China shows a future of the epidemic and the world

by Fabius Maximus

Summary:  The findings of the experts sent to investigate the COVID-19 epidemic in China not only tells us about the epidemic (an antidote to the misinformation pandemic) but also gives hints about the future of the world’s economy and politics.

Pandemic

Before looking at the epidemic in China, look at a different infection in America. Discussion about the epidemic in China often describe its government and society in ways similar to 19th century Brits describing central Africa: dark, primitive, untrustworthy, lesser than us. No surprise since for a decade US elites have demonized China – as it has become a serious commercial and geopolitical rival to America.

Much the same paranoia, insularity, and ignorance has infected discussions in America of Russia, again the result of propaganda serving the interests of America’s elites (better that the proles focus on foreign foes than our own corrupt leaders).

Perhaps this epidemic will help break this lock on our minds. China’s efforts to contain the epidemic have been innovative and unprecedented, with many lessons America should learn.

Press Conference reporting about results of

the WHO Joint Mission to China on COVID-19

Excerpts; see the full transcript here. Emphasis added.

Liang Wannian.

Head of the COVID-19 Response Panel of the China National Health Commission (NHC), also Director-General of Health Care Reform for the NHC.

Let me begin with {our} purposes and the findings …The joint team was composed of 25 international and Chinese experts in fields including epidemiology, virology, clinical management, and public health. {These} experts gained a comprehensive and thorough understanding of the epidemic situation, prevention and control measures, health care services, and scientific research …across China. During the mission, the Joint Mission held detailed discussions and consultations with government officials, emergency response teams, senior scientists, front-line health care staff, and the general public. …Here I will briefly introduce the major findings of this mission. …

(2)  Epidemiological characteristics of the epidemic.

In terms of demographic characteristics, the average age of the confirmed cases was 51 years old, and nearly 80% of these patients aged 30 – 69 years. As of February 20, about 78% of the confirmed cases were from Hubei Province. …

Editor’s note: That’s important. Many doomsters say that this is a devestating epidemic across all of China. I doubt that most of them could find Hubei Province on a map. It has not taken hold in China’s other 30+ provinces and other units.

(4)  Routes of transmission.

Familial clustering of COVID-19 has been identified, especially in Guangdong and Sichuan, where up to 78% – 85% of the confirmed cases were from familiar clusters. The familial clustering just reflected that the prevention and control measures in these two provinces are highly effective. Thanks to the these strict prevention and control measures, the only second-generation cases and clusters occurred inside families (i.e., other than the imported cases). No continuous community spread was found. …

Close contacts are closely managed nationwide, and they are now tracked and medically observed. Approximately 1% -5% of the close contacts {of the infected} have been laboratory confirmed as COVID-19 patients. …

About COVID-19.

The current data have indicated that the disease are mild and can be cured in most cases. The proportions of mild, severe, and critically ill patients are about 80%, 13%, and 6%, respectively.

Some asymptomatic patients have been found. However, whether such cases are patients with asymptomatic infections or carriers whose virus is still in the incubation period warrants further study. It is unclear whether the asymptomatic carriers can also spread the disease.

The case-fatality rate is estimated at …about 0.7% …outside Wuhan. …According to the currently available data, the average time from symptom onset to recovery is two weeks for mild cases and three to six weeks for severe patients. …

Ed’s note: The fatality rate outside Wuhan (i.e., provinces with adequately functioning health care systems) is estimated to be 0.7%. Not the 2 – 3% commonly cited by doomsters (who also mention that the fatality rate in developed nations will probably be lower than China’s).

Dr. Bruce Aylward (bio).

…So first, what has China done? In the face of a previously unknown disease, China has taken one of the most ancient approaches for infectious disease control and rolled out probably the most ambitious, and I would say, agile and aggressive disease containment effort in history.

China took old-fashioned measures, like the national approach to hand-washing, the mask-wearing, the social distancing, the universal temperature monitoring. But then very quickly, as it started to evolve, the response started to change. And it moved from this sort of one-size-fits-all approach to a science-and-risk-based approach, which was tailored to use different containment approaches and measures, depending on the context, the capacity and really the nature of the coronavirus circulation. So they refined the strategy as they moved forward, and this is an important aspect as we look to how we might use this going forward.

They took this old approach and then turbo-charged it with modern science and modern technology in a way that was unimaginable even a few years ago.

Just a couple of small examples. As they cleared these giant hospitals to make space for overwhelming numbers of COVID-19 cases, they moved a huge amount of the routine provision of medical services onto online platforms and other mechanisms that they’ve really come to a cutting edge with. When we were in Sichuan …they showed us a 5G platform so they could do real-time contact, support. In two minutes they contacted an epidemiological investigation team in the field that was having problems, and was getting walked through it by the top experts from the province. It’s fundamentally different from the way most people approach a dangerous respiratory pathogen in the modern era.

The second issue: how did they make it happen? This was only been possible because of tremendous collective commitment and will of the Chinese people from the most bottom-level community leaders to the governors at the top. It was an extraordinary all-of-government, all-of-society approach. …

Is it working?

It’s the opinion of the joint mission …that China’s bold approach to the rapid spread of this new respiratory pathogen has changed the course of what was a rapidly escalating and continues to be deadly epidemic.

There’ve been challenges with statistics that come out of China, the changing numbers. We looked carefully at different sources of information, and can say with confidence that this is declining.

When you get out into the field, there is a lot of compelling data and observations to support this decline. …First, we saw a steep decline in visits to fever clinics. In one province that we went to, it dropped from 46,000 at one point for the whole province down to 13,000, so dropping very quickly despite a heightened awareness of push to get people in and get them tested.

Second, when we spoke to physicians in Wuhan, they said that hospital beds are opening up – so we can move people in. This was the first time in weeks that they found there was more than enough capacity. …

I know people look at the numbers and ask what is really happening. …I work for the WHO. But I have 12 people with me who work for the best research and public health institutions around the world. …multiple sources of data pointed to the same thing. This is falling and it’s falling because of the actions that China has taken.

{He presented graphs of the data they collected.}

The last point is what happens next as China is already preparing to reopen businesses and schools in the near future, maybe some weeks. They want to get society back to a more normal semblance – a new normal, because this virus may be around for months. …Also, it could come back again as the shops open, restaurants open, schools open. That risk is being managed very carefully. …

To show you how quickly China is adapting, seven weeks into this outbreak China is already on the 6th edition of its clinical guidance. China didn’t approach this new virus with an old strategy from other diseases. It developed a new approach to a new disease. It turned around this disease with strategies most of the world didn’t think would work. …

This brings us to the 3rd finding in terms of the global response, probably the biggest challenge. The global community is simply not yet ready in mindset or with the materials to implement the measures that have been employed in China, the only successful measures we know so far to contain COVID-19 as it has here in China. …,There’s an ambivalence to using what we call non-pharmaceutical measures. We don’t have a vaccine, we don’t have a therapeutic. China said, OK, we don’t have those. Let’s get out the old ones. Let’s adapt them. Let’s innovate and let’s stop this virus and save lives. And that’s what they’ve done. …

Important recommendations.

it’s important that other countries think about …a rigorous approach, is because they are now the second line of defense, before this virus gets into the low-income countries – that have weaker capacity to deal with this. This little bit of time could be important. It’s only seven weeks since a new disease was described. We have diagnostics, we’re trying antivirals, we are probably within months trying vaccines. The situation could be very different with just a few gained weeks.

That brings us to the last point, in terms of the global response, we will gain a bit of time, but we have to be using that time better than we are today. …

The single biggest lesson is speed. Speed is everything. And what worries me most, sorry, I didn’t catch it in, but what worries me most is that has the rest of the world learned the lesson of speed? …The most important message is don’t be complacent. …It can come back up and that would require really rapid work again. Sometimes when we’re used to dealing with a virus, we get complacent. That is always the single biggest risk. …

Liang Wannian.

The overall judgment is that Wuhan is still the epicenter of the epidemic in China. The current situation is still grim and complex, but to a certain extent, we are now at the most critical period that determines whether the epidemic prevention and control efforts will prevail.

  • The number of new cases per day is decreasing,
  • the number of reported cases is declining daily,
  • the proportion of severe and critically ill patients is declining, and
  • the mortality rate of confirmed cases is declining.

These are good news. {But} the epidemic has not yet been completely contained by us. However, our judgment is that the epidemic in Wuhan has been effectively contained. …

Bruce Aylward discusses the numbers

People keep asking me to explain why is the numbers {keep changing}. In any crisis like this, especially for a new disease, you’re trying to figure out what is the case definition. What are the characteristic of every confirmed case? You’re trying to be as efficient as possible so you can get people into treatment. It takes a while to figure out. It’s not unusual that numbers bounce around. What I’m always interested in are the trends. …If we go back and look over time with China, with all the different information, the trends have been incredibly clear and consistent.

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