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probability
14,496 posts
Posted by probability > 2020-01-31 18:51 | Report Abuse
What Will It Take to Stop Coronavirus?
https://hbr.org/2020/01/what-will-it-take-to-stop-coronavirus
Contact tracing
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People who have been around someone with a confirmed infection should be identified and monitored. If they develop any symptoms, they should be isolated and treated until laboratory testing can be done to determine if they have 2019-nCoV.
Screening with clinical case definition.
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Because there are likely many unreported cases, we need to use a clinical case definition, a checklist of symptoms and risk factors suggestive of infection, to screen people not known to be contacts of infected people but who have concerning symptoms. Because 2019-nCoV, like SARS, causes such ubiquitous symptoms, a case definition includes whether patients with these symptoms have been in an area with known transmission or around people who have. Those who screen positive should be isolated and treated until tested and, if positive, quarantined until they are no longer capable of transmitting infection.
These strategies are already being implemented. However, if it turns out that asymptomatic transmission — transmitting the disease by someone who displays no symptoms — is possible, all contacts and people who have been exposed to areas with known transmission would also need to be tested, regardless of whether they show any signs of illness. This is not currently being done.
These approaches may suffice to contain the spread of 2019-nCoV in countries, such as the United States, where there have been only a few cases (all with links to recent travel to affected parts of China) and in places yet to be affected. However, in affected parts of China where transmission is already widespread, these strategies will face major challenges in containing the spread of the virus.
Since virtually anyone living in an area of transmission could have been exposed, any of the thousands who develop a fever or a cough each day need to be isolated and treated while awaiting laboratory testing. This does not appear to be happening in the Chinese lockdown zones where hospitals, some of which cannot even test for 2019-nCoV, are overrun and patients are being turned away without being tested.
Chinese authorities are setting up screening checkpoints throughout the country. In the city of Wuhan, the epidemic’s epicenter, they are rapidly building two large hospitals with a combined total of 2,300 beds for isolating, testing, and treating 2019-nCoV; they hope to have the hospitals operational within two weeks. But 2019-nCoV may have already spread so extensively that even 2,300 beds might not be enough in a city of 11 million.
What is more, it may not be possible to establish such hospitals in every affected city or transport patients from far-flung areas to these centralized facilities. In addition, diagnosing 2019-nCoV requires specialized equipment and personnel that may be difficult to scale to test the thousands of people who need it.
If people without symptoms are capable of transmitting the virus, it would be impossible to test entire city populations.