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MERS Virus Not Yet a Global Emergency, WHO Panel Says
17 July 2013 5:00 pm
A special panel established by the World Health Organization (WHO) decided today that the novel coronavirus that has been infecting people in the Middle East is "very concerning," but does not yet constitute a "public health emergency of international concern." The new pathogen, known as Middle East respiratory syndrome (MERS) virus, has sickened 82 people and killed 45 of them so far.
The so-called emergency committee of public health experts, which WHO established on 5 July, met for the first time last week. The 15-member panel was tasked with keeping a close eye on MERS and determining whether it posed risks serious enough to justify WHO recommending that governments limit travel or take other steps to prevent MERS from spreading. Under a global agreement known as the International Health Regulations, the panel's declaration of an emergency would give WHO the power to issue recommendations on addressing MERS.
After convening by telephone for 4 hours this afternoon, the panel unanimously decided that the conditions for a public health emergency of international concern had not been met—so far.
The committee decided that "this was not the time to go ahead with such a declaration but to monitor the situation very closely," said Keiji Fukuda, WHO's assistant director-general for health security and environment, at a press conference in Geneva, Switzerland. In part, the decision reflected the negative effects an emergency declaration could also have, he noted. "You want to make these declarations when they are proportionate to the event."
The panel made the right call, says Mike Osterholm, director at the Center for Infectious Disease Research and Policy at the University of Minnesota, Twin Cities. But he worries that some people could take the decision to mean that there is nothing to worry about. "We have this unfortunate nomenclature that has been given to us," he tells ScienceInsider. "And it is either a yes or a no."
If the panel had said yes to an emergency declaration, however, it also faced the risk of losing public trust if MERS failed to become a serious global health problem, he notes. "If nothing had happened, people would have said you scared us needlessly, we cannot believe you. And credibility is the number one asset in public health."
Osterholm says that WHO needs to work on a better way of highlighting a possible danger without calling it an emergency. "What we are really talking about here is not the evidence or the data, but how do we describe this to the world," he says. "And there is a lot of room in between 'don't worry' and 'on the brink of disaster.' "
Today's decision also "raises questions and creates potentially confusing messages from WHO" according to David Fidler, an expert on international law and global health at Indiana University, Bloomington. He notes that the International Health Regulations define a public health emergency of international concern as " an extraordinary event" which "constitute[s] a public health risk to other States through the international spread of disease" and "potentially require[s] a coordinated international response." It is not clear which conditions MERS did not meet in the eyes of the emergency committee, Fidler says. "Is MERS not an extraordinary event? It does not constitute a public health risk to other States through international spread? It does not require a coordinated international response?"
On top of that, WHO Director-General Margaret Chan called MERS "a threat to the entire world" at the World Health Assembly in Geneva in May. "That is a dramatic statement," Fidler says. How that statement squares with today's decision is unclear, he argues. "The WHO could do everyone a great service by being more transparent."
Unless there are serious new developments, the committee will not convene again until September, WHO announced. Fukuda also said that although the organization is not planning to recommend any travel restrictions, it is preparing advice for travelers that would be made public in the next few days.
Researchers, meanwhile, are continuing to study MERS. So far, they haven't been able to find the virus's "animal reservoir" (the species it infects other than humans), or nail down how people are infected and how many mild or asymptomatic infections there are in the region.