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Since 1995, the global community has experienced six outbreaks that the World Health Organization (WHO), as authorized in a 2005 revision of the International Health Regulations (IHR), designated as a Public Health Emergency of International Concern (PHEIC): H1N1 Infl uenza, polio, Ebola in West Africa and in the Democratic Republic of Congo, Zika, and now a novel coronavirus, which WHO offi cially termed SARS-CoV-2.SARS-CoV-2 is the virus responsible for the disease state termed COVID-19.Two other novel coronaviruses, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), also spread internationally.SARS occurred before the major IHR revision in 2005 and thus was not designated a PHEIC.MERS arose on the Saudi peninsula after the IHR revision, but WHO never offi cially designated it a PHEIC, even though it spread internationally, including a major outbreak in South Korea.PHEIC is not a color-or numeric-coded system of alert levels, but is strictly a technical description designed to support coordination among the 196 states that are parties to the IHR-coordination which has so far proven diffi cult to achieve in the case of COVID-19.
Ratzan et al. (Wed,) studied this question.