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  • China is stepping up efforts to contain a new Corona virus outbreak, but people abroad have already been affected.

  • So are these efforts enough, or is the world witnessing the start of a global epidemic?

  • This is inside story.

  • Hello and welcome to the program.

  • I'm Mohammed Jamjoom.

  • China's reporting People with Corona virus outside the epicenter of the outbreak have now died.

  • This as health authorities fear around the world, the infection rate could increase during what's usually China's busiest travel period of the year.

  • Hundreds of millions of Chinese air preparing to celebrate the Lunar New Year.

  • Although Beijing has canceled all public celebrations and as the death toll rises, more countries are taking their own precautions.

  • Scott Heidler has more from Beijing Rushing to catch the last trains before the Lunar New Year, many of these passengers of the Beijing West Railway Station are thinking of the Corona virus.

  • I don't think this virus has been properly controlled.

  • I just came back to China.

  • I read a lot of news.

  • I Internet.

  • I'm not very satisfied with how the government prevented and controlled the disease.

  • I'm very afraid of getting infected.

  • I am really afraid off those people relieved and left hand.

  • But I do hope the situation in Wuhan can be improved, and those inside the city of Wuhan are becoming more frustrated because medical supplies are running short and hospitals are short staffed.

  • Many festivals for the Lunar New Year holiday have been cancelled across China and not just in the central hub, a province the epicenter of the virus.

  • In a rare move, the government has closed the Forbidden City here in Beijing over health concerns related to the Corona virus, something they didn't do some 17 years ago.

  • During the SARS crisis, the Chinese government was criticized for the way it handled the SARS virus back in 2003 mainly for its lack of transparency.

  • The World Health Organization has decided not to declare the current outbreak a global health emergency.

  • But there's growing concern over the coming week when the millions of people have travelled to the holiday return again, raising the risk.

  • The virus may be spread further by people who are contaminated but have yet to show symptoms.

  • Scott Heidler, AL Jazeera Beijing In a moment we'll bring in our panel, but first let's speak to Tarek Yashar, a bitch from the World Health Organization in Geneva.

  • Tareq, the W H.

  • O, said it was too early to consider this outbreak of public health emergency of international concern.

  • Why?

  • Well, what are the reasons for that decision and what would have to happen for it to become a global health emergency?

  • Well, as we have said yesterday in a press conference following the meeting, there were different opinions that have been expressed at the meeting of the emergency Committee and Director General of the W.

  • Chou was very clear when he said that this is clearly an emergency in China on there is a high risk off further spread.

  • Ah, he may reconvene a the meeting of emergency committee at that very short notice as the as the situation develops further, China has locked down numerous cities in their response so far to this outbreak.

  • What is the W H.

  • O stance on that?

  • And does the W.

  • H.

  • O believe that that is an appropriate or effective containment measures?

  • Well, the role of W chore is to provide a science based recommendations and opinion to our country's.

  • Every country obviously has the right to introduce measures that dating are necessary on their territory.

  • We hope that these measures will be will be effective and that they will not last very long.

  • It is really important to say that that, uh, what is important when you have an outbreak of a new virus, you have to have containment measures and mitigation measures, meaning providing help, who those who fall sick and containment basically trying to reduce the risk off a spread so different measures can be introduced to do that, to try to at least slow down the disease.

  • What is really important is that health systems are on alert around the world as China has already put in place monitoring for sick people, being able to test them and diagnose them and being able to treat them.

  • It is also important to provide a writer information to the population.

  • So when it comes to the measure measures, it's it's really difficult sometimes to strike the balance between the benefit for the population off some containment measures on some social disruption.

  • So I think each country, based on their context, we'll decide what measures are needed.

  • Since you're speaking about measures, the W.

  • H O warned the public not to underestimate the severity of this epidemic.

  • Could you speak to specific measures that people can take to try to protect themselves going forward?

  • Exactly.

  • So I mentioned what health systems should do, what health officials should do.

  • They should be on alert.

  • They should raise a preparedness levels in the health facilities being equipped on and be able to provide assistance to those who are sick now for the general public for the time being.

  • There still much off unknown about the virus itself, but we know it is a Corona virus, so it is co causing respiratory illness.

  • So we recommend the measures that are always recommended for respiratory illnesses.

  • That is, hand hygiene.

  • That is basically a covering mouth when, when sneezing and coughing, avoiding contact with the person who is sick with the flu like symptoms, avoiding contact with the live animals in the market, and really for people before they travel.

  • If they are sick, if they should really first go and see they're doctors so they can be diagnosed.

  • So really everyone should try really to help the health system, because what may happen as well that lot off people because of this outbreak will rush to the hospitals even though they may not have symptoms that are that are consistent with a respiratory only symptoms.

  • The target.

  • Do we know yet the actual extent of human to human transmission rate?

  • Well, we know that there is a human to human transmission on this is consistent with the Corona viruses in general, as we have seen with sauce with Merce on me that a current of our says this means that there is a human to human transmission among close contacts.

  • Eso we have no really clear this off sustained human to human transmission Although there are some indications that that virus the virus has infected from the infected person to another one.

  • So second generation, but again, so far we see clusters.

  • But we really have to look at it.

  • We have to look at the data.

  • We are still at the early stage.

  • So we know about Corona viruses in general.

  • But we have to get into the data and try really to understand, understand better and and same goes really for the severity of the virus.

  • Some people have mild symptoms.

  • Some people have severe symptoms.

  • We still don't know if there are are symptomatic cases.

  • We have noticed that the majority of people who get sick are older people and those who eventually died.

  • Most of them had underlying health conditions.

  • But again, it's really too early to draw conclusions because we need really to to look, to look more.

  • We need to do more testing and more studies to be able to understand.

  • But as we do these studies to understand the virus, we need to be ready to help those who will fall sick and make sure that all measures are being put in place to reduce the risk.

  • All right, thank you so much for your time talk.

  • We can now speak to our other guests.

  • In Hong Kong, we have Nicholas Thomas.

  • He's an associate professor at City University of Hong Kong and specializes in Asian health, security.

  • And in London we have Natalie McDermott.

  • She is a clinical lecturer at King's College London, who researches disease outbreak control.

  • Nicholas, let me start with you.

  • The Chinese government was criticized for how it handled its reaction to the SARS virus in 2003 especially for its lack of transparency.

  • How is China dealing with this outbreak.

  • And do you believe that they have learned the lessons from the SARS outbreak?

  • I think thank you.

  • I think that we need to sort of break this down a little bit.

  • I think on the technical side with the medical people, this was a very fast response.

  • We found out about the market on the 31st of December in line with the W H O.

  • Chinese authorities shut down the market on the first.

  • On the seventh, the genome was sequenced on the eighth, it was confirmed as a Corona virus.

  • That's fairly quickly.

  • However, I think that when we look at maybe at the local level, measures could have been implemented a lot faster.

  • It's but the central level at least has beens significant concern and pressure from the Chinese leadership that the policies to address these issues, lessons that China has learned sent size be taken forward.

  • Natalie Right now, in China, there is an unprecedented lock down of cities going on.

  • Do you believe that this will actually minimize the risk of the virus spreading S.

  • So I think that's a difficult question because essentially, we've never locked down an entire city before to see how well we can contain an outbreak.

  • It depends on the population that you're dealing with often because the primary understanding is that if you look down a city, you prevent people migration.

  • And so you prevent the disease spreading further afield.

  • Now we already know that with this Corona virus outbreak, we have cases in what is 29 different provinces in China.

  • Already on, we've had cases go overseas, So whether quarantine in the entire city or several cities is going to achieve much now, I'm not sure it also depends on how compliant the population are willing to be.

  • With that, in this context, we do seem to have a population who are being very compliant with what they've been asked to do.

  • But in some circumstances, if you quarantine an entire city, you introduce fear and panic.

  • And sometimes you have people who take things into their own hands, and you might end up creating a situation where you have defiance and rioting on people trying to escape the city on that ultimately makes the situation worse.

  • So it really depends on the population you're you're addressing.

  • In that context, Nicholas, is the region capable of handling this effectively.

  • Well, I think I'd agree with Natalie.

  • I think China is trying to deal with this as best it can.

  • But to a certain extent, it's winter.

  • In China, there are already different viruses.

  • Different fluids in circulation on DSO people's immune systems are already going to be challenged.

  • Now, as we've seen, we are getting second and there are reports from the W H O off third generation transmission, which means we no longer thinking just about the people who are initially exposed to the infected wildlife.

  • We're thinking about the people that they have infected, and then the people, the next tier, the people that they have infected as well.

  • This is going to make the job of the authorities to actually bring this to Ah Holt that much more difficult, especially because it is coming up to Chinese.

  • New Year is well on.

  • We are looking at hundreds of millions of people about to be going on the move eso beyond Wuhan beyond the 10 shut down cities, we are gonna have a lot of people who do carry the virus who are moving to other parts of China and also beyond China as well.

  • At the moment, we're talking about quarantines on flights out of Wuhan in particular.

  • But we're already finding cases in Shanghai, for example, or in Guangdong, where there are major international transit hubs on.

  • That's going to further challenge not just the Chinese authorities to contain it, but also the regional and international ports as well.

  • To deal with this, Natalie, how much does the concern grow if the virus spreads to a poorer country?

  • Let's take me and Maura's an example.

  • A country whose health sector is not as developed may not be able to respond as quickly.

  • Yes, so I think that that's probably where the major concerns are because we're aware that countries that have a very developed and robust health infrastructure are probably able to contain any cases that arrive in their country and identify them very quickly and trace any contacts.

  • And so the likelihood of of a disease spreading in a country like that is much more limited.

  • But if you take a country that perhaps doesn't have ready access to testing facilities, that perhaps doesn't have the personnel or the infrastructure to implement any kind of screening or monitoring of people who have arrived in the country on also that may have a health infrastructure that's quite limited.

  • With a limited number of health professionals, perhaps not even appropriate isolation facilities or equipment, things start to become much more complicated.

  • Andi.

  • It's likely that in that situation, while this virus may cause disease and may cause problems and spread in a country like that, it's likely actually that it's the overwhelming of the health infrastructure in that country.

  • That's gonna cause secondary effects, such as people who have other diseases or other illnesses not being able to access treatment.

  • Because the facilities are overwhelmed by trying to deal with a viral disease outbreak, Nicholas hospitals and medical workers in Wuhan are making urgent appeals for supplies.

  • The central government has acknowledged the severe strain on resource is, but just how bad is the situation?

  • Right now we're seeing video is being uploaded through various Chinese social media sites, showing very crowded hospitals where people are going along to them still wearing face masks, of course, but going along complaining of high fevers and other flu like symptoms.

  • Now, in some cases on the social media sites these have been cardinals have been jam packed with people and simply not enough healthcare.

  • Frontline health care, pret helpers around doctors and nurses.

  • Now the danger with this, of course, is that most those people will not actually have the Corona virus.

  • They may have the flu, which makes them more susceptible.

  • But then, in being in tight, confined spaces with someone who would have the Corona virus, there's a much greater risk of it spreading into the general population.

  • And as you said at the same time, the hospitals in Wuhan in the quarantined cities simply don't have the resource is to deal with this massive influx.

  • And so here's another question for China.

  • How do they get this?

  • All the equipment they need from the rest of the country and indeed from overseas into these affected cities.

  • This is very much a supply and logistics question, which I think the learning curve on this is very steep, and I think what we're seeing here is China really trying to sort of play catch up to all the technical infrastructure type issues such as gowns, masks and so on that the people coming into the hospitals need Natalie.

  • I just want to take a step back for a moment for our viewers so we can help them better understand this topic.

  • Could you tell us more about Corona viruses?

  • How rare is it that they transmit from animals to humans?

  • How rare is it they transmit from human to human?

  • So we know now that there's about seven Corona viruses that cause disease in humans.

  • This most recent one from Wuhan is the seventh eso.

  • We've known that there are Corona viruses for quite a long time that can infect humans on the vast majority of them cause some form of respiratory illness.

  • So we've known also that they can usually spread from human to human by it droplet infection.

  • So when people sneeze and cough, if they're infected and somebody is nearby, they might become infected.

  • Now that really varies, though depending on the virus you're talking about.

  • So we know that sauce, which which was also a Corona virus, was quite infectious.

  • So if people sneezed and coughed, other people became infected as well.

  • Whereas we don't see that as much with the MERS virus, which is a corona virus that we see circulating in the Middle East for the most part on.

  • While that sometimes can spread to humans, particularly in hospital settings, we don't see it so much in immediate family members.

  • Although it has been reported that that can occur so they these Corona viruses can vary and how infectious they are on, they can vary a little bit in the type of disease that they cause as well.

  • How often a virus essentially does a species hop, so from a an animal host into a human is a good question.

  • We know that there's a number of Corona viruses as well that infect animals that don't at the moment infect humans.

  • Over the last couple of decades, we've seen three Corona virus is essentially do a species hop, So saws in 2000 to 2003 that was found in bats but originally did the species hot from a civet animal into humans on then with murders that was around 2012 so that again was found in bats.

  • But it infected camels and then did the species hot from camels into humans.

  • Andi, obviously, in this current outbreak, we're still waiting to identify what the animal reservoir is.

  • In the past two decades, several fast spreading diseases have caused global alarm.

  • Between 2002 and 2003 the highly contagious Severe acute respiratory syndrome, or SARS, outbreak in China led to nearly 800 deaths in 17 countries, according to the W H O.

  • That's almost 10% of those who became infected.

  • It's thought to have spread from the civic Capt.

  • Humans.

  • Swine flu, also known as H one N one, quickly spread around the world in 2009.

  • Categorized as a pandemic, it's estimated to have killed between 100,000 and half a 1,000,000 people.

  • The Middle East Respiratory syndrome.

  • Merce was identified in Saudi Arabia in 2012 it killed more than 850 people and it's thought to have come from a camel.

  • Nicholas, let me ask you are the Chinese authorities do Ah providing enough information about how this disease is spreading?

  • I think what we've seen in the past two weeks, in particular, the Chinese CDC has been very proactive in releasing patient A data a CE fast as they can on a daily basis.

  • The question, though, is to what extent the frontline doctors actually have the diagnostic testing facilities to correctly identify people who are suffering from the new novel Corona virus.

  • This is a new issue that goes along with needing more masks and more gowns needing Maur diagnostic facilities and also more technicians who can run the tests.

  • We're seeing very quickly the local infrastructure in Wuhan, although it has some very good hospitals being overwhelmed with the demand being placed on them on the amount of tests that they're actually there, then subsequently having to do so.

  • I think on the one hand there is a clear line of reporting coming out the Chinese CDC.

  • But the information coming into that at the grassroots level is very much still being.

  • It is being overwhelmed on.

  • They need to be more streamlining of the procedures.

  • But then this.

  • We're dealing with populations we've never dealt with before in the quarantine situations on DSO.

  • I think this is very much a case of learning as best as you can as you go.

  • Natalie China's government cabinet has now been appointed control over this crisis.

  • How significant is that?

  • What message does that send to the international community as faras, how China is dealing with this versus how they dealt with other outbreaks in the past.

  • Yes, so I think it sends the message that they're taking it very seriously.

  • I think all of their actions so far have demonstrated how seriously they're taking this on.

  • As Nicholas said, we have seen them act far more promptly this time than with the SARS outbreak in 2002 and 2003.

  • Such that we actually have the sequence of this virus very promptly on that sequence was released to health care professionals and researchers around the world very promptly so that they could start developing diagnostic tests in their own countries.

  • And they could start looking at the nature of the virus and how it might behave.

  • So this has been very prompt.

  • I think that there nature of quarantining communities and cities, well, that's that's something that hasn't really been done before.

  • Andi, I think, as Nicholas said, Time will tell us to how effective that is in this context.

  • But I don't think that even if it is effective in this context, I don't think we can necessarily extrapolate that to other cultures and other countries, necessarily.

  • I think each country needs to make their own decisions about how best to address that, understanding their population and ensuring that they have circulated appropriate disease messaging as well.

  • Nicholas, I saw you nodding along toward Natalie was saying, Did you want to jump in?

  • No, I just think that we are very much in a new situation.

  • I think I have one looks at stars as the Touchstone.

  • It's a Corona virus.

  • It emerged from China.

  • But I think when you look at, for example, the Hate seven and nine outbreak, which took place roughly eight years ago, seven years ago in China, there you have an example of when the Chinese authorities were very proactive and engaging in engaging the international community.

  • I think that lesson is perhaps more relevant to what we're seeing today.

  • We've had external experts come in the central level.

  • Government and the CDC have been quite proactive in sharing the scientific information.

  • I think the question is very much now, getting local authorities a TTE the municipal at the provincial level and perhaps even lower down at county levels within China to be more responsive to whenever a novel threat is identified to immediately putting in place measures to contain it as well as get information out to the local population.

  • But the same time I think that also implies that local populations themselves are in a bit of a learning curve as to how to deal with these issues, because undoubtedly they're going to re arise.

  • Given what we've seen in China for the last two decades, certainly here in Hong Kong I was here in 2003.

  • When size broke out, there was considerable fear.

  • We had streets being very empty.

  • Now, today, what was seeing people taking those lessons forward and saying right, there's an outbreak.

  • We need to wear masks.

  • We need to observe better personal hygiene and even if they're not sick themselves, they're already wearing masks as a preventative measure.

  • And so I think it a social level.

  • You can see how here in Hong Kong, people have actually taken those lessons on board on our applying them in a way which helps to limit the possible transmission of the disease.

  • All right, we've run out of time, so we're going to have to leave it there.

  • Thanks so much to our guests, Nicholas Thomas and Natalie McDermott.

  • And thank you too.

  • For watching you could see the program again any time by visiting our website aljazeera dot com.

  • And for further discussion, go to our Facebook page.

  • That's facebook dot com forward slash a j.

  • Inside story you can Also doing the conversation on Twitter are handle is at a J Inside story from me, Mohammed Jamjoom and the whole team here Bye for now.

China is stepping up efforts to contain a new Corona virus outbreak, but people abroad have already been affected.

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新たな世界的流行病?インサイドストーリー (A new global epidemic? I Inside Story)

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    林宜悉 に公開 2021 年 01 月 14 日
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