Coronavirus stress tests world’s health systems
Some lessons have been learned from previous epidemics, but the weakness of many countries’ health systems leaves everyone vulnerable.
China has taken a lot of flak in the media for its handling of the coronavirus (COVID-19) but the World Health Organization (WHO) and health scientists applauded its strategy for containing the virus.
WHO Assistant director-General, Bruce Aylward, said the world could learn from China’s rapid response and “extraordinary mobilisation”.
“China knows how to keep people alive,” Aylward said.
“It is staggering. Every person you talk to there has a sense of responsibility. They are mobilised like in a war against this virus.”
WHO Director-General, Tedros Adhanom Ghebreyesus, says the drastic measures to shut down Chinese cities, particularly Wuhan, to contain COVID-19 gave other countries a window of opportunity to prepare for the virus.
He said Chinese health authorities had been “working tirelessly” to respond to and control the COVID-19 outbreak.
This had given “countries around the world precious time needed to prepare for the possible arrival of the virus inside their borders”.
“Importantly, health authorities in China have paved the way for the international scientific community to join the fight,” he said.
Ghebreyesus said that although COVID-19 was completely unknown a few months ago, “scientists are sprinting to outpace the novel coronavirus”.
“China’s doctors laid the foundation for this mobilisation of scientific and research muscle by rapidly identifying the new coronavirus in the middle of the influenza season. Chinese scientists lifted obstacles to researching the virus by sharing its genome sequencing publicly,” he said.
“The fact that this information was shared with networks world-wide is accelerating the design of vaccines and drugs targeted at the new coronavirus.”
The global collaboration by scientists quickly revealed important characteristics about the hitherto unknown virus, he said.
“We have found that the proportion of severe cases increases with age. We know that SARS-CoV-2 (aka COVID-19) came from an animal.
“Researchers have also found that approximately 81 per cent of known infections can be classified as mild and that 2.3 per cent result in death.”
Africa is particularly vulnerable
The respected medical journal The Lancet agreed that China had learned from its previous experiences during the SARS epidemic and that the country’s strong public health system was a bulwark in the fight to contain the virus.
“It’s clear the large number of cases of COVID-19 is testing the health system in China. Yet, China was able to build a hospital for affected patients in a matter of days.
“No other country could mobilise resources and manpower at such speed. While health systems in high-income countries would be stretched by the outbreak, the most devastating effects would be in countries with weak health systems, ongoing conflicts, or existing infectious disease epidemics,” it said in an editorial.
WHO, using the narrow window of opportunity provided by the initial containment of the virus in China, moved quickly to bolster the capacity of these weaker health systems, particularly in Africa and Latin America, to meet the challenge of the spread of the virus.
On 3 February 2020, Senegal and South Africa were the only African countries with laboratories that could test for severe acute respiratory syndrome coronavirus. A fortnight later, WHO had sent testing kits to 27 countries on the continent.
By the end of February, the number of African countries able to detect COVID-19 was up to 40 with a further 27 in the Americas.
“The importance of the ability to test for SARS-CoV-2 in poorer countries cannot be overstated. It gives them the best chance of containment before the virus can spread and devastate weak health systems. Reliable diagnostics are crucial in the response to the outbreak,” Ghebreyesus said.
Pandemics are dangerous in a globalised world
While lessons have been learned from previous epidemics such as SARS, Ebola and H1N1, the magnitude of the COVID-19 outbreak and its spread highlights the dangers of pandemics in a globalised world.
WHO and the scientific community agree that pandemic preparedness has become a priority for the global health agenda.
Scientific and technological advances already provide the tools to prevent, manage, and contain global pandemics but the allocation of sufficient resources has been woeful, they say.
“Rather than thrashing around every time a new pathogen surprises us, we should simply deploy the same resources, organisation, and ingenuity that we apply to building and managing our military assets,” wrote Julie Sunderland, a former director of the Gates Foundation Fund in Project Syndicate.
“Here, the first step is for governments to increase funding for Coalition for Epidemic Preparedness Innovations (CEPI), which was created after the 2014 Ebola epidemic to develop and deploy vaccines.
“The agency’s initial funding, provided by a coalition of governments and foundations, totalled only $500 million, or about half the cost of a single stealth bomber. Its budget should be far, far larger.”