Thread by @juliaoftoronto

NEW: A growing number of public health experts say #covid19 is probably impossible to stop, and that we're looking at a pandemic:

vox.com/2020/2/23/2114…

Why? Allow me to thread:

New and growing outbreaks in Italy, Iran, South Korea, and on the cruise ship in Japan show how highly contagious this virus is, and how cases may be lurking silently in countries around the world.

But there's more reason to believe we're tilting toward or in a pandemic...

1) Countries are still mostly looking for the disease in people who’ve traveled from China. That means they're likely missing cases.

2) Flu season ongoing, this virus looks like flu, and it's possible cases are being missed that way, too...

3) Many countries are only now getting testing up and running

4) Some people may have abdominal pain before respiratory symptoms — and that’s not something health officials are screening for...

5) China may also see another surge in cases soon as travel restrictions are gradually lifted

6) SARS containment worked because people were only contagious after they got sick; with #Covid19 people seem to be contagious early in illness or even when asymptomatic...

So that's why @mtosterholm said the fact that extraordinary measures to contain this virus haven’t worked doesn’t mean containment failed.

“Containment never had a chance because of the influenza-virus like transmission.”

@mtosterholm It's why @LawrenceGostin said: “We are at a turning point in the Covid-19 epidemic... We must prepare for the foreseeable possibility, even probability, that Covid-19 may soon become a pandemic affecting countries on virtually all continents.”

And why @NIAIDNews Anthony Fauci said, "When several countries have widespread transmission, then spill-over to other countries is inevitable."

@NIAIDNews So what happens now?

Countries need to move from trying to contain the virus to mitigating its harm — reducing the spread, and caring for the very sick. “It is beyond time,” said @JenniferNuzzo.

Hospitals need to be ready with Covid-19 protocols, healthcare workers need to be protected with access to protective equipment such as face masks/gowns, and instead of travel bans, countries need plans for maintaining supply chains and carrying on with travel and trade...

As @mtosterholm said: “I don’t think the answer is shutting down the world to stop this virus. It’s already out."

The US and other high-income countries don't want to find themselves on the receiving end of the kinds of travel/trade restrictions they've imposed already.

@mtosterholm Your weekly reminder: a pandemic doesn't mean it's time to panic.

We don't know how severe #covid19 is. It's likely the severity/2 percent case fatality rate will decrease as countries find more mild cases.

Countries just need to do all they can to be ready. END