"The Worst- Case Scenario For Coronavirus Is Likely," Jonathan Quick, Epidemics Expert (Feb. 27)
'Interview (Feb. 27), Epidemics expert Jonathan Quick: ‘The worst-case scenario for coronavirus is likely,’ Laura Spinney. The former chair of the Global Health Council talks about the mentality that left the world vulnerable to the Covid-19 epidemic and what can be done to minimise its effects. The Guardian, March 1, 2020.
In 2018 global health expert Jonathan D Quick, of Duke University in North Carolina, published a book titled The End of Epidemics: The Looming Threat to Humanity and How to Stop It. In it he prescribed measures by which the world could protect itself against devastating disease outbreaks of the likes of the 1918 flu, which killed millions and set humanity back decades. He is the former chair of the Global Health Council and a long-term collaborator of the World Health Organization (WHO).
The Covid-19 epidemic looks like it’s edging towards becoming a pandemic – that is, as the WHO defines it, “the worldwide spread of a new disease” – but the WHO hasn’t declared a pandemic yet. What are the best-case and worst-case scenarios? The best case is that the Chinese conflagration is brought under control, the smaller “flames” we’ve seen flare up in other countries are extinguished, there’s little or no spread to new countries or continents, and the epidemic dies out. The worst case is that the outbreak goes global and the disease eventually becomes endemic, meaning it circulates permanently in the human population.
Your feeling as to which is more likely, as of today, 27 February? The worst-case scenario is looking increasingly likely. We’ve now seen cases on six continents, apparently “silent” – that is, at least partly asymptomatic – chains of human-to-human transmission both inside and outside China, with additional countries reporting cases within the last week – bringing the total to 47 – and new, accelerating outbreaks in Iran, Italy and South Korea. If it becomes a pandemic, the questions are, how bad will it get and how long will it last? The case fatality rate – the proportion of cases that are fatal – has been just over 2%, much less than it was for Sars, but 20 times that of seasonal flu. There are still many unknowns – we may have underestimated the period during which a person is contagious, for instance, and the variety of ways in which the virus spreads.
If the worst-case scenario comes true, are there still things we can do to minimise the pandemic’s impact? Absolutely. We can mobilise more health officials and keep engaging the public, implementing sensible travel controls and ensuring that frontline health workers have ready access to diagnostic tests and are vigilant – that they don’t send anyone who may have been exposed home without testing them, for example. Judging by past experience, however, it’s likely that health officials and the public in much of the world remain unaware or unconvinced of the danger this virus poses.
You have said that time and trust are critical to good epidemic management. What do you mean? The delay between the frontline health workers noticing something unusual,...
More, https://www.theguardian.com/world/2020/mar/01/the-worst-case-scenario-for-coronavirus-dr-jonathan-quick-q-and-a-laura-spinney
