World Health Organization says the coronavirus crisis will NOT officially be called a pandemic because ‘they no longer use that phrase’ – but the outbreak is still a public health emergency
- Pandemic fears are mounting, with a spike in cases in South Korea and Italy
- But the WHO will no longer officially declare an outbreak as being a pandemic
- It says a pathogen must spread easily between humans across the world first
- The body argues most of the confirmed cases can be tracked back to China
The World Health Organization has today admitted the killer coronavirus outbreak sweeping the world won’t be officially declared a pandemic.
Instead, the UN-body said the crisis has already been a public health emergency of international concern – the highest warning level – for a month.
Fears of a pandemic are mounting, with a surge in COVID-19 cases in South Korea, Italy and Iran taking the world close to the ‘tipping point’.
But the WHO – which defines a pandemic as the worldwide spread of a new disease – will no longer officially declare that stage of an outbreak.
The body, headquartered in Geneva in Switzerland, argues a pathogen must spread easily between humans across the world before it is called a pandemic.
The WHO said the current crisis, which has infected almost 80,000 people and killed 2,600, is a cluster of cases in 36 countries and territories which can be traced back to Asia.
An Italian soldier with a gun stands guard today outside the Duomo cathedral in Milan, which has been shut to tourists over coronavirus fears – as Italy confirmed its sixth death from the virus today
The WHO said the current crisis, which has infected almost 80,000 people and killed 2,600, is a cluster of cases in 36 countries and territories
Leading scientists say most of the cases can be tracked back to China, where 97 per cent of cases of the pneumonia-causing virus have been recorded.
And a WHO spokesperson said it would start using the term pandemic in briefings if human-to-human transmission is sustained outside of Asia.
Professor Paul Hunter, an infectious disease specialist based at the University of East Anglia, warned the outbreak was moving closer to a pandemic.
He said: ‘The director general of the WHO has recently spoken of a narrowing of the window of opportunity to control the current epidemic.
‘The tipping point after which our ability to prevent a global pandemic ends seems a lot closer after the past 24 hours.’
HOW CLOSE ARE WE TO A PANDEMIC?
How close are we to a pandemic?
The World Health Organisation (WHO) no longer uses the official term pandemic.
Under the old system, a pandemic was declared when a new disease spread to several countries and showed sustained transmission between humans. Some experts say this is obviously happening with coronavirus.
What’s happening in the UK?
There have been 13 confirmed cases in the UK so far, all linked to known cases from Asia.
Experts are worried, however, about the emergence of Covid-19 disease in people with no clear contact with anyone from affected Asian countries, suggesting it is being passed on by people with no symptoms.
At the moment, Public Health England (PHE) and the Department of Health are confident about containing an outbreak here, though the head of the NHS, Sir Simon Stevens, has warned it is likely more people will have to stay at home in the future.
Should we be worried about Italy?
Yes. Cases in Italy have doubled within a few days and the country now has the largest number of cases in Europe, at more than 160.
In the regions of Lombardy and Veneto, a lock-down is in place in several towns, affecting about 50,000 people.
There is concern that unless the outbreak of the virus is contained within Italy, there could be more rapid spread in other European countries.
What about the rest of the world?
About 77,000 people in China, where the virus emerged in the city of Wuhan, have been infected and nearly 2,600 have died. More than 1,200 cases have been confirmed in 26 other countries globally, and there have been more than 20 deaths.
What happens next?
While the WHO has been advising countries to work on containing the virus, the next step would be to mitigate the impact of continued transmission.
Measures could include social distancing, such as closing schools, nurseries, sporting events and workplaces, and asking people to stay home and avoid public transport.
Health systems would also need to ramp up their plans, such as preparing for the impact more people with Covid-19 would have on intensive care services.
Professor Mark Woolhouse, of University of Edinburgh, said: ‘A pandemic means an infectious disease is spreading out of control in different regions of the world.
‘We already have a COVID-19 epidemic in China and, more recently, large outbreaks in South Korea, Iran and Italy.
‘If those outbreaks cannot be brought under control, then I would expect the World Health Organisation to declare a pandemic.’
He warned many different countries around the world may be sources of COVID-19 infections, putting the UK at risk of a spate of more cases.
Thirteen cases have already been recorded in the UK, with the latest four diagnosed after being evacuated from the quarantined Diamond Princess cruise in Japan.
Professor David Heymann, of the London School of Hygiene and Tropical Medicine, said terms such as pandemic are ‘distracting’.
He added: ‘Transmissibility in the community is not yet fully understood – what is necessary is to understand the current situation in each country.
‘It is for WHO to determine when the outbreaks should be called a pandemic and they will do this based on information from many different sources.’
The WHO drew flak for declaring the 2009 swine flu outbreak a pandemic, which turned out to be mild and less deadly than feared.
It used to use a six-phase system for outbreaks, with phase six being a full-blown pandemic.
Critics said the WHO created panic about swine flu and caused governments to stockpile vaccines which went unused.
Some even questioned its links to the pharmaceutical industry, after firms such as GlaxoSmithKline profited from producing a H1N1 vaccine.
H1N1, which emerged in Mexico and the US, is thought to have killed up to 200,000 people in more than 200 countries.
WHO spokesperson Tarik Jasarevic told MailOnline that the body no longer uses the six-tier phasing system but added its advice ‘remains the same’.
He said: ‘We continue working with countries to limit the spread of the virus while also preparing for the possibility of wider spread.’
The WHO eventually declared the coronavirus outbreak a public health emergency of international concern (PHEIC) on January 30.
It came as 213 people had died in China after contracting the virus. Less than 10,000 cases had been recorded when the declaration was made.
The WHO rejected making the coronavirus outbreak a PHEIC before its eventual U-turn. It is only the sixth time the term has been used.
The designation, still in place, was aimed at helping countries with weaker health systems shore up their defenses, especially in Africa.
WHAT DO WE KNOW ABOUT THE DEADLY CORONAVIRUS IN CHINA?
Someone who is infected with the coronavirus can spread it with just a simple cough or a sneeze, scientists say.
Over 2,600 people with the virus are now confirmed to have died and more than 79,000 have been infected. But experts predict the true number of people with the disease could be as high as 350,000 in Wuhan alone. Here’s what we know so far:
What is the coronavirus?
A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.
The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.
Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.
The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.
Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals.
‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses).
‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’
The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.
By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.
The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.
Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died.
By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.
By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.
By February 5, there were more than 24,000 cases and 492 deaths.
By February 11, this had risen to more than 43,000 cases and 1,000 deaths.
A change in the way cases are confirmed on February 13 – doctors decided to start using lung scans as a formal diagnosis, as well as laboratory tests – caused a spike in the number of cases, to more than 60,000 and to 1,369 deaths.
By February 24, around 80,000 people had been infected and some 2,600 had died.
Where does the virus come from?
According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.
The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.
Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat.
A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.
However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.
Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.
‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’
So far the fatalities are quite low. Why are health experts so worried about it?
Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.
It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however.
Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.
Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.
‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’
If the death rate is truly two per cent, that means two out of every 100 patients who get it will die.
‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.
‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’
How does the virus spread?
The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.
It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky.
Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.
There is now evidence that it can spread third hand – to someone from a person who caught it from another person.
What does the virus do to you? What are the symptoms?
Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.
If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients – at least 97 per cent, based on available data – will recover from these without any issues or medical help.
In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.
What have genetic tests revealed about the virus?
Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world.
This allows others to study them, develop tests and potentially look into treating the illness they cause.
Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.
However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.
This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.
More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.
How dangerous is the virus?
The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.
However, experts say the true number of patients is likely considerably higher and therefore the death rate considerably lower. Imperial College London researchers estimate that there were 4,000 (up to 9,700) cases in Wuhan city alone up to January 18 – officially there were only 444 there to that date. If cases are in fact 100 times more common than the official figures, the virus may be far less dangerous than currently believed, but also far more widespread.
Experts say it is likely only the most seriously ill patients who are seeking help and are therefore recorded – the vast majority will have only mild, cold-like symptoms. For those whose conditions do become more severe, there is a risk of developing pneumonia which can destroy the lungs and kill them.
Can the virus be cured?
The COVID-19 virus cannot be cured and it is proving difficult to contain.
Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.
No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.
The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.
Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.
People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.
And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).
However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.
Is this outbreak an epidemic or a pandemic?
The outbreak is an epidemic, which is when a disease takes hold of one community such as a country or region.
Although it has spread to dozens of countries, the outbreak is not yet classed as a pandemic, which is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
The head of WHO’s global infectious hazard preparedness, Dr Sylvie Briand, said: ‘Currently we are not in a pandemic. We are at the phase where it is an epidemic with multiple foci, and we try to extinguish the transmission in each of these foci,’ the Guardian reported.
She said that most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.
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