After expressing deep concern over the levels of spread and severity of the novel coronavirus, and the alarming levels of inaction, the World Health Organization (WHO) declared on 11th March that COVID-19 can now be characterized as a pandemic. As of 13th March, the novel coronavirus has infected more than 132,500 people and killed nearly 5,000 globally, according to WHO.
A real turning point occurred toward the end of February when more cases were detected in South Korea, Japan, Italy and Iran, rather than contained around the original epicenter of Wuhan in China. Because the virus has evolved so quickly, public health officials are having to make rapid decisions with limited information. Chaos and change should be expected with something this new as a result, and constant reevaluation the bedrock of an outbreak response.
The response in the US has been considered very strong up to the end of February with the initial imposition of quarantine and travel restrictions successful in delaying the arrival of coronavirus to its shores. Nonetheless, health officials and governments now realize we are dealing with a pandemic, which is a reference as to how far the disease has spread rather than by its fatality rates. More importantly, there were new cases reported that do not have clear ties to travel, and now that the virus is in less developed countries with inadequate healthcare systems, the US is going to find it difficult to contain for much longer. In other words, it’s not a question of if, but a question of when.
Because of the widespread nature and the fact that the coronavirus is in so many different countries, some experts believe that we are at the point where it does not make sense to simply restrict borders any longer because those methods of quarantining and travel restrictions are neither effective or feasible when the virus is so widespread. There is also additional concern that many people have been affected with coronavirus who have minimal symptoms or no symptoms at all. Further, because there has not been enough testing at point of care and surveillance for these individuals, the numbers of people infected are likely to be much greater than being reported. Simply put, just because the US is not testing does not mean that these cases do not exist. Indeed, the US has faced a major problem with testing because the confirmatory testing requires shipping the sample to the CDC resulting in a 48-hour delay. The CDC can only process up to 400 tests a day which is considered a huge limitation.
Public health hinges on public trust and transparency, otherwise people tend to make up conspiracy theories. We saw this occur in China, for example, when fear and panic was in abundance at the outset because the Chinese government had initially attempted to hide the disease by censoring doctors and stifling the distribution of scientific information. What was effective in containing the virus within China, however, were the significant quarantine mechanisms imposed.
Political stability and the public health infrastructure of countries have everything to do with the ability of that country to handle this particular epidemic. For example, there are worries if COVID-19 reaches community transmission in sub-Saharan Africa as there is nowhere near the types of facilities needed for everyday healthcare, much less to face something like an epidemic of this scale.
Looking forward, there is still a lot more to be done when it comes to developing a vaccine, treatments, getting better testing, and preparing local health departments. The development of a vaccine is a very challenging process and will take at least a year and a half to produce, although clinical trials for antiviral treatments are already underway and patients with COVID-19 are currently being tested.
Whilst the development of vaccines and testing of treatments is a positive development, the focus should now be on preventing people from getting sick in the first place. This is because the disease is most certainly being transmitted in the community from person to person due to the fact we are now seeing cases where individuals have no known travel history or contact with sick people. It is important to start preparing for mitigation efforts, including hospitals ramping up their search capacity the way that they would for vaccine season, and businesses and schools looking at their telework and telecommuting plans. This would also involve social distancing measures at major events.
It is the firm belief of experts that the world simply is not prepared for global outbreak due to inadequate investment into public health. The main lesson we should learn from this ordeal is that we should not only become worried about public health only during an outbreak, but rather be preparing for these outbreaks long before they occur.
This call was hosted on February 27, 2020, under the title: “COVID-19: On The Verge of Coronavirus Pandemic, Assessing New Epidemiological Dynamics & Core Challenges Ahead.”
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