Caixin
Mar 15, 2020 09:22 PM
OPINION

Opinion: The Essential Principles for Successfully Fighting the Coronavirus

In the last few days, the novel coronavirus has spread around the globe. World leaders, including the U.S. president, U.K. prime minister, French president and German chancellor, have introduced national strategies to fight the deadly disease. In a nutshell, the U.S. approach is hardening, while Europe’s is softening.

Their different approaches can be starkly seen by how they are performing tests for Covid-19. The U.S. has launched large-scale testing; by contrast, Europe has been slowing down on this front — the mainstream approach there is to only test people who meet strict criteria.

For reference, let’s first take a look at China and South Korea’s experiences regarding hard or soft measures being taken in both countries.

Since January, China’s approach has been based on the following six points: strictly preventing cross-infections in hospitals, focusing on severe patients, isolating suspected cases, creating makeshift hospitals for mild cases, being transparent and a nationwide shutdown. Those measures in China have borne fruit, but with extreme costs.

South Korea has also successfully contained its serious epidemic. Although South Koreans adopted an approach similar to China’s, they have not implemented a nationwide shutdown and the economic cost has therefore been smaller.

The approach taken in South Korea has two major characteristics.

First, the South Korean government moved to quickly test many people to identify the infected at an early stage. Remember that in China, there was a category of “suspected patients” who had to be quarantined, a task that was more challenging than isolating mild cases. But South Korea’s swift testing solved this problem.

Second, South Korea’s home quarantine was subject to close monitoring and supervision. Every patient that self-quarantined was supervised through various tools, which made it effective.

In fact, no matter what kind of approaches are taken by different countries, there are three principles that have assured effective containment:

1. Make sure hospitals are not overwhelmed by severe cases.

If there is no flood of severe cases, the death rate is about 0.8%. But if it happens, the death rate will spike. Even a developed country like Italy is experiencing a death rate close to 7% today. That’s exactly because their hospitals have been overrun by severe patients.

2. Control the total number of infections to limit the total number of severe cases.

At the moment, the rate of severe case is about 20% of total patients. If you control the total number of confirmed cases, then you can limit the number of severe cases.

3. Effectively isolate sources of infection to control the total number of infections.

If sources of infection cannot be effectively isolated, people can pass it on to their family members and medical workers, among others. According to The Financial Times now, the number of confirmed cases in Europe is increasing 33% per day. That means fourfold growth in five days!

Since February, both China and South Korea have followed these three principles. The first and foremost principle in both countries is to isolate sources of infection via swift testing.

Now the U.S. has started to launch widespread testing, while Europe is softening its stance on testing by establishing strict criteria. The United Kingdom typifies this soft approach.

U.K. Prime Minister Boris Johnson said this week that “We are now getting onto the next phase. This is now not just an attempt to contain the disease as far as possible, but to delay its spread.” His chief scientific adviser, Patrick Vallance, added that 60% of the British population could eventually be infected.

Why delay? Because if you cannot destroy the virus, then delaying its spread is the only practical solution. To delay means to prolong the duration of infection among human beings, which will help flatten the peak of infections and avoid overwhelming hospitals.

For the U.K., the first target is to prolong the infection until June when seasonal influenza is supposed to end. It does not mean that rising temperatures will definitely contain the virus, but it will definitely contain the influenza. When the flu season ends, the medical resources given over to treating seasonal flu will be available for Covid-19 patients.

The second target is in 12 to 18 months, when there is likely to be a return of the virus during the next winter.

It will take time for scientists to develop antiviral drugs and a vaccine. It will also take time for human bodies develop antibodies against the virus. When there are enough people carrying antibodies, then it is believed that there will be a firewall of immunity for all. The British government has decided to choose this immunity-led approach.

This means that the British government has already admitted that it cannot win the battle against the virus and it will keep fighting during retreat. So the peak will be delayed and its hospitals will not be overrun.

The logic of this approach stands. But the questions still linger: When the government gives up on mild and suspected patients and leaves it all to people’s own capabilities, then would the sources of infection be effectively isolated? Would the total number of confirmed cases be under control, thus limiting the number of severe cases?

Given what is happening in Italy today and Wuhan in early stage of the outbreak, I feel quite worried.

However, nobody should abandon their responsibilities. China won’t change its tactics until June. The U.S. is taking more tough measures. Europe is softening its actions. If the delay strategy works and hospitals are not overwhelmed with severe cases, Europe will continue its current tactics; otherwise it will change. When next winter nears, approaches among different countries will probably be more or less the same.

The fundamentals for dealing with the Covid-19 will be positioned for the long term. The Europe and the U.S. are looking into 12 to 18 months. China should also prepare for the long run.

Wang Shuo is editor-in-chief of Caixin Media and Caixin weekly.

Contact translator Lu Zhenhua (zhenhualu@caixin.com)


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