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The World Health Organization on Thursday declined to declare a global emergency as a deadly respiratory virus spread from China to at least five other countries.

Less than a month after the first few cases of illness were reported in Wuhan, China, at least 600 people are known to have been infected, and at least 18 have died. Most who died had underlying health problems, and many were older than 60.

Carried by travelers, the virus has also reached Japan, South Korea, Thailand, Singapore, Taiwan and the United States. Investigators in other countries, including Mexico, are evaluating suspected cases.

Officials in China have closed transportation links from and within Wuhan, and are imposing travel restrictions on other affected cities. These steps have significantly escalated the country’s efforts to contain the spread of the virus just days before the Lunar New Year holiday, when hundreds of millions travel in and out of the country.

Only five global public health emergency declarations have been made in the past:

  • In 2009, for pandemic influenza;

  • In 2014, for a polio resurgence in several countries;

  • Again in 2014, for the Ebola epidemic in West Africa;

  • In 2016, for the Zika virus epidemic;

  • And in 2019, for an Ebola outbreak in the Democratic Republic of Congo.

The decisions are fraught. Health authorities do not want to cry wolf by raising alarms about an illness that turns out not to be severe — or to ignore a real threat. If they act relatively early in an outbreak, as in this case, they may lack key information about the severity and contagiousness of the disease.

There are political and economic considerations as well. Declaring an emergency signals to governments that the situation is serious and that international help and cooperation are needed to contain the outbreak.

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Control measures may save not only lives, but money: the SARS epidemic, caused by a related coronavirus in 2002 and 2003, cost the global economy $30 billion to $100 billion, according to an article published Thursday in the Journal of the American Medical Association.

But declaring an emergency may stigmatize the country struggling with an outbreak, and spur costly bans on travel and trade by other countries, even if health authorities discourage those actions.

“I think there is a general sense that we need to go back and revisit public health emergencies and what they mean,” said Michael Osterholm, an epidemiologist at the University of Minnesota. “I think it’s not clear, do they or do they not bring more resources, or more controversy?”

The new infection is caused by a coronavirus, from the same family that caused epidemics of SARS and MERS, which have killed hundreds of people in dozens of countries.

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