2020-05-02 06:55:59 UTC
interview with World Health Organization assistant director
general Dr. Bruce Aylward. The subject is the COVID-19 policies
used by various countries:
Jessica Hamzelou: How did China get to this point?
Dr. Aylward: China did something that most other countries would
not even have tried, and many people thought would have been
impossible. It used fundamental public health approaches – such
as case finding and contact tracing – to stop a respiratory virus.
That seemed almost impossible as a premise because respiratory
viruses transmit so effectively and efficiently – typically the
only way you can stop them is with a vaccine or pharmaceutical
treatment. What China did provides a lesson for infectious
JH: Does that mean China's extreme lockdowns were the right way to go?
Aylward: Everyone always starts at the wrong end of the China
response. The first thing it did was try to prevent the spread as
much as it could, and make sure people knew about the disease and
how to get tested.
To actually stop the virus, it had to do rapid testing of any
suspect case, immediate isolation of anyone who was a confirmed
or suspected case, and then quarantine the close contacts for
14 days so that they could figure out if any were infected.
Those were the measures that stopped transmission in China,
not the big travel restrictions and lockdowns.
Dr. Aylward emphasized that Chinese policy is based on flexibility
"China decided that it cannot afford to wait for cases to go to
absolute zero – not knowing if they ever will – so it decided to
strengthen its whole system so that it could live with the disease
if it had to. It is building additional capacity to isolate people,
and it is building additional ventilators. It is planning to be
able to manage low-level disease and prevent large outbreaks.
It's a very sensible way to plan."
Others have pointed out that the quickest a vaccine has ever been
developed is for ebola, and that took five years. Also, there has
never been an effective vaccine for any corona virus.
In the United States we are still in the talking stage of fielding
adequate numbers of dedicated contact tracers. Of course, contact
tracing got off to a late start in the United States because of delays
Adapting to COVID-19 has already required great productivity in
building masks and ventilators, and very likely more in such things
as modifying and building infrastructure.
Looking toward sustainability, there is a great deal of existing
technology that can be used to control workplace transmission of
air born disease. For example, coal miners and others in physically
demanding jobs often use helmets or complete suits supplied with
filtered air at slight positive pressure. This could be adapted
to other fields. For years, the air-handling systems in hospitals
have been designed to keep pathogens in or out of various rooms;
for patients with contagious diseases, keep them in, for patients
with compromised immune systems, keep them out. This could also
be done in schools, airliners, and trains, to prevent one classroom
or passenger from infecting another.
Operating an educational system is a challenge. In addition to
academic subjects, lower grades teach social behavior and cooperation,
which don't really lend themselves to distance learning.
Doctor Aylward said in the interview:
"But one of the curious things with [covid-19] is that we have not
seen school outbreaks. I talked to my colleagues in South Korea,
in China, in Italy, everywhere – no one has seen school outbreaks.
They have seen situations where a teacher is infected and they have
infected kids, but that is different to the kids all getting each
Several western countries have recently reopened schools, and Sweden
never did close elementary schools.
I am interested in any thoughts on this and related issues.