Thread by @MackayIM

"Chinese took a very pragmatic approach and decided we are going to go after containment this virus"

Dr Bruce Aylward, Team Lead, WHO-China Joint Mission on #COVID19

🎙Wuhan, a city of 15million people, was a ghost town; massive community commitment to stopping this virus.
🎙Everyone in government has a role, repurposed to this task.
🎙Technology turbocharged response; life is lived online

🎙take whole hospitals out of general service and made them response hospitals to #COVID19 response because so many cases
🎙kept some designated hospitals for regular patients
🎙how to feed people? all done online and through deliveries

🎙the response is science driven in China; issued the 6th set of clinical guidance while Team was there (he is clearly impressed 🙂)
🎙all sites everywhere were using the latest guideline (!)
🎙Aylward reminds us that we have to tackle it super-fast -multi site epidemic right now

🎙Provinces, counties, towns could adapt the big rules as needed to work for them; fundamentals the same but flexible (-I'm not sure we can do what China has done)
🎙they have changed the course of this outbreak
🎙how many cases prevented /delayed? Roughly 100s of thousands

🎙"it's our responsibility to do this for the world, not just for them"
🎙Is this trend real? Everywhere treating Doctors were saying "we have open beds"; cases going down. Also, fever clinics with idle HCWs - lines gone

🎙People who want to be tested dropped (46k being tested almost daily)
🎙Third proof of decline; enrolment for Remdesivir trial becoming harder.
🎙speaks of practical things that need to be a focus for country authorities outside China
🎙

🎙Aylward had heard that 24/31 Provinces had reported zero cases for a day; hopeful
🎙where next with China (which has SARS experience) and global response
🎙

🎙those who get more seriously sick, stay in hospital for 2 to 6 weeks
🎙over 50,000 people still recovering from #COVID19
🎙spectrum of disease-80% are mild (few➡severe or critical or death); severe have breathing problems, oxygen down, breathing rate up-<50%➡ die;

🎙 critical cases, ~50%➡die
🎙 mild does seem to include non-pneumonia illnesses it seems - but what % still not spelt out here as it wasn't in the large study from China CDC Weekly weekly.chinacdc.cn/en/article/id/…

🎙new cases now generally able to be linked because of their online capability (not a surprise because of number infected?)
🎙despite curve going down, China still preparing for more cases; we don't know *this* virus so don't get stuck in SARS or Flu thinking

🎙keep an open mind
🎙China doesn't think it will just disappear; are other countries thinking like this?
🎙we all need China's expertise in this now
🎙phased restart of life in China is underway

🎙"this is gonna come soon, potentially, you've gotta be shifting to a readiness, rapid-response thinking"
🎙modified whole wards to be isolation units by putting up a wall at the entrance

🎙we're going to try to not have Wuhan; as soon as you see clusters, be ready to stop transmission chains
🎙world not ready but it could get ready fast
🎙bring your populations with you in readiness; bring them with you early as things are going to change readily, adapt

🎙access the expertise of China - they're keen to help
🎙solidarity among Provinces - impressive. Can we all replicate that?
🎙BA hasn't seen this in 30y of experience and wasn't sure it would work; he's clearly been convinced

🎙community spread, tip of iceberg, huge fog of war etc; turned to influenza-like illness surveillance system (ILI)-not present in Dec but was in Jan, not outside of Hubei tho
🎙320,000 [😮] samples tested perhaps Guangdong; 0.49% were initially testing (+), recently just 0.02%

🎙so data don't support "everyone is infected" and "its spreading everywhere" theories

🎙a couple of serological assays now licensed in China so we will soon learn more about how widespread the virus has been (so long as those with missed disease mounted a measurable immune response using these assays)

🎙antibodies but not sick, virus was widespread; if not, we've been tracing what there is and all those % and numbers we've seen suddenly become more solid
🎙right now, doesn't look like widespread community transmission, it looks like main driver is household-level of infection

🎙China's strategy of find the case - close contacts are family (don;t have to find every single one, never will, just slow the thing down) might have been the best one

🎙"when you're in a war like this..."
🎙bottom line is that this virus kills people, vulnerable people, our elderly, but is can also kill young people
🎙ppl say "but in China, they don't have this, they don't have that" - AW would *want* to be treated in China

🎙China is realty good at keeping people alive

Q&A
🎤"we're not great at coronavirus vaccines"; we don't have the experience & China is pragmatic, not holding off waiting for it
🎤we haven't seen big nosocomial outbreaks & we're not seeing all the kids get sick or as index cases

🎤early on, people were caught int this war without the right PPE but that changed.