Action to suppress Coronavirus 2019-nCoV is a global healthcare priority
… Coronavirus 2019-nCoV: A Public Health Emergency of International Concern (PHEIC)

Coronavirus 2019-nCoV: A Public Health Emergency of International Concern (PHEIC)

John G. Baresky

The World Health Organization has declared the Coronavirus 2019-nCoV a Public Health Emergency of International Concern (PHEIC). The declaration of PHEIC is rare. Upon its designation, various government agencies, healthcare institutions and other stakeholders are officially organized to act and escalate measures in collaboration with each other to combat the issue. The decision was made at a point as 171 persons in China have succumbed to the illness and the disease has spread to at least 18 other nations.

WHO has deployed the emergency designation five times since the rules were implemented in the mid-2000s:

  • Ebola virus, 2019
  • Zika virus, 2016
  • Polio outbreak, 2014
  • Ebola outbreak, 2014
  • Swine flu, 2009

According to the World Health Organization:

The term Public Health Emergency of International Concern is defined in the IHR (2005) as “an extraordinary event which is determined, as provided in these Regulations…:

  • “to constitute a public health risk to other States through the international spread of disease”
  • “to potentially require a coordinated international response”

This definition implies a situation that: is serious, unusual or unexpected; it carries implications for public health beyond the affected State’s national border and may require immediate international action.

One of the unique challenges is the newly discovered status of Coronavirus 2019-nCoV (other coronavirus strains have been identified) and its unknown ability to flourish and for that matter, what the overall severity of symptoms in larger populations be. Timing is critical as northern hemisphere climes are largely in the middle of their traditional Flu seasons. If 2019-nCoV were to widely spread into these regions, it could be harder to distinguish those cases from the expected Flu strain cases in those areas.

When WHO assigns PHEIC status to a particular circumstance, it is an urgent paramount call to action. For any health emergency, the primary goal is to resolve it as soon as possible. There are precautions to be considered, however; as they were for Zika, Polio, H1N1, Ebola, based strictly on the merits of Coronavirus N-CoV19 so that PHEIC designation is not given prematurely.

Lesser scale issues declared as PHEICs could sap attention and resources from other significantly dangerous healthcare matters plus unnecessary alarm and waste. As a result, other healthcare challenges could escalate due to various supporting measures being steered away from them. Even when an event is issued PHEIC status to be dealt with more assertively, it does create its own set of challenges which could involve travel and trade restrictions plus individual as well as sizable population inconveniences and discomfort.

Conversationally speaking, WHO bases its decision on hard facts and qualified opinions provided by their committee members and information from healthcare professionals, government healthcare officials and input from select thought leaders and authorities of the healthcare challenges at hand.

  • What is the scale of the threat risk to public health?
  • How unusual or unexpected are the circumstances?
  • What level of success thus far has been achieved in dealing with the threat and in what direction is its momentum moving?
  • How significant is the risk for international exposure as a disease or other threat manifests itself?
  • What is the level of risk that would require international travel and trade restrictions?

The discovery of Coronavirus 2019-nCoV is a recent event. Similar viruses have been dealt with before and immunizations developed for them however none would be effective against 2019-nCoV. As new virus strains emerge, the severity of their symptoms and scale of their impact geographically on people may not be significant and do not immediately warrant the time, clinical and financial investment for an immunization to be developed for them.

It took researchers about 20 months to develop a vaccine for SARS. While several companies are now involved with creating a vaccine for Coronavirus 2019-nCoV, none are close to being fully developed for approval and manufactured in mass quantities.

Numerous government agencies and bureaus are taking an active role in protecting the health and well-being of U.S. citizens from the threat of Coronavirus. These are some of the primary stakeholders responsible for safeguarding the country from healthcare threats originating from outside the nation creating issues inside it:

  • Centers for Disease Control (CDC)
  • Department of Health and Human Services (HHS) and the Biomedical Advanced Research and Development Authority (BARDA) unit
  • Department of Homeland Security (DHS) and the U.S. Citizenship and Immigration Services (USCIS) unit
  • Food and Drug Administration (FDA)
  • National Institutes of Health (NIH)

Quite evidently, 2019-nCoV has met or exceeded the requirements for PHEIC status. An escalation is underway between WHO, government leaders and the global healthcare community to work together and put this PHEIC behind us as soon as possible. It will be a learning experience for all those involved and lead to even better responses and successes in dealing with PHEIC challenges in the future.

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