世界卫生组织（WHO）紧急委员会关于武汉新型冠状病毒的声明

（本文来源：WHO官网）

关于新型冠状病毒（2019-nCoV）疫情的《国际卫生条例（2005）》突发事件委员会会议的声明

2020年1月23日 世卫组织的声明 瑞士日内瓦

世卫组织总干事根据《国际卫生条例（2005）》召集的突发事件委员会于2020年1月22日星期三日内瓦时间（欧洲中部时间）12:00至16:30和2020年1月23日星期四中午12:00至15:10举行会议，讨论中华人民共和国发生的2019新型冠状病毒疫情以及目前据报告对大韩民国、日本、泰国和新加坡的输出问题。委员会的作用是向总干事提供咨询意见，并由总干事就确定国际关注的突发公共卫生事件作出最后决定。委员会还将提供公共卫生咨询意见或酌情提出正式的临时建议。

会议议事情况

突发事件委员会委员和顾问举行了电话会议。

总干事对委员会表示欢迎，并感谢委员们的支持。他随即将会议交由会议主席Didier Houssin教授主持。

Houssin教授也对委员会表示欢迎，并请秘书处发言。

1月22日，世卫组织法律司以及合规、风险管理和道德操守司的代表向委员会委员介绍了他们的作用和责任。

委员会委员被提醒注意其保密义务和有责任披露可能被视为构成利益冲突的个人、财务或专业关系。与会的每一委员都接受了审核，据认定没有与会议相关的任何利益冲突。

主席随后解释了会议议程，并介绍了与会者。

1月23日，中华人民共和国、日本、泰国和大韩民国卫生部的代表向委员会通报了各自国家的最新情况。中国报告的病例数目有所增加，截至今日已有557例确诊病例。

结论和建议

1月22日，突发事件委员会委员对这次疫情是否构成国际关注的突发公共卫生事件表达了不同意见。当天的建议是，这次疫情未构成国际关注的突发公共卫生事件，但委员会委员一致同意局势紧迫，并建议委员会应在日内再次举行会议，进一步审查这一局势。

1月22日，武汉宣布了新的控制措施，随后，总干事要求突发事件委员会于1月23日再次举行会议，研究中国当局提供的关于疫情的最新演进情况和所采取的风险管理措施的信息。

中国有关部门提供了新的流行病学信息，显示受影响省份的病例数和疑似病例数有所增加，目前报告病例的死亡率为4%（557例中有17例）。他们报告了武汉的第四代病例和武汉以外的第二代病例，以及湖北省以外的一些聚集性病例。他们解释说，采取了强有力的控制措施（关闭武汉市以及附近其它城市的公共交通系统）。在此介绍之后，突发事件委员会获悉在日本、大韩民国和泰国的演进情况，同时新加坡发现了一例新的疑似病例。

委员会欢迎中国为调查和控制本次疫情所作的努力。

以下因素被认为至关重要：

人际传播正在发生，初步传播速率估计值为1.4-2.5。一家医疗机构出现了疫情扩散现象。在确诊病例中，据报告有25%为重症。起源仍然未知（最有可能源于动物宿主），人际传播程度也仍然不清楚。

一些委员认为，鉴于在国际关注的突发公共卫生事件问题上必须二中择一，宣布其为国际关注的突发公共卫生事件为时尚早。

基于这些不同意见，突发事件委员会提出以下建议:

对世卫组织的建议

委员会随时准备在大约10天内再次举行会议，如果总干事认为有必要，也可以提前举行。

委员会敦促通过世卫组织国际多学科专家组，包括各国专家，支持正在开展的工作。专家组将审查和支持为调查疫情的动物源、人际传播程度、在中国其他省份的筛查工作，扩大对这些地区严重急性呼吸道感染的监测，以及加强控制和缓解措施而作出的种种努力。一专家组将向国际社会提供信息，以帮助了解局势及其潜在的公共卫生影响。

世卫组织应继续提供一切必要的技术和业务支持，以应对这一疫情，包括与其广泛的伙伴和协作机构网络合作，实施全面的风险通报战略，并针对这一新型冠状病毒推进相关的研究和科学发展。

面对疫情的不断演进，以及在是否宣布存在国际关注的突发公共卫生事件问题上必须二中择一，世卫组织应考虑建立更加精密的制度，允许发出中等水平的警报。这一制度将更确切地反映疫情的严重程度、影响和所需采取的措施，并有利于改进国际协调，包括研究制定医疗对策。

对中华人民共和国的建议

• 提供更多关于各级政府风险管理措施的信息，包括国家、省和市一级的危机管理制度，以及在国内采取的其他措施。
• 加强合理的公共卫生措施，控制和缓解当前疫情。
• 加强中国各地的监测和积极发现病例工作，尤其是在中国春节期间。
• 与世卫组织和相关伙伴合作开展调查，以了解此次疫情的流行病学和演进情况，包括进行专门调查，以了解新型冠状病毒的起源，特别是动物宿主和牵涉人畜共患病传播的动物，并了解其在人际传播中的全部潜力，以及发生传播的场所、与感染相关的临床特征以及降低发病率和死亡率所需的治疗。
• 继续向世卫组织通报所有病例的完整数据，包括基因组序列和任何医务人员感染或聚集性病例的详细信息。
• 在受影响省份的国际机场和港口进行出境筛查，及早发现有症状的旅客，以便进一步作出评估和治疗，同时尽量减少对国际交通的干扰。
• 鼓励在国内机场、火车站和长途汽车站进行必要的筛查。 

对其它国家的建议

预计任何国家都可能出现进一步的国际输入病例。因此，所有国家都应作好控制疫情的准备，包括主动监测、早期检出、隔离和病例管理、接触者追踪和防止2019-nCoV感染的进一步传播，并与世卫组织共享全部数据。

根据《国际卫生条例》，要求各国与世卫组织共享信息。

技术咨询可查阅世卫组织网站。各国应特别重视减少人类感染，防止二次传播和国际传播，以及通过多部门交流与合作、积极参与增加关于该病毒和该疾病的知识和推进研究工作，为国际对策作出贡献。各国还应遵循 世卫组织的旅行建议。 

对国际社会的建议

由于这是一种新型冠状病毒，而且以往的经验表明，针对类似的冠状病毒，需要在定期共享信息和研究工作方面作出巨大努力。因此，国际社会应按照《国际卫生条例(2005)》第四十四条，继续团结合作，相互支持，以确定这一新型病毒的起源及其在人际传播中的全部潜力，防范病例的输入并研究如何开展必要的治疗。

总干事感谢委员会提供的咨询意见。

以下为英文版本

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

23 January 2020 

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.

To other countries

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.

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