What Will It Take to Stop Coronavirus?

ARZ · 2020-04-13T01:10:06Z

Summary Save Share Comment Print8.95 Buy Copies RecommendedPerformance Management at Vitality Health Enterprises, Inc.HBS Brief Case 8.95 View Details Focus (HBR Emotional Intelligence Series)Book 19.99 View Details Discovery LimitedCase 8.95 View Details Stringer/Getty Images We’ve made our coronavirus coverage free for all readers. To get all of HBR’s content delivered to your inbox, sign up for the Daily Alert newsletter. A new respiratory coronavirus, 2019-nCoV, is rapidly spreading throughout China, where authorities have imposed an unprecedented travel lockdown in 16 cities with a combined population of over 50 million. Cases have also been reported in several other countries, including Australia, France, Japan, Thailand, and the United States. As of Monday night, there were nearly 4,500 confirmed cases and 107 deaths. Experts believe it likely that there are thousands more infected who have gone undetected and that it’s possible the virus is even being spread by people who do not have any symptoms. The results of a study of 41 patients hospitalized for 2019-CoV infection highlight the need for urgent action: A third required ICU-level care and 15% died.Efforts are underway to find a vaccine, but even the most optimistic timelines suggest several months of scientific development before human clinical trials can begin. With no vaccine or treatment, the most effective way to stop 2019-nCoV’s spread is to limit transmission by identifying infected individuals as quickly as possible and isolating them for treatment before they can infect others. This strategy worked against the SARS (Severe Acute Respiratory Syndrome) epidemic in 2003. Global and national health authorities are implementing the approaches used during the SARS crisis, but, other measures also need to be taken because 2019-nCov is already widespread in China. Similar to 2019-nCoV, SARS was a never-before-seen virus that spread to 30 countries, stirring panic and ultimately causing over 8,000 infections and 900 deaths. Because 2019-nCoV, like SARS, causes common symptoms such as a fever and coughing and can only be distinguished from more routine illnesses with laboratory testing, the same playbook used against SARS could be adapted to counter 2019-nCoV: Contact tracing. 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. 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 require...

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