Back to list 2020-03-09 10:33:12

China, and specifically Hubei province, is where the Covid-19 disease emerged; it’s where 80 percent of the 110,000 cases known to date have been recorded; and it’s where doctors and health authorities have been battling an epidemic for two months using unprecedented public health measures, including a cordon sanitaire and lockdowns that affected millions.

In recent weeks, though, the number of new infections and deaths reported in China has been declining, which suggests spread of the virus may have peaked there and that transmission is slowing down.

At the same time, cases are rapidly increasing in several other countries, with major outbreaks in South Korea, Italy, and Iran. It’s now critical that the rest of the world learn as much as it can from China’s efforts to respond to and limit the spread of the virus.

That was precisely the intention of a recent World Health Organization(WHO) mission to China, led by the agency’s assistant director general and veteran epidemiologist Bruce Aylward. Its major finding: “China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic.”

The majority of the response in China, in 30 provinces, was about case finding, contact tracing, and suspension of public gatherings. The lockdown was concentrated in Wuhan and two or three other cities that also exploded with Covid-19 cases. These are places that got out of control in the beginning and China made the decision to protect China and the rest of the world.

The key learning from China is speed. The faster you can find the cases, isolate the cases, and track their close contacts, the more successful you’re going to be. Another big takeaway is that even when you have substantial transmission with a lot of clusters, what China demonstrates is if you settle down, roll up your sleeves, and begin that systematic work of case finding and contact tracing, you definitely can change the shape of the outbreak, take the heat out of it, and prevent a lot of people from getting sick and a lot of the most vulnerable from dying.

So, No. 1, if you want to get speed of response, your population has to know this disease.

Your population is your surveillance system. Everybody has got a smartphone, everybody can get a thermometer. That is your surveillance system. Make sure the surveillance system is primed. Make sure you’re ready to act on the signals that come in from that surveillance system. You’ve got to be set up to rapidly assess whether or not they really have those symptoms, test those people, and, if necessary, isolate and trace their contacts.

In China, they have set up a giant network of fever hospitals. In some areas, a team can go to you and swab you and have an answer for you in four to seven hours. But you’ve got to be set up — speed is everything.

So make sure your people know about the virus. Make sure you have mechanisms for working with them very quickly through your health system. Then enough public health infrastructure to investigate cases, identify the close contacts, and then make sure they remain under surveillance. That’s 90 percent of the Chinese response.