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‘Pandemic’ is not an alert level used under our emergency response framework: WHO

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GoaChronicle.com in continuance with its investigations on the Coronavirus Pandemic posed questions to the World Health Organisation (WHO). Tarik Jasarevic, spokesperson for the WHO replied to our questions via an email. Read on:

GC: PHEIC was declared on Jan 30, 2020 but COVID-19 was termed a pandemic on March 11th. Most countries took the coronavirus threat seriously post the declaration of it being a pandemic. What is the difference between PHEIC and Pandemic and why did WHO not declare it as a pandemic on Jan 30, 2020?

TJ: Within WHO, the highest level public health alert is the declaration of a Public Health Emergency of International Concern. ‘Pandemic’ is not an alert level used by WHO under its emergency response framework and does not have any operational significance within WHO.

On 11 March, deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction, WHO made the assessment that the new coronavirus COVID-19 could be characterised as a pandemic.

GC: Has WHO demanded an investigation into origins of the coronavirus and has China conceded to allow WHO to do an investigation in China?

TJ: It is our understanding that a number of investigations to better understand the source of the outbreak in China are currently underway or planned, including investigations of human cases with symptom onset in and around Wuhan in late 2019, environmental sampling from markets and farms in areas where the first human cases were identified, and detailed records on the source and type of wildlife species and farmed animals sold in these markets. WHO is not currently involved in the studies in China.

Results from these studies are essential to preventing further zoonotic introductions of the virus that causes COVID-19 into the human population. WHO continues to collaborate with animal health and human health experts, countries and other partners to identify gaps and research priorities for the control of COVID-19, including the eventual identification of the source of the virus in China.

WHO would be keen to work with international partners and at the invitation of the Chinese Government to participate in investigation around the animal origins

GC: While WHO declared a PHEIC on Jan 30, 2020 then why did Dr Tedros Adhanom Ghebreyesus, Director General  – WHO voice concern over the travel ban some countries put on China. Could not travel to and from China have been curtailed to stop the spread of virus?

TJ: Although travel restrictions may intuitively seem like the right thing to do, this is not something that WHO usually recommends. This is because of the social disruption they cause and the intensive use of resources required. The costs usually outweigh the potential benefits and, except in very special circumstances, we would prefer countries to focus on other response measures.

On 30 January, the Emergency Committee did not recommend any travel or trade restriction based on the current information available and reiterated that countries must inform WHO about travel measures taken, as required by the IHR.

The Emergency Committee is made up of international experts who provide technical advice to the WHO Director-General in the context of a public health emergency of international concern (PHEIC) The Committee provides views on:

  • whether the event constitutes a public health emergency of international concern (PHEIC);
  • the Temporary Recommendations that should be taken by the country experiencing an emergency of international concern, or by other countries, to prevent or reduce the international spread of disease and avoid unnecessary interference with international trade and travel; and

GC: Why did WHO rely on the China health authorities and on Jan 14th stated that there was no clear evidence of human-to-human transmission?

TJ: As of the 14th of January China had reported to WHO 41 positive cases of the novel virus. Of the 41 cases, seven have been discharged, six are severely ill, and no new deaths were reported after the death of a patient on 11 January.

On 14th January, Chinese authorities issued a new statement indicating that limited human-to-human transmission cannot be excluded, although they reiterated that their investigations currently show no evidence of sustained human-to-human transmission – that is, there is no evidence to date of a highly contagious virus that can be easily transmitted among people who had no contact with either the original source of the virus, or as a close contact or family member of a person infected at the source.

On the basis of available information WHO indicated there was no clear evidence of human to human transmission. WHO also stated that  the mode(s) of transmission had not yet been determined and human to human transmission is always a concern when patients have respiratory symptoms, noting that this question would require further investigation.

Dr. Maria Van Kerkhove, noted in a press briefing that there may have been limited human-to-human transmission of the coronavirus (among the 41 confirmed cases), mainly among family members, and that there was a risk of a possible wider outbreak.  She noted that human to human transmission would not be surprising given our experience with SARS and MERS, and other respiratory pathogens.

GC: Will WHO supports nations demanding for an investigation into the role of China in the origin of the Coronavirus and its spread globally?

TJ: WHO’s policies are set by its 194 Member States. WHO’s mandate is to work to promote the health of all people everywhere, without distinction of race, religion, political belief, economic or social condition.

As DG said to G20 Health Ministers on 19 April, the COVID-19 pandemic has highlighted weakness in health systems and global preparedness and WHO is committed to leading the work requested by the G20 leaders, in cooperation with our partners, to assess gaps in global preparedness, and to lay the foundations for the healthier, safer, fairer world we all want.

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