LESSONS TO LEARN FROM CHINA VS COVID-19

                There's one country in the world that currently has the most knowledge and experience with Coronavirus, CHINA and specifically Hubei province, is where the COVID-19 disease emerged, it's where 83% of the 284,814 cases known to date have been recorded and it's where doctors and health authorities have been battling an epidemic for more than three months using unprecedented public health measures, including a cordon sanitaire and lock downs that affected millions. In recent weeks, though, the number of new infections and deaths reported in china has been declining, which suggests spread of the virus may have peaked there and that transmission is slowing down, at the same time cases are rapidly increasing in several other countries, with major outbreaks in Italy, Spain, South Korea and Iran, it's now critical that the rest of the world learn as much as it can from China's efforts to respond and limit the spread of the Coronavirus. That was precisely the intention of a recent World Health Organization WHO mission to China, led by the agency's assistant director general and veteran epidemiologist Bruce Aylward, China's bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic, it's all about SPEED the most important lessons to learn, the playbook china used to curb COVID-19 spread is insisting on speed in responding to an outbreak is so crucial, whether the Chinese data is trusted and why smoking could be exacerbating the impact to the epidemic, Bruce thinks that people are not paying close enough attention, the majority of the response in China, in 30 provinces, was about case finding, contact tracing and suspension of public gatherings, Lock downs people are referring to the human right concerns, usually reflect the situation in places like Wuhan city.
The outbreak hit many countries in Asia several weeks earlier, some have been praised for containing the number of infections, for example Singapore, Hong Kong and Taiwan all kept case numbers relatively low despite their proximity to mainland China. Health experts agree on the same measures for containing the outbreak, test widely, isolate those infected a,d encourage social distancing, such measures are being adopted to varying degrees in the other countries but a key difference is that many countries didn't act as quickly and didn't take it seriously. The UK and US lost an opportunity they had two months from what happened in China, yet there was this perception that China is very far away and nothing is going to happen, says Tikki Pangestu a former director of research policy at WHO. China first reported cases of  mysterious Sars-like pneumonia to the WHO on 31 December, at this point there was no confirmed human-to-human transmission and little was known about the virus, but within three days Singapore, Taiwan and Hong Kong had all stepped up screening at border points (Taiwan even checked passengers on flights from Wuhan before they got off the plane). As scientists learned more about the virus, it became apparent that people without symptoms could still be contagious, so testing would be crucial.
Cases in South Korea spiked initially, however it swiftly developed a test for the virus (and had tested more than 290,000 people), it conducts about 10,000 tests daily for free. The way they stepped up and screened the population was really remarkable, we can do what we did because we are small, to replicate what we are doing in its entirely would not make sense, it has to be adapted to suit each country, says Ooi Eng Eong, a professor in emerging infectious disease at the National University of Singapore. South Korea had a rapid approvals system in place for infections disease tests, following an outbreak of Middle East Respiratory syndrome in 2015 that left 35 dead. By contrast, testing in the US was delayed, initial test kits were faulty and private laboratories found it hard to get their tests approved, many people struggled to get a test and they were expensive, eventually, free testing for everyone was passed in law, meanwhile, the UK has said that only those in hospital will be routinely tested, that makes it harder to identify cases with milder symptoms. Prof Pangestu recognizes that in some countries there are not enough test kits, however, he describes extensive testing as the most important priority, testing those who are symptomatic but not necessarily hospitalized and still spreading the virus is perhaps even more important.
It's not enough to just test those with symptoms, tracing those with whom they were in contact has been key, in Singapore, detectives have contact traced more than 6,000 people testing them and ordering them to self isolate until their results are clear. In Honk Kong, contact tracing goes back to two days before someone develops symptoms, they have also adopted intrusive ways of ensuring that those ordered to self isolate actually stay at home, in Hong Kong, new arrivals from abroad are required to wear electronic bracelets to track their movements, while in Singapore those self isolating are contacted several times a day and required to send photographic proof of their whereabouts, Singapore has hefty penalties for anyone who breaks a stay at home order, it stripped one offender of his residency rights. Many countries in the west will find it hard to adopt such measures due to their larger populations and greater civil liberties.
Social distancing is considered one of the best ways of containing an outbreak, but the later the measures are introduced, the most extreme they need to be to work, in Wuhan where the Coronavirus is thought to have started, five million people had left the city before the shutdown began, this led to the government imposing the biggest quarantine in human history. Both Italy and Spain were forced to introduce national lock downs after their case numbers rose to the thousands, New York and California have ordered residents to stay at home, except for essential trips like buying groceries, by contrast, in Hong Kong schools have been closed and workers encouraged to work from home but restaurants and bars remain open, the same thing in Singapore where schools are still running although large public gatherings have been cancelled. Prof Ooi believes the difference is down to how quick governments were to implement social distancing, by time a lot of countries has stepped up control measures, the number of cases was so large, that drastic steps were needed, social distancing is affected by government decisions to ban gatherings or close schools but it also depends on people being willing to take part, that's why public messaging and individual attitudes matter.
Keep the public well informed and on side, Prof Pangestu says: Unless you get the co-operation of the public, your policies may not be adhered and enforcement only goes so far, the important thing is to show that policies are based on scientific evidence. China came under fire for being slow to acknowledge the outbreak, it allowed a large political gathering to take place in Wuhan even as concerns grew, the authorities also punished doctors who tried to warn others sparking fury after one died from Coronavirus, it has since been praised for effectively slowing the spread of the virus, after imposing a massive lock down and up scaling its hospital capacity but critics say such extreme measures were only required because its initial response was slow. In the US, President Donald Trump has often contradicted health officials about the severity of the outbreak and number of test kits available, the government has been unable to provide information on the number of people who have been tested, as many private laboratories have not been feeding data to the Center for Disease Control and Prevention. Outbreak response involves being transparent that stops people panicking and hoarding things, some governments have used technology to update residents in great detail, Hong Kong provides an online dashboard of all cases which includes a map that shows the individual buildings where cases were found, South Korea issues mobile alerts letting people know if they were in the vicinity of a patient, in Singapore, the government has been praised for its clear communications on Coronavirus, including a speech by the Prime Minister which encouraged people to stop panic buying, its measures have had widespread public support helped by the fact Singapore has a long history of emphasizing collective responsibility for national security and the media doesn't tend to challenge the official line.
The individual attitude also play a big role, it's far too simplistic to say, as some have that Asians are more likely to comply with government orders, in Hong Kong for example public trust in the government is low and there have been months of anti-government protest but in one of the densest cities in the world, many have voluntarily socially distanced themselves with some even avoiding Lunar New Year gatherings, the equivalent of skipping Christmas events, while the citizens do not trust the government they are very proud of Hong Kong and see the outbreak as a threat to identity, because many people there have what we call the individual responsibility (which is the idea that human being choose, instigate or otherwise cause their own actions) especially after they remembered the 2003 Sars outbreak that hit the territory particularly hard, that's also seen in the prevalent use of masks in part of Asia which is a sign of respect towards others, experts in Asia agree that masks are far less effective than other measures like hand washing but there are different opinions over whether wearing a mask is still harassment while wearing one, because masks are not a magic bullet against Coronavirus but if everybody wears face masks it probably can help, along with all the other measures, to reduce transmission, by contrast, in Europe and other countries people have specifically been told not to wear masks and many Asian have experienced harassment while wearing one.
Experts believe the more aggressive measures being put in place all the countries will successfully slow the rate of transmissions over time but to get a sense of their next challenge after that, they could also look ahead to Asia, despite having contained the Coronavirus, they are now facing a second COVID-19 fueled by people entering their borders and it's not clear how long this outbreak could go on for, even the optimism as new infection numbers started falling down within 2 or 3 weeks of lock down while China's shutdown was drastic, countries with softer measures should be able to contain the pandemic within weeks, those lessons should be serve as inspiration for other countries right now, it's painful but it can be done and as much as lock down ends early, local transmissions  could start again also prolonged lock downs are damaging for the economy, while an epidemic is damaging to public health, there's not a lot of good choices, except if scientists find a vaccine which could take about 18 months or even more.