 January. “The fact that to date we have only seen 68 cases outside China and no deaths is due in no small part to the extraordinary steps the government has taken to prevent the export of cases,”
Cases across five WHO regions.
The Committee also acknowledged that there are still many unknowns, cases have now been reported in five of the six WHO regions in one month and human-to-human transmission has occurred outside Wuhan and outside China.
For the purpose of reporting, data analysis and administration the WHO divides countries around the world into six WHO regions. African Region, Region of the Americas, South-East Asia Region, European Region, Eastern Mediterranean Region and the Western Pacific Region. China is a part of the Western Pacific Region which is region 14.
The Emergency Committee will continue to provide advice to the Director-General throughout the duration of the PHEIC, including any necessary changes to the recommended measures and on the determination of PHEIC termination.
What does a PHEIC status mean?
A declaration would lead to a boost in public health measures, funding and resources to prevent and reduce international spread.
The measures could include recommendations on trade and travel, including airport screening of passengers — although the WHO generally aims to avoid disruptive trade restrictions.
Under the WHO’s current regulations for managing such situations, the emphasis is on containing an outbreak at its source. They also require countries to be transparent with information about the outbreak and be prepared to isolate patients who are infected.
How does the WHO define a PHEIC?
There are two criteria to define an outbreak as such. Firstly, the outbreak must pose a risk to more than one country.
The second requirement is that an outbreak requires “a coordinated international response.”
In the WHO’s official definition, they say this means a “situation that is serious, unusual or unexpected.”
A panel of experts, called the IHR Emergency Committee, is convened to discuss the situation. IHR stands for International Health Regulations
Ultimately, after assessing evidence including human-to-human transmission rates, the final decision rests with the WHO Director-General
Public Health Emergency of International Concern in the past decade.
The procedures to declare a PHEIC were implemented in 2005, as a response to the outbreaks of SARS and H5N1 (bird flu) in the early 2000s.
Previous emergencies in the past decade have included, the H1 virus that caused an influenza pandemic (2009), West Africa’s Ebola outbreak (2013-2016), polio (2014), Zika virus (2016), and the ongoing Ebola outbreak in the Democratic Republic of Congo (2019).
The World Health Organization Emergency Committee
The committee advises the Director-General on the recommended measures to be promulgated on an emergency basis, known as temporary recommendations. Temporary recommendations include health measures to be implemented by the State Party experiencing the PHEIC, or by other States Parties, to prevent or reduce the international spread of disease and avoid unnecessary interference with international traffic.
At least one member of the Emergency Committee should be an expert nominated by a State Party within whose territory the event arises.
Director-General, Dr. Tedros Adhanom Ghebreyesus makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC).
International Health Regulations (2005)
The International Health Regulations, or IHR (2005), represent an agreement between 196 countries including all WHO Member States to work together for global health security.
Through IHR, countries have agreed to build their capacities to detect, assess and report public health events. WHO plays the coordinating role in IHR and, together with its partners, helps countries to build capacities.
IHR also includes specific measures at ports, airports and ground crossings to limit the spread of health risks to neighbouring countries and to prevent unwarranted travel and trade restrictions so that traffic and trade disruption is kept to a minimum.
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