We must avoid losses caused by fear, overreaction: top epidemiologist
China is fighting a battle against the novel coronavirus epidemic. How can China win this battle? Is the epidemic’s turning point emerging? How should we evaluate the response of Wuhan, where the coronavirus outbreak started, to the epidemic? Global Times (GT) Editor-in-Chief Hu Xijin talked to Zeng Guang (Zeng), chief epidemiologist of the China Center for Disease Control and Prevention, on these issues.
GT: Some experts have pointed out that the epidemic’s turning point is about to emerge. How do you see this view?
Zeng: I think this judgment makes sense. The high-level panel of experts returned from Wuhan with two new recommendations, one of which was to classify the novel coronavirus pneumonia as a type B infectious disease but to be managed as a type A. Wuhan people don’t go out, outsiders don’t come in. This means that the number of cases exported from Wuhan is reduced to a minimum, or even to zero. The longest incubation period is 14 days. The situation changes in six days, and will change in the next few days.
Now is an opportunity, the first step must be to control the cases outside Wuhan quickly. I think we should have the determination and ability to control it. I think around the 15 day of the first lunar month, we should see significant results. Now our battlefield is divided into two parts, one is outside Wuhan, the other is inside Wuhan and the whole of Hubei Province. So I think the emergence of a turning point is contributions from Wuhan people.
GT: There are many discussions on the internet that the early notification of the epidemic situation in Wuhan was delayed and action was taken slowly. People complained about this. What do you think?
Zeng: First of all, I can understand the thoughts of netizens, but our understanding of this disease is changing with each passing day. How can you tell if there is no outbreak? I went to Wuhan twice and the feeling is different each time, we can only make inferences based on virus’ feature.
Wuhan’s response to the outbreak, if slow, is mainly due to scientific understanding, but we do not rule out some hesitations regarding decision-making, mainly due to the lack of confidence in their own understanding of the disease.
The public health personnel’s decision-making is based on science, which is from a scientific perspective. However, government officials’ consideration of these issues are not purely from a scientific perspective. This is only part of their decision-making basis. They have to consider the political factor, consider the issue of maintaining stability, the economic issues, the happiness of family members during the Spring Festival and ordinary people’s satisfaction.
It cannot be said that the perspective of the government officials is wrong. The decision-making must consider many aspects, but it is necessary to establish experience on key issues and use more scientific perspectives. If the scientific perspective is not used well, other perspectives will be meaningless.
GT: Early on in the outbreak, eight Wuhan citizens warned that this was a “new SARS,” and they were contacted by the public security authority. Is the expert team aware of this?
Zeng: I didn’t hear it. In hindsight, we can give these citizens high marks. They were wise before the outbreak became widespread. But from what these people said, what did they base it on, the disease, the transmission, or what? Science stresses the importance of case and evidence to make a fundamental judgments. If I had heard them say so, I could not have believed them. We have to keep pace with the times, constantly adjust our knowledge based on the development of the virus, and constantly deny ourselves. I think this is a real process.
GT: Now that the Spring Festival returning travel rush is coming soon, will there be a second outbreak?
Zeng: That’s what our work in public health is all about. It’s not about doing things in an ideal state. It’s about meeting the needs of a functioning society. As long as we do our best to prevent and find out if the patients are quarantined in time, I think it’s best to solve the problem in a dynamic way. Solving problems in an ideal state is unrealistic. That is not public health. Public health has always been about a functioning soceity.
GT: Soon everyone will take the train and plane back to their workplaces. If there is a patient in the same compartment or cabin for example, what is the probability of myself becoming infected?
Zeng: The World Health Organization has a rule that on a plane, the three rows in front of and after (a patient) are viewed as close contacts. There are many instances where people overreact. For example, when a clinical doctor is infected probably through eye, everyone rushes to buy goggles. Goggles should be given to medical staff. Ordinary people do not need to wear goggles.
At present, most coronavirus pneumonia cases found in cities outside Wuhan are still the initial infections, with relatively few severe cases. Compared with SARS, there were few mild cases. But the good thing about SARS is that you don’t have a hidden infection. Virus in the incubation period is not infectious. In this regard, the Wuhan pneumonia is hard to discern. Some patients do not come to the degree of pneumonia, but they are the source of infection. Instead of fighting the novel coronavirus pneumonia, we’re fighting the novel coronavirus infection. So we have now updated the diagnostic criteria to the fourth draft. What does it mean? The disease changes so quickly that we have to adapt to it and race against it.
GT: Now if you find yourself suffering from fever, should you go to the hospital immediately or stay in isolation at home for observation?
Zeng: I think it would be better to go to the hospital. Because everything outside Wuhan is in the early stages (without the high risk of cross infection). When seeing the doctor, you need to report whether you have contact with fever patients. Have you ever been to Wuhan or Hubei? Have you had any contact with people who have been to Wuhan? The contact history is very important. In addition, every hospital should maintain daily operation, and other medical treatments should be guaranteed. If you don’t go to the hospital because of fear, and you don’t catch the novel coronavirus, but you delay the treatment of other diseases. This doesn’t work.
GT: Do you think it’s safe for us all to go to the supermarket to buy food, go to the mall, and take the subway?
Zeng: I think it’s safe in Beijing. There is no absolute safety in public health. Wearing a mask in Beijing is not only a protection against the novel coronavirus, but also against the flu. In fact, on the street and in the open air, you don’t need to wear a mask. You are less likely to be infected by someone walking down the street than by a car accident.
GT: If you come back from the non-epidemic areas, before you start working together, do you need to quarantine yourself?
Zeng: I don’t think there is such a need yet, I only represent my personal opinion. It can’t be completely closed off. I think it ‘s an overreaction. The loss of infectious disease to human society is not only the loss of illness and death, but also two kinds of losses, one is caused by fear, and the other is caused by overreaction. We should be able to manage this part and don’t blindly follow other people.