According to the World Health Organization, “Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.” The current outbreak that started in Wuhan, China may have first been detected in early December 2019, hence its name COVID-19.
From the policy perspective there are several global, regional, national and local steps and policies that must be considered. At is second meeting on the novel coronavirus, the WHO Emergencies Coronavirus Emergency Committee on 30 January 2020 recommended and the WHO Director General declared, “We would have seen many more cases outside China by now – and probably deaths – if it were not for the government’s efforts and the progress they have made to protect their own people and the people of the world… I’m declaring a Public Health Emergency of International Concern over the global outbreak of novel coronavirus.”
The PHEIC was declared based on “the IHR, our main international health treaty.” This declaration and treaty enable WHO’s “leadership role for public health measures, holding countries to account concerning additional measures they may take regarding travel, trade, quarantine or screening, research efforts, global coordination, anticipation of economic impacts, support to vulnerable states,” which is where global and national policies and actions may come into concordance or conflict. Clearly some of the more draconian control measures by a few countries were perceived to be beyond the scope of these regulations, policies and treaty.
While as of this writing the spread of COVID-19 appears to slowed in China, it is picking up pace on other continents. The next policy question is whether to name the current outbreak a “pandemic.”
WHO says that, “A pandemic is the worldwide spread of a new disease.” Thus there is community level spread of the disease, not just imported cases from another country. As of today, there is still no evidence of community spread in Africa and Latin America, but a suspected community acquired case has been detected in North America.
Policy and action implications for declaring a pandemic have been spelled out in the Guardian: “a pandemic would mean travel bans would no longer be useful or make sense and would alert health authorities that they need to prepare for the next phase… This includes preparing our hospitals for a large influx of patients, stockpiling any antivirals, and advising the public that when the time comes ,they will need to think about things like staying at home if ill, social distancing, avoiding large gatherings etc.” experts said. And a big challenge for governments would be “encouraging people to change their behaviours, such as forgoing or cancelling large social events if they are sick.”
It is most likely that class members in Social and Behavioral Foundations of Primary Health Care at JHSPH will address some of these policy challenges in their blogs during the coming months.