According to the latest and most optimistic projections, the outbreak in provinces outside Hubei will reach an inflection point around Feb. 20, when the number of confirmed cases and the number of suspected infections will actually decline. In Wuhan and its surrounding areas, the light at the end of the tunnel may not appear for another month, given the large number of infected people who have not been admitted in time. How to make decisions about the next step in the deployment of outbreak prevention and control Commentator/Huang Yanzhong is a Senior Fellow for Global Health at the Council on Foreign Relations, where he moderates the Roundtable on Global Health Governance. He is also a professor and director of the Center for Global Health at the School of Diplomacy and International Relations at Occidental University, where he created the first program in the U.S. to study health issues from a diplomacy and security perspective. With the virus still spreading and the originally expected inflection point yet to come, the fight against the new crown epidemic has reached a critical point. As it stands now, the epidemic has surpassed both the 2003 SARS and the 2009 global H1N1 pandemic in terms of destructive power and responsiveness. From a more macro perspective, the pandemic is also a challenge and a test of the country’s governance system and capacity. According to the latest and most optimistic projections, the outbreak in provinces outside Hubei will reach an inflection point around Feb. 20, when the number of confirmed cases and the number of suspected infections will actually decline. In and around Wuhan, the light at the end of the tunnel may not appear for another month, given the large number of infected people who have not been admitted in time. However, the prediction itself has major limitations, given the current lack of sufficient knowledge about the virus itself. For example, some experts have pointed out that the criteria for diagnosing NCRP early in the epidemic were wrong, resulting in many patients not being diagnosed; the animal source and intermediate host of the virus have not been conclusively identified to date; and, in contrast to the effectiveness of traditional Chinese medicines and the public’s expectation of the efficacy of the new antiviral drug raltegravir that have been portrayed by some organizations, the WHO believes that an effective antiviral has not yet been truly found, and that vaccine Research and development is also a long way off. It is important to note that while improved herd immunity is key to the emergence of an inflection point, it is not yet certain whether full immunity will be achieved after a new coronavirus infection is cured. Of course, saying this does not rule out the possibility that the inflection point is coming early. Nationwide, the number of new suspected cases has declined continuously since Feb. 5, a development that seems to suggest that the interventions of the current all-powerful government are beginning to work. In and around Wuhan, the problem of patient intake is expected to be largely resolved through the deployment of additional medical staff and the construction of square pod hospitals. Nationwide, the potential for second- and third-generation transmission and community-based transmission has also been greatly reduced through the mobilization of all society’s efforts and resources, including the use of high-tech means to tighten security and block all unnecessary movement of people. In the next two weeks, the current policy of containment of the spread of the virus and the measures to avoid crowd contact should continue to be implemented without fail, and early detection, isolation and treatment remain the best policy. However, at the same time, it should also be taken into account that the negative effects of the strict control measures will become increasingly obvious. If the epidemic still continues to spread after late March, it is necessary to consider not only the impact on the economy, but also the public’s ability to withstand the existing preventive and control measures. As a matter of fact, viruses mutate after a period of epidemics with the aim of coexisting with their hosts, perhaps becoming more infectious but less pathogenic. For example, Wuhan has a high case-fatality rate (more than 4%) for patients with first- and second-generation infections, but the case-fatality rate for patients in other provinces is well below 1%. Relevant disciplines should step up their research on the characteristics of the virus, and government decisions should be based on clarifying the mutation of the virus and the characteristics of the susceptible and critically ill populations before deciding on the next step of prevention and control deployment. In the light of the changes in the epidemic, the government should formulate a plan as early as possible, choose an appropriate time and replace the containment strategy with the mitigation strategy. Once the mitigation strategy is chosen, more emphasis will be placed on treating seriously ill patients and high-risk groups, instead of focusing mainly on locating infected persons and their close contacts. At the same time, effective measures should be taken as soon as possible to restore the economy and get social life back on track. This strategy is essential to avoid unnecessary waste of limited resources and to focus the effective use of treatment resources. Of course, this approach should be promoted in a gradual, positive and prudent manner. At the same time, it is important to communicate actively with the public to avoid unnecessary social panic as a result of policy adjustments. Through the experience of fighting the Xinguang epidemic, the whole country should reach a consensus on the national governance system and capacity building, and make up for the shortcomings. Only then, once such a major crisis is encountered again in the future, can timely, transparent, scientific and effective response strategies be adopted to minimize social losses. Source: China Newsweek