March 7, 2020

expert reaction to steady decline in COVID-19 cases in Hubei province

The number of new cases reported in Hubei province, the origin of the COVID-19 outbreak, has been declining steadily for the past few days.

Martin Hibberd, Professor of Emerging Infectious Disease, London School of Hygiene and Tropical Medicine (LSHTM) said:

“China is currently the only place where we can see a large reduction in cases and also where the most active control programs have been put in place. This gives us hope that we understand enough about how SARS-CoV-2 is spreading to prevent its transmission. However there are still unanswered questions, for example about the total number of infections and even how protected previously recovered people are from new infections, before we can give confident descriptions on how to contain the disease.  I would like to see detailed, population based (as opposed to clinic based) serological investigations to be conducted. This would allow an individual’s history of the disease, including inapparent (or asymptomatic) cases, to be evaluated. And this needs to be done in large areas where cases have been reported, in order to find out how many cases were missed by the surveillance programs. These numbers will also help us to calculate the disease severity following infection more accurately, in a similar way to how we are able to calculate this for Influenza. This will also allow us to put this new disease into a better perspective with existing diseases, such as Influenza (does it spread faster or slower? Is the severity similar or worse?).

“Meanwhile, outside of china, countries are working on their own program strategies to contain, not only their outbreak but also to play their part in a world response. In doing this, they are balancing the need to help the world delay the spread of SARS-CoV-2, with keeping their economies running as well as possible. Putting too much of their health care resources into COVID-19 may prevent allocating into other areas which may turn out to be equally important. Getting this balance correct is difficult and should be guided by the science, which means potentially altering their strategies as new information comes to light (such as an accurate comparison with Influenza – although of course we already have therapies and vaccines for Influenza).

“The world community has done an amazing job of detecting COVID-19, discovering its cause (SARS-CoV-2), enabling diagnostics and understanding its spread in such a short space of time (even compared to SARS, which itself was much faster than AIDS). This knowledge and action (especially in China) has allowed us to delay the spread of disease, giving the world time to prepare these containment and delay strategies and hopefully also to develop therapies and vaccines.”

Paul Hunter, Professor in Medicine, The Norwich School of Medicine, University of East Anglia, said:

 “The continuing drop in cases reported each day from Hubei province and its capital Wuhan is one of the few good news stories from the past week. Excluding the days when clinical diagnosed cases and not only laboratory diagnosed cases were given as the daily totals, the epidemic in Hubei peaked on the 5^th February with 3,156 new cases (WHO Situation report 16). Since then there has been an almost steady decline in cases reported each day. Today’s (Saturday) provisional figures show only 74 new cases from Hubei. Case numbers elsewhere in China have also fallen dramatically over the same period, though the last few days may have seen a small reversal in the decline.

“The experience from China is that the rigorous control measures put in place have been effective in delaying the spread of the infection globally. Ultimately, however, the infection did spread from China and is now spreading globally with several countries experiencing rapid increases in numbers. It looks like the UK is also at the start of a rapid growth in locally acquired infections.  However, the extra weeks that we have had to prepare, thanks to the control measures in Wuhan and Hubei generally, will make quite a difference to our ability to mitigate some of the more harmful effects of the epidemic.”

All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19

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