Why Sars shows China should not lower its coronavirus guard
- Scientists in the southern city of Guangzhou said that during the 2003 outbreak cluster infections reappeared when schools reopened
- Study also suggests that the city was able to bring the Covid-19 outbreak under control much more quickly due to a swift and aggressive response
Experts have warned the Chinese authorities not to let their guard down over Covid-19 because their experience during the severe acute respiratory (Sars) outbreak showed that it could return when schools reopen.
Although the outbreak appears to been brought under control, epidemiologists from the Guangzhou Centres for Disease Control and Prevention (CDC) and two other hospitals said that data collected during the Sars outbreak in 2003 suggested there had been cluster infections in schools after they reopened.
The World Health Organisation on Wednesday declared the coronavirus outbreak a global pandemic and warned that confirmed cases of infection outside China have risen to over 43,000 with more than 100 countries now affected.
Meanwhile, China reported only nine new confirmed cases of infection – excluding imported cases – on Thursday, signalling that the government may soon be prepared to lift its disease control measures and reopen schools and businesses.
But the scientists said the authorities should remain vigilant even if they decide to reopen schools and return to normal business and pointed out that the spring-summer months were also the peak influenza season.
The analysis was published in the Chinese Journal of Epidemiology on Wednesday, with former Guangzhou CDC director Wang Ming as one of its corresponding authors.
Wang played an important role in identifying Sars transmission routes and methods and advised the provincial authorities on disease control strategies.
Comparing 1,072 Sars and 346 Covid-19 cases they studied in Guangzhou, the experts said there had been 129 days between the identification of the first Sars case in the city and the first day with no new cases, but the same process had only taken 35 days for Covid-19.
With a population of 13 million, Guangzhou is China’s southern gateway and its airport is the third busiest airports in China. The city has not reported any new infections since Saturday.
The city has reported a total of 347 cases with only one death, but the official Sars data recorded 1,274 cases and 46 deaths.
The experts said the swift response to Covid-19 was the key weapon in controlling the outbreak.
On January 23, two days after the first case was reported in Guangzhou, the municipal government raised the public health emergency response to the highest level, implementing strict controls on personnel movements and ordering shops and businesses to close down.
They said such restrictive measures worked effectively as the city showed no obvious signs of widespread community infection in the following weeks.
According to their analysis, only 17 per cent of Covid-19 cases in Guangzhou became seriously ill, much lower than the 30 per cent recorded in Sars.
The mortality rate of Covid-19 in Guangzhou stood at just 0.29 per cent, which was also substantially lower than 4.01 per cent for Sars.
Early pathogen identification, better medical treatment and arrangements to centralise treatment were cited as the key factors.
“Before the first Covid-19 case hit Guangzhou, we already knew the pathogen, and that is a key factor in shaping our ways in tackling the disease,” the report said. “It took us 104 days to confirm the Sars coronavirus.”
During the Sars outbreak, patients were treated in different hospitals, but the decision to centralise the treatment of Covid-19 patients was credited with helping to bring the morality rate down.
“The strategy has played an important role in strengthening our case management and mitigating disease severity and lowering the mortality rate,’’ the research paper said.
Coronavirus far more likely than Sars to bond to human cells due to HIV-like mutation, scientists say
The paper also revealed that the disease control authorities were able to tap into data provided by other departments, including the police, to identifythe infection routes.
They said that in the case of one infected medical worker they had been able to rule out the hospital where they worked as the source of the infection by using police data, but did not explain how this had been done.
The Chinese scientists suggested more investment should be put into public health data systems to boost real-time data collection capabilities, early warning intelligence and emergency resource management.
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