The designation comes as the first person-to-person transmission of the virus is reported in the U.S

The World Health Organization declared the coronavirus outbreak a public-health emergency of international concern Thursday as the first person-to-person transmission of the virus was reported in the U.S.

The WHO designation, pointing to an increase in the number of cases, indicates that international public-health authorities now consider the respiratory virus a significant threat beyond China, where it originated last month. The move could further heighten the global response to the outbreak.

The agency made the declaration after a meeting of its emergency committee, which declined to do so last week. Since then, China, other governments and multinational businesses have taken emergency steps to limit the virus’s spread, including halting some travel to China.

 
A plane carrying more than 200 Americans arrived at March Air Force Base in Riverside County, Calif., on Wednesday. They have been screened multiple times and will be temporarily housed at the airbase. Photo: Matt Hartman/Agence France-Presse/Getty Images

Noting the WHO’s declaration, the State Department told Americans not to go to China, raising its travel alert to the highest level Thursday. It advised that people in China should consider leaving the country and said it requested that all nonessential U.S. government personnel postpone travel there. The State Department advises the same “do not travel” warning for countries including Afghanistan and Syria.

In the U.S., a sixth person tested positive for the infection in the first case of human-to-human transmission. The patient is the husband of a Chicago woman infected with the virus whose case was reported last week. She had recently traveled to Wuhan, the central Chinese city where the coronavirus first emerged last month.

The U.S. Centers for Disease Control and Prevention and state officials emphasized that the overall risk for people in the U.S. and in Illinois remains low. “This person-to-person spread was between two very close contacts, a wife and husband,” said Ngozi Ezike, the director of the Illinois Department of Public Health. “It is not spreading in the wider community.”

Public-health authorities said the WHO designation helps mobilize resources to contain the virus’s spread. The WHO’s director-general can make recommendations to the international community, though they aren’t legally binding.

WHO Director-General Tedros Adhanom Ghebreyesus said he was confident in China’s capacity to control the outbreak, which has sickened more than 9,500 people and killed 213—up from 170 a day earlier—mostly in China’s Hubei province, which surrounds Wuhan.

“Let me be clear. This declaration is not a vote of no confidence in China,” Dr. Tedros said. “I have never in my life seen this kind of mobilization.”

The number of infection cases in China surpassed the global total for severe acute respiratory syndrome, though SARS killed nearly 800 people after emerging in southern China in late 2002 and into 2003.

Since it gained the power, in 2005, to declare an international emergency, WHO had applied the designation to just five prior situations. The first was in 2009 in response to the H1N1 swine flu, followed by polio in 2014 and the Ebola and Zika virus outbreaks in 2016. It declared a public emergency for another Ebola outbreak in 2019 and faced criticism for delaying that decision.

 At least 18 other countries or territories have also reported a small number of coronavirus cases, with Finland, India and the Philippines now reporting cases in people who have traveled to Wuhan, according to WHO.

In response to the virus, Russia has tightened its border with China and the U.S. announced plans for a second evacuation of Americans from Wuhan. Companies including Tesla Inc. and IKEA temporarily halted operations in China.

The CDC has investigated 165 people in the U.S. for the virus, according to the numbers released Wednesday, and 68 have tested negative and been cleared. Over 90 cases are pending, and health authorities said that they expect additional cases.

The new Chicago patient lived with and was in consistent close contact with his wife. After returning to the U.S. on Jan. 13, she developed symptoms and was hospitalized in an isolated setting. Once her husband also started developing symptoms he was quickly taken to the hospital. The patient, who has underlying health issues, is in a stable condition, health authorities said.

“It is clear that this virus is highly transmittable, and this assumption is based on the rapid rate of spread of this infection in China,” said Eyal Leshem, director of the Institute for Travel and Tropical medicine at Sheba Medical Center in Israel.

“When there is a public-health uncertainty, you always want to slightly overreact to make sure that you don’t miss a critical issue,” Dr. Leshem said. “Once you learn a little bit more about the risk and the effective steps, then you can scale back.”

Health authorities believe the virus spread while the first patient in Chicago was symptomatic, rather than before.


A transit worker takes the temperature of a passenger during a screening at a passenger ferry terminal in Shanghai, China, on Thursday. PHOTO: QILAI SHEN/BLOOMBERG NEW

Officials said the man, who is in his 60s, didn’t attend any mass gatherings. There are 21 people under investigation in Illinois for possible infection, Dr. Ezike said, and local and federal health authorities are working to monitor close contacts of the second Chicago patient.

Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC, called the coronavirus “a very serious public-health situation.” She added: “We’re trying to spark a balance in our response right now.”

The CDC said that people who had recently traveled should be vigilant for symptoms and signs of the virus, which include fever, cough and shortness of breath.

President Trump during a speech in Michigan said the administration is working closely with China and sought to minimize fears about the virus in the U.S.

“We think we have it very well under control. We have very little problem in this country at this moment,” Mr. Trump said, adding that the handful of victims are recuperating. “We think it’s going to have a very good ending for us. That I can assure you.”

On Wednesday, Mr. Trump announced a task force to address the coronavirus, which he said had been meeting daily since Monday. The group is led by Health and Human Services Secretary Alex Azar.

Members of a House of Representatives panel briefed by federal medical officials Thursday said that traditional means of stopping infection are still the best guard against the virus’s spread.

Members of the subcommittee said federal officials appear to have the situation in hand and that there isn’t any need for a coronavirus “czar,” as was appointed during the Ebola virus epidemic in West Africa during the Obama administration.

Authorities in Russia, meanwhile, said they would temporarily restrict passage through 16 road, rail and river checkpoints along its 2,670-mile border with China. Though Russia’s national carrier Aeroflot hasn’t stopped flying to China smaller Russian airlines have canceled flights.

A number of countries have pushed ahead with efforts to extract their citizens from central China.

The State Department on Thursday said it is planning a second evacuation flight from Wuhan for the hundreds of American citizens still believed to be in the city.

The Indian government is seeking permission from Chinese authorities to operate two flights to repatriate citizens from Hubei province, and will quarantine them for 14 days

How men’s sexuality is just as mental as it is physical, and why having good sex doesn’t necessarily mean having an orgasm.

What happens when you interview a famous relationship therapist? You go in with a bunch of questions that sounded smart when you wrote them down, but now sound quite stupid as you say them out loud. She does her best to answer them but you sense she is bored. She can tell they are questions designed to avoid other, deeper, more personal questions. So the interview is going badly.

Then, in an effort to keep the conversation from tanking completely, you offer up some of your own insecurities about sex and dating. You back into the questions that are really bugging you. That’s when she lights up. She starts picking you apart. In fact, in about an hour and a half, she deconstructs the whole shaky edifice of male sexuality in America.

At least, that’s what happened to me when I met Esther Perel, the Belgian-American psychotherapist and author of Mating in Captivity and The State of Affairs. Over tea and coffee at the Soho Grand, Perel gave me a personal seminar on everything that men (and women) get wrong about sex. Here, she explains why good old American pragmatism doesn’t work so well when applied to sex and romance; how Tinder is a tool for avoiding rejection; and why hookup culture is fueled by alcohol.

GQ: There’s a refrain in the sex and relationships discourse that the European level of sexual intelligence is higher. Why? Is it because all of the prudes moved to the U.S.?
Esther Perel: It's not all European. It’s also Protestant versus Catholic and Anglo-Saxon versus Latin. But there is something about sexuality [here in the U.S.], it becomes something you do versus a place where you go and experience. It’s a goal with an objective and an end. [It’s] the same way that Americans don't know how to flirt, because they are so goal-oriented. They [want to] score. What's the point of flirting if you're not going to score? There's no appreciation for the thing itself, the game, the possibility, the imagination. If you're not going to land the result, then what's the point? It's bringing American pragmatism to the erotic and the mystic.

To a place where it doesn't apply.

This model is very good for the economy, for the market, but not for the intimate landscape of relations, and that's part of why sex is taken out of the context of a story. It doesn't have a plot. It’s just an act. How was it? "It was good, we both came."
 

How do you bring the plot back in?

Start a new education program. Do something with the four-year-olds. Because that's when we are natural theologians, right? “Where do I come from, and where do we go when we die?” So that's the time when you begin to talk about that story. There's conception of self. People feel the ones they like, the ones they don't like, why they like them

"Foreplay is not five minutes before the real thing. Foreplay starts at the end of the previous orgasm."

I guess the problem is that sex can be an uncomfortable subject in this country.
There's a profound discomfort here. But the discomfort is not only with sex. The discomfort is with the body, with loss of control. This place is obsessed with self-control, and sex is a form of surrender. It comes with excess; it comes with loss of control; and it comes with pleasure. And pleasure that is not always productive for its own sake. All these things are held in great suspicion in the American psyche.

For men in particular, sex can be acquisitional, something they have to pursue in order to prove or confirm their masculinity.

Every gender is given license to seek its needs in a particular language. Throughout history, the language of women has been feelings and emotions, and, in there, they could wrap their lustful inclinations. The language of men has been sex, and, through sex, they can request acceptance, longing, connection, tenderness, intimacy, abandon. Sex is the gateway for a host of forbidden emotions in men. They believe that what they want is sex. They believe that they should want sex. If they don't want sex, if they're not always up for it, if that's not the only thing they have in mind, there is something wrong with them.

The assumption with men is that their sexuality is more physical than mental.

Male sexuality is often seen as biologically driven, autonomous, spontaneous, you don't have to do anything—you get a hard-on, it's there.
He's always in search of an outlet, ready to do the deed. And it's so far from the truth. In fact I think [men’s sexuality] is massively psychologically driven. If you think about the fear of rejection, isn't that a psychological factor? If you think about the fear of inadequacy and performance anxiety, isn't that a relational matter?
And if you think about not knowing if she's lying to him or if she's actually liking it—which she could do for 30 years, she could lie to his face and he would never know—if those are not relational aspects of male sexuality, then I don't know what is. Your sexuality is no less relational than that of a woman.

When we talk about male sexuality, we don’t often focus on the emotional and mental parts of it.
Do you know, the majority of research on loss of desire, or lack of sexual desire, is done on women? Because it's so ingrained, even in the science, that he's always up for it. If he's not, what's wrong with him? Maybe when he's depressed or anxious, he's not in the mood. When he worries about his job or about money, his parents dying, he's not in the mood. When he has gained 50 pounds, he's not in the mood. The fact that all kinds of internal experiences may affect his arousal is just inconceivable. The notion is: if you're a dude, wherever you can get it, you take it. It's unbelievably archaic.

"You learn that confidence is your ability to see yourself as a flawed person, and still hold yourself in high regard. Confidence is your ability to tolerate uncertainty."

How do you free guys from that?
How do you free guys from the thinking that their gender and their sex are one and the same? That they're tied into one, and if one isn't interested, than the other one is broken? It's a reeducation. [For instance,] foreplay is not five minutes before the real thing. Foreplay starts at the end of the previous orgasm. It's a whole different idea about foreplay, right? What does it mean to lubricate the relationship as a whole? Not to just say, "Shall we?" The most important turn on for everybody is confidence.

How do you get sexual confidence?

In the same way that you get confidence at work, or as you play an instrument. It's practice. It's learning. You gain confidence with experience, self-acceptance, maturity. You learn that confidence is your ability to see yourself as a flawed person, and still hold yourself in high regard. Confidence is your ability to tolerate uncertainty, without thinking that if you don't know you're not worthy. You don't say, “How was it for you?” You say, “How was I?” Confidence is the person who really says, "How are you? How was it? What do you love the most? Anything you'd like me to do more?"

That sounds very vulnerable.

It means you don't know everything. See, the male sexual education is that he knows without her having to say, and she thinks he knows without her having to say. Everyone colludes on the same myth. On what basis would you know without having said? Every woman is different. Ask! How does she like to play?

The crazy thing about asking is acknowledging to her that you don't know. That's the scary part. You say, "You know what? There's a whole freaking pressure on dudes to have to pretend that they know, when they know squat. I don't want to play that game, so I'm going to be a different kind of guy. Can you handle it? Do you want me to play the part of the guy who pretends, or do you actually want me to be the guy who really wants to know? You tell me, lady.”

People don't take the time to actually develop a certain comfort with the person, a certain ease. Then there's so many ways to be sexual that don't have to do instantly with intercourse and orgasms.

There is such an expectation [to know] that it produces false confidence. The false confidence produces exacerbated anxiety. The exacerbated anxiety makes people reluctant to actually want to engage with each other, because they're so afraid to fail, instead to try out a whole bunch of things and just say, “Who said this had to succeed the first time?”
 

It seems almost heretical to say that you can actually fail and it will be okay.

What is failure? What is bad sex? Bad sex is measured by the fact that he couldn't keep it up, that he couldn't come, or that he did and he came too soon? Or is bad sex the fact that midway he completely forgot to think that there was somebody there, because he was so busy making sure that he was functioning? She wants to feel that she matters, not that he's able to enjoy his own prowess. If he caresses her hair in a way that just gives her shivers throughout her entire body... that's pleasure. Him just being able to get it done? That is not pleasure.

"What is Tinder? Tinder is a rejection prevention app for dudes."

Speaking as the descendant of Puritans, there’s something about sex that is almost inherently scary.
And dirty. That's why everybody's freaking drunk these days. Because you're fundamentally scared. You're scared of owning it, of actually saying, “I want it.” The alcohol is a fundamental expression of the discomfort. It's not that people drink here just because they enjoy it. It's to get freaking smashed.

If you only want to have sex with someone after a few drinks, you probably don't really want to have sex with them.

You don't. You think you should want to. You think there's something wrong with you. There’s no, “Am I in the mood?” It’s: “There's a pretty girl here, therefore I should.” There's no checking in with yourself.

Do you feel like it tonight? Maybe you don't. Do you want to run three miles tonight? No, you don't. Once you begin to make analogies, people get out of the exceptionalism of sex, as if sex was functioning with rules of its own.

Is it fair to say that the male hang up when it comes to finding intimacy is fear of rejection?

Everybody is [scared of rejection]. It's normal. What is Tinder? Tinder is a rejection prevention app for dudes. They don't have to do the effort anymore. Men get rejected a lot more than girls, it's true. Girls get rejected, but if she's pretty, if she has some cachet of some sort, she's less likely to be rejected than him. Boys deserve support for that. They are the initiators, they are the ones that have to make the moves. All over the world, that's the case.

How do you move beyond fear of rejection, or normalize it, or get comfortable with rejection?

You don't. You don't get comfortable. You talk about it with other people and you say, “It sucks.” The experience of being rejected, this experience of somebody loving somebody ends. The experience of jealousy, of loneliness, these are part of the human condition. Today people want to anesthetize their life from all these experiences. They want sure bets. This is life. You're going to be in pain, you're going to suffer, you're going to feel rejected, you're going to feel loved, you're going to feel jealous, you're going to feel possessive, you're going to feel generous, you're going to feel stingy, you're going to feel all kinds of things.

That's the richness of our emotional lives. You're going to cry with music. You're going to read literature, and it's going to show you that you're not the only one. You're going to cry with your friends, and you're going to realize that they have gone through some of the same things. And, gradually, you learn to build resistance, to become resilient in the sense that you're going to beat back and move forward through these experiences of life so that you're not just a fragile creature.