On January 30, 2020, the World Health Organization (WHO) declared the novel (as in "new") coronavirus (2019-n-CoV) a public health emergency of international concern (PHEIC) (pronounced "fake"). The following day, January 31, 2020, the United States followed by declaring a public health emergency for the entire U.S. "to aid the nation's healthcare community in responding to the 2019 novel coronavirus." This document outlines what these declarations mean to businesses and individuals.
What is a "coronavirus"?
As defined by the WHO: "Coronaviruses are a large family of respiratory viruses that can cause diseases ranging from the common cold to the Middle-East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS)." The 2019 coronavirus is referred to as "novel," as in a new type of coronavirus, and as the "Wuhan coronavirus" after the city in China where the first major outbreak occurred.
What is a PHEIC?
A PHEIC is a formal declaration by the WHO of "an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response." The WHO's International Health Regulations (IHR) (2005) further define a PHEIC to be an event that "is serious, unusual or unexpected; carries implications for public health beyond the affected State's national border; and may require immediate international action."
What is the impact of declaring a PHEIC?
The IHR have specific requirements that may be exceeded by individual countries. IHR standards require collaboration among countries to contain the emergency, and set out the following broad guidelines:
As to Travelers:
On arrival or departure, a country may require:
- Information concerning the traveler's destination and contact information.
- Information concerning the traveler's itinerary to see if there was travel in or near an affected area, or other potential contacts with infection or contamination.
- A non-invasive medical examination (the "least intrusive examination that would achieve the public health objective of preventing the international spread of disease").
- With prior express informed consent, a more invasive medical examination, vaccination, prophylaxis or health measure may be required.
- Travelers to remain in quarantine for a reasonable time and shall provide adequate accommodations and medical treatment, communication in a language the traveler can understand, and other appropriate assistance free of charge.
- Personal information from travelers which "shall be kept confidential and processed anonymously as required by national law" but may be disclosed as essential for "assessing and managing a public health risk."
As to Shippers:
The IHR set out broad standards that apply to "conveyances and conveyance operators," including ships and aircraft in transit. These rules defer to health measures adopted by each country and, to the extent any international standard can, directs countries to ensure that aircraft and ships are "free of sources of infection or contamination." How these directions are put into effect will have a substantial impact on shipping between China and the rest of the world.
- FedEx, for example, has shipped surgical masks, hand sanitizer, and protective equipment to China, where FedEx operates 220 flights weekly out of five airports. It has stated that coronavirus containment activities may impact inbound and outbound shipments to and from, and movements within, Wuhan.
- UPS, a member of the Pandemic Supply Chain Network, is planning, through its foundation, to ship 2 million face masks, 11,00 protective suits and 280,000 pairs of nitrile gloves to China.
- A large number of passenger airlines have suspended service to and from China, thereby reducing the amount of air freight space available between China and many air cargo hubs around the world.
U.S. Government Response
Following WHO's lead, the U.S. Secretary of Health and Human Services (HHS) declared a nationwide public health emergency on January 31, 2020, but effective as of January 27, 2020. This declaration has numerous consequences:
- The president issued a proclamation on January 31, effective February 2, 2020, that
- Suspends the entry into the U.S. of all aliens who were present in China (excluding Hong Kong and Macau) during the 14-day period prior to their attempted entry into the U.S., except for permanent residents of the U.S., the spouse of a U.S. citizen or permanent resident, and similar categories.
- Authorizes U.S. authorities to prevent any alien subject to the proclamation from boarding an aircraft to the U.S.
- Requires HHS "take all necessary and appropriate steps to regulate the travel of persons and aircraft to the U.S.," including "where appropriate, [the] quarantine of persons who may have been exposed to the virus."
- Requires the HHS Secretary, every 15 days from January 31, 2020, to recommend "that the President continue, modify, or terminate this proclamation."
- Authorizes (as has been put into effect) quarantine of people entering the U.S. from China.
- The State Department issued a travel advisory on January 31, 2020, raising the level of travel to China to "Level 4: Do Not Travel," the highest level, "due to greater likelihood of life-threatening risks . . . [and because] the U.S. government may have very limited ability to provide resources [in China]."
- A number of U.S. companies, including Apple (42 stores), Disney (both Shanghai and Hong Kong), Tesla, have suspended their China operations; Starbucks has closed about half of its more than 4,000 stores in China and McDonalds has suspended operations in five cities close to the center of the outbreak.
- China itself has ordered mandatory factory shutdowns until at least February 9, a decision that impacts a large number of U.S. companies.
- American, Delta, and United airlines halted service between the U.S. and China.
- The U.S. Centers for Disease Control and Prevention (CDC) has issued several notices on the Wuhan coronavirus. Perhaps most importantly, the CDC and the WHO stress that:
- There is currently no vaccine to prevent 2019-nCoV infection; and
- Everyone should take "everyday preventive actions to help prevent the spread of respiratory viruses."
Other parts of the world
- European Union (EU). The EU has mobilized the European Center for Disease Prevention and Control to conduct risk assessments and to coordinate the response measures of the member states.
- Each member state's guidance should be consulted with regard to travel and shipment of goods.
- A number of non-U.S. airlines have also suspended flights from their home countries to and from China and should be checked.
- A number of other countries, including Australia, Singapore, Russian, Japan, Pakistan, and Italy, have instituted travel bans with China.
The situation in China and around the world is clearly fluid and will no doubt change on a frequent basis. The links contained in this article should be consulted for updated guidance.