WASHINGTON — Amid growing international concern over coronavirus, a World Health Organization panel on Thursday declined to declare the new outbreak a global emergency, saying it was largely confined to China, where strong steps toward its containment were already underway.
“This is an emergency in China, but it is not yet a global health emergency,” said WHO Director-General Tedros Adhanom Ghebreyesus at a news conference, describing the conclusions of the organization’s emergency panel, which had a near 50-50 split vote on the decision. “It may yet become one.”
WHO reported 584 confirmed cases of coronavirus — also known as 2019-nCoV — and 17 deaths since the outbreak began Dec. 31. Local news outlets in China reported slightly higher totals: 644 confirmed cases and 18 deaths.
The virus, a newly discovered member of the coronavirus family that includes past outbreak diseases SARS and MERS, was first reported from a patient who had visited a seafood and meat market in Wuhan. The coronavirus causes pneumonia-like symptoms, including coughing, fever, headaches, difficulty breathing, and fatigue.
As of Thursday, Singapore, Japan, South Korea, Taiwan, Thailand, Vietnam, and the US had reported cases in which coronavirus patients had traveled from China. And Texas A&M University confirmed Thursday afternoon that one of its students who had traveled from Wuhan is under investigation as a possible second US coronavirus case.
But all the deaths, and 575 of the 584 reported illnesses, took place in China, Tedros said, arguing that the outbreak was not yet of global concern. The cases of person-to-person transmission of the virus also appear to be confined to China, largely among family members and health care workers, rather than infections from everyday activity. Deaths are taking place among elderly patients, or ones with underlying health conditions that may worsen their pneumonia.
In addition, the WHO panel concluded that China had taken appropriately aggressive measures so far to contain the outbreak. Early on Thursday, China widened a travel ban from Wuhan, the city of 11 million people at the center of the outbreak, extending the quarantine to include more than 20 million people in nearby cities in Hubei province.
Tedros declined to set a date for another meeting of the emergency panel but said he would not hesitate to do so if the conditions of the outbreak changed.
In response to a US patient first reported on Tuesday, the CDC has been screening air travelers from Wuhan at major airports in Atlanta, Chicago, Los Angeles, New York, and San Francisco, redirecting flights to those cities.
In their last comments on the outbreak, federal health officials last week rated the risk to people in the US from the outbreak as low. “For a family sitting around the dinner table tonight, this is not something that they generally need to worry about,” said Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases.
“There is still a lot we don’t know about this coronavirus,” chiefly just how infectious and how deadly the virus is, Stanley Perlman, a coronavirus expert at the University of Iowa, told BuzzFeed News. “It will take time and a larger number of cases to calculate that for this virus.”
Quarantines proved to be effective in the SARS coronavirus outbreak of 2003, he noted, because the virus was largely contagious only when it reached the late stages of illness, usually transmitted via coughing. SARS ended up killing 774 people across 29 countries, with the majority of deaths in China and Taiwan.
If the new coronavirus is similar, becoming infectious only late in a case, then quarantines will likely prove to be effective, he said. The flu, a different kind of virus, is partly more infectious because it lodges in the nose and throat, leading to sneezing early in a case and triggering more infections from casual contact.
But if the new coronavirus mutates and lodges in the nose and throat like the flu, Perlman added, “then all bets are off.”
The unknowns led some experts to criticize the WHO’s decision, arguing the outbreak met the criteria for issuing an emergency declaration.
“WHO should have declared a Public Health Emergency of International Concern. All the legal criteria have been met, including a novel virus, rising cases, and international spread,” said Lawrence Gostin, a professor at Georgetown, in a statement. “There are already major impacts on travel and trade. I expect the crisis to escalate, as cases will mount in China, Asia, and globally.”
Coronaviruses typically spread first from animals to people, as in the MERS outbreak of 2012, which originated in camels and has killed 858 people to date. Which animal in the Wuhan seafood and meat market was the host for the new coronavirus is another unknown, Tedros noted. Some studies have pointed to snakes as the point of origin, while others have suggested that the outbreak was sparked by bats sold as food in the market in Wuhan.
“Probably all coronaviruses are bat viruses. The question is just whether the bat virus went through some intermediary animal before infecting people,” said Perlman.