- Click to share on Facebook (Opens in a new window)
- Click to share on Twitter (Opens in a new window)
- Click here to share on LinkedIn (Opens in a new window)
- Click to email a friend (Opens in a new window)
Coronavirus: are we near a global pandemic? 1:40
Editor's Note: Dr. Tom Frieden is the former director of the Centers for Disease Control and Prevention. and former commissioner of the New York City Department of Health. He is currently President and CEO of Resolve to Save Lives, a global nonprofit initiative funded by Bloomberg Philanthropies, the Chan Zuckerberg Initiative and the Bill and Melinda Gates Foundation and part of the Global Nonprofit Vital Strategies. The opinions expressed in this column are exclusive to the author.
(CNN) - The coronavirus COVID-19 will become a pandemic. We still don't know how serious it will be, nor do we know if the virus will spread to all continents, but it is already spreading widely in China, South Korea, Italy, Iran and elsewhere, and thousands of undetected and infectious patients have been and They continue to travel around the world.
- What is a pandemic?
This is unprecedented. Apart from the flu, no other respiratory virus has been traced from the onset to continuous worldwide spread. The last moderately severe influenza pandemics were in 1957 and 1968; each killed more than one million people worldwide. Although we are much more prepared than in the past, we are also much more interconnected, and many more people have chronic health problems that make viral infections particularly dangerous.
Based on extensive planning of an influenza pandemic by many national and international experts, we must do eight things, some immediately and others in the coming months, as we move from the beginning of the pandemic to the stage acceleration:
1. Get more information on how COVID-19 spreads, how deadly it is and what we can do to reduce its damage . Up to half of people with infection have no symptoms, and at least 80% of those who feel sick have only mild symptoms. In Wuhan, China, the reported proportion of diagnosed patients dying is now 3%. That is a substantial overestimate; Many patients were not examined, many infected people have no symptoms and hospitals were overwhelmed. The proportion could be as low as 1 in every 1,000 —30 times lower — and it is unlikely to be more than 1 in 100. The actual rate makes a big difference, not only for patients but also for decisions about interventions.
2. Reduce the number of people who get infected. If it turns out that many of those infected become seriously ill, this would justify drastic measures such as closing or reducing school hours, limiting public meetings and reducing social contact. The lower the risk of death from infection, the less meaningful it is to take these and other actions that disrupt social and economic stability. In any case, the spread can be minimized by quickly isolating sick people, often cleaning potentially contaminated surfaces and changing common routines. We need to take the little things that make a big difference seriously: wash your hands, cover your cough and, if we're sick, stay home or wear a mask when we go out. Let's stop shaking hands for a while. I prefer the traditional Namaste greeting from Southeast Asia, although the elbow is fun.
3. Protect health workers. Even before COVID-19, too many health workers and patients contracted infections in health centers. We need rapid and drastic improvements in classification, treatment, cleaning and general infection prevention. It is likely that there is a shortage of medical masks; We must ensure that health workers have enough, as do household members who care for sick family members and people who are sick and need to leave. For health workers, newer and more durable technologies, such as elastomeric and positive air pressure respirators, could address an inevitable shortage of medical masks.
4. Improve medical care and prevention of COVID-19. There is at least one year left for a vaccine, and the success is uncertain. The treatments they promise should be rigorously evaluated. In a moderately severe pandemic, there would not be enough fans to support patients' breathing. Health facilities and health departments in the United States can prepare for the worst case by preparing, with training, equipment and detailed operational plans, for an increase in the number of patients seeking care and for the subset of those who must Ventilate mechanically, even through fans available from the Strategic National Reserve.
- The modern biotechnology company says its coronavirus vaccine is ready for initial testing
5. Protect health services. During the 2014-2016 Ebola epidemic in West Africa, more people died due to the interruptions of daily medical care than due to Ebola. Telemedicine should be much more accessible, and people with chronic conditions should receive three months of medication whenever possible, in case of supply interruptions. Routine vaccines and other preventive services must be preserved.
6. Support social needs. Patients and their families will need support, especially those who are isolated and less familiar with virtual or delivery services. Continuing to support individuals and groups ranging from community centers to nursing homes will require detailed plans.
7. Protect economic stability. Continuing to plan, teach, learn and work will reduce disruption. Companies must be ready to maximize telecommuting, increase cross-training and operate with up to 40% of their sick or quarantined personnel. Mission critical companies need practical plans to continue operating.
8. Invest in public health. It will cost about $ 1 per person per year for at least a decade to build the necessary health protection systems in Africa and Asia. That's a lot of money, about $ 25,000 million, but a small fraction of what a preventable epidemic like this can cost. (SARS costs $ 40,000 million; estimates for the potential cost of COVID-19 exceed $ 1 billion).
The virus and appropriate interventions will behave differently in areas of high resources than in areas of low resources, depending on overcrowding, diagnostic and treatment capacity, and the ability to reduce the spread. We still don't know if COVID-19 will cause thousands, hundreds of thousands or millions of deaths.
Above all, we should not hurt. We don't close schools every year for seasonal influenza, and we don't close them for the 2009 H1N1 influenza pandemic, for good reason: the level of severity didn't deserve it. If the virus emerged from the wet market that sold exotic animals as food in Wuhan, then China's failure to close those markets after SARS is the root cause of this outbreak.
On the other hand, the extraordinary Chinese cordon of Hubei Province and other areas bought the world at least one month of preparation time. The news last week means that the world must take these steps, and quickly, to limit the health, social and economic damage of the COVID-19 pandemic.
coronavirus