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OPINION

Strengthen readiness

The outbreak of the novel coronavirus 2019-nCoV is a Public Health Emergency of international concern. The highest l...

By Dr Poonam Khetrapal Singh

The outbreak of the novel coronavirus 2019-nCoV is a Public Health Emergency of international concern. Countries in the WHO South-East Asia Region must continue to strengthen their readiness to respond


The outbreak of the novel coronavirus 2019-nCoV is a Public Health Emergency of international concern. The highest level of international solidarity and cooperation is needed to protect health and keep people safe. Since the novel coronavirus emerged late December, the number of cases reported globally has climbed. Human-to-human transmission has been reported in a number of countries. It is imperative that countries report and share information on suspected cases early, provide detailed reports on confirmed cases, and ensure all people receive the care they need in accordance with the rights and dignity that is due. 


The WHO South-East Asia Region must continue to strengthen its readiness to respond. In recent weeks, several countries in the Region have detected and reported cases of 2019-nCoV. The vigilance of health authorities in each country is commendable, and reflects Region-wide efforts to strengthen emergency risk management, which is one of the eight Flagship Priority Programs in the Region. Member States have made substantial progress in recent years to strengthen health systems to achieve universal health coverage and to build core capacities required by the International Health Regulations—the international legal framework that helps countries work together for global health security.


The response to the emergence and spread of 2019-nCoV has been rapid. Over the past month, WHO has worked with countries across the world to roll out a series of preparedness measures, including guidance on how to detect and manage cases, improve infection prevention and control, and reduce transmission. In the South-East Asia Region, WHO and its Member States have focused on increasing capacities to rapidly detect and care for patients, and to guard against onward transmission. To date, most cases reported in the Region have been imported. It is imperative that countries in the Region scale up vigilance and prepare to prevent, control and interrupt local transmission. 


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There is much that we do not yet know about the virus, but which we are working to find out. The world’s best scientists are on the case. As we learn more, WHO will continue to provide Member States and the public high-quality information through regular situation reports and our social media accounts. Accurate, timely information empowers all people to assess risks and to take preventive measures. Regular hand-washing, coughing or sneezing into one’s elbow, avoiding close contact with people with flu-like symptoms, and thoroughly cooking meat and eggs are all great ways to stay healthy and to limit one’s exposure to pathogens. 


The International Health Regulations (IHR) and the Region’s own Delhi Declaration on Emergency Preparedness, which Member States adopted in September 2019, are clear: By implementing evidence-based policies, health authorities can increase their capacity to detect and control emerging and reemerging diseases, care for affected people and protect health workers. As Member States make all efforts to tackle 2019-nCoV, several priorities stand out.


Priorities to focus 

First, we must strengthen early warning, alert and disease surveillance systems. To help individuals monitor their own health, authorities at ports of entry can provide information on the virus to incoming and outgoing travelers. Where they don’t already exist, contingency plans to assess and manage ill passengers should be developed. Event-based surveillance should be scaled up, including via detailed case reporting, which will help authorities better understand the virus and more effectively respond. Regular risk assessments using multiple sources of data should be carried out.


Second, infection prevention and control (IPC) in health facilities should be stepped up. By ensuring IPC protocols are enforced, health authorities will limit the spread of the virus. By making personal protective equipment accessible, they will protect health workers. Triaging systems for patients with acute respiratory illness will increase the efficiency of health facilities, as will clear patient placement and transportation procedures. WHO’s technical guidance on clinical case management should inform facility-based care.


Third, rapid response teams must be equipped to act decisively. At national and sub-national levels, response teams must have adequate resources, both logistic and financial. They must have the skills to carry out contact tracing and collect biological samples for respiratory pathogens. It is imperative that national command and coordination structures for emergency response are activated, and relevant sectors—such as the animal health sector—are brought on board where appropriate.


Finally, the importance of providing accurate and timely information must be fully grasped across sectors, and at all levels of government. Streamlined procedures for developing and clearing transparent communication and messaging will increase responsiveness. Information that empowers people to protect themselves will promote trust. Systems to correct misunderstandings, misinformation and rumors will ensure all people can make health-positive decisions that are fact-based and evidence-informed.


The emergence and spread of the novel coronavirus highlights the need for all countries to be ready to respond to acute public health events by acting on the four ‘Is’ of emergency risk management: identify risks, invest in people and systems for risk management, implement plans, and interlink sectors. As the current situation evolves, and the Region strengthens its readiness, we must continue to implement the Delhi Declaration and achieve full IHR compliance. We live in a dynamic world that is interconnected and on the move. We are moving with it. Member States in the Region will continue to step up and stand tall. WHO will continue to support them to secure health for all. 


The author is Regional Director at WHO South-East Asia Region

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