Is the wild Health Organization mishandling the wild wild response to the corona virus as the u. N. Agency warns that the window to contain the outbreak at narrowing the w. H. R. Stop the spread is inside story. Of and welcome to the program i missed a now more and more country is our reporting cases of the coronavirus the world Health Organization is worried that some of the new infections appears to have no direct link to china where the outbreak was 1st reported in december new deaths have now been reported in iran and italy and south korea the number of infections more than doubled on saturday to 433 many of them members of a religious group w. H. O. Experts in china have finally now been given permission to visit will harm the at the center of the outbreak the head of the w. H. O. Is warning that the window of opportunity to contain the virus globally is narrowing although the number of. People is more. Above the number of pigs is reason more clearly if you didnt know that you could leave so i just drove the least 3 to joy or voted. Weaves these are the goods of both of the increasing breezes. Go well lets take a quick look at just how this crisis has unfolded now in the final day of last year chinas government unless of the world Health Organization about several cases of an unknown virus in the city of the capital of a province a week late said the new strain of corona virus was identified and then a few days after that the fast fatality was reported by late january more than 600 Chinese People were infected a quarantine was imposed on the 11000000 people who live there but the w. H. O. Said the outbreak wasnt a public imagine c. With no evidence of human to human transmission outside china it wasnt until the end of the month that a global imagines he was declared by then 213 people had died and almost 10000 were infected fast forward to mid february and the virus continues to spread around the wild the number of infections tops 66000 partly due to a change in how doctors in china identify new cases well lets now take a look at the virus track at Johns Hopkins university in the United States is monitoring the spread of the outbreak world wide the rate of infection appears to be falling but the total number continues to rise as of saturday 22nd february almost 78000. 00 people have the virus the vast majority of those in china at least 2300 people have now died so far. Well lets now bring in our guests from geneva we have dr Margaret Harris shes a spokeswoman for the world Health Organization in houston dr peter hotez hes dean for the National School of tropical medicine at the Baylor College of medicine and in liverpool we have dr mohammad when he is electra and biomedicine at Lancaster University thank you oil for all for joining us on the program so dr hotez i want to start with you and i want to ask you about these dots that weve been looking at on this map because theyre worrying not necessarily because of this size but because of where theyre located so not necessarily a direct link now to hanoi china were seeing travelers from a wrong now turning up in 11 on and canada testing positive for the virus are we now in a new stage of contagion here. Well its certainly a possibility and 1st of all thank you for having me on and this is but dr ted gerson the world Health Organization has been worried about and the reason they called up a Public Health emergency of International Concern because as as this unfolded it became clear that this virus does have pandemic potential because of its of its easy transmissibility so the fact now that were seeing clusters of cases now in korea and south korea in iran and singapore it doesnt mean that were seeing sustained viral transmission going on at this point but it looks like we could be headed there and that would mean that were what weve been talking about is an epidemic mostly confined to Central China who bay province and some of the other provinces in china now could emerge into a Global Pandemic and this is this is cause for great concern especially when you talk about nations where Health Systems are not so strong and so i do worry about places like iran i also worry about other countries in the middle east i think this could be this could gain a foothold in the middle east which would cause places like yemen syria iraq this would be a catastrophe of course and as well as elsewhere in africa and asia so d the next few weeks are going to be very important to see whether this emerges or whether there is a seasonality to this in the Northern Hemisphere which will help things die down but of course we have no evidence for that so well see how this unfolds well clearly the corona virus is spreading and i do want to take a look at what the w. H. O. Has been specifically saying about it as time goes on and the response has obviously shifted from the director general as it spread lets take a listen to what hes had to say im not declaring a publicans emergency of International Concern today. As it was yesterday the Emergency Committee was divided over whether the outbreak of north dakota and our voters but he presents a fic or not and because partly because imagine the International Concern. Over the global outbreak of call about the virus the main reason for this new collaboration is not because of what is happening in china but because of what is happening in countries although the window of opportunity is not only to contain the outbreak we still have a chance to contain it but while doing that we have to prepare at the same time for any eventuality because this outbreak could go any direction it could even be messy. Well overall it sounds like the tone there of as has been one of course optimism but now were hearing this web messy i mean that soundbite was just from yesterday and looking at the map of the spread and looking at the numbers i mean it looks like its already messy dr harris can we contain that well chinas give us a hit stot so theyve given us 7 weeks and some of the modeling suggested its been mostly in china for 7 weeks most of the modeling suggests they really gave us 2 weeks to prepare yes so 2 weeks have essentially passed but in that time countries around the world have been preparing especially i dont know as professor hood as quite rightly mentioned the concern about fragile Health Systems and a lot of our work has been to work with the ministries of health in in the countries that we have identified as particularly fragile and made sure that things like the Barter Services are available that they have the tist and can do the test but also that they have the means to protect the health staff and the training and provision of people is stepped up so yes. It is it is a period where the opportunity is narrowing but the work has already been going on for many weeks to get the well prepared dr harris you say that china has given you a head start what do you mean by that specifically well they worked intensively to to really contain the virus and even though we now also think spread to a considerable number of other countries for most of the time it really was within china to 99 percent of cases where within china its really only this week that weve seen the kind of spread that suggests that indeed that window of opportunity has narrowed well there has been some criticism of the amount of time that it took to declare a globe. A Public Health emergency and i know the imagine c. Committee who initially were advising on it where split 5050 but dr ted ross himself couldve overruled them he was ultimately the man who decided so dr many a let me ask you was he right to wait well i think there are a few things important to understand before we reach to that conclusion is that what is a Public Health emergency what would it bring into the whole picture. The Public Health emergency because i dont know that that that was intentional or unintentional or influence was significantly late than you do should in principle would have been put in place but the major question really comes in that triple to Public Health emergency what bills may use have been put in place especially in wonder able countries will contribute that in infrastructure what efforts have been made really to emphasize on to the fact that the wireless is continued use is spreading lot more broader scale than any other lives in the recent history we have seen i mean weve been 2 months we have seen some people 1000 people already been impacted i know all been killed majority of them have been in china but still now the number is increasing significantly in other countries so i think having Public Health emergency or not having public out against the minority a Crucial Point but the point is that having probably. What significant changes have been put in place and how to contain the infection well one of the big measures that was taken initially was by china and that was the quarantine of i mean thats the largest quarantine in Human History but by my understanding theres a little Scientific Evidence that such a large scale quarantines actually work and i do realize that some experts have said that its actually in violation of w. H. O. Guidelines so dr hotez i want to ask the w. H. O. Is quite vocal in its praise of the Chinese Government here was it the right call. Well you know as you know i as a vaccine scientist and pediatrician research or pediatrician scientist ive been watching us now for over 30 years and terms of epidemics or pandemics i think its important also to emphasize that a number of things have gone right this time compared to say what happened with sars in 20022003 remember if you dont have a vaccine in hand youre essentially fighting a highly transmissible agent with one hand tied behind your back with these virus highly transmissible viruses set you up to make you look bad and even despite that i think theres a lot thats gone right look one of the things where we develop vaccines we actually have to coronavirus vaccines that were developing one of the really impressive things coming out of china was the flow of information about the virus and if you think about it were only talking a few weeks we already have the virus isolated we have the full genetic code of the virus you know it receptor the virus binds to in the longs we hit the ground running as the other groups in terms of developing new vaccine concepts developing antiviral drugs that has gone extraordinarily well in the chinese scientists been extremely transparent about getting their information up on a preprint server called bio archive thats gone very well in terms of how you deal with a highly transmissible and agent this is this was a tough call the chart the chinese had to make in and its actually a pretty remarkable by this time that this virus is not pervasive across the nation of china that effect is still largely contained within. Not endorsing some of the draconian measures that they took but i think you know again the chinese have done the best they could do given the limited options that theres that one fortunately we can have a long discussion about this unfortunately were still relying on 14th century technologies. Which is what quarantine is or passive and by the transfer is what we did in the 1900 flu pandemic we can do better than that in terms of preparing for new technologies but given what they have to work with these things have gone as well as i think they could have been by this point dr harris i see you nodding there and i want to ask you because the director has praised the quarantine but at the same time the director also decided not to impose travel restrictions and im looking at a an advisory here from the w. H. O. That stated johnny 27th and it says the doctor advised against the application of any restrictions of International Traffic based on the information currently available not didnt change after the declaration of a Public Health emergency either i see a number of countries ignore that and did it anyway but can you talk us through the thinking here why not impose travel restrictions well so actually we didnt praise quarantine as such what we were praising was exactly what professor hotez is identified excellent provision of data a provision of the information that allowed the scientists around the world to look at this virus to understand genetics to develop testing and exactly have kenda that that seen since thats never happened before in the history of an outbreak of the speed with which all of this is being done so this is when we just as professor her to say we were very pleased and happy to see that this kind of information flow which is one of the reasons we have things Like InternationalHealth Regulations and what we are asking a Member States to get together and shared data and share information so exactly so that everybody whos got the expertise can get together and try to help now all the travel and trade restrictions this was very much something that caused major problems during the sars outbreak the world shut down on hong kong and china and it became very difficult for anybody to get in and help and it and it destroyed economy. Is it so terrible panic and im actually from hong kong i was living there at the time the shelves were stripped big you see exactly the same thing happened this time so even though we stay and one of the reasons we emphasize do not panic in terms of travel and trade restrictions it seems that that natural human that human reflex to panic the minute we say yes this is serious still keep did dr harris let me ask you then because there has been a lot of speculation around the politics of this and there was a lot of talk in china about a clamp down on of information about the spread of the virus in the immediate aftermath of that imagining and chinas obviously a hugely important country also for the w. H. O. Not only is the current owner of a future diana and also as a partner working together to fight Global Health problems in the future so clearly a very important critical relationship to maintain so let me ask you straight out then has the importance of that relationship affected any kind of the response to the coronavirus. I can tell you absolutely honestly no we have 192 Member States and they all have equal status china does represent one 5th of the worlds people so they do represent a huge chunk of the human population but in terms of whether we say one Member States more than important than another no we do work with everyone and we do strive to keep as much openness and as much as is clear and open a relationship with all Member States do remember in the early stages of any outbreak people just dont know whats going on and and sometimes people arent sure that theyve really got no break on their hence they actually notified us on 31st of december when seeing that they probably were cases but with any outbreak what is in retrospect was perhaps a cluster of cases is not necessarily obvious at the time well in terms of timing dr harris weve also seen it take some time to get a w. H. O. Team of experts into the country an advance team and then a team of experts thats now on the ground and has only just been given permission to go to hand why has it taken so long. Well who particularly there were concerns that everybody thought it was so extremely overstretched that sending a mission who how these Missions Work is you sit down with your counterparts in the air and you dont think they stepped into it really but you ask them to provide them with all the information theyve got available on that particular area so youre asking somebody who is actually trying to deal with thousands of people people that they need to careful to sit down and take a day off and spend time with you know thinks things seem to have settled down a bit it has been possible and so the team is now in there well one of the really critical parts of all of this has been testing for the coronavirus rice and i say that in a number of places it does seem that people are having up to 6 negative tests before then testing positive and dr lee when young that the chinese doctor who initially raised the alarm he dived off to testing negative multiple times and then testing positive and now were saying evacuees from the diamond princess the chris ship who initially tested negative going home and then testing positive there so let me ask you dr money is there something wrong with the test should we be worried about but. One thing thats important. Under to test has been seeing the china who are good information very early in time and. Information and the doctor has been used to sort of defined the last aggressors in the beginning but floor having a high you sense 2 diagnostic assay and a reliable one in the emerging space of this old break we carry on revising back to see if it can catch up all those mutations or anything else comes in so the track off. To my. Patient going to be you changes into the diagnostic when i mean what number has been available to order Scientific Community is what we can offer to this moment up to the mark dr hotez let me throw that to you because i know it seems that trivial. Province gave up on the test and then started diagnosing people based on symptoms rather than actual test results and thats when we saw lots of spike in numbers so is there an argument that everyone should be doing the same well you know remember developing diagnostics for respiratory infections is not trivial we were a bit behind in all of our diagnostic capabilities for respiratory infections and thats why the bill and Melinda Gates foundation has invested a huge amount of funds to improve our diagnostics so i think what the problem that you just saw in han is not too different from any respiratory diagnostic thats a matter and thats the question of sensitivity in order to be able to detect the virus early on in the infection because presumably theyre not a lot of virus particles around for you to easily diagnose it so this is not actually unusual for somebody to test negative early on and then as the infection worsens as the viral load accumulates that it becomes positive weve seen this scene play out over and over again and so thats a problem you know again when this is a brand new Infectious Disease agent and trying to get your arms around it when you dont really know the mode of transmission theres a lot of the we still dont know the mode of transmission in detail we we think its through droplet contact but there may be airborne transmission there may even be fecal oral transmission and this takes time and remember i think its really important to keep this timeframe in perspective were talking just a few weeks and were already wondering whether our diagnostic test is sensitive enough and specific enough compared to any other. Epidemic of pandemic potential the amount of information were learning so its easy to see how. China chinese Public Health authorities might go back and forth in terms of their diagnostic criteria whether they use the diagnostic test for these. The clinical test going back and forth these are these are stumbling blocks to be expected and i think were slowly getting our arms around it but its still going to take a few weeks to really sort everything you know so i do want to take a bit of a step back here and because the w. H. O. Has had to grapple with a number of epidemics and pandemics and ebola swine flu and there was a lot of criticism particularly with the bowler about a very slow bureaucratic response that dr ted ross himself acknowledged and when he was elected he was elected on a platform of saying that he was going to make some pretty big changes and reforms at the w. H. O. So let me ask you then dr harris whats changed at the w. H. O. Since it. It changed extraordinarily and i was there at the time i was one of the people brought in in 2014 when w. H. O. Did step up and we were criticized for stepping up a late that was in august 2014 what w. H. O. Was then was essentially a scientific standards sitting body that looked at things like an epidemic coming in and what to do but wasnt really operational so now the difference is that we have set up an entire organization within the Organization Called the Emergencies Program and we respond operationally as well as scientifically to all emergencies and even scientifically we operate on a emergency 40 except for instance weve brought. All the research is all of the scientists around the Work Together 2 weeks ago as an emergency to ask them what can we do right now what science can we do right now what do we have to accelerate what are the big priorities and weve got chinese colleagues who couldnt join us because theyre actually dealing with this mess about rachel to join us and we said so what are your biggest and its interesting that weve mentioned diagnostics because that was a 1st ask they wanted a test that could be point to a kid that means whether youre in a clinic you know no station or at the bedside you could do the test right away and confirm whether or not somebody had coronavirus and of course the other thing everybody wants is excel aeration on understanding which there are which drugs which medicines might help. Limit this disease or stop this disease and of course the other one is the vaccine of course and moving forward theres going to be a huge amount of demand for resources particularly in fragile Health Systems as weve been talking about dr many let me ask you how does this play out we need Something Like 675000000. 00 to respond just until april 2020 and and obviously were seeing the coronavirus spread. Where do we go from here. Developing maxines. Much more sensitive and consciously improved as days arent really challenges i mean for these kind of infractions the vaccine is. Always been with its own complication i mean we do know that chappie and Gates Foundation not many has been allocated for development of the maxines but this is vaccine is really a long Term Solution what were looking on i mean we even with the ability of the Lacrosse Technology is what were looking on is like a 2 month country in an emergency situation so therefore i dont really see that vaccine would be an immediate solution because once you establish a vaccine that is probably the easiest for it comes to preclinical and clinical stages they are most of the economists used at this moment who are the should be on to the Infrastructure Development in terms of sensitive diagnostic nazis and really to refurbish the countries those are having poor infrastructure to really emphasize that if there is any threat approaching to those countries they would be probable to really diagnose and isolate those one are able to order positive cases so that disease transmission can be into the show so this is ultimately about strengthening Health Systems more broadly across the wild and obviously i will continue watching this very very closely indeed and id like to thank all of our guests that sluggard harris peterhead has and the 120 at thank you for and thank you too for watching you can see the program again any time by visiting our website aljazeera at dot com and to further discussion to get her Facebook Page thats facebook dot com for trash a. J. And side story and you can also join the conversation on twitter handle is at a. J. And storing the meanest as it had a whole team here and im. On counting the cost a tale of 2. 00 nations australias unrelenting charges you call a germanys plan to get out of Coal Powered Energy plus the unseen polluter we find out what the shipping industry is doing to end soaring emissions. Counting the cost on aljazeera. Talk to aljazeera let me talk about 2 of the biggest problems facing and they all the endemic corruption and the gang we listen so if you really put place china as an enemy of the world and thats really that yours we meet with global news makers and talk about the stories that matter on the edges their own context these are live feed in day storytelling around the biggest issues done had to do you should do it again. What you all just means the whole robin in doha these are all top news stories these spread all the coronavirus is growing outside of china with italy seeing the worst outbreak so far in europe almost 80 people are confirmed to have been infected 2 people have died from the virus catherine stands as well. The Lombardy Region of northern italy is in lockdown as more cases of the covert 19 coronavirus are confirmed dunya is effectively a ghost town after at least 3 people there tested positive for the virus the sudden spread has led local authorities to take swift action urging businesses schools and churches and suffer old hounds to close their doors