The outbreak of the novel coronavirus (COVID-19) is now a national crisis in China and caused great concerns around the world. Can you briefly explain what coronavirus is and what might have led to the outbreak in China this time?
COVID-19 is a member of the coronavirus family which also includes MERS and SARS. The coronavirus is an RNA virus, which has a high mutation rate, making it difficult to develop vaccine and medical countermeasures during the outbreak.
I will break down the coronavirus story into three parts: the virus itself, the coverup, and inaction. So far, we still don’t know much about the virus. It is contagious, with a relatively high transmission rate. Data also suggested that the coronavirus is “smart”: asymptomatic carriers can shed the virus, and the incubation period could be up to 24 days. The number of deaths caused by coronavirus has exceeded that caused by SARS, but the mortality rate varies widely depending on age, gender and medical history. There are a number of questions raised on the nature of the virus, which also triggered conspiracy theories that suspected the virus could be biological weapon.
Secondly, there’s the story of cover up. Dr. Li Wenliang, who shared the news of the coronavirus on his social media, was disciplined by the government for being a rumormonger. If people were allowed to speak out at the initial stage, the tragedy could have been avoided. The failure of sharing the information with the public is another example. I was told by a public health expert that the government learned that the virus could cause human to human transmission by Jan. 3, but the Chinese citizen were not told until Jan. 20, when Dr. Zhong Nanshan announced the information in the press conference. It is clear that the public was not adequately informed during the outbreak. Transparency is crucial in responding to this kind of outbreak.
The third is about inaction. Though local leaders knew that the deadly virus was spreading in the city, they didn’t take any pre-cautionary measures. Instead, they told the people the virus was preventable and controllable, claiming there was nothing to worry about. They clearly failed to educate the people and to raise their awareness of the virus. The Chinese government did take some actions to deal with the virus. For example, on Jan. 12, Chinese scientists share the sequence of the virus with the international community. But according to Caixin, as early as December 27, 2019, Chinese scientists had sequenced the virus genome, but they were told not to publicize the information.
China invested a huge amount in upgrading its technical capacities to monitor the outbreak of epidemics. How would you evaluate the performance of this system this time?
Since 2003, China has invested a lot in building its disease surveillance and response capacities, which allows public health workers to report directly to China CDC anything unusual. But this time, the system didn’t work. It was until the end of December that a doctor insisted to report the situation to the upper-level health authorities.
Since January 23 China has imposed draconian measures that effectively have quarantined more than 50 million people in Hubei province. What are the pros and cons of this step?
When Chinese leaders realized they faced a much bigger problem than SARS, they started by quarantining the city of Wuhan. Later, similar measures were implemented in entire China. Such measures are not new – they could be traced back to the medieval era. But international public health experts still don’t have consensus on the effectiveness of this method, though it appears to be effective in stabilizing the disease situation, especially in provinces other than Hubei. But it’s hard to establish a causal linkage. During the SARS period, for example, the transmission rate had already been below one before the government took any large-scale quarantine measures. In the meantime, there are lots of drawbacks of this measure – inconvenience of living; difficulties for patients suffering conventional diseases to access life-saving medicine; negative economic consequences, etc. The quarantine measure thus brought very mixed results.
How would you assess the global responses to the coronavirus outbreak?
This current situation is very chaotic. Countries declared public health emergencies, evacuated citizens from China, and imposed travel bans on Chinese citizens. Many of these measures are violations of International Health Regulation (IHR) Article 43, which claims that countries could enact measures based on their national laws, but in the meantime, they should not be more intrusive or invasive to people than reasonably available alternatives.
China News Service／中国新闻网 / CC BY (https://creativecommons.org/licenses/by/3.0)