Photo: Courtesy of Tarik Jašarevic

Editor's Note:

The global outbreak of COVID-19 has become a black swan event for the world in 2020. In addition to China, many other countries and regions including Italy, South Korea, Iran and France have also been seriously affected by the epidemic. To find out why the COVID-19 is still spreading in other countries and regions, despite China's strict control measures and repeated warnings from the World Health Organization (WHO), and how we should balance epidemic prevention and economic activities, Global Times (GT) reporter Li Qingqing sent these questions by email to WHO's spokesperson Tarik Jašarević. Here are his replies. 

GT: China has been taking strict measures to control the epidemic for over a month, and the WHO has made COVID-19 warnings many times. But why is the epidemic still spreading in many other countries, including Western countries that have good healthcare systems?

Jašarević: We are deeply concerned about the increasing number of countries reporting cases, especially those with weaker health systems. However, this epidemic is a threat for every country, rich and poor. As we have said before, even high-income countries should expect surprises. The solution is aggressive preparedness.

As per WHO Director-General (DG) Tedros Adhanom Ghebreyesus' speech, "China and other countries are demonstrating that the spread of the virus can be slowed and impact reduced through the use of universally applicable actions, such as working across society to identify people who are sick, bringing them to care, following up on contacts, preparing hospitals and clinics to manage a surge in patients, and training health workers. WHO calls on all countries to continue efforts that have been effective in limiting the number of cases and slowing the spread of the virus. Every effort to contain the virus and slow the spread saves lives. These efforts give health systems and all of society much needed time to prepare, and researchers more time to identify effective treatments and develop vaccines. Allowing uncontrolled spread should not be a choice of any government, as it will harm not only the citizens of that country but affect other countries as well."

GT: Dr Tedros said on Monday that "the threat of a pandemic has become very real" and that "it would be the first pandemic in history that could be controlled." Could you assess the possibility of the COVID-19 turning into a pandemic?

Jašarević: There is no possibility to predict the spread of the virus linked to COVID-19 [as it ] is a new virus with many unknowns, including on severity and transmission, and represents an evolving public health emergency and we expect more cases to be reported in other countries.

As WHO DG said, "This epidemic can be pushed back, but only with a collective, coordinated and comprehensive approach that engages the entire machinery of government. We are calling on every country to act with speed, scale and clear-minded determination." 

GT: The WHO has praised China's efforts to combat the epidemic, but some people in the West said that the WHO bowed to China's pressure. What is your opinion?

Jašarević: Our communication on China's response is based on evidenced, science-based facts:

First of all, strong public health capacity: China's capacity to diagnose, treat and manage communicable diseases and health emergencies has advanced considerably over the past 20 years. The level of response of China has clearly evolved since the SARS outbreak in 2002 and 2003;

Second, reinforced surveillance capacity: China has built a strong surveillance system including disease detection and reporting for monitoring flu, pneumonia and other illnesses, and detecting unusual patterns amongst patients. This is a system WHO and other partners have worked alongside China to put in place and this is thanks to this system that COVID-19 outbreak was initially detected in Wuhan;

Third, sharing sequencing quickly: They shared the genome sequencing of the virus with WHO and the world in record time, thus preventing the virus from spreading to other countries;

Fourth, unprecedented response: The relatively low number of cases of the virus outside of China is as a result of the intensive efforts the Chinese government is taking to contain the emergency and protect other countries;

Fifth, scientific collaboration: They willingly joined all WHO experts' networks (expanded programme on immunization (EPI) and health operations, clinical management, lab network, R&D on treatments and vaccines)and are sharing their experience and knowledge daily through these platforms; they welcomed a WHO-led team of international experts to come to China and support local counterparts.

GT: On February 29, WHO said it continues to advise against travel or trade restrictions to countries experiencing COVID-19 outbreaks. But there have been many imported cases in China. How should we balance epidemic prevention and economic activities?

Jašarević: WHO's mandate is to provide rational and science-based public health guidance and recommendations so that countries can be better prepared to respond to the outbreak. National authorities should implement the necessary public health measures to contain the virus. We are with the World Bank and the International Monetary Fund to estimate the economic impact of the epidemic.

Based on the Emergency Committee's recommendations, WHO does not recommend restrictions on travel and trade. WHO's mandate is to provide evidence-based scientific advice to countries, and does not have a mandate to challenge measures implemented by countries.

Evidence on travel measures that significantly interfere with international traffic for more than 24 hours shows that such measures may have a public health rationale at the beginning of the containment phase of an outbreak, as they may allow affected countries to implement sustained response measures, and non-affected countries to gain time to initiate and implement effective preparedness measures. Such restrictions, however, need to be short in duration, proportionate to the public health risks, and be reconsidered regularly as the situation evolves.