Where will we be in six months, a year, 20 years from now? COVID-19 When will this end? I lie to get up at night wondering what the future holds for my loved ones. My accessible friends and relatives. I feel fear of what will happen to my job, even though I’m one of the happy ones: I get a good sick reward and can work remotely. How will COVID-19 change the world? I am writing this from India, where I still have self-employed friends who are presenting down the barrel of months without pay, friends who have already lost jobs. The contract that pays 80% of my earrings runs out in December. As a result, Coronavirus is hitting the economy badly.
Can I go for a run? A WHO expert on Coronavirus explain?
- Senior advisor to the Director-General of the World Health Organization (WHO) Bruce Aylward talks testing and how to break the COVID-19 transmission chain.
- Lockdowns will likely last more than two weeks.
- To hold off a second wave, governments must fast find and test suspect cases, isolate and treat confirmed cases, and quarantine others.
The COVID-19 pandemic is surging around the world and China is preparing itself for the second wave of infections. World Health Organization Director-General Tedros Adhanom Ghebreyesus told G20 leaders this week, “The pandemic is accelerating at an exponential rate.“
Bruce Aylward, the senior advisor to the WHO Director-General, says governments must keep their populations under lockdown while chasing down every suspect case for testing, and treating and isolating those who test positive.
How long will it last?
Well, probably the best symbol of how long this might last comes from China because it’s the only country that has truly taken a fast escalating COVID-19 outbreak and really turned the corner and brought it down.
And if you look across China, across the 31 provinces, all of which were damaged at one point or another, the longest and most painful, of course, was Wuhan, which remains locked down. It will be nearly 10 weeks by the time they will have boost there – all of February, March, and much of April. Now, there are many other zones, however, that we’re able to manage this with a much less shutdown period, that arranges anywhere from a month to two months. It really depends on the background how well control part bite or take the heat out of this outbreak. But it will be more than a couple of weeks anywhere, around definitely.
We saw that Spain’s death rate, following Italy’s, overtook that of China’s. Is there any way of saying why those two countries are getting it so heavily? Or is it just the way of these things and many other countries will be going down that route in a week’s time or so?
Well, there’s a solution to factors. When we look at a country like Italy or Spain and we think, ‘Well, why did they get so bad to blow?’ Part of it is just temporal. But by that, I mean timing. They got hit earlier than any of the others. And then some of the large number of death rates that we’re seeing, etc. can be associated with different factors. We hear about this in the news all the time.
Italy is the second oldest population in the world after Japan, of course. It can also be the fact that we’re mainly seeing the serious cases that are hitting the hospitals and not all the mild cases are getting tested. So, we have a falsely high death rate and there’s another point that can be at play as well.
What we have learned in this virus?
What I always mention people is all of that is happening against a background of biologic processes in large populations that we don’t fully understand. We’ve known this disease for 12 weeks. Even diseases that we’ve known for decades, we still don’t know everything about why they expressed themselves in different ways and different populations. But what we have learned is this virus has the bias to cause severe disease, societal disruption, massive outbreaks, economic disruption in any status. We’ve seen it now in the Middle East, Asia, Europe. And what it tells us everywhere is: be prepared, be ready, take every step you possibly can to try and prevent the explosive outbreaks we’re seeing in places like Spain and Italy.
Does the World Health Organization have certain milestones you’re looking ahead to? And what are the positive milestones?
Well, first of all, you don’t wait (for positive milestones). You push for those things. You push very hard. And what we really are looking at is how many regions in the world can find their suspect cases and test them within 48 hours of their onset of symptoms. Because when you get that number very, very high, you’re going to understand the magnitude of what you’re dealing with. How many countries can completely isolate their cases within 24 hours? Because when you can do that, you know that you’re getting the known virus out of the community. It’s not infecting other people and you’re getting in front of it. And then similarly, we look at quarantine rates, etc. So, there’s a whole bunch of indicators that tell us whether a country is on top of the measures needed to slow it down.
Two and Three weeks is enough to bend a curve
The other things we look at, of course, is how well are the lifesaving measures working? And there, you’re looking at the case fatality rates in different age groups and different sub-groups. But what’s most important is looking at what’s happening to that epidemic trend. Is the rate of new cases slowing and has it actually turned that outbreak? But that can be due to a number of factors. So, some people are just watching those curves go up and seeing them turn. But what you want to see is the combination of the curve plus the response measures. And that’s why when I was in China and doing a briefing at the end of it, I would never show just a curve.
I would also say, ‘Here’s the curve and here are all the things that were being done to change that curve.’ And that’s what we need to see: what does the curve look like? What are the big measures in place? Are they at the performance levels we want?’ Because that will tell you in maybe two or three weeks if that curve is going to bend.
And, when the curves have bent, you want to be sure that it’s for the right reasons and not just because testing dropped off or surveillance. So, it’s a combination: what’s happening to the curve and the response measures on top of it. Anyone of the two only gives you a partial understanding.
The thinks we’ll be looking out for in the coming weeks.
Part of it will be watching – we’ll be watching the curves but the response part we’ll be pushing. That’s the part we control. This is what’s so important: we went into China wondering about this disease. There was a lot we didn’t know. We knew it was a respiratory pathogen. We knew we didn’t have a vaccine. And that usually means you’re trying to do as much as possible just to save lives because the virus is always going to be in front of you. And what we learned was, to our surprise, old-fashioned case-finding, isolation, quarantine can actually slow down a respiratory disease. Countries are now taking extraordinary measures to put shutdowns and slowdowns and lockdowns in place. But unless you’re doing the other part, when they lift the big measures, this thing could take off again. And we want to make sure that when you lift the measures, the virus stays down.