When Bruce Aylward gave a press conference on #covid19 this week in Geneva, he said: "The single biggest lesson is speed. Speed is everything and what worries me most is, has the rest of the world learned the lesson of speed?" It seems clear to me the world hasn’t. Quick thread
That means: Even if we were perfect at finding everyone who has #covid19 the moment they have symptoms, we would know in 14 days how many people are infected today. Looking at epidemiological data is like looking at the light from a far-away star. You are always seeing the past!
And we aren’t perfect. Far from it! Some countries couldn't test for #covid19 until recently. Most that could, only tested people seen as potential cases because of travel to affected regions or contact with known case. So any missed case was able to spread the virus undetected.
It will usually take several generations, so several weeks, for a single case to have grown into an outbreak large enough that severe cases and deaths start popping up that get noticed and tested. And those severe diseases also need some time to develop after infection.
This is what we have seen in Iran, Italy and now in Washington State. The virus was introduced, it spread for a few weeks and when enough people were infected for serious cases to pop up, they were discovered and slowly the rest of the iceberg came into view as testing expanded.
Again: this is not a surprise. Most experts have been saying this and people like @cmyeaton have long urged for more testing because of this. When this is over we will need to take a long, hard look at why this was not done. It is incomprehensible to me.
@cmyeaton What does all of this mean? To me, at least, it suggest, that if there are public health interventions that we think may seem prudent in two or three weeks given our current trajectory, then we should be implementing those interventions today.
@cmyeaton The smaller an outbreak is, the more likely we will be able to actually make a significant dent in it with social distancing etc. If we wait until the last moment, when the outbreak is visibly on the verge of being too big for that, we will actually be weeks too late.
@cmyeaton This is my biggest gripe with many politicians etc. in this outbreak. They are speaking/behaving as if they had to react to whatever the reported situation is that day. But we know that we are looking at a picture of the past.
