With ongoing transmission in multiple @who regions, it hard to argue that COVID-19 doesn't meet definition of pandemic. Here's WHO's language on classifying geographic spread: who.int/csr/disease/sw…
In 2009, when there were <30,000 global cases @who told countries that influenza A/H1N1 was unstoppable and told countries to "recalibrate their strategies to minimize the harm" from the virus. cnn.com/2009/HEALTH/06…
This @nytimes article illustrates how costly and resource consuming containment activities are. Unfortunately, pursuing this strategy leaves little bandwidth for mitigation planning. nytimes.com/2020/02/22/us/…
You can only argue that containment buys us time if we actually use that time. I have seen insufficient evidence that countries are doing the preparedness work necessary for effective mitigation. Please send examples of my being wrong on this. I want to be wrong!
I would like to see countries doing more testing that would allow for discovery/characterization of local transmission, rather than continuing to require travel history to China, etc, We will be blindsided w/ sudden rise in cases if we don't expand surveillance beyond geography.
I would like to see plans to identify sick people and isolate them at home unless they require hospitalization. We need to support people with food, medicine, etc so they can remain isolated. Triage lines are needed to help people know when/if to seek medical care.
We need plans to protect the most vulnerable. At this point, that looks like elderly and those with underlying medical conditions. What can we do to keep them from becoming ill and treat them if they do become sick?
I know as soon as countries find cases, there will be calls to close schools. It may be inevitable that schools close due to parental concerns. But to what end? We don't know if kids spread virus like they do flu. And for how long? What does that mean for working parents?
With every action we consider taking to try and slow the spread of the virus or protect vulnerable, we have to ask ourselves if they are justified. This is not just about epidemiology. We can't pick measures that cause more harm to society than virus itself.
