WHO Expert Explains Why China’s Cases Of COVID-19 Are Declining

Julia Belluz

There were reports from China about collateral damage from this outbreak — the HIV patients, for example, who were reportedly not getting treatment in time because of travel restrictions and lockdowns. What can we learn from China to minimize this type of damage in other countries?

Bruce Aylward

China took a whole bunch of steps when they realized they had to repurpose big chunks of their hospital systems to [respond to the outbreak]. The first thing is, they said testing is free, treatment is free. Right now, there are huge barriers [to testing and treatment] in the West. You can get tested, but then you might be negative and have to foot the bill. In China, they realized those were barriers to people seeking care, so, as a state, they took over the payments for people whose insurance plans didn’t cover them. They tried to mitigate those barriers.

The other thing they did: Normally a prescription in China can’t last for more than a month. But they increased it to three months to make sure people didn’t run out [when they had to close a lot of their hospitals]. Another thing: Prescriptions could be done online and through WeChat [instead of requiring a doctor appointment]. And they set up a delivery system for medications for affected populations.

Is this the big pandemic we’ve been told is coming — the “big one”?

Julia Belluz

The idea that the spread of this virus is driven mainly by families features prominently in your report. How do we know that?

Bruce Aylward

You look at the big, long lists of all the cases and identify those where you have clusterings in space and time and try to investigate what kind of clustering happened: Was it in a hospital, an old-age home, theaters, restaurants? We found it was predominantly in families. It’s not a big surprise; China had shut down a lot of the other ways people could gather. And family clusters are the closest, longest exposures [to the virus], and getting the virus is a function of whether someone’s got it, how long they’re exposed, and how much virus they are shedding.

More of a surprise, and this is something we still don’t understand, is how little virus there was in the much broader community. Everywhere we went, we tried to find and understand how many tests had been done, how many people were tested, and who were they.

In Guangdong province, for example, there were 320,000 tests done in people coming to fever clinics, outpatient clinics. And at the peak of the outbreak, 0.47 percent of those tests were positive. People keep saying [the cases are the] tip of the iceberg. But we couldn’t find that. We found there’s a lot of people who are cases, a lot of close contacts — but not a lot of asymptomatic circulation of this virus in the bigger population. And that’s different from flu. In flu, you’ll find this virus right through the child population, right through blood samples of 20 to 40 percent of the population.

Julia Belluz

If you didn’t find the “iceberg” of mild cases in China, what does it say about how deadly the virus is — the case fatality rate?

Bruce Aylward

It says you’re probably not way off. The average case fatality rate is 3.8 percent in China, but a lot of that is driven by the early epidemic in Wuhan where numbers were higher. If you look outside of Hubei province [where Wuhan is], the case fatality rate is just under 1 percent now. I would not quote that as the number. That’s the mortality in China — and they find cases fast, get them isolated, in treatment, and supported early. Second thing they do is ventilate dozens in the average hospital; they use extracorporeal membrane oxygenation [removing blood from a person’s body and oxygenating their red blood cells] when ventilation doesn’t work. This is sophisticated health care. They have a survival rate for this disease I would not extrapolate to the rest of the world. What you’ve seen in Italy and Iran is that a lot of people are dying.

This suggests the Chinese are really good at keeping people alive with this disease, and just because it’s 1 percent in the general population outside of Wuhan doesn’t mean it [will be the same in other countries].

Julia Belluz

That’s really concerning for the rest of the world. Are you suggesting this is the big one — the once-a-century pandemic people have been bracing for?

Bruce Aylward

It’s not. It can be the big one but like, for flu — whether you have a pandemic with flu, it’s a function of the virus. That’s a virus with a very, very high infectivity rate, a very, very high transmissibility rate. The time [the virus] takes to go from [one person to the next] can be as short as 1.5 days. For Covid-19, it’s longer — four to five days. Look around the world. We’re seeing a whole bunch of outbreaks controlled with the right responses, and even turned around if they get to a bad state.

Panic and hysteria are not appropriate. This is a disease that is in the cases and their close contacts. It’s not a hidden enemy lurking behind bushes. Get organized, get educated, and get working.

Julia Belluz

How should countries look out for the virus?

Bruce Aylward

Originally, I was a big believer in the idea that we should swab millions and see what’s going on [how many have the virus]. But the data from China made me rethink that. What could be done instead is that every hospital should test people with atypical pneumonia for Covid. People with flu-like symptoms — test for Covid.

We have a lot of surveillance systems for flu in the world, trying to pick up the big one, and should use those systems to test for Covid.

Trusting China

Julia Belluz

We have been seeing a small uptick in Hubei for the last couple of days. What is going on there?

Bruce Aylward

I wrote to the [team] in China yesterday and asked them about the uptick in cases, which was very slight. They said they are getting through the backlog of suspect cases — so people who had clinical symptoms, CT scan findings — and rather than clinically confirming them, they are making sure they test them. Some of them are also in some of those prison outbreaks. But the big driver is coming off the suspect cases. In 48 hours, [we’ll know if that] theory is true. Already today, cases started to come down. The [new case count] dropped again today.

Julia Belluz

Can we trust China’s data?

Bruce Aylward

The big question is, are they hiding things? No, they are not. We looked at many different things to try to corroborate that cases are dropping. When I went to fever clinics and talked to people working there, they’d say, “We used to have a line out the door, and now we see a case once per hour.”

According to the national data, fever clinics went from seeing 46,000 people per day at one point and it’s now down to 1,000. So there’s been a huge drop in numbers into the feeder system.

Second thing: When talking to physicians in hospitals, I heard again and again that we have open beds, we can get people isolated even more rapidly. I heard that in Wuhan and other provinces. The third thing: I talked to people running clinical trials of drugs, and they are having a problem recruiting patients. All these things helped corroborate [China’s data].

Julia Belluz

What were the biggest vulnerabilities in China, and what are you most worried about for other countries as they face more cases?

Bruce Aylward

You have to have enough beds. In China, they closed off whole wings [of hospitals], sealed them to make them a dirty zone [where patients with the disease could be treated safely]. They worked at scale. They bought a heap of ventilators to keep people alive. They made sure they had a lot of high-flow oxygen, CT-scanning capacity, lab capacity. So beds, ventilators, oxygen, CTs, and labs. And they had problems with all of those supplies at different points. [The Chinese] will say there are shortcomings in our response, in how fast we found this, how fast we responded. And there will be a major reform to address that.

Why the virus disproportionately kills the elderly and spares the young

Julia Belluz

While deaths are occurring at higher rates in elderly people, there have been reports of young, otherwise healthy people dying, too. What’s going on there? And is there any talk of how China’s high smoking rates may be contributing to these deaths?

Bruce Aylward

[Smoking] definitely does because the co-morbid conditions makes [Covid-19] worse. Over the long term, we know smokers get cardiovascular and lung disease, and these are all co-factors in terms of a higher probability of mortality. From that perspective, we know it’s a problem. In some of the mortality [research,] we see a higher mortality rate in males than females in China. There’s a suspicion that may be a function of differences in smoking patterns: There’s very high smoking rates among men in China compared to women.

We spent a lot of time asking doctors who these people in their 30s and 40s are who are rapidly progressing and getting this disease and dying. They’d say, “We don’t know.” I’d ask, “What about smoking?” I never found one who said yes to that question. It’s something I couldn’t get an answer to.

Julia Belluz

What are the other important knowledge gaps?

Bruce Aylward

It’s hard to find the virus in general swabs done in the community. And that’s interesting and reassuring. It’s not like flu. But we couldn’t answer the question of why some young, otherwise healthy people suddenly deteriorate. We need to understand that if we [want to] keep people alive.

Julia Belluz

In the elderly, what explains the high death rate? Is it something about deterioration of the immune system with age or the higher probability you have [of developing] other illnesses as you age?

Bruce Aylward

I think it’s the latter. These people are dying of an inflammatory process in their lungs. It’s not an infectious process, like a bacterial or viral infection. It’s inflammatory, like we see with SARS. We’re not sure of the mechanism. We do know the proportion of people who die who had cancer was half compared to hypertension and cardiovascular disease. Diabetes is a little bit lower than those two, and cancer lower again.

Julia Belluz

So why do kids seem to be spared so far? What’s the best hypothesis?

Bruce Aylward

It’s a million-dollar question. There are three possibilities: Kids don’t get infected for some reason; they get infected but have a low expression of disease; they get infected and express disease like everyone else but we haven’t seen it because of schools being closed. I think the first and last aren’t the reality. So it’s that middle group.

There are a couple of theories going around [to explain this]. The receptors [Covid-19] binds to in the lungs aren’t very mature in children. But the reality is we see this phenomenon up to 90 years of age, so that sounds unlikely. Second, maybe the four coronaviruses that cause colds confer some temporary immunity in kids. But then why aren’t the elderly [protected]?

We’ve got to get an antibody test [to test the population for antibodies to the virus] to know if kids are driving the epidemic and we just can’t see it. 

Correction 3/2: A graphic in this piece previously misstated the percentage of cases in China that were not linked back to the Wuhan area. The graphic has been updated with the correct figure, 14 percent.

Source Article from https://popularresistance.org/who-expert-explains-why-chinas-cases-of-covid-19-are-declining/

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One Response to “WHO Expert Explains Why China’s Cases Of COVID-19 Are Declining”

  1. Anonymous says:

    Trying following “the nose”. It is beginning to look historically familiar. First THE CHINESE ARE BLAMED (just like 9-11 and the USS Liberty were BLAMED ON THE ARABS, and ‘terrorism’ is being blamed mostly on “WHITE SUPREMACISTS”). Did the Jew ever admit ANYTHING?

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