Pandemic: What NZ should do
The emerging coronavirus outbreak has tragic consequences for vulnerable populations in its path, but also has potential to unlock the best in international collaboration in science and public health.
Unlike armed conflict, here we are fighting an external threat to global health where collaboration and sharing of information benefits all nations.
By definition, new infectious diseases are an unknown quantity. When they emerge, there are three big questions we need to answer when assessing their pandemic potential: How harmful? How transmissible? How controllable?
The most important measure of severity is the fatality risk. Currently this is about 4 per cent based on 1072 confirmed cases in China and 41 deaths recorded at the time of writing. It is clearly a serious infection for those who are elderly and have underlying illness, with many cases hospitalised with severe pneumonia.
Transmissibility is summarised by the reproduction number, which is the number of people typically infected by each case.
Early figures reported by the World Health Organisation (WHO) suggest a reproduction number of between 1.4 and 2.5 – which suggests that every case detected is typically infecting two other people.
The biggest unknown is how controllable it will be. There is currently no vaccine and no specific treatment for coronaviruses so these interventions are not available.
So far this coronavirus has continued to spread despite initial control efforts in China. It therefore ticks all the boxes for being a potential pandemic threat.
The whole world is watching to see if the massive effort now being taken by China is enough to control this epidemic.
The world has come a long way since the severe acute respiratory syndrome (Sars) coronavirus pandemic in 2002-03. China delayed reporting this emerging infection for several months, hindering an effective response and resulting in severe negative economic consequences for the country.
That pandemic was a major stimulus to acceptance of the International Health Regulations which in 2005 were adopted by all 193 member states of WHO.
The regulations require all WHO members to rapidly report potential emerging health threats, particularly where they pose a risk of international spread. China was quick to report this new coronavirus and has been reasonably transparent in reporting its progression and disseminating scientific data about it.
After a country reports a new event, the WHO then assesses the potential for an international public health emergency.
WHO convened Emergency
Committee meetings last week to consider the need for internationally coordinated control measures. They concluded that it had not yet reached the threshold to declare an international emergency but they will meet again as new information becomes available.
This epidemic is already having an — on New Zealand that is likely to grow over time. There is grief and worry for those at the centre of the epidemic in China.