Bubonic Plague: WHO dealt huge blow hours after claiming outbreak ‘not high-risk’

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The world is on alert after the city of Bayan Nur in the Chinese region of Inner Mongolia issued an urgent warning on Sunday – 24-hours after a hospital reported a case of the bubonic plague. This followed four reported cases of plague in people there last November, including two of pneumonic plague, which is a far more deadlier variant. The city’s health committee has issued a third-level alert – the second lowest in the current four-level system. This forbids the hunting and eating of animals that could carry the plague, and also asks the public to report any suspected cases of fever with no obvious causes, while also reporting any sick or dead marmots.

But the WHO, which has been accused by the likes of Donald Trump of not reacting quickly enough to the early outbreaks of COVID-19, is so far playing down the threat of the latest possible plague.

WHO spokeswoman Margaret Harris told a UN press briefing in Geneva: “We are monitoring the outbreaks in China, we are watching that closely and in partnership with the Chinese authorities and Mongolian authorities.

“At the moment we are not considering it high-risk but we are watching it, monitoring it carefully.”

The bubonic plague, more commonly known as the ‘Black Death’ in the Middle Ages, is a highly infectious and quite often deadly disease that is mostly spread by rodents.

Plague cases are not uncommon in China, but outbreaks have become increasingly rare over recent years.

For nine years from 2009 until 2018, China reported just 26 cases and 11 deaths.

But the attempt to downplay the risk of the bubonic plague comes after 239 scientists from 32 countries warned the potential for coronavirus to spread through airborne transmission by remaining in the air is being underplayed by the WHO.

In an open letter due to be published in the journal Clinical Infectious Diseases this week, the group of scientists highlight the need for greater acknowledgement of how significant the airborne spread of COVID-19 can be, as well as calling on Governments to implement stricter control measures.

WHO guidance states coronavirus, which has infected nearly 12 million people worldwide, can be transmitted by inhaling respiratory droplets from an infected person who is close by, or by touching a surface contaminated with the virus and then touching your eyes, nose or mouth.

But the organisation has played down the potential for COVID-19 to spread via aerosol transmission, which sees smaller particles linger in the air for long periods of time, and carried over distances of more than one metre.

Dr Benedetta Allegranzi, the WHO’s technical lead on infection control, has said: “Especially in the last couple of months, we have been stating several times that we consider airborne transmission as possible but certainly not supported by solid or clear evidence.”

But the letter from scientists accuses the WHO of underplaying airborne transmission’s risk, particularly in poorly ventilated rooms or confined spaces like public transport.

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The letter is authored by Lidia Morawska, of the Queensland University of Technology in Brisbane, and Donald Milton, of the University of Maryland, and has been endorsed by the 239 scientists, some of whom have been involved in drawing up medical advice from the WHO.

They say emerging evidence, including from settings such as meat processing plants where there have been outbreaks, suggests that airborne transmission could be more important than the WHO has acknowledged.

Linsey Marr, an expert in airborne transmission of viruses at Virginia Tech and a co-signatory of the letter, told the New York Times the WHO had relied on studies from hospitals, suggesting low levels of virus in the air.

This meant the risk is being underestimated because in most buildings “the air-exchange rate is usually much lower, allowing virus to accumulate in the air”.

But Paul Hunter, a professor in medicine at the University of East Anglia and a member of the WHO’s infection prevention committee, has defended the advice from the WHO.

He said: “Aerosol transmission can occur but it probably isn’t that important in the grand scheme of things. It’s all about droplets.

“Controlling airborne transmission isn’t going to do that much to control the spread of COVID-19.

“It’s going to impose unnecessary burdens, particularly in countries where they don’t have enough trained staff or resources already.”

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