Western countries responded very late to #COVID19. But it is not too late. Learning from leaders would be helpful. We have enough reports about the lessons from Asian countries. That's a summery how to combat #COVID19 @kakape @florian_krammer @niccijsmith @chenchenzh @C_Althaus/1
However, there's no time for policy mistakes. "Flattening" for instance is a dangerous illusion that can and does not work medium.com/@joschabach/fl… @OttoKolbl /2
Flatting is also a totally contradictive appraoch: while the epidemiological goal is to make the pandemic last longer, the economic logic is to make the pandemic as short as possible to prevent economic systems around the world from collapsing. Flattening does not make sense /3
The idea of "herd immunity" is inhuman. In fact it is mass slaughter not only of elderly but also of many young people. It would certainly destroy or societies and political systems. So, just like Asian countries, our priority must be to safe life and contain #COVID_19 /4
Mainland China, Taiwan, Hong Kong, Vietnam, Singapore, South Korea have applied only one strategy: CONTAINMENT. Every small and big outbreak. Full containment. They have already the systems in place to #ContainCOVID19 for years if necessary /5
Here's a way how to combat the virus based on what we know from Asia's examples researchgate.net/publication/33… I hope other Asia experts can add and correct where I got some details wrong /7
First, we have to look to #China and #Southkorea, as all European countries are far beyond the situation of other Asien countries. It is clear from both countries that a lockdown/social distancing is by far not enough. We can't wait until experts and policy makers realize this /8
A lockdown of hot spots must be done. Strict social distancing everywhere is needed but only buys some time. But social distancing has not slowed down the virus much in Wuhan. R0 remained above 2. medrxiv.org/content/10.110… It is not doing the actual job of containing the virus /9
To contain the virus, first, comprehensive infection chain tracing is needed. It needs to be done on a industrial scale and by using dig data and algorythmic automation. Only by that measure applied with high efficiency can all suspected cases be found, tested and isolated /10
All Asian countries, democratic or not, do massive testing. It is THE key instrument. Unlike Western epidemiologists who think testing is a mere instrument to see how a pandemic is developing, in Asia it is used to find every single case. cdc.gov/mmwr/volumes/6… /11
Second, every country needs to build a layered system of isolation and quaratine. Possible spaces are hotels, sport stadiums, schools or other big commercial and public spaces. Every (suspected) case needs to be put in isolation and tested (two times) /12
China, now puts every suspected "close case" in isolation, tests two times. Even if negative, the person remains in special quarantine for 2 weeks. If positive a person gets into hospital and stays until healed (whatever are the symptoms). Nobody stays at home unattended /13
For most Western countries, however, the situation will soon look like in Wuhan in mid-January to mid-February where hospitals where quickly overwhelmed (at least 50k cases). So we need to look at how authorities in #Wuhan have improvised /14
At first, suspected cases and even confirmed cases with mild symptons (often also severe cases) where simply sent home. However, doctors realized that these persons infected their families and many than died together. This happened at least to dozens of #Wuhan families /15
The Chinese authorities than set up a system of "Cabin" clinics and other facilities in order to seperate all the cases into groups together. Nobody was anylonger left with their family to avoid further spreading and death who.int/docs/default-s… /16
I was a layered system: suspected cases (hotels), confirmed cases mild (cabin clinics), severe cases (other facilities), critical cases (hospitals). This system avoids further spread in families and provides centralized oversight/care with oxygen and necessary services. /17
The most urgent support are different forms of oxygem supplies. Oxygen is important even for many mild cases as it prevents them from becoming more severe. (information is from a Chinese NGO that provided 2000 Plus oxygen generators to Wuhan) /18
There are many challenges and solutions: how to build a big data based tracking system? We have it already: cellphone data would be enough. An app for sharing data on temperature could be build very fast. nytimes.com/2020/03/04/hea… /19
Of course, there is much more to say about the "Chinese" approach to contain #COVID19 such as the participation of civil society. /20
The essentials from SARS-affected Asia: you must contain #COVID19. It can be done, even now: Through a) industrial-scale testing and transmission chain tracing, b) a system to isolate and treat every single case, c) improvise hospital/care capacity to safe as many as possible /21
Authorities need to move very fast; no time to think whether certain measures are right, perfect, or against privacy. If our priority is to safe the life of millions and to maintain democratic societies, than there is no time to discuss. No alternative to containment /22
Imperial College study supports these findings: "We therefore conclude that epidemic suppression is the only viable strategy at the current time." #ContainCOVID19 imperial.ac.uk/media/imperial… Yet, they present a best-case scenario for CFR in my view /23
