14.2  What can we learn from the 2020 nCoV epidemic in China?
The SARS-CoV-2 epidemic of 2020 in China is an international crisis, affecting human lives, the global economy, societal views and lifestyle. During times of crisis, misinformation, blame and conspiracy theories abound. It is probably prudent to not entirely trust the media, whether local, regional or international, as each most likely has their own agenda. On the other hand, it is the responsibility of doctors and scientists to evaluate the events to ascertain whether or not more effective management of the crisis could have been attained. This comes with its own set of challenges, as hindsight is always 20/20.
The quarantining of an entire country has been extreme, astounding and unprecedented. This not only involves quarantining measures within China but also internationally, as countries canceled flights into China, quarantined their own nationals as they returned from China and installed thermal scanners to detect ill people. But the quarantine measures inside China are certainly eye-opening. The entire city of Wuhan was shut off, and this was extended to every other city in China. In effect, the entire country was told to stay home, creating an enormous impact on the economy and on people's daily lives. Roads and stores became deserted (Fig. 10 ). In Ningbo, each household was only permitted to send one person out for groceries every other day. Schools were closed till the end of March. Everyone wears masks. The objective was to starve the virus, to eliminate hosts. Yet even with these measures, new cases continued to appear. The quarantine measures in China have obviously come under a great deal of scrutiny, with so called “experts” weighing in, some saying that it will not work, that isolating a city deprives it of medical resources. Whatever the criticism, it is humbling to think of what may have happened without these draconian measures. It is also difficult to comprehend if such measures could actually take place in other parts of the world, or if the implementation of these changes could have taken place as quickly. For example, hand shaking is not part of Chinese culture, but it is almost automatic in other parts of the world, and it is normally done without even thinking. This is the first thing that would have to stop to help contain the virus.
Fig. 10 Life in China in Beijing and Hubei during quarantine measures. Quarantine measures have led to empty streets and shopping centers.
Then there is the matter of the ophthalmologist and others who voiced concerns in the media about a cluster of cases of a flu-like illness near the end of December. At the present time, it is difficult to say whether or not the response could have been faster than it actually was, as this corresponds to the time when work began on viral sequencing. It is possible that medical teams were already working on the sequence at that time. It is also quite possible that officials did not initially sound the alarm publicly because they did not want to cause a panic. Perhaps this was the wrong decision, but these decisions are difficult in times of crisis and it is of course easy to second guess. It is easy to understand that this can be perceived as withholding information and why the public would be frustrated. The lesson here is that dissemination of accurate and validated information and establishing guidelines to prevent the spread of infections is critical.
There are many “heroes” in these crises, people who have risked their lives and made incredible sacrifices to help society rid itself of this scourge, including those who work on the front lines, epidemiologists, scientists, doctors, first responders, and members of the public. Unfortunately, these events also bring out the worst in people. Numerous accounts of racial discrimination have been perpetrated against Asians across the world, many rising to the level of hate crimes. One must not forget the psychological impact of an infection such as this on people who are not even infected or who will never encounter an infected person.
The emergence of SARS-CoV, MERS-CoV, and now SARS-CoV-2, suggests that coronavirus will pose a lasting threat to human beings. The epidemic will eventually be contained, and people's memory of the coronavirus may gradually blur. But we must not forget the lessons learned from this crisis, and already begin to take measures to prevent the next new outbreak of Coronavirus or some other virus from appearing in the future. If it does appear, how will we respond to it? What if it does not happen in China? Will other countries have the fortitude to implement even more drastic measures and mobilize resources to prevent the spread of the virus and to care for the sick?
We can always improve on the handling of global pandemics or epidemics. From the lessons learned during the SARS and now the SARS-CoV-2 epidemics, we can nearly provide a roadmap for the response to future outbreaks. The development of a vaccine for coronavirus is a critical step in prevention, but it may not be effective for future strains, and we must be ready for the next epidemic.