On March 11, director-general of the World Health Organisation (WHO), Tedros Adhanom Ghebreyesus, declared the outbreak a pandemic – that is, according to the WHO’s definition, “the worldwide spread of a new disease”. Dr Ghebreyesus said the decision was taken because the WHO was “deeply concerned” by the severity and rate of spread of the disease, and by the alarming levels of inaction. US President Donald Trump is among the WHO’s critics over its handling of coronavirus, accusing the body of being “too slow to respond
But there is an explanation for why it took 40 days to make the move.
In 2018, Australian broadcaster Ali Moore held a hypothetical pandemic exercise titled “This Is Not a Drill” to analyse expert’s response to a “highly infectious disease” from the tropics of Southern China, dubbing it Disease X, which helps explain the real reason for the process.
She said: “What if there was a far more dangerous virus, spreading from person-to-person and country-to-country with authorities struggling to work out how to stop it?
“There’s no vaccine, at least not yet, how do you contain it? How do you treat those who have been infected and how do global authorities work together to find the answers?
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This is a decision the WHO does not take lightly
“In a joint project with Asialink, the University of Melbourne and the Wheeler Centre, our expert panel those questions in a hypothetical pandemic called Disease X.
“What if this unknown pathogen, warned of by the World Health Organisation, arrived?”
Ms Moore set the scene, comparing this Disease X to previous pandemics.
She added: “You have to go back 100 years to find true global devastation, the Spanish Flu of 1918 infected one-third of the world’s population and 50 million died.
“The only disease to rival that level of destruction since is HIV/AIDS, but there have been other fatal infections.
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“In 1957, Asian Flu killed up to two million, 10 years later Hong Kong flu claimed one million, then in 2003, there was SARS and six years later Swine Flu arrived.
“Since then, Ebola, MERS and the Zika virus have all made headlines, now for the first time, the World Health Organisation has added Disease X to its watchlist.
“A recognition that we don’t know where the next pandemic will come from, but we do know how we will respond to it will be critical.”
But, like the recent COVID-19 outbreak, Disease X was not named a pandemic until it had already infected a high number of people in several countries.
Among a panel of experts in government and science was Professor Kanta Subbarao, Director of the WHO Collaborating Centre for Reference and Research on Influenza, who explained the delay in the decision.
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She said: “This is a decision the WHO does not take lightly, it’s a very significant decision because there are implications through the international health regulations.
“There are also implications on trade, travel and international interaction.
“It’s not made lightly, but as you talked about, the number of cases there have been and how widespread this suggests we may be seeing the tip of the iceberg in terms of case fatalities.
“There may be a lot more illness out there.”
Professor Subbarao went on to explain that each country should already have pandemic plans in action prior to their declaration.
She added: “What the WHO has recommended and was done in 2009, is to study the first few hundred cases in each country in great detail.
“This is to try and learn more about the clinical illness, the range of clinical disease, the outcomes, the epidemiology, more about the virus and the immune response.
“The WHO is particularly at risk for complications, so there is a suggestion that each country – as part of their pandemic preparedness – should set up the ability to do such investigations of the first few hundred.”
The WHO declared a global health emergency on January 30, acknowledging then that the crisis corresponded to the maximum level of threat.
That decision unlocked all the WHO’s available powers and resources for addressing the crisis without the panic that comes with the term pandemic, but complacency is reported to be the reason why the WHO scaled-up to a pandemic.
Dr Ghebreyesus said on March 11: “We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic.
“If countries detect, test, treat, isolate, trace, and mobilise their people in the response, those with a handful of cases can prevent those cases becoming clusters, and those clusters becoming community transmission.”
Annelies Wilder-Smith, a professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine told the New Statesman in March: “Declaring a pandemic does change the alert system in many countries, in addition to changing ordinary people’s psychology.
“I think that Dr Tedros chose the right timing: not too early, not too late.”
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