The coronavirus, which originated in the Chinese city of Wuhan, has caused significant consternation. A short note follows on the legal, and to some extent, the practical issues arising in PNG. This note is written on 3 February 2020 and the issue is moving quickly, so if reading this note after that date please be conscious that events may have moved on.
We encourage sober reflection based on reliable source information rather than knee-jerk responses to mass and social media. The World Health Organization's (WHO) advice to the public at present1 is simply:
- Frequently clean hands by using alcohol-based hand rub or soap and water.
- When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands.
- Avoid close contact with anyone who has fever and a cough.
- If you have fever, a cough and difficulty breathing seek medical care early and share previous travel history with your health care provider.
We invite you to view an excellent article in the New York Times from a doctor/reporter who covered the SARS outbreak as a medical reporter in China: "How to Avoid the Coronavirus? Wash Your Hands".
Whilst not holding ourselves out as medical experts, we understand to the best of our knowledge at the time of writing that:
- Coronavirus is a genus of virus of which the SARS virus and the current coronavirus are distinct species. The current coronavirus is technically labelled 2019-nCoV.
- 2019-nCoV is 'droplet' borne, rather than airborne, and is less infectious than the SARS coronavirus, and much less infectious than diseases such as measles. Prolonged exposure (i.e. 15 minutes) at a close proximity seems to be required. The virus doesn't last long and washing of hands is a highly effective and practical measure to minimise risk.
- There has been no suggestion that 2019-nCoV is present in animals sold live or dead in PNG markets.
1. The international position
On 30 January 2020 the WHO Director-General declared the outbreak of 2019-nCoV a Public Health Emergency of International Concern. Under the International Health Regulations 2005 (IHR) certain responsibilities now lie on signatory countries, including under Article 44 to demonstrate solidarity and cooperation in supporting each other, and a legal requirement to share information.
The WHO Director-General issued the following Statement to 'all countries' (other than China – to which a specific Statement was addressed).2
It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO. Technical advice is available on the WHO website.
Countries are reminded that they are legally required to share information with WHO under the IHR.
Any detection of 2019-nCoV in an animal (including information about the species, diagnostic tests, and relevant epidemiological information) should be reported to the World Organization for Animal Health (OIE) as an emerging disease.
Countries should place particular emphasis on reducing human infection, prevention of secondary transmission and international spread, and contributing to the international response though multi-sectoral communication and collaboration and active participation in increasing knowledge on the virus and the disease, as well as advancing research.
The Committee does not recommend any travel or trade restriction based on the current information available.
Countries must inform WHO about travel measures taken, as required by the IHR. Countries are cautioned against actions that promote stigma or discrimination, in line with the principles of Article 3 of the IHR.
The Committee asked the Director-General to provide further advice on these matters, and if necessary, to make new case-by-case recommendations in view of this rapidly evolving situation.
Note that no travel or trade restrictions were recommended, though many countries are in fact doing just that. For example, the American Centre for Disease Control (CDC) has issued a Level 3 warning to avoid nonessential travel to China3, a Public Health Emergency was declared in the USA on 31 January, and on the same day the US President restricted entry into the US of anyone who had been within China (excluding Hong Kong) within the last 14 days.4
2. The legal position in PNG
In PNG, the primary legislation dealing with infectious diseases is the Public Health Act Ch. 226
(a) The Public Health Act
The initial legal step is a declaration in the gazette by the relevant Minister that a disease is 'an infectious disease' for the purposes of the relevant part of that Act; and possibly a declaration of a particular area as an 'Infected Area'. At the time of writing we have not seen such a notice5 and our clerks are continuing to monitor the gazette.
It is conceivable (though we have not as yet found a document) that the 2003 SARS virus resulted in a gazette notice at that time, which may or may not have been drafted widely enough to capture the 2019-nCoV.
Once it is officially treated as an 'infectious disease' it becomes notifiable and medical practitioners6, employers7, and government officers8 must report any occurrence to their local health authority. For the benefit of employers the relevant section reads:
19. Reports by employers
Immediately on any case of infectious disease or suspected infectious disease being discovered amongst his employees, an employer must report the case, in the prescribed form, to the Local Medical Authority.
If a medical practitioner attends a house and diagnoses the disease a certificate must be furnished to the householder9, and if there is a school child in the house the school must be notified10.
Wide powers are also given to control declared infectious diseases by disinfection or vacation of buildings and cars, restrictions on movement or isolation of infected areas.
(b) Obligations on PNG employers
Employers obviously have real interests in the good health of their workforce, but as well as the notification obligation if 2019-nCoV is 'declared' and an employee is diagnosed, there is a legal obligation to take proper and reasonable steps to provide a safe place of work.
In our view, for general employers at present the adoption of the recommendations of the WHO would be more than sufficient to discharge your employer duty of care.
The WHO 'Advice for the Public' can be found on their website – which includes some useful downloadable posters.
It may be sensible to ask your staff if they or the people they live with have been to China since about October last year, and if any have ask if they will voluntarily say if they have been well or fevered. Remember that health information is confidential to the employee and they are not obliged at the moment to disclose it to you.
(c) Travel Restrictions into PNG imposed by the PNG Government
Employers, business people and those expecting non-citizen visitors to PNG will need to closely monitor the situation – which is likely to be fluid for some time. Our best understanding today may be obsolete fairly quickly.
Under the Migration Act and Regulations an Entry Permit is required for non-citizens to enter PNG. In recent years a 'visa on arrival' at the airport has been available for certain foreign passport holders who wish to enter PNG for tourist or short term business purposes.
At the time of writing we are advised that the 'visa on arrival' process for visitors has been suspended, but paper visas and visas obtained online are still available.
Even with a visa any entry to PNG is still subject to Section 8(1)(b)(ii) & (c) of the Migration Act which gives migration officials power to refuse entry even to the holder of a valid Entry Permit if the officer believes the traveller is "suffering from a disease which would make his presence in the country a danger to the community" or the traveller refuses to submit to medical examination to check. The Migration Act language does not seem to depend on whether or not the disease has been declared an 'infectious disease' for the purposes of the Public Health Act.
(d) Social media and conspiracy theories
Even in developed countries conspiracy theories and misinformation are problematic, and certainly have the capacity to be very disruptive in PNG generally and workplaces in particular. We advise employers to be aware of tok tok amongst employees, and any other persons who you may have legal responsibility for.
3. Conclusion
Care without panic is advised. Sensible precautions should be all that is needed.
- Print and display the WHO posters – and generally impress on staff the importance of hygiene.
- Perhaps print and display the NY Times SARS article to help minimise anxiousness.
- Ask your staff if anyone has travelled to China since, say October last year and see if they are happy to disclose their health status now.
- Keep an eye on media for any formal announcement in PNG that it has been gazetted as an 'Infectious Disease'.
Footnotes
1 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
3 https://wwwnc.cdc.gov/travel/notices/warning/novel-coronavirus-china
4 https://www.cdc.gov/coronavirus/2019-nCoV/summary.html
5 Unfortunately, delivery and access to gazettes can be sporadic and somewhat unreliable.
6 Section 18
7 Section 19
8 Section 20
9 Section 22/p>
10 Section 21
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