Someone thinks it’s a good idea to trash China and the World Health Organization (WHO) for the Covid-19 pandemic. Or, that is equally productive to point the finger at other countries and political systems for their “nefarious” lack of transparency.
The argument, ostensibly, is that “had we known, we would/could have taken the appropriate precautionary measures. A more productive approach might be to find a way to channel our discontent and to explore corrective strategies, for the immediate and the long term.
USA President Trump has set off a “blame game” by tarring the WHO as an accessory after the fact puppet of China officials who “hid” everything from an unsuspecting Western Society. It may be so; however, that would require ignoring the very much publicized lock-down of Wuhan, a very modern city of eleven million people. If that didn’t “grab our attention”, nothing else will. The Chinese announced, to everyone willing to listen, that it was to contain and mitigate a highly contagious disease. I proceeded to provide the medical/scientific assessments to the WHO (and other sub-global organizations) and anyone willing to read the literature – both popular and professional.
As early as February 23, the European Centre for Disease Prevention and Control (ECDPC), was publishing -virtually daily – risk assessments for the transmission of Covid-19 in the EU/UK and other areas indicating the risk to be moderate to high. Europe has among the very best health care systems globally, hence the trust factor of their reporting and assessments would be most trustworthy. France, for example is ranked first and Italy second.
Countries were encouraged to report rigorously on a predefined form, developed in tandem with the WHO, so that the interactive platforms could inform medical scientists and policy makers. Here’s an extract from the ECDPC’s risk assessment report on February 23, following an outbreak in Lombardy, Italy – arguably among the wealthiest and best equipped, from a health service perspective, regions in the world:
“The accumulated evidence from clusters reported in the EU/EEA and the UK indicates that once imported, the virus causing COVID19 can transmit rapidly. This may emanate from cases with mild symptoms that do not provoke healthcare-seeking behaviour… infection into the EU/EEA and the UK.
The impact of such clusters in the EU/EEA would be moderate to high, especially if hospitals were affected and a large number of healthcare workers had to be isolated. The impact on vulnerable groups within affected hospitals or healthcare facilities is considered to be severe, in particular for the elderly.”
It went on to add that, “the rigorous public health measures that were implemented immediately after identifying the Italian COVID-19 cases [would] reduce the impact of such outbreaks as well as the further spread”
This didn’t happen in a vacuum. On February15, ECDPC reported on a Eurosurveillance survey of 47 national Laboratories checking for their readiness and capabilities to generate and process tests for COVID-19. 38 indicated a capacity to process a minimum of 8,275 per week. At least they were readying to add a further 825 to the capacity and indicated a great willingness to share their results.
Which jurisdictions were paying attention? Eurosurveillance also cautioned that the “main challenges for test implementation were an initial lack of positive control, lack of personnel/time and a lack of primers and/or probes” That was on February 15.
What was going on in Canada – more specifically, Ontario? From a political activity point of view, in a word… And in the USA, two words – not much. In fact, the Premier of Ontario expressed shock two weeks ago on learning that our first class, best in the world health care system was woefully ill prepared for what he had described a few days earlier as panic generating data that his experts had just brought to his attention.
As of today, Italy, Spain, Germany, Switzerland, Portugal and Israel have registered upwards of 20,000 tests per million inhabitants. Their laboratory and clinical findings will better inform their policy leaders – governments (which are still in session, by the way). Canada is inching upwards at 12,000 and the USA at 10,000 tests per million inhabitants.
By April 18, the ECDPC’s risk assessment added another factor in the spread of, and fatalities induced by, Covid-19. It was first noted in Italy then in the UK, Spain and the Netherlands - Health worker shortages. The shortage surfaced early “due to increased demand and also because healthcare workers are being infected with COVID-19 at high rates in some settings (20% of all reported cases in Lombardy, 26% in Spain; 19.6% of all health workers in a sample tested in the Netherlands).
The risk assessment report by the ECDPC highlighted what we now know first-hand in Ontario: the impact of COVID-19 will be very high and probably result in considerable additional morbidity and mortality. Particularly high all-cause excess mortality has been observed in some countries (Italy, Spain) and was above the expected rate in the Netherlands and UK (England) during week 13 (23–28 March 2020), primarily in the age group of 65 years and above.
Should we be surprised that our nursing care and long-term care centres are now the focus of attention?
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