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The Novel Coronavirus Originating in Wuhan, ChinaChallenges for Global Health Governance

Educational Objective
Understand the current status of 2019-nCoV, assess the response, and review proposals for strategies to bring the outbreak under control.
1 Credit CME

On December 31, 2019, China reported to the World Health Organization (WHO) cases of pneumonia in Wuhan, Hubei Province, China, caused by a novel coronavirus, currently designated 2019-nCoV. Mounting cases and deaths pose major public health and governance challenges. China’s imposition of an unprecedented cordon sanitaire (a guarded area preventing anyone from leaving) in Hubei Province has also sparked controversy concerning its implementation and effectiveness. Cases have now spread to at least 4 continents. As of January 28, there are more than 4500 confirmed cases (98% in China) and more than 100 deaths.1 In this Viewpoint, we describe the current status of 2019-nCoV, assess the response, and offer proposals for strategies to bring the outbreak under control.

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Article Information

Corresponding Author: Lawrence O. Gostin, JD, O’Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Ave NW, Washington, DC 20001 (gostin@law.georgetown.edu).

Published Online: January 30, 2020. doi:10.1001/jama.2020.1097

Conflict of Interest Disclosures: Mr Gostin is the director of the World Health Organization Collaborating Center on National and Global Health Law. No other disclosures were reported.

References
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World Health Organization. Novel coronavirus (2019-nCoV) situation report-8. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200128-sitrep-8-ncov-cleared.pdf?sfvrsn=8b671ce5_2. January 28, 2020.
2.
US Centers for Disease Control and Prevention. 2019 Novel coronavirus, Wuhan, China: symptoms. https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html. Published January 26, 2020. Accessed January 27, 2020.
3.
Shih  G, Lynch  DJ, Denyer  S, Shammas  B. Chinese coronavirus infections, death toll soar as fifth case is confirmed in U.S. https://www.washingtonpost.com/world/asia_pacific/coronavirus-china-latest-updates/2020/01/26/4603266c-3fa8-11ea-afe2-090eb37b60b1_story.html. Published January 26, 2020. Accessed January 27, 2020.
4.
Hong Kong declares Wuhan virus outbreak “emergency”—the highest warning tier. Hong Kong Free Press. https://www.hongkongfp.com/2020/01/25/breaking-hong-kong-declares-wuhan-virus-outbreak-emergency-highest-warning-tier. January 25, 2020.
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Markel  H, Lipman  HB, Navarro  JA,  et al.  Nonpharmaceutical interventions implemented by US cities during the 1918-1919 influenza pandemic.  JAMA. 2007;298(6):644-654. PubMedGoogle ScholarCrossref
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Shih G, Denyer S. Wuhan mayor says 5 million people left city in recent days. Washington Post. https://www.washingtonpost.com/world/coronavirus-china-latest-updates/2020/01/27/3634db9a-40a7-11ea-aa6a-083d01b3ed18_story.html. January 27, 2020.
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World Health Organization. International Health Regulations. 2nd ed. https://www.who.int/ihr/publications/9789241596664/en/. Published 2008. Accessed January 27, 2020.
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Gostin  LO, DeBartolo  MC, Katz  R.  The global health law trilogy: towards a safer, healthier, and fairer world.  Lancet. 2017;390(10105):1918-1926. PubMedGoogle ScholarCrossref
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