LONDON -- The infectious disease expert who led the global response to the 2003 SARS outbreak said the end of February will be a key milestone to understand the true scale of the coronavirus outbreak, and called on countries to ensure their preparedness plans are up to date and they have mitigation measures in place.
David Heymann, Chair of the World Health Organization's Scientific and Technical Advisory Group for Infectious Hazards, also said businesses need to watch the situation closely and carry out their own risk assessments based on WHO guidance and their own environment, rules, regulations, and insurance. He is also a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine.
"By the end of February, countries to which the first wave of persons with infection traveled from China will have passed through at least 14 days -- considered the most likely maximum incubation period -- and there will then be a possibility to assess containment activities and obtain descriptive information about the outbreak epidemiology," said Heymann in an interview with the Nikkei Asian Review.
"We'll see whether or not they have been contained or whether there is transmission further than those clusters," he said.
The WHO now has people working alongside in China to go through the mass data to understand the situation on the ground. According to the WHO's daily briefing on Tuesday, China has reported a total of 72,528 COVID-19 cases which include 1,870 deaths, and 25 countries other than China have cases of the virus.
While how the disease is transmitted -- through close social contact to a sneeze or cough, or inadequate prevention measures in households and hospitals -- and how to prevent it is known, there are still unknowns about the virus. The reproductive number, which signifies how easily it transmits between people, is unknown, as is the natural history of infection.
David Heymann, Chair of the WHO Scientific and Technical Advisory Group for Infectious Hazards, speaks to the Nikkei Asian Review in London. (Photo by Rhyannon Bartlet-Imadegawa)
By the end of February, Heymann is hopeful there could be some definitive understanding.
A group of WHO experts is expected to make recommendations based on the new evidence and developments at that point.
He explained that if transmission can be interrupted within China and internationally, the virus could disappear from the human population, as SARS did. If not, it could spread widely.
As the epicenter of the outbreak, China is focusing on containing the curve of infection cases. Affected countries such as Japan and Singapore should prepare for mitigation, according to Heymann.
Strengthening the surveillance of influenza-like illnesses to ensure they can detect possible cases and having testing in place will be important. With the majority of cases in China thought to be in family clusters, according to Heymann, better knowledge in households when a family member is infected would also be needed.
It is within the WHO's power to make recommendations on travel and trade, but Heymann considers it is unclear whether this would be called for in the coronavirus outbreak because the modes of transmission and prevention are understood to not be in the environment.
He points out that travel recommendations were made during the SARS outbreak, but only when there were cases where the infection could not be traced to another case, and it was feared environmental causes such as infected insects or animals were spreading the disease.
Since the WHO has not made recommendations on travel and trade restrictions for this outbreak, companies should make their own risk assessments based on WHO guidance and their own environment, rules, and regulations, said Heymann.
"They need to watch closely as everyone else is for the next couple of weeks and understand the risks, and then continue to do their work based on those risks," he explained.
"What industry needs to do, and companies, is to look through their own risk assessments and understand what they can do within their own frameworks of insurance and workers' protection."
For example, factories could put in place ways to make sure people working there are not infected.
Heymann, who also chaired the Emergency Committee to assess the Zika outbreak in the lead-up to the 2016 Rio Olympic Games, considers it is still too early to make a judgment on whether the Tokyo Olympics this summer should go ahead from a public health perspective.
"I would think that it would be easier to make a recommendation, say at the end of March or April time. But that's only an estimate," he said.
From the experience of SARS, MERS and Ebola, the WHO has strengthened its setup in times of global health emergencies.
The Emergency Committee and the Scientific and Technical Advisory Group for Infectious Hazards are additions based on the responses to previous outbreaks. The Scientific and Technical Advisory Group which meets twice a year face-to-face and regularly via virtual means throughout the year, are now meeting every week virtually to tackle the outbreak.
