Time’s up

A molecular biologist and contributing correspondent for Science Magazine reflects on the apparent failure of the global efforts to contain the coronavirus outbreak to China:

For me and for everyone I know who has been following #covid19, the last few days have felt like a profound shift in the epidemic. We are clearly entering a new phase. And since I’ve had some time to digest recent news, here is a short thread about that „window of opportunity“

From the start, @WHO has been very clear about its strategy: Fight #SARSCoV2 hard at its source in China and keep it from establishing a foothold elsewhere. It was always a long shot, but it was the right thing to do and it has bought the world time.

The @WHO and @drtedros have emphasized again and again that there is a “window of opportunity” to contain #COVID19. On Friday, Tedros said he believed that window of opportunity was still there, but narrowing. Personally, I think the last days have shown that time is up.

Why do I believe that? First in general: there is the way the virus has spread on the #Princessdiamond, in hospitals, in prisons. #SARSCoV2 is very infectious, patients seem to spread it for a long time and cases are hard to detect. It is simply very hard to contain such a virus.

Iran: Until three days ago, Iran had not reported a single #COVID19 case. Now we are at 28 cases, incl. 5 deaths. The number of deaths and also the cases of travellers from Iran testing positive suggests this is the tip of an iceberg. We will soon see how large that iceberg is.

South Korea: The country has now confirmed 433 #COVID19 cases. Most of these are related to a hospital outbreak and to meetings of a religious group. The sheer number is going to make it hard to contain this. Are we looking at a second China? Hopefully not, but it’s possible.

Singapore with its gold-standard surveillance, has at least 7 #COVID19 cases that have not been traced to a known transmission chain. Japan has a similar problem. Italy has local transmission incl. 2 deaths, which suggests those numbers will go up significantly.

And these are just the things we know. We can only guess what we don’t know. This MRC analysis suggests that 2/3 of all #COVID19 cases exported from China have been missed https://imperial.ac.uk/mrc-global-infectious-disease-analysis/news–wuhan-coronavirus/

From the summary: “we estimated that about two thirds of COVID-19 cases exported from mainland China have remained undetected worldwide, potentially resulting in multiple chains of as yet undetected human-to-human transmission outside mainland China”

None of this is a shock. Most researchers always expected it would get to this point. The question is: What happens now? I’m not a public health expert, I’m not an epidemiologist. I’m a journalist. That means I think a lot about communication and that has to enter a new phase too

The massive efforts in China have bought us time. But we should be using that time to prepare and that includes preparing the world by communicating what is happening, what is likely to happen and what the response might look like. That is the “window of opportunity” we have now

I first posted about coronavirus almost exactly one month ago. I commented: “My modest proposal: shut down international travel until we get this thing firmly under control.”

At the time, according to an article I cited in the post, coronavirus had sickened more than 400 people and killed at least 17. China had just made the decision to shut down transportation out of Wuhan (Jan 23). The first US case had been reported on Jan 21.

Now? 77,923 total cases in 29 countries. 2,361 deaths.

634 cases from that cruise ship. 433 cases in South Korea. 132 cases in Japan. 86 cases in Singapore.

35 cases in the US. 7,600 people who recently traveled to China have been asked to self-quarantine in California, not including those returning from Hubei province, who are being quarantined on military bases.

In other words, read this blog today to find out what everyone’s going to be discussing tomorrow.

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