世界卫生组织关于新型冠状病毒爆发的最新声明

会议

要点

1

人与人之间的传播正在发生，初步的R0（基本传染数）估算值是1.4-2.5；

2

有一个医院发生了大面积的传染；

3

确诊有武汉的第四代传染病例和武汉以外的第二代传染病例；

4

已确诊病例中，有25％为重症病例；

5

病毒来源仍然未知（很可能是动物的资源库）；

6

人与人之间的传播程度尚未清楚。

7

鉴于“国际公共卫生紧急事件”（PHEIC）具有限制性和二元性，现在宣布此事件为“国际公共卫生紧急事件”还为时过早。

8

预计十天后或更早（如有必要）会再召开一次会议。

会议背景

世界卫生组织总干事根据《国际卫生条例（IHR）（2005）》召集紧急委员会会议，分别于日内瓦时间（CEST）2020年1月22日星期三12:00至16:30以及2020年1月23日星期四12:00至15:10举行，重点讨论2019年在中国爆发的新型冠状病毒，以及已经确诊的韩国，日本，泰国和新加坡输出型案例。

 该委员会的职责是向总干事提供咨询，总干事则对确定“国际关注的突发卫生事件”（PHEIC）做出最终决定。委员会还提供公共卫生建议或酌情提出正式的临时建议。

会议纪要 

1月22日，紧急委员会成员对该事件是否构成“国际公共卫生紧急事件”（PHEIC）表示了不同意见。当时的建议是，该事件并不构成“国际公共卫生紧急事件”（PHEIC），但委员会成员同意情况紧急，并建议应在几天之内重新召集委员会，以进一步审查局势。

1月22日在武汉宣布采取新的遏制措施后，总干事要求紧急事务委员会于1月23日再次召开会议，以研究中国当局提供的有关最新流行病学演变和采取的风险管理措施的信息。

1月23日，中华人民共和国卫生部，日本，泰国和大韩民国的代表向委员会通报了各自国家的情况。在中国，已报告的病例数量有所增加，截至今天已确认557例。

中国代表更新了最新疾病传染情况，其数据显示受感染省份的病例数及可疑病例数目增加，目前确诊病例中死亡率4％（17/577）。已经确诊了武汉的第四代传染病例和武汉以外的第二代传染病例，以及湖北省以外的一些集中发病地区。中国介绍了目前采取的强制措施——譬如关闭武汉市及附近其他城市的公共交通系统。演讲后，紧急委员会获悉日本，韩国和泰国的发展情况，以及新加坡发现一个新的疑似病例。

委员会肯定了中国为调查和遏制当前疫情所作的努力。

与会者认为至关重要的要素：

• 人与人之间的传播正在发生，初步的R0（基本传染数）估算值是1.4-2.5。

• 有一个医院发生了大面积的传染。

• 已确诊病例中，有25％为重症病例。

• 病毒来源仍然未知（很可能是动物的资源库），人与人之间的传播程度尚未清楚。

几个成员认为，鉴于“国际公共卫生紧急事件”（PHEIC）具有限制性和二元性，现在宣布“国际公共卫生紧急事件”（PHEIC）还为时过早。

根据这些不同的观点，紧急委员会提出以下建议：

世卫组织

委员会准备在大约十天后再召开一次会议，如果总干事认为有必要则可以更早召开。

委员会敦促通过包括国家专家在内的世卫组织国际多学科访问团支持正在进行的努力。访问团将审查和支持以下工作：

• 调查病毒的动物源头

• 人与人之间的传播程度

• 在中国其他省份的筛查工作

• 在这些地区加强对严重急性呼吸道感染的监测以及加强遏制和缓解措施

世卫组织应继续提供一切必要的技术和业务支持，以应对这一爆发，包括通过广泛的合作伙伴与合作机构网络，实施全面的风险交流战略，并促进与这种新型冠状病毒相关的研究和科学发展。

鉴于不断变化的流行病学情况以及PHEIC的限制性与二元性，世卫组织应考虑采用更细微的系统，以实现中等程度的警报。这样的系统将更好地反映疫情的严重程度，影响和所需的措施，并将有助于改善国际协调性，包括为制定医疗对策进行研究。

中国方面

• 提供有关跨政府风险管理措施的更多信息，包括国家，省和市级的危机管理系统以及其他国内措施。

• 加强合理的公共卫生措施，以遏制和缓解当前的疫情。

• 在全中国范围内，尤其是在农历新年庆祝活动期间，加强监测汇报病例。

• 与世卫组织及其合作伙伴合作进行调查，以了解流行病学和这次疫情的演变，调查：

1. 新型冠状病毒的来源，特别是动物族类和参与人畜传播的动物

2. 病毒在人与人之间传播的潜力

3. 正在发生传播的地方

4. 感染相关的临床特征和降低发病率和死亡率所需的治疗方法

• 在受影响省份的国际机场和港口进行出口检查，目的是及早发现有症状的旅行者来进行进一步评估和治疗，同时最大程度地减少对国际交通的干扰。

• 必要时鼓励在国内机场，火车站和长途汽车站进行检查。

其他国家

预计在任何国家都有可能出现新的病例输出。因此，所有国家都应做好遏制工作的准备，包括积极监测，及早发现，隔离和病例管理，接触者追踪以及防止2019-nCoV感染继续蔓延，并与世卫组织共享全部数据。

根据《国际卫生条例》，各国必须与世界卫生组织共享信息。

可在此处获得技术建议。各国应特别强调减少人类感染，防止二次传播和国际传播，并通过多部门的交流与合作以及积极参与对病毒和疾病知识的了解以及促进研究的发展，为国际应对做出贡献。各国也应遵循世界卫生组织的旅行建议。

国际社会

由于这是一种新型冠状病毒，而且以前已经表明类似的冠状病毒需要为定期的信息共享和研究付出巨大的努力，因此，国际社会应根据《国际卫生条例（2005）》第44条，继续表现出团结与合作。在鉴定这种新病毒的来源，其在人与人之间传播的全部潜力，为可能的病例输入做好准备以及为开发必要的治疗方法的研究方面相互支持。

附纪要原文

Statement on the meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)

23 January 2020 Statement Geneva, Switzerland

The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the outbreak of novel coronavirus 2019 in the People’s Republic of China, with exportations currently reported in the Republic of Korea, Japan, Thailand and Singapore, took place on Wednesday, 22 January 2020, from 12:00 to 16:30 Geneva time (CEST) and on Thursday, 23 January 2020, from 12:00 to 15:10. The Committee’s role is to give advice to the Director-General, who makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC). The Committee also provides public health advice or suggests formal temporary recommendations as appropriate.

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference.

The Director-General welcomed the Committee and thanked them for their support. He turned the meeting over to the Chair, Professor Didier Houssin.

Professor Houssin also welcomed the Committee and gave the floor to the Secretariat.

On 22 January, representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.

The Chair then reviewed the agenda for the meeting and introduced the presenters.

On 23 January, representatives of the Ministry of Health of the People’s Republic of China, Japan, Thailand and the Republic of Korea updated the committee on the situation in their countries. There have been increased numbers of reported cases in China, with 557 confirmed as of today.

Conclusions and Advice

On 22 January, the members of the Emergency Committee expressed divergent views on whether this event constitutes a PHEIC or not. At that time, the advice was that the event did not constitute a PHEIC, but the Committee members agreed on the urgency of the situation and suggested that the Committee should be reconvened in a matter of days to examine the situation further.

After the announcement of new containment measures in Wuhan on 22 January, the Director-General asked the Emergency Committee to reconvene on 23 January to study the information provided by Chinese authorities about the most recent epidemiological evolution and the risk-management measures taken.

Chinese authorities presented new epidemiological information that revealed an increase in the number of cases, of suspected cases, of affected provinces, and the proportion of deaths in currently reported cases of 4% (17 of 557). They reported fourth-generation cases in Wuhan and second-generation cases outside Wuhan, as well as some clusters outside Hubei province. They explained that strong containment measures (closure of public-transportation systems in Wuhan City, as well as other nearby cities). After this presentation, the EC was informed about the evolution in Japan, Republic of Korea, and Thailand, and that one new possible case had been identified in Singapore.

The Committee welcomed the efforts made by China to investigate and contain the current outbreak.

The following elements were considered as critical:

Human-to-human transmission is occurring and a preliminary R0 estimate of 1.4-2.5 was presented. Amplification has occurred in one health care facility. Of confirmed cases, 25% are reported to be severe. The source is still unknown (most likely an animal reservoir) and the extent of human-to-human transmission is still not clear.

Several members considered that it is still too early to declare a PHEIC, given its restrictive and binary nature.

Based on these divergent views, the EC formulates the following advice:

To WHO

The Committee stands ready to be reconvened in approximately ten days’ time, or earlier should the Director-General deem it necessary.

The Committee urged to support ongoing efforts through a WHO international multidisciplinary mission, including national experts. The mission would review and support efforts to investigate the animal source of the outbreak, the extent of human-to-human transmission, the screening efforts in other provinces of China, the enhancement of surveillance for severe acute respiratory infections in these regions, and to reinforce containment and mitigation measures. A mission would provide information to the international community to aid in understanding of the situation and its potential public health impact.

WHO should continue to provide all necessary technical and operational support to respond to this outbreak, including with its extensive networks of partners and collaborating institutions, to implement a comprehensive risk communication strategy, and to allow for the advancement of research and scientific developments in relation to this novel coronavirus.

In the face of an evolving epidemiological situation and the restrictive binary nature of declaring a PHEIC or not, WHO should consider a more nuanced system, which would allow an intermediate level of alert. Such a system would better reflect the severity of an outbreak, its impact, and the required measures, and would facilitate improved international coordination, including research efforts for developing medical counter measures.

To the People’s Republic of China

• Provide more information on cross-government risk management measures, including crisis management systems at national, provincial, and city levels, and other domestic measures.

• Enhance rational public health measures for containment and mitigation of the current outbreak.

• Enhance surveillance and active case finding across China, particularly during the Chinese New Year celebration.

• Collaborate with WHO and partners to conduct investigations to understand the epidemiology and the evolution of this outbreak, including specific investigations to understand the source of the novel coronavirus, notably the animal reservoir, and animals involved in the zoonotic transmission, as well as the understanding of its full potential for human-to-human transmission, and where transmission is taking place, the clinical features associated with infection, and the required treatment to reduce morbidity and mortality.

• Continue to share full data on all cases with WHO, including genome sequences, and details of any health care worker infections or clusters.

• Conduct exit screening at international airports and ports in the affected provinces, with the aims early detection of symptomatic travelers for further evaluation and treatment, while minimizing interference with international traffic.

• Encourage screening at domestic airports, railway stations, and long-distance bus stations as necessary.

It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO.

Countries are required to share information with WHO according to the IHR.

Technical advice is available here.  Countries should place particular emphasis on reducing human infection, prevention of secondary transmission and international spread and contributing to the international response though multi-sectoral communication and collaboration and active participation in increasing knowledge on the virus and the disease, as well as advancing research. Countries should also follow travel advice from WHO.

To the global community

As this is a new coronavirus, and it has been previously shown that similar coronaviruses required substantial efforts for regular information sharing and research, the global community should continue to demonstrate solidarity and cooperation, in compliance with Article 44 of the IHR (2005), in supporting each other on the identification of the source of this new virus, its full potential for human-to-human transmission, preparedness for potential importation of cases, and research for developing necessary treatment.

The Director-General thanked the Committee for its advice.

【无事生妃】MuchAdo_USA 原创文章

欢迎个人转发分享

公众号及其他媒体未经许可，禁止转载

转载合作请写邮件至

[e-mail]