Global markets are in a panic. Japan has shut down schools. Australia has warned of a pandemic. Italy has locked down towns. South Korea has seen a frightening surge in the number of people sickened by the fast-spreading coronavirus. The World Health Organization has said the global risk posed by the virus that causes COVID-19, now confirmed in 53 countries, is “very high.”
But it’s not too late to tame the outbreak, says the Canadian doctor who headed a WHO team to China’s Hubei province, the epicentre of the virus.
“What China demonstrates is that this one is not beyond control. It’s a function of your response,” said Bruce Aylward, who led an independent fact-finding mission to study the spread of the virus in China, as well as that country’s response.
COVID-19 spreads so rapidly that one Harvard researcher has warned that 40 to 70 per cent of the world’s adults will be infected. Its deadliness has raised frightening comparisons with the Spanish flu.
But “we don’t need to end up there,” said Dr. Aylward, who came away from China convinced that the virus is not spreading as easily as feared and that the outbreak can be arrested if public-health authorities prepare well and act swiftly. In China and elsewhere, there is little evidence of widespread community transmission, he said. Instead, “it is more a whole bunch of clusters of transmission.” Take the Diamond Princess cruise ship in Japan. Or members of a sect in South Korea. Or people living in single buildings in Beijing or Hong Kong.
That, he said, “is really important. Because you can get on top of that.”
But to do so, “speed is everything here.”
Dr. Aylward joined the WHO in 1992 and has spent his career working on infectious diseases, polio eradication and preparedness.
He spoke to The Globe and Mail from Geneva, after his return this week from China, whose unprecedented response he has praised publicly. Chinese authorities have shut down most of Hubei and have imposed severe restrictions on movements and daily life in cities and villages across the country.
Chinese officials initially waited weeks to respond to the outbreak of COVID-19, with police even arresting doctors for discussing the appearance of a dangerous new virus.
Since then, however, China has responded with a speed unmatched any where else, Dr. Aylward said. He saw control rooms where authorities responding to the crisis deftly marshalled real-time statistical information with access to front-line workers. He heard from authorities who described graduated responses, with measures that varied depending on the severity of local outbreaks.
In Hubei, the problem is severe.
But China has 31 other provinces and regions. “Almost none of the other provinces look like what other areas outside of China are looking like,” he said. ”And other countries had a month and a half of notice.”
There is much to learn from China, he said – in particular the importance of creating broad public awareness of COVID-19, whose primary symptoms are a fever and dry cough.
“Your success hinges on your population,” he said. “Your population has got to have a high index of suspicion. They have to understand what this disease is – how it manifests. And they have to know how to get tested if they think they have it.”
Think of efforts to contain the virus as “war,” he said. “This is a function of leadership, communication and engagement of your population against a common threat.”
He complimented Canadian public-health authorities, who have taken less severe measures than their counterparts in the United States and Australia.
“Canada made the right call,” he said, pointing to the relatively low number of cases – 13 – confirmed in the country to date. Canada responded quickly to the cases that arose and has reaped the benefits of changes it made after the deadly SARS crisis. “The investments Canada has made in public health and heightened awareness is paying off,” Dr. Aylward said.
“Canada has it right in terms of: You have to go really fast – find these cases, shut down these transmission channels.”
Still, he warned that large numbers of cases are likely to arise quickly, and provinces must be ready to rapidly delegate health-care resources to manage them. That could include sealing off entire hospital wards for COVID-19 patients.
“You’re in for a run here. This isn’t going to end in a week or a month,” Dr. Aylward said.
At the same time, the Chinese experience offers reason for guarded optimism. While he was in China, officials in Guangdong province told him they had tested 320,000 people around the peak of the outbreak there in late January. Only 0.47 per cent tested positive.
“So not 70 per cent – 0.47 per cent,” he said.
Still, he said, Japan did the right thing by shutting schools once the virus began to spread. “Measures like that in the face of an escalating transmission, one they’re trying to get under control, are probably a good idea.”
At the same time, he warned against the use of the term “pandemic,” which signifies an uncontrollable disease that must be managed rather than battled.
“When people say ‘pandemic’ they feel it’s one global outbreak with transmission everywhere. That’s not what this is,” he said. “If ‘pandemic’ means that all of a sudden it’s beyond your control, that’s a disaster.”
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