The World Health Organization (WHO) has scheduled another meeting of its emergency committee on Thursday to determine whether or not this outbreak of novel coronavirus constitutes an international health emergency, the agency said on Wednesday.
WHO officials cited the rise in confirmed cases, as well as the cases of human-to-human transmission reported in Germany, Vietnam and Japan, as chief reasons for reconvening the emergency committee.
"The continued increase in cases and evidence of human-to-human transmission outside China are, of course, deeply concerning," said WHO director-general Tedros Adhanom Ghebreyesus, MBBS, PhD.
Latest WHO data indicate there are now 6,065 confirmed cases of novel coronavirus, including 5,997 inside China, which means the virus has passed SARS in terms of case count, according to media reports. There have been 132 deaths, all within China, and 2% of cases have died. WHO officials said 20% of the cases have been severe.
Adhanom Ghebreyesus also characterized the 68 cases outside China, almost all travel-associated, as a small number, but one that may grow with increased surveillance.
These numbers "hold the potential for a much larger outbreak," he said.
Michael Ryan, MD, executive director of WHO's emergencies program, added that a 2% case-fatality rate is still "tough" compared with seasonal flu, though WHO officials acknowledged that it's still "too early" to determine exactly what the mortality rate will be.
"A relatively mild virus can cause a lot of damage if a lot of people get it," he said.
Asked about the virus's risk to healthcare professionals, Maria Van Kerkhove, of WHO's emerging diseases and zoonosis division, confirmed there has been a "hospital cluster" in Wuhan with 14 healthcare workers infected, and "reports of healthcare worker infections in other parts of China," but so far there have not been reports of other "hospital outbreaks" elsewhere in China or in other countries.
Van Kerkhove said that evidence indicates the virus can be transmitted through the respiratory route, via droplets, and physical contact between people, but also from fomites, as the virus can live on surfaces for a short period of time.
Asymptomatic transmission was a big topic of conversation, with WHO officials noting that most questions from reporters online focused on the topic.
Ryan said that it's very difficult to work out whether such type of transmission is occurring based on "routine data from epidemics," and it requires more detailed studies, adding that WHO has received disaggregated data to attempt this type of analysis.
"Epidemiological studies [and] clinical studies need to take place [to] better understand transmission [and] severity of the virus," Van Kerkhove said.
A reporter asked Adhanom Ghebreyesus to comment on several countries' decisions, including the U.S., to evacuate their citizens out of the outbreak areas, as was reported in a Department of Health and Human Services press briefing on Tuesday.
"Of course, the decision to evacuate citizens is up to the countries. The one thing the WHO advises is they have to prepare themselves if there is an importation of cases. So they have to have a full understanding of their actions."
WHO will be evaluating whether the outbreak of novel coronavirus constitutes a Public Health Emergency of International Concern (PHEIC), which triggers obligations on member states to "respond promptly" when one is declared.
Towards the end of the press conference, Adhanom Ghebreyesus mused about having a "traffic light" system, to create an "intermediate" level of health emergency, a so-called "yellow light" or warning.
"It is now green [no PHEIC] or red [a PHEIC]. I think it would be good to have green, yellow, or red," he said. "A yellow would be a warning where there's some state that could be serious enough, but not really red."