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Will the Coronavirus Ever Go Away? Here’s What a Top WHO Expert Thinks

Dr. Bruce Aylward has almost 30 years experience in fighting polio, Ebola and other diseases, and now, he’s turned his attention to stopping the spread of COVID-19.

Aylward, the senior adviser to the Director-General of the World Health Organization (WHO), is one of the world’s top officials in charge of fighting the coronavirus pandemic.

The doctor, who led a joint WHO mission to China in February to study the effectiveness of the coronavirus response in the country, has seen firsthand the measures Beijing took to fight the virus. Now he’s sharing what he learned with governments and communicating with the WHO response teams working to fight COVID-19 in virus epicenters around the globe.

In an extensive teleconference interview with TIME from his office in Geneva, Aylward shared what he thinks needs to be done to stop the pandemic, and what the future might hold.

The following excerpts from the conversation have been condensed and edited for clarity.

Do you expect COVID-19 to continue to spread?

We can get little glimpses into the future from places that are recently getting infected, places that aren’t infected, but also the places where it all started. And if you go back and look at China right now, they [identified the virus] in early January, they had a full on response, sort of threw everything at it, and it’s middle of March now and they estimate maybe end of March they’ll be coming out of it, so a full three months.

When you look around the world in Europe, North America, the Middle East, you can see that we’re really at the period of exponential growth, we’re still seeing the virus going up very, very rapidly, even in hard hit places like Italy, for example. These countries still have months of this challenge in front of them.

When you look to other parts of the world, like Africa, for example, and parts of the Indian subcontinent you can see that it’s just beginning. Even though they have very, very few cases, if you look carefully at that curve, it’s also in a phase of exponential growth.

What do you think the coronavirus pandemic will look like six months from now?

I expect we will be emerging—still with disease in various parts of the world—but we should be emerging from a bad wave of this disease across a large swathe of the planet. The challenge is we’re going to be back into the flu season. And one of the big questions is, are we going to see a surge of it again at that period?

Looking further into the future, what do you anticipate? Will COVID-19 ever disappear?

What it looks like is that we’re going to have a substantial wave of this disease right through basically the globe unless something very different happens in the southern hemisphere. And the question then is: What’s going to happen? Is this going to disappear completely? Are we going to get into a period of cyclical waves? Or are we going to end up with low level endemic disease that we have to deal with? Most people believe that that first scenario where this might disappear completely is very, very unlikely, it just transmits too easily in the human population, so more likely waves or low level disease.

A lot of that is going to depend on what we as countries, as societies, do. If we do the testing of every single case, rapid isolation of the cases, you should be able to keep cases down low. If you simply rely on the big shut down measures without finding every case, then every time you take the brakes off, it could come back in waves. So that future frankly, may be determined by us and our response as much as the virus.

The U.S. and Europe had quite a head start to get ready for this. Was a major outbreak inevitable, or could it have been stopped?

I don’t like to use the word “squandered,” that’s a big word. But we probably haven’t optimized how we used that time. Now what we’ve done is, we’ve gained time again by putting in place these big shutdowns. All they do is they buy time, they don’t actually stop the virus, they suppress it, they slow it. What you want to do now is use that time well to get the testing in place, to get the systems in place, so that you can actually manage the individual level cases that are going to be fundamental to stopping this.

And the big question right now is “Are countries going to use this time during these shutdown periods optimally?” Because if you just shut it down your societies, your economies and hope for the best… This is guerrilla warfare against a virus, the virus is just going to sit you out, it’ll just circulate quietly among households and then you’re going to let them all go again and phoom there’s no reason it shouldn’t take off again, unless you’re ready for it.

How long do you think this outbreak will impact daily life in the U.S. and western Europe? How long do you think it’ll take for life to return to normal?

You have to compare it to the few examples you have that have been through this, hence you have to go back to China, look at [South] Korea, look at Singapore. These countries in the very early stages, if they were to throw everything at it, probably a solid two months in front of them, if not a bit longer, maybe three months.

What we’re seeing is that they’re throwing bits and pieces at it. Most countries in the west frankly are really struggling with, “Can we really test all these cases? Can we really isolate all the confirmed cases?” They’re struggling with that. So they’re approaching it a bit differently than China did and the big question is going to be: Is that approach going to work and limit it to just a few months, that hard hit China took? Or is it going to drag it out so long that the bigger societal, economic impacts linger longer than anyone want?

Do you think the U.S. lost critical time with its testing rollout issues?

I think every country may not have optimized the use of the time it had available, and for different reasons. Some people just continued to think this might be flu and some cases they may not have had the testing capacity.

Is there reason to be concerned about a second wave of infections in China?

Absolutely, and China is concerned. As we traveled around China, one of the most striking things that I found, especially in contrast to the West, as I spoke to governors, mayors, and their cases were plummeting—in some of the places they were down to single digit cases already—as I spoke to them and I said, “So what are you doing now?” They said, “We’re building beds, we’re buying ventilators, we’re preparing.” They said, “We do not expect this virus to disappear, but we do expect to be able to run our society, run our economy, run our health system. We cannot end up in this situation again.”

Have you seen examples of politics overruling public health or slowing down responses?

No. I know a lot of people will challenge my assessment. The reasons that there have been problems in some countries is they haven’t had a consensus on the severity of the disease, or they haven’t had a consensus around the transmissibility. You have to have that consensus that you’re dealing with something serious and severe and dangerous for your society and individuals. Otherwise you just cannot generate the public support which is fundamental to accepting the measures, but also the implementing.

Why does the fatality rate in Italy looks to be so high?

It’s a combination of factors. If you look at Italy, and the age distribution, it’s the second-oldest country in the world after Japan, people forget that. You have an older population number one, they get the more severe disease and they’re more likely to die.

What countries are in the most vulnerable situation?

Everyone is vulnerable, but the big question of course is what’s going to happen when this really starts to take off in those low-income countries where they don’t have as much medical capacity such as in Africa.

It’s one of those things that you don’t want to imagine because the numbers could be so grave. The population distribution could help. Is the humidity and the temperature going to help make a difference? I would hope so, but look at the situation in Singapore, that’s a hot, humid country. So the situation in these countries could be very difficult.

The WHO is urging countries to “test, test, test.” Are there any countries in particular that you think are not doing enough testing?

That’s much easier answered the other way around. Is anyone doing enough testing? There it’s limited. It’s China, [South] Korea, Singapore.

There are reports of people dying of coronavirus who are otherwise healthy. What have your teams seen in terms of who the virus is killing?

One of the things that terrifies me now is, as this is spread in the west is, there’s this sense of invulnerability among millennials. And absolutely not. Ten percent of the people who are in [intensive care units] in Italy are in their 20s, 30s or 40s. These are young, healthy people with no co-morbidities, no other diseases.

We don’t understand why some young healthy people progress to severe disease and even die and others don’t. We don’t have clear predictors.

What would your message be for young people around the world?

This is one of the most serious diseases you will face in your lifetime, and recognize that and respect it. It is dangerous to you as an individual. It is dangerous to your parents, to your grandparents and the elderly in particular and it is dangerous to your society in general. You are not an island in this, you are part of a broader community, you are part of transmission chains. If you get infected you are making this much more complicated and you are putting people in danger, not just yourself.

Never, never underestimate a new disease, there’s just too much unknown. What we do know is it will kill young people, it will make young people sick in large numbers. You’ve gotta respect this.

What should a country’s first priority after locking down be?

Test, test, test, test, test. Not test, test, test, test, test everyone, but test the suspects, test the suspects, test the suspects.

Then, effectively isolate the confirmed cases. The third piece is the quarantine piece.

How do you think this will end?

This will end with humanity victorious over yet another virus, there’s no question about that. The question is how much and how fast we will take the measures necessary to minimize the damage that this thing can do. In time, we will have therapeutics, we will have vaccines, we’re in a race against that.

And it’s going to take great cooperation and patience from the general population to play their part because at the end of the day it’s going to be the general population that stops this thing and slows it down enough to get it under control.

By Amy Gunia March 23, 2020

Source: Will the Coronavirus Ever Go Away? Here’s What a Top WHO Expert Thinks

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Dr. Bruce Aylward of the World Health Organization talks about how the world has passed the tipping point with the COVID-19 outbreak and while countries tried to curb the spread, none of them were prepared for the scope of the disease. Aylward says small, incremental measures are not going to curb the spread and steps need to be taken with the same speed that the disease itself is spreading. For more info, please go to https://globalnews.ca/tag/coronavirus/ Subscribe to Global News Channel HERE: http://bit.ly/20fcXDc Like Global News on Facebook HERE: http://bit.ly/255GMJQ Follow Global News on Twitter HERE: http://bit.ly/1Toz8mt Follow Global News on Instagram HERE: https://bit.ly/2QZaZIB #GlobalNews

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What Is Coronavirus & What Happens Now It Is a Pandemic

The disease appears to have originated from a Wuhan seafood market where wild animals, including marmots, birds, rabbits, bats and snakes, are traded illegally. Coronaviruses are known to jump from animals to humans, so it’s thought that the first people infected with the disease – a group primarily made up of stallholders from the seafood market – contracted it from contact with animals.

Although an initial analysis of the virus that causes Covid-19 suggested it was similar to viruses seen in snakes, the hunt for the animal source of Covid-19 is still on. A team of virologists at the Wuhan Institute for Virology released a detailed paper showing that the new coronaviruses’ genetic makeup is 96 per cent identical to that of a coronavirus found in bats, while an as-yet unpublished study argues that genetic sequences of coronavirus in pangolins are 99 per cent similar to the human virus. Some early cases of Covid-19, however, appear to have inflicted people with no link to the Wuhan market at all, suggesting that the initial route of human infection may pre-date the market cases.

The Wuhan market was shut down for inspection and cleaning on January 1, but by then it appears that Covid-19 was already starting to spread beyond the market itself. On January 21, the WHO Western Pacific office said the disease was also being transmitted between humans – evidence of which is apparent after medical staff became infected with the virus. Since then, evidence of widespread human-to-human transmission outside of China has been well established, making chances of containing the virus much harder.

What exactly is Covid-19?

Coronaviruses are a large group of viruses that are known to infect both humans and animals, and in humans cause respiratory illness that range from common colds to much more serious infections. The most well-known case of a coronavirus epidemic was Severe Acute Respiratory Syndrome (Sars), which, after first being detected in southern China in 2002, went on to affect 26 countries and resulted in more than 8,000 cases and 774 deaths. The number of people infected with Covid-19 has now well surpassed those hit with Sars.

While the cause of the current outbreak was initially unknown, on January 7 Chinese health authorities identified that it was caused by to a strain of coronavirus that hadn’t been encountered in humans before. Five days later the Chinese government shared the genetic sequence of the virus so that other countries could develop their own diagnostic kits. That virus is now called Sars-CoV-2.

Although symptoms of coronaviruses are often mild – the most common symptoms are a fever and dry cough – in some cases they lead to more serious respiratory tract illness including pneumonia and bronchitis. These can be particularly dangerous in older patients, or people who have existing health conditions, and this appears to be the case with Covid-19. A study of 44,415 early Chinese Covid-19 patients found that 81 per cent of people with confirmed infections experienced only mild symptoms. Of the remaining cases, 14 per cent were in a severe condition while five per cent of people were critical cases, suffering from respiratory failure, septic shock or multiple organ failure. In the Chinese study, 2.3 per cent of all confirmed cases died, although the actual death rate is probably much lower as many more people will have been infected with the virus than tested positive.

How far has it spread?

China has borne the brunt of Covid-19 infections (so far). As of March 11, Chinese health authorities had acknowledged over 81,250 cases and 3,253 deaths – most of them within the province of Hubei. On March 17, China recorded just 39 new cases of the virus – a remarkable slowdown for a country which, at the peak of its outbreak in mid-February, saw more than 5,000 cases in a single day.

But while things were slowing down in China, the outbreak started picking up in the rest of the world. There are now confirmed cases in at least 150 countries and territories. Outside of China, Italy has seen the highest number of cases, with 47,035 confirmed infections, mostly in the north of the country, and 4,032 deaths – more than in China. The entire country is now on lockdown after the quarantine covering the north of the country was extended on March 9.

Spain is also in the grip of a significant outbreak. The country has 20,410 confirmed infections and 1,043 deaths – the second-highest number within Europe. There, citizens are under lockdown, with the government shutting all schools, bars, restaurants and non-essential supermarkets down. People are only allowed to leave their homes to buy food or to go to work. Germany has 19,711 cases and 53 deaths, with the state of Bavaria implementing a full lockdown.

Iran, too, is seeing a surge in cases. The country has confirmed at least 1,433 deaths and 19,664 cases. In the US, there have been more than 14,631 cases and 210 deaths – 74 of them in Washington State, which has become the epicentre of the US outbreak.

While the number of new cases continues to rise sharply, people are also recovering from the infection. Globally, 84,960 people have recovered from Covid-19 – about 32 per cent of all of the people who had confirmed infections, although the true number of coronavirus cases will be much higher.

What’s the latest in the UK?

As of March 18, the UK has reported 3,983 confirmed Covid-19 infections and 177 deaths. On March 16, prime minister Boris Johnson led the first daily coronavirus press conference, saying that the government now advised all UK residents to avoid non-essential social contact and travel where possible. On Friday March 20 this was extended to include a shutdown of all bars, pubs, cafes and restaurants in the UK. From the same day all schools in England, Scotland and Wales were shut until further notice. Only vulnerable children, or those who are the sons and daughters of employees in the NHS or other key industries, will be permitted to remain at school.

People who currently live alone are recommended to self-isolate for seven days if they develop a fever or persistent dry cough – the two most common symptoms of coronavirus. For families and other people who live together, the advice is that the entire household should self-isolate if any member develops either of those symptoms. This strategy is part of the government’s ‘delay phase‘ plan to flatten the peak of the virus and reduce the burden on the NHS.

A key part of this plan is shielding those who are most vulnerable to Covid-19: people older than 70, or those who have underlying health conditions. The prime minister said that this shielding may last as long as 12 weeks in order to ensure that the peak of the outbreak has passed, although modelling from Imperial College London suggests that these measures may have to be in place for as long as 18 months. Despite these measures, some have been critical that the government’s stance doesn’t go far enough. Italy and Spain have both in place widespread lockdowns, while South Korea has rolled-out extremely comprehensive testing for many of its population.

The outbreak has also had a serious impact on the UK’s stock market. On March 9 the FTSE 100 fell by more than eight per cent, knocking billions off the value of major UK companies. Cinema changes Odeon, Cineworld and Vue closed their doors while Euro 2020 was also delayed until 2021, which is an added blow to broadcasters, particularly ITV.

What are the symptoms of Covid-19?

Covid-19 shares many of its symptoms with the flu or common cold, although there are certain symptoms common to flu and colds that are not usually seen in Covid-19. People with confirmed cases of Covid-19 rarely suffer from a runny nose, for instance.

The most common Covid-19 symptoms are a fever and a dry cough. Of 55,924 early Chinese cases of the disease, nearly 90 per cent of patients experienced a fever and just over two-thirds suffered with a dry cough. That’s why the UK government is advising anyone with a high temperature or a new, continuous cough to stay at home for seven days or, if they live with other people, for the entire household to isolate for 14 days from the first onset of symptoms.

Other Covid-19 symptoms are less common. Just under 40 per cent of people with the disease experience fatigue, while a third of people cough up sputum – a thick mucus from within the lungs. Other rarer symptoms include shortness of breath, muscle pain, sore throats, headaches or chills. According to the WHO, symptoms tend to appear between five and six days after infection.

What’s happening with a vaccine?

A vaccine for Covid-19 isn’t around the corner. Bringing vaccines to the market is a notoriously slow process and any potential vaccine will have to pass multiple stages of testing for safety and effectiveness. And once we know a vaccine is safe, we will also need to manufacture it at a scale high enough to use across the world. It’s likely that any vaccine is around 18 months away.

That said, there is lots of work being done to develop a vaccine for Covid-19. The pharmaceutical firm Sanofi is trying to build on its already-approved flu vaccine and turn it into something suitable to treat Covid-19. Other approaches – such as one being trialled by the University of Oxford – are focusing on the external spike proteins on the Covid-19 virus as a way to target vaccines.

But accelerating these efforts will require funding. The Coalition for Epidemic Preparedness Innovations (CEPI) has called for $2 billion in funding to support the development of new coronavirus vaccines.

What’s going to happen next?

WHO chief Tedros Adhanom Ghebreyesus has warned that the window of opportunity to contain Covid-19 is “narrowing”. Recent outbreaks in Italy and Iran, which so far have no clear link to China, pose a significant challenge to health authorities trying to stop the spread of the virus.

After initially delaying the decision, on March 11, the WHO declared the Covid-19 outbreak a pandemic. The agency cited the rapid growth of cases outside of China and the global spread of the disease as reasons behind the designation. In January, it also declared the outbreak a “public health emergency of international concern” – the highest category of warning for an infectious disease outbreak.

Since 2009 there have only been five declarations of international public health emergencies: the swine flu pandemic in 2009, a polio outbreak in 2014, the Western Africa Ebola outbreak in 2014, the Zika virus outbreak in 2015 and another Ebola outbreak in the Democratic Republic of the Congo in 2019.

Matt Reynolds is WIRED’s science editor. He tweets from @mattsreynolds1

Source: What is coronavirus and what happens now it is a pandemic?

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And why the disease first appeared in China. NOTE: As our expert Peter Li points out in the video, “The majority of the people in China do not eat wildlife animals. Those people who consume these wildlife animals are the rich and the powerful –a small minority.” This video explains how the people of China are themselves victims of the conditions that led to coronavirus. The virus is affecting many different countries and cultures, and there is never justification for xenophobia or racism. You can find further reading on this on Vox: https://www.vox.com/2020/2/7/21126758… https://www.vox.com/policy-and-politi… https://www.vox.com/identities/2020/3…

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