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March 4, 2020

In China, coronavirus cases are actually going down. Here's how they did it.

Daily Briefing

    The number of newly reported coronavirus cases in China are declining, and World Health Organization Assistant Director General Bruce Aylward in an interview with Vox's Julia Belluz offers some insight on how China curbed the virus' spread.

    Our analysis: The 'recurring themes' of disease outbreaks

    About the coronavirus epidemic

    Reports of the new coronavirus first surfaced in early December 2019 in Wuhan, China. According to WHO, the main symptoms of the virus are fever and lesions in both lungs. Some patients also have reported difficulty breathing, WHO said.

    As of Wednesday, officials reported more than 94,300 cases of the virus globally, with most of those cases occurring in mainland China, the New York Times reports. Officials said as of Wednesday there had been at least 3,210 deaths linked to the virus, and all but 229 of the deaths occurred in mainland China.

    WHO officials on Tuesday estimated that the global mortality rate for new coronavirus infections, known as COVID-19, is about 3.4%, which is higher than the 2% officials previously had reported. However, a spokesperson noted that the rate is expected to "change over time, and vary from place to place."

    Rate of new coronavirus cases drops in China

    While the global mortality rate is higher than previously expected, the number of newly reported coronavirus cases in Chinas has slowed in recent weeks.

    Chinese officials on Sunday reported 202 newly confirmed coronavirus cases, representing the lowest daily number of newly confirmed cases reported in the country since late January. In Wuhan, officials on Sunday reported 196 new coronavirus infections, which marked the first time the daily number of newly confirmed infections in Wuhan fell below 200.

    Mi Feng, a spokesperson for China's National Health Commission, during a briefing on Monday said, "The rapid rising trend of virus cases in Wuhan has been controlled. Outbreaks in Hubei [province] outside of Wuhan are curbed and provinces outside of Hubei are showing a positive trend."

    In response to the case decline, officials in Wuhan announced that they've closed one of the 16 makeshift hospitals that were built to treat coronavirus patients, according to China's state media.

    What other countries can learn from China's response

    Meanwhile, the number of newly reported cases of the coronavirus outside of China has surged over the past few weeks. According to WHO, 61 countries have reported more than 8,739 new coronavirus cases and 127 deaths.

    In an interview with Belluz, Aylward said there are key lessons other countries can learn from how China responded to and contained the new coronavirus' spread as their caseloads rise.

    According to Aylward, the majority of China's response focused on identifying coronavirus cases, tracing people who came into contact with others who had been infected, and suspending public gatherings, which are "all common measures used anywhere in the world to manage [the spread of] diseases." Aylward also noted that Chinese officials decided to institute lockdowns in Wuhan and at least three other provinces where cases had quickly surged.

    Collectively, these decisions helped prime China to rapidly detect and respond to new coronavirus cases, Aylward said. The measures also helped to prevent other provinces from experiencing an influx of cases, he explained.

    But the key takeaway from China's response is "speed," Aylward told Belluz.

    Aylward said that one of the first steps officials should take to help speed up their own countries' responses is to inform people about the symptoms of infection. Aylward said a country's general population serves as its primary surveillance system, but if people don't know that fever and a dry cough are the two most common symptoms of the virus, they can't help report suspected cases.

    Aylward said countries also should set up an emergency response system. Once suspected cases begin to trickle in, officials need to be prepared to test people for the virus. For instance, in China, officials set up makeshift hospitals and launched teams to rapidly diagnose patients with the virus.

    Aylward said although providers in other countries might not need to take those exact steps, they can open emergency lines to better triage patients with suspected cases of the virus to help reduce barriers to care. Officials also could ensure that patients won't face costs for getting tested for the virus, he said.

    Once a case is confirmed, providers need to quickly isolate and treat patients, Aylward said. Rapid treatment has helped to keep the coronavirus death rate relatively low, according to Aylward.

    In China, hospitals purchased ventilators, maintained high-flow oxygen, kept hospital beds open, isolated patients, and increased their CT-scanning and lab capacity, and all of those measures helped with the country's response, Aylward said.

    China's actions demonstrate how countries "can change the shape of [an] outbreak," avoid new infections, and prevent the most vulnerable patients from dying by simply beginning to systematically identify cases and contacts, Aylward said. He told Belluz, "China's bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic" (Belluz, Vox, 3/2; Weixel, The Hill, 3/2; Woo et al., Reuters, 3/1; Budryk, The Hill, 3/2; Weixel, The Hill, 3/3; New York Times, 3/4).

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