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Why Isn't the Coronavirus Outbreak a Pandemic Yet?

A medical staffer works with test systems for the diagnosis of coronavirus, at the Krasnodar Center for Hygiene and Epidemiology microbiology lab in Krasnodar, Russia, Feb. 4, 2020.

Amid the worldwide spread of the novel coronavirus, 2019-nCoV, the World Health Organization (WHO) said Tuesday the outbreak is a “global health emergency” and “an epidemic with multiple locations” but not yet a pandemic.

Where is the virus spreading?

As of Feb. 4, WHO says as of Tuesday there are 20,630 confirmed cases in 24 countries, and the virus has claimed 426 lives. Most of the infections were reported in China with 20,471 cases, and 13,522 cases from the Hubei province. So far, no confirmation has been made across Africa or Latin America. China’s National Health Commission says about 80% of those who died from the virus were over the age of 60 and 75% of them had pre-existing health conditions.

Why does WHO say the outbreak is not yet a pandemic?

WHO officials say the virus is currently considered to be an epidemic in multiple locations, and they are hopeful the transmission of the virus can be contained. Dr. Sylvie Briand, director of the World Health Organization’s Infectious Hazards Management Department said at a press conference Tuesday an estimated 78% of cases are coming from the Hubei province in China. She said cases outside of Hubei are “spillover cases” with people infected in Hubei moving to other places with the disease. “We believe it (stopping transmission) can be done, so that’s why we’re not in a pandemic,” said Briand.

What does it mean to be a ‘global health emergency’?

On January 30, the WHO declared the outbreak of a novel coronavirus a Public Health Emergency of International Concern (PHEIC). The decision was taken primarily because of the signs of human-to-human transmission outside China, and what might happen if the virus were to spread in a country with a weaker health system. The decision was an acknowledgment the risk is “serous, unusual or unexpected.” This is only the fifth time the WHO has declared a global health emergency. Previous emergencies have included Ebola, Zika and H1N1.

When is a pandemic declared?

Calling the virus a pandemic refers to a more global outbreak than an epidemic. The WHO defines a pandemic as “the worldwide spread of a new disease.” This description is reserved for an infectious disease that can greatly increase morbidity and mortality over a wide geographic area. The last pandemic declared was the H1N1 flu pandemic in 2009.

How likely is it that a pandemic will be declared?

WHO Director-General Dr. Tedros Adhanom Ghebreyesus says the spread outside of China so far appears to be “minimal and slow.” But Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, believes we could be heading toward a pandemic. Dr. Fauci told The New York Times that “It’s very, very transmissible, and it almost certainly is going to be a pandemic.”

What would a pandemic declaration mean for global travel?

Already, 19 countries had formally notified the U.N. of measures or restrictions taken in connection with the outbreak and the declaration of a pandemic may further fuel anxiety. The U.S. also has suspended entry for foreigners who have visited China in the 14 days before arriving in the U.S. In the past, several countries also imposed travel restrictions during the severe acute respiratory syndrome outbreak in 2003 and the H1N1 influenza pandemic in 2009.

What are WHO’s next moves?

The WHO will hold a meeting Wednesday with travel and tourism industry representatives to draw up further recommendations to protect their crews so they can resume flights to China. WHO is against travel bans. “There is no reason for measures that unnecessarily interfere with international travel and trade,” said WHO Director-General Ghebreyesus.