- A team of 25 health experts from around the world just returned from a trip to China’s Wuhan province, the epicenter of the COVID-19 outbreak.
- Team lead Bruce Aylward said Tuesday that the “big conclusion for the world is, it’s simply not ready.”
- He talked about what conditions are like inside China, where trains roll through stations, makeshift sick bays are being built in mere days, and hospitals are erecting walls to keep COVID-19 patients in isolation.
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COVID-19 appears to be loosening its grip on China, just as other countries around the world are starting to grapple with the effects of person-to-person spread of the deadly virus for the first time on their home turf.
The number of virus cases reported in China continues to decline. Doctors there say they’ve got beds available for patients, and the 31 affected provinces around the country are beginning to wake up from a quarantine-induced slumber. Some people in Hubei province, at the epicenter of the outbreak, are heading back to their factories. But schools are still closed there, and street life in the capital Wuhan has been relatively quiet for more than a month.
Dr. Bruce Aylward, a physician and public health expert with the World Health Organization, has just returned from an independent fact-finding mission in China, along with more than 20 health counterparts from around the world, including the Chinese.
His message is sobering.
The world is not ready for the novel coronavirus known as COVID-19
“Big conclusion for the world is – it’s simply not ready,” Aylward said, just hours after disembarking in Geneva from his China trip. “Folks, this is a rapidly escalating epidemic in different places that we’ve got to tackle super fast to prevent a pandemic.”
That may be difficult in countries that don’t have the same disease-surveillance setup as China, a country that was hit hard by the deadly SARS outbreak in 2002-2003.
Still, Aylward pointed to a few basic preparedness measures that are being used in China, which other countries could potentially mimic, to help control the spread of this poorly understood virus.
“Hundreds of thousands of people in China did not get COVID-19 because of this aggressive response,” Aylward said, adding that the techniques were “old fashioned public health tools,” but applied “with a rigor and innovation of approach on a scale that we’ve never seen in history.”
“In 30 years of doing this business, I’ve not seen this before, nor was I sure it would work,” he said.
Here are Aylward’s big takeaways from his time in China, where he traced the COVID-19 response.
Cordoning off sick people from society appears to be effective, but you don’t have to put a whole country on lockdown to do it
Aylward said the Chinese took a “tailored” approach to their response to the outbreak.
In the normally bustling, New York-sized city of Wuhan, which has been under a strict quarantine for over a month, trains often roll right through the stations with the blinds down, he said.
The approach in other Chinese cities is different, depending on how many people are sick.
“A lot of people say you can’t do this at scale, because you will exhaust your response,” he said. “But the Chinese pragmatically said ‘not if you tailor this properly.'”
Other health and legal experts, however, have concerns that draconian and drawn-out quarantine measures may be unethical and inhumane.
Fostering a sense ‘that it’s our duty to help stop this virus’ can help
“It’s a ghost town,” Aylward said of Wuhan. “But behind every window and every skyscraper there are people cooperating with this response.”
The same is true of the medical teams being dispatched to help in the outbreak. More than 3,000 of those workers have gotten sick in the line of duty so far, though.
Aylward said one of these medical teams was traveling on his same train as it arrived in Wuhan.
“They had these little jackets on, and a flag,” he said. “It was a medical team coming in from Guangdong to be part of the 40,000 healthcare workers from other parts of China that have come in, many of whom volunteered to go into Wuhan and help with the response.”
Aylward said it isn’t just medical workers who are chipping in. Everyone from Chinese forestry workers to toll booth attendants are doing their jobs differently now to respond to the outbreak, which began in December and is still sickening tens of thousands.
It’s important to prepare hospital beds, ventilators to help people breathe, and public health workers to trace close contacts
Prepping “hundreds” of hospital beds and ventilators, while also enlisting thousands of public health workers, are some of the most crucial “really practical things you can do to be ready,” Aylward said.
In China, makeshift sick bays in stadiums have been built in mere days during the outbreak, and Aylward said some hospitals are erecting new walls around entire wards to keep COVID-19 patients in isolation.
“We’re going to find every case,” he said. “We’re going to go after every contact. We are going to make sure that we can isolate them and keep these people alive so they survive the case. This is the way we’ve got to be thinking. It takes a real shift in mindset.”
Use ‘massive amounts of data’ to track the outbreak’s spread
China has harnessed data in its attempt to trace every case of COVID-19, Aylward said.
“Remember, you don’t have to find every single one, cause you never will,” he added. “You want to find enough to break the big chains of transmission, slow this thing down, and get a grip on it.”
The technique might sound draconian, but it is how a lot of public health work is done. (In the US, this is often a key part of how investigators pinpoint where foodborne illnesses come from.)
In addition to tracking the spread of the virus, technology also helped move entire workflows online, Aylward said, like prescription refills. This eased strain on the country’s medical system, even as lots of elective surgeries have gone undone in hospitals burdened with COVID-19.
Evolve with the science
Aylward noted how national guidelines on how to take care of severely sick patients had changed “six times by six weeks,” in China, as scientists learned more about how the disease works.
Wash your hands. Tell your friends to wash their hands, too.
This is still one of the most effective prevention measures against the novel coronavirus. Avoid touching your face, and keep your hands as clean as possible.
“It looks like the main driver is not widespread community infection,” Aylward said. “It looks like it’s household-level infection.”
Because of all these different measures, Aylward says he’s been stunned to see the number of cases decreasing in China. But this does not mean the outbreak is coming to an end. Even in China, it’s hard to predict where the virus may head next.
“What was a rapidly escalating outbreak has plateaued and then come down faster than one would have expected,” he said. “You know, if I had COVID-19, I’d want to be treated in China.”
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