Thread by @joshmich

I think there are some silver linings in the comments here, from the WHO official in charge of #2019CoV #coronavirus response. Those have been hard to come by over the past couple of weeks. statnews.com/2020/02/01/top…

Dr. Ryan notes evidence from China shows fairly limited transmission in households where the virus is introduced (low “secondary attack rate”). So far there has been limited spread of infection to health care workers (this had been a major component of the SARS epidemic in 2003).

So far, most severe cases and deaths have been among adults 50 or older, and a large proportion have been people with pre-existing conditions. We’ve seen no deaths outside China so far.

We have no evidence of widespread community transmission outside China. While there has been human-to-human spread, including third generation spread at this point, outbreaks in other countries look nothing like those in the heavily affected areas in China *at this point*

How and why did is it so bad in China, then? Slow recognition and early missteps in China, an overwhelmed and politicized public health system, and authorities that placed secrecy over directly addressing an emerging health threat, it would appear.

The NY Times describes officials hiding and downplaying reports of this unusual disease early on. It wasn’t until January 20 that serious action began, after President Xi made public statements about the outbreak nytimes.com/2020/02/01/wor…

The Washington Post reports that a bureaucratic, politically-beholden and insufficiently prepared public health structure in China was quickly overwhelmed as the epidemic progressed. washingtonpost.com/world/2020/02/…

The Chinese public health and political system struggled early with this rapidly growing epidemic. When action was finally taken, it came too late to stop the large early wave of disease that was already in motion.

Since then, though, we’ve seen the Chinese mount the largest emergency public health intervention in history. The heavy-handed actions are a marked shift from the past, and likely have reduced transmission in China significantly.

We're still seeing cases/deaths from that earlier, uncontrolled stage. The next few days and weeks will tell us whether things take a turn for the better. We can hope that the emerging anecdotal evidence and silver linings mean the epidemic can indeed be curtailed.