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Interview

Dismantling WHO won't solve COVID-19: Agency's pandemic specialist

Nahoko Shindo says it's too soon to relax restrictions based on antibody tests

World Health Organization Senior Adviser Nahoko Shindo speaks to Nikkei in Geneva. (Photo by Rintaro Hosokawa)

GENEVA -- Eighteen years ago, Nahoko Shindo was brought into the World Health Organization to fight pandemics. Since then, her battle experience includes fighting SARS, avian influenza, the Indian Ocean Tsunami, the deadly viral hemorrhagic fever outbreaks in Africa, and more recently, the 2009 influenza pandemic.

She is an infectious disease specialist, who previously was chief researcher at Japan's National Institute of Infectious Diseases, the country's equivalent to the Centers for Disease Control and Prevention (CDC) in the U.S. 

A doctor who counsels faith in science, Shindo decided to pursue a medical career after her brother, who died at age 12 of a brain tumor, asked her to become a doctor to give hope to patients like him. They were his last words.

Armed with full protective gear, Shindo travels to hot spots across the world, often to Africa.

Now Shindo, senior adviser for infectious hazards management at the WHO Health Emergencies Program, has another pandemic to conquer. She sees finger-pointing at the agency as not helping the fight against COVID-19.

Excerpts from the interview follow.

Q: China contained the coronavirus via a lockdown, but similar efforts by Italy and other countries failed. Why do you think that is?

A: After SARS [the severe acute respiratory syndrome outbreak of 2003 and 2004], China took measures such as strengthening its ability to respond to surges in patients and its intensive care unit capacity. Forty thousand medical personnel were rushed out to Wuhan.

Asian countries, including Singapore and South Korea, have a degree of experience with infectious diseases. Europe initially saw the outbreak as being someone else's problem.

Q: Is the pandemic coming under control?

A: Carriers of the novel coronavirus shed the most virus on the day they start to show symptoms. That means, when they have a mild fever, for instance, they are the most infectious. The outbreak spread so rapidly because people moved around without knowing they were infected.

When medical institutions are flooded with patients to the point that they hit the limits of their capacity, they're forced to make tough ethical decisions such as saving those that can be saved first. It's important to have a division of labor between hospitals that handle coronavirus patients and those that handle other conditions, and to build support systems for them.

In Europe, the situation has stabilized thanks to measures such as strict limitations on going out. The WHO has drafted criteria for determining when to return to normal daily life.

The time will come when the outbreak will temporarily subside worldwide. It will be important to figure out how to limit the next wave, and international cooperation will be essential for that. We will face that challenge, and we [at the WHO] will provide explanations with confidence.

Q: Some countries have begun using antibody tests to determine whether people have been infected, as part of plans to reopen their economies. How effective is this?

A: The reliability of antibody tests has yet to be established. There's a lot that's still unknown, including how much of an immune defense antibodies provide on their own and how long the protection lasts. It's too soon to relax restrictions based on the results of antibody tests.

Q: What do you make of U.S. President Donald Trump saying he will halt funding for the WHO?

A: I don't know whether the U.S. is fundamentally questioning the WHO's response or is using it as a scapegoat for the spread of the outbreak. But if you ask me whether dismantling the WHO will solve the problem, I don't think it will.

Q: What is needed to control the coronavirus in Japan?

A: The state of emergency sends a message, but the actual regulations are weak.

The most important thing is to thoroughly trace patients' contact history. Because of Japan's strong culture of shame, many people can't answer contact surveys honestly. It's important for workplaces and schools to accept people without vilifying them.

Since Japanese people are very hygiene-conscious, Japan will surely overcome this as long as individuals act with self-awareness and everyone works together.

Q: What lessons can be learned from the coronavirus?

A: In the 21st century, economic and social activity have evolved from zero dimensions to one to two to three. Everything is so much faster than it used to be, and diseases can spread in the blink of an eye. We have to act with the view that the coronavirus is not an aberration, but the new normal.

Belief in science must form the foundation of these measures. Whether we make science-based preparations will determine whether infections can be controlled.

We need strong leadership from politicians as well. Ultimately, everything depends on the actions of individual people, so communication by governments and businesses with individuals will be key.

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