World’s leading health expert and Professor of Epidemiology and Medicine at Columbia University, Wafaa El-Sadr says China was successful in containing the coronavirus due to the strong and rapid measures undertaken by the government. In an interview to Outlook’s Rajat Mishra, El-Sadr, who is also the director of ICAP at Columbia University, New York and the director of the Global Health Initiative at the Mailman School of Public Health, tells that most experts would say the US took an incremental approach rather than a decisive approach to contain the virus and that may have been the Achilles’ heel.
Excerpts from the interview:
What should be the strategy of developing countries to fight coronavirus pandemic?
There are tried and tested approaches to confronting epidemics and which should also be used in the context of COVID-19 pandemic. Firstly, it is important to focus on containment i.e. ensuring rapid identification, assessment and isolation of cases in combination with tracing of contacts and putting them under quarantine. Importantly, such measures must make sure that such individuals have access to food and health services. Secondly, mitigation measures are also vital such as social distancing through the limitation of movement, avoiding congregation of people and promotion of strong prevention methods such as frequent hand washing. Most importantly, it is critically important to communicate frequently with the population through their most trusted sources of information and to provide people with accurate information.
How do you see the action of China in battling this pandemic?
China was facing a catastrophic situation with potential for spread of the new coronavirus to hundreds and thousands of people. China was able to rapidly identify the virus, determine its structure and share it with scientists around the world. This enabled the development of diagnostic tests and the beginning of work to identify specific treatment for this infection and the pursuit of a vaccine. In addition, facing the onslaught of an enormous number of cases and the potential for movement of millions of its citizens for the annual lunar new year holidays, China was compelled to take strong measures to contain the virus. This included restriction of movement of populations, as well as rigorous social distancing measures such as closing schools and businesses, stopping mass transit, requiring people to stay at home, with exceptions for seeking health services or food. These measures, while difficult to implement and sustain, were successful in controlling COVID-19 in China.
The US has not imposed any lockdown. How do you see the effectiveness of a lockdown across the world?
With the spread of the virus around the globe at a rapid pace, it has become necessary to constrain the movement of people as much as possible, whether that be within their community, city, country or between countries. The hope is that such constraints on movement will result in sufficient decrease in mixing of people and enable control of the pandemic. This will not be easy, but it is necessary.
Do you see any flaw in China's way of dealing with the pandemic?
China put in place rapid strong measures. Millions of people were affected by the restrictions on movement. Only time will tell whether it was necessary to put in place such wide measures or could these have been restricted to the region’s most severely affected. Careful research will hopefully shed light on this question.
In your opinion, why has the US been faltering in dealing with the pandemic?
It will be critically important to be able to look back, once this pandemic is behind us, to examine the US response in detail, what worked, what did not work and why. In the midst of the outbreak with a rapidly evolving response, it is too early to dissect the various steps taken. Most experts would say that the US took an incremental approach rather than a decisive approach and that may have been the Achilles’ heel.
What is the ideal way of dealing with this virus at an individual level?
There are ways that individuals can protect themselves from acquiring coronavirus and prevent its transmission to others. The virus is transmitted by close contact and by droplets that are expelled from a person with COVID-19 when they cough or sneeze. This means that it is important to wash hands frequently with soap and water, to never cough or sneeze in one’s hand but rather to use a tissue and promptly dispose of it or cough or sneeze in one’s elbow. It is important to stay home when one is sick and avoid going to work or school, avoid touching face and frequent cleaning of surfaces that may have been contaminated by someone who is sick. Most important it is about collective action, each one of us doing our best to protect ourselves and our fellow citizens.
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