Thread by @kakape

“Today is my birthday and I have been given a good gift from DRC”, says @drtedros: 2 weeks with no #Ebola case. No Ebola patient in treatment. Good news for the whole world, he says.
“But as one epidemic looks like ending… another is becoming increasingly complex”: #covid19

@DrTedros New numbers first:

Global total:
90893 cases
3110 deaths

New cases in past 24 hours:
China: 129 cases
Rest of the world: 1848 cases
(80% of those are from South Korea, Iran and Italy)

12 new countries have reported their first #covid 19 case.

@DrTedros Important statement now on asymptomatic #covid19 cases:
Evidence from China: "only 1% of reported #COVID19 cases do not have symptoms and most of those cases develop symptoms within 2 days”, says @DrTedros. Countries like Singapore also found few asymptomatic cases, he says.

@DrTedros But, importantly, @DrTedros also points out that the only way to be sure is “looking for #covid19 antibodies in large numbers of people”. Several countries doing those studies. “We encourage all countries to do these studies and share their data"

@DrTedros This is one major difference between #influenza and #covid19, says @DrTedros:
People who are infected but not yet sick, are major driver in influenza, but apparently not in #covid19.

@DrTedros Further differences:
- #covid19 causes more severe disease than seasonal influenza
- no vaccines or therapeutics to treat #COVID19
-containment is not viable strategy for #influenza: "It’s just not possible. But it is possible for #covid19."

@DrTedros Every day someone asks: Is this the time to declare a pandemic?
Today it’s a Brazilian journalist. Answer by @drmikeryan:
"If we’re gonna wave the white flag at one case, we’re gonna have a serious problem on our hands” (Brazil has two #covid19 cases, but his point is clear).

@DrTedros @DrMikeRyan Says again that even if containment fails, it will buy time. And also says that calling it a pandemic will not mark any radical shift in strategy in fighting #covid19.

@DrTedros @DrMikeRyan Long discussion of #covid19 in Latin America with Tedros running down the (short) list of cases there. Argues that how few reported cases there are, clearly warrants aggressive containment strategy. (I do wonder how aggressive testing has been here, however.)

@DrTedros @DrMikeRyan On Iran, @DrMikeRyan says concern are "supplies, equipment, specific training in use of PPE, intensive case management of severely ill patients, ventilators, respirators, oxygen."
"Those needs are more acute for the Iranian health system than they are for almost any other."

@DrTedros @DrMikeRyan .@DrMikeRyan taking on travel restrictions: Says these measures by themselves are never an adequate response to an infectious disease. But if countries take such measures that are not evidence-based, "there is not a whole lot we can do.”

@DrTedros @DrMikeRyan So, I asked at the press conference about the discrepancy between the 1% asymptomatic cases in China and data from #PrincessDiamond and also between joint mission report saying few mild cases missed and modelling studies based on travellers saying hundreds of thousands missed.

@DrTedros @DrMikeRyan Answer (@mvankerkhove): “complex question”, 1% asymptomatic number is based on reported cases in China (and 75% of these actually do develop symptoms later). Through contact tracing and surveillance more cases being picked up early before symptoms. “Truly asymptomatic is rare”.

@DrTedros @DrMikeRyan @mvankerkhove Says modelling studies are important pieces of data. But serological data (testing for antibodies) will give reliable answer. "Without those studies, we really can't say how many people have been infected so far.” Says serological test is ready (at unprecedented speed).

@DrTedros @DrMikeRyan @mvankerkhove Regrettably, she didn’t address cruise ship data. Will try and follow up. This question is a crucial point. It is clear that there is a lot of uncertainty around but important to understand what the data is for different scenarios.