The decision was made on January 30, after more than 5 hours in the council chamber: according to the World Health Organization (WHO), there are now the conditions to officially declare that the 2019-nCoV coronavirus represents a “public health emergency of international interest”, or in short a “global emergency”. Almost simultaneously, while the alarm went off for the two feverish tourists on board the Costa Smeralda ship at the port of Civitavecchia, the Prime Minister Giuseppe Conte announced the presence of the first two confirmed casesof coronavirus infection in Italy. These are two Chinese tourists already hospitalized in the Spallanzani hospital in Rome, in isolation and in conditions deemed “not serious” .

This news could further increase the state of agitation and concern in our country, also because the words emergency and global in itself do not certainly instill serenity. But is there really to be distressed?

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The concept of global emergency according to WHO

As the Organization itself wrote in the final minutes of the council held yesterday in Geneva, the main consequence of this formal emergency is the issue of a series of temporary recommendations , partly specific for China and partly valid for all countries at the level global. Many of these measures are aimed at transparency, sharing information with other countries and creating health culture with adequate public information, but at the same time other indications suggest intensifying efforts in scientific research, in contagion containment operations. and in the carrying out checks, especially in ports and airports.

Viewed from a historical (short-term) perspective, the global emergency declaration is neither unique nor exceptional. Just think that since 2005, when the International Health Regulations (Ihr) were drawn up following the Sars pandemic, we are already on the sixth occasion when a similar decision is made. The first case was in 2009 with the so-called H1N1 swine flu, then in 2014 with poliomyelitis, again in 2014 and then in 2019 with ebola , in the middle in 2015 with Zikaand finally now with 2019-nCoV. However, the emergency was not declared in the case of another pathology due to a coronavirus: Mers in 2013.

On many international texts our global emergency is translated with the English acronym Pheic , which stands for Public Health Emergency of International Concern .

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A substantial choice, but also a bureaucratic one

Although the official statement leaves little room for imagination and interpretation, it was the WHO itself that premised a formal clarification. “The World Health Organization will continue to evaluate the possibility of creating an intermediate alert level between the dichotomous Pheic-non Pheic choice”, ie to create a slightly more varied classification that allows to differentiate (in some way) between different emergency levels.

What happened compared to the previous WHO council of 22 and 23 January, when it was decided not to trigger the emergency, is that the number of commissioners in favor of the decision has increased , in a context in which neither before nor this time there was a clearly majority position within the commission. What made some commissioners, and consequently the general manager Tedros Adhanom, change their minds, was the increase – recorded in the last few days – both in the absolute number of cases and in the number of countries involved in confirmed cases of infection.

The numbers that triggered the emergency

At the time of the WHO meeting, there were 7,818 confirmed cases, distributed in 19 countries. In China alone, confirmed infections had reached 7,711 (almost 99%), to which are added over 12 thousand other suspected cases . Among the certainly infected, 170 people have already died (now the number has risen to 213) and another 1,370 are in conditions defined as “serious” .

Outside China, in the other 18 countries affected by the infection (to which Italy would soon join) there were 82 total cases, of which 75 related to travelers who have recently passed through China. For the other cases, the person-to-person transmission was confirmed . Out of China, however, no serious cases have been recorded so far, let alone deaths.

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What is happening now?

What will not happen – or at least the WHO suggests and hopes that it will not happen – is the marginalization of the countries affected by the infection, starting with China. The main reason is that there is no evidence  that preventing people from moving is useful to reduce the infection, and that sometimes the blockade of transport can take resources away from more useful interventions, as well as certainly having a negative effect on the economy. Trade restrictions are also “not recommended”. An exception, explains the note released by the WHO, are the places where the transmission of the virus is particularly intense, or areas where national infrastructure and systems are not sufficiently developed.

Given the scientific progress made in recent weeks, according to the commission “it is still possible to stop the spread of the virus”. Essential in this sense is the development of systems for early diagnosis, isolation of infected people and education of the population to respect the essential hygiene standards.

The other point emphasized by the WHO is the need to maintain a high level of international cooperation, both as regards China and for all other countries, also with a view to helping those regions of the world where – given the underdevelopment of health systems – the outbreak could have the worst effects.

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The very first reactions of Italy

The government has first established the suspension of all air flights bound for China and arriving from China, moving ahead of many other countries. For the first two cases already ascertained, in addition to hospitalisation in isolation, the seal of the hotel room where they had been staying for 8 days and the transfer to hospital with a bus escorted by the police of all the other members of the tourist group was prepared.

What happened was however largely predictable and partly expected, so much so that the health minister Roberto Speranza spoke of a “serious” situation but for now  “totally under control” . Of course, the effort now focuses on avoiding that the infection spreads. On the morning of January 31 an ad hoc Council of Ministers it should lead to the definition of new prevention and containment measures, and the involvement of civil protection has also been discussed.