Q: What can other countries learn from the way China has approached COVID-19?
A: Social distancing is the essential strategy for the control of any infectious diseases, especially if they are respiratory infections. First, we used “non-pharmaceutical strategies”, because you don’t have any specific inhibitors or drugs and you don’t have any vaccines. Second, you have to make sure you isolate any cases. Third, close contacts should be in quarantine: We spend a lot of time trying to find all these close contacts, and to make sure they are quarantined and isolated. Fourth, suspend public gatherings. Fifth, restrict movement, which is why you have a lockdown, the cordon sanitaire in French.
Q: The lockdown in China began on 23 January in Wuhan and was expanded to neighboring cities in Hubei province. Other provinces in China had less restrictive shutdowns. How was all of this coordinated, and how important were the “supervisors” overseeing the efforts in neighborhoods?
A: You have to have understanding and consensus. For that you need very strong leadership, at the local and national level. You need a supervisor and coordinator working with the public very closely. Supervisors need to know who the close contacts are, who the suspected cases are. The supervisors in the community must be very alert. They are key.
Q: What mistakes are other countries making?
A: The big mistake in the U.S. and Europe is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.
Q: What about other control measures? China has made aggressive use of thermometers at the entrances to stores, buildings, and public transportation stations, for instance.
A: Yes. Anywhere you go inside in China, there are thermometers. You have to try to take people’s temperatures as often as you can to make sure that whoever has a high fever stays out.
And a really important outstanding question is how stable this virus is in the environment. Because it’s an enveloped virus, people think it’s fragile and particularly sensitive to surface temperature or humidity. But from both U.S. results and Chinese studies, it looks like it’s very resistant to destruction on some surfaces. It may be able to survive in many environments. We need to have science-based answers here.
Q: People who tested positive in Wuhan but only had mild disease were sent into isolation in large facilities and were not allowed to have visits from family. Is this something other countries should consider?
A: Infected people must be isolated. That should happen everywhere. You can only control COVID-19 if you can remove the source of the infection. This is why we built module hospitals and transformed stadiums into hospitals.
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