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As Fears of a Pandemic Mount, W.H.O. Says World Is Not Ready As Fears of a Pandemic Mount, W.H.O. Says World Is Not Ready
(7 days later)
BEIJING — As new cases of the coronavirus spiked on two continents, the World Health Organization warned on Monday that the world was not ready for a major outbreak, even as it praised China’s aggressive efforts to wrest the epidemic under control.BEIJING — As new cases of the coronavirus spiked on two continents, the World Health Organization warned on Monday that the world was not ready for a major outbreak, even as it praised China’s aggressive efforts to wrest the epidemic under control.
After two weeks on the ground in China, a team sent by the W.H.O. concluded that the draconian measures China imposed a month ago may have saved hundreds of thousands of people from infection. Such measures — sealing off cities, shutting down businesses and schools, ordering people to remain indoors — have provoked anger in China and could be difficult to replicate in democratic countries with a greater emphasis on protecting civil liberties.After two weeks on the ground in China, a team sent by the W.H.O. concluded that the draconian measures China imposed a month ago may have saved hundreds of thousands of people from infection. Such measures — sealing off cities, shutting down businesses and schools, ordering people to remain indoors — have provoked anger in China and could be difficult to replicate in democratic countries with a greater emphasis on protecting civil liberties.
“There’s no question that China’s bold approach to the rapid spread of this new respiratory pathogen has changed the course of what was a rapidly escalating and continues to be a deadly epidemic,” said Bruce Aylward, a Canadian doctor and epidemiologist who has overseen international campaigns to fight Ebola and polio and who led the W.H.O. delegation.“There’s no question that China’s bold approach to the rapid spread of this new respiratory pathogen has changed the course of what was a rapidly escalating and continues to be a deadly epidemic,” said Bruce Aylward, a Canadian doctor and epidemiologist who has overseen international campaigns to fight Ebola and polio and who led the W.H.O. delegation.
The epidemic has already killed more than 2,600 people in China, mostly in Hubei Province, where the outbreak began in December, and infected more than 77,000 people. But the number of new infections in China has been steadily dropping, giving officials in the country confidence that the extraordinary measures have been effective in blunting the virus’s spread.The epidemic has already killed more than 2,600 people in China, mostly in Hubei Province, where the outbreak began in December, and infected more than 77,000 people. But the number of new infections in China has been steadily dropping, giving officials in the country confidence that the extraordinary measures have been effective in blunting the virus’s spread.
There are concerns, however, that as people begin returning to work in China, the virus could flare up again.There are concerns, however, that as people begin returning to work in China, the virus could flare up again.
At the same time, new cases are escalating outside China. In Italy, where there has been an eruption of more than 150 cases, the authorities have locked down at least 10 towns, closed schools in major cities and canceled sporting events — all moves that are echoes of China’s tactics, if not quite as draconian.At the same time, new cases are escalating outside China. In Italy, where there has been an eruption of more than 150 cases, the authorities have locked down at least 10 towns, closed schools in major cities and canceled sporting events — all moves that are echoes of China’s tactics, if not quite as draconian.
In Iran, the outbreak has killed at least 12 people as of Monday, the largest number of coronavirus-linked deaths outside China.In Iran, the outbreak has killed at least 12 people as of Monday, the largest number of coronavirus-linked deaths outside China.
South Korea on Monday reported 231 additional cases, bringing the nation’s total to 833 cases and seven deaths. By Tuesday, another 60 infections had been recorded, bringing the total to just under 900.South Korea on Monday reported 231 additional cases, bringing the nation’s total to 833 cases and seven deaths. By Tuesday, another 60 infections had been recorded, bringing the total to just under 900.
Dr. Aylward said responding swiftly and aggressively to contain outbreaks and treat those infected was paramount.Dr. Aylward said responding swiftly and aggressively to contain outbreaks and treat those infected was paramount.
“We have all got to look at our systems because none of them work fast enough,” Dr. Aylward said.“We have all got to look at our systems because none of them work fast enough,” Dr. Aylward said.
The virus that has crippled China for more than a month now threatens to become a pandemic that could touch virtually every part of the globe. Stock markets in Asia, Europe and North America plunged on Monday as investors worried that the economic disruption the outbreak has already caused in China is all but certain to have wider impact.The virus that has crippled China for more than a month now threatens to become a pandemic that could touch virtually every part of the globe. Stock markets in Asia, Europe and North America plunged on Monday as investors worried that the economic disruption the outbreak has already caused in China is all but certain to have wider impact.
The S & P 500 dropped nearly 3 percent in early trading on Monday, after European markets recorded their worst day since 2016, and major benchmarks in Asia closed sharply lower. The Dow Jones industrial average fell more than 900 points in the first hours of trading.The S & P 500 dropped nearly 3 percent in early trading on Monday, after European markets recorded their worst day since 2016, and major benchmarks in Asia closed sharply lower. The Dow Jones industrial average fell more than 900 points in the first hours of trading.
China, which was the source of the outbreak, might also offer solutions, according to Chinese officials and the W.H.O.’s assessment, despite the confusion and obfuscation that slowed the government’s initial efforts to respond to what was then a mysterious new illness appearing in hospitals in Wuhan, the epicenter, in December.China, which was the source of the outbreak, might also offer solutions, according to Chinese officials and the W.H.O.’s assessment, despite the confusion and obfuscation that slowed the government’s initial efforts to respond to what was then a mysterious new illness appearing in hospitals in Wuhan, the epicenter, in December.
Since late January, the Chinese government has put at least 760 million people — more than half of its population — under residential lockdowns of varying strictness, from checkpoints at building entrances to hard limits on going outdoors, according to a New York Times analysis of government announcements in provinces and major cities.Since late January, the Chinese government has put at least 760 million people — more than half of its population — under residential lockdowns of varying strictness, from checkpoints at building entrances to hard limits on going outdoors, according to a New York Times analysis of government announcements in provinces and major cities.
While China’s reporting has been at times confused — with changes to its method of counting causing huge swings in daily tolls — the overall trend since the middle of this month has indicated a slowing in the rate of infections.While China’s reporting has been at times confused — with changes to its method of counting causing huge swings in daily tolls — the overall trend since the middle of this month has indicated a slowing in the rate of infections.
On Sunday, 24 Chinese provinces reported no new cases. Six of them lowered their emergency response measures. In Hubei Province there were 398 new cases, the second consecutive day in which the number of new cases declined.On Sunday, 24 Chinese provinces reported no new cases. Six of them lowered their emergency response measures. In Hubei Province there were 398 new cases, the second consecutive day in which the number of new cases declined.
“The decline we are seeing is real,” Dr. Aylward said.“The decline we are seeing is real,” Dr. Aylward said.
Even so, the death toll continues to rise, with 150 deaths reported on Sunday, the highest in nearly three weeks. In total, 2,663 people in China have been killed by the virus, according to official figures released Tuesday morning.Even so, the death toll continues to rise, with 150 deaths reported on Sunday, the highest in nearly three weeks. In total, 2,663 people in China have been killed by the virus, according to official figures released Tuesday morning.
Liang Wannian, a senior official with China’s National Health Commission, said China was not ready to declare victory yet.Liang Wannian, a senior official with China’s National Health Commission, said China was not ready to declare victory yet.
“The situation is still very grim,” he said at a news conference. “We haven’t stopped the epidemic in Wuhan yet.”“The situation is still very grim,” he said at a news conference. “We haven’t stopped the epidemic in Wuhan yet.”
Many health experts agree it is premature to celebrate given the highly contagious nature of the virus and the potential for a new surge in cases when millions of people go back to work in China or when travel restrictions are lifted.Many health experts agree it is premature to celebrate given the highly contagious nature of the virus and the potential for a new surge in cases when millions of people go back to work in China or when travel restrictions are lifted.
But they generally agreed with the W.H.O.’s assessment on China’s measures.But they generally agreed with the W.H.O.’s assessment on China’s measures.
“The containment definitely worked in China,” said Leo Poon, the head of the public health laboratory sciences division at the University of Hong Kong. “The question now is whether similar policies can be applied in other countries.”“The containment definitely worked in China,” said Leo Poon, the head of the public health laboratory sciences division at the University of Hong Kong. “The question now is whether similar policies can be applied in other countries.”
Clarence Tam, an assistant professor of infectious diseases at the School of Public Health at the National University of Singapore, said it was difficult to interpret the case numbers from China, particularly from Hubei. That is because the total number of infections jumped when the authorities expanded the methods used to diagnose them twice in two weeks.Clarence Tam, an assistant professor of infectious diseases at the School of Public Health at the National University of Singapore, said it was difficult to interpret the case numbers from China, particularly from Hubei. That is because the total number of infections jumped when the authorities expanded the methods used to diagnose them twice in two weeks.
“Trying to look at the case numbers is very difficult,” Dr. Tam said. “We don’t really know what is influencing those case numbers.’'“Trying to look at the case numbers is very difficult,” Dr. Tam said. “We don’t really know what is influencing those case numbers.’'
Adding to the confusion, Chinese media outlets reported on Monday that Wuhan would begin easing a sweeping lockdown, by allowing some people to leave. But just hours after news of the change emerged, the authorities backtracked, saying the announcement had been made in error.Adding to the confusion, Chinese media outlets reported on Monday that Wuhan would begin easing a sweeping lockdown, by allowing some people to leave. But just hours after news of the change emerged, the authorities backtracked, saying the announcement had been made in error.
Updated June 16, 2020 Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
What is unclear to many public health experts is whether a shortage of testing kits is causing a large number of cases to remain undetected. Hospitals in China remain overstretched and many patients say they have been turned away. Health care workers are still coming down with the virus despite official pledges to protect them. Mr. Liang, the health official, said more than 3,000 health care workers have been infected.What is unclear to many public health experts is whether a shortage of testing kits is causing a large number of cases to remain undetected. Hospitals in China remain overstretched and many patients say they have been turned away. Health care workers are still coming down with the virus despite official pledges to protect them. Mr. Liang, the health official, said more than 3,000 health care workers have been infected.
Another problem is that China does not disclose how many people are being tested. If the proportion of people being tested is really declining, it would suggest there is a downturn in the rate of transmission. “But we don’t have that yet,” Dr. Tam said.Another problem is that China does not disclose how many people are being tested. If the proportion of people being tested is really declining, it would suggest there is a downturn in the rate of transmission. “But we don’t have that yet,” Dr. Tam said.
“From my perspective, it’s ‘watch and wait and see,’ ” he said. “It looks positive but it’s difficult to interpret what those numbers mean at the moment.”“From my perspective, it’s ‘watch and wait and see,’ ” he said. “It looks positive but it’s difficult to interpret what those numbers mean at the moment.”
In a speech on Sunday, China’s leader, Xi Jinping, called the epidemic the country’s most serious public health crisis and said it was “the most difficult to prevent and control” since the founding of the People’s Republic.In a speech on Sunday, China’s leader, Xi Jinping, called the epidemic the country’s most serious public health crisis and said it was “the most difficult to prevent and control” since the founding of the People’s Republic.
The epidemic has already severely disrupted life and commerce — as well as the Communist Party’s annual legislative conferences that had been scheduled to begin in Beijing in early March. The Standing Committee of the National People’s Congress announced on Monday that it had postponed the conferences indefinitely.The epidemic has already severely disrupted life and commerce — as well as the Communist Party’s annual legislative conferences that had been scheduled to begin in Beijing in early March. The Standing Committee of the National People’s Congress announced on Monday that it had postponed the conferences indefinitely.
Mr. Xi said controlling the outbreak in Wuhan and Hubei as well as preventing the epidemic from spreading to Beijing, the capital, were the country’s top two strategic goals. He pledged more pro-growth policies to help overcome the epidemic.Mr. Xi said controlling the outbreak in Wuhan and Hubei as well as preventing the epidemic from spreading to Beijing, the capital, were the country’s top two strategic goals. He pledged more pro-growth policies to help overcome the epidemic.
David Heymann, an epidemiologist at the London School of Hygiene and Tropical Medicine, said the case numbers from China suggest that there “may be a decrease in transmission.”David Heymann, an epidemiologist at the London School of Hygiene and Tropical Medicine, said the case numbers from China suggest that there “may be a decrease in transmission.”
China was following its playbook from the severe acute respiratory syndrome outbreak of 2002-2003, said Dr. Heymann, a former chief of communicable diseases at the W.H.O., when it was “able to stop outbreaks outside the epicenter in Guangdong Province by meticulous outbreak containment and control.”China was following its playbook from the severe acute respiratory syndrome outbreak of 2002-2003, said Dr. Heymann, a former chief of communicable diseases at the W.H.O., when it was “able to stop outbreaks outside the epicenter in Guangdong Province by meticulous outbreak containment and control.”
The real test could be yet to come. As China moves to restart its economy, the coronavirus could flare up again.The real test could be yet to come. As China moves to restart its economy, the coronavirus could flare up again.
“There is an acute recognition here that just as we — the Chinese — forced the tail of this outbreak down, it could come back up again as people start to move again, the shops start to open, the restaurants open, the schools open,” Dr. Aylward said. “It’s a risk.”“There is an acute recognition here that just as we — the Chinese — forced the tail of this outbreak down, it could come back up again as people start to move again, the shops start to open, the restaurants open, the schools open,” Dr. Aylward said. “It’s a risk.”
Steven Lee Myers reported from Beijing and Sui-Lee Wee from Singapore. Amber Wang and Claire Fu contributed research in Beijing.Steven Lee Myers reported from Beijing and Sui-Lee Wee from Singapore. Amber Wang and Claire Fu contributed research in Beijing.