WHO-China Joint Mission COVID-19 Report Details
Late last month, the World Health Organization (WHO) released the Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) as misinformation regarding COVID-19 continued to spread throughout social media, leading to stigma being associated to Asian members of the population in various parts of the world.
The report lists the main objectives of the joint mission:
•To enhance understanding of the evolving COVID-19 outbreak in China and the nature and impact of ongoing containment measures;
•To share knowledge on COVID-19 response and preparedness measures being implemented in countries affected by or at risk of importations of COVID-19;
•To generate recommendations for adjusting COVID-19 containment and response measures in China and internationally; and
•To establish priorities for a collaborative programme [sic] of work, research, and development to address critical gaps in knowledge and response and readiness tools and activities.
The Joint Mission involved 25 experts from China, Germany, Japan, Korea, Nigeria, Russia, Singapore, the United States of America, and the WHO, headed by Dr. Bruce Alyward (WHO) and Dr. Wannian Liang from the People’s Republic of China.
Despite false rumors propagating on the internet concerning the origin of COVID-19, the report explained how the virus was isolated and identified.
Virus isolation was conducted with various cell lines, such as human airway epithelial cells, Vero E6, and Huh-7. Cytopathic effects (CPE) were observed 96 hours after inoculation. Typical crown-like particles were observed under transmission electron microscope (TEM) with negative staining. The cellular infectivity of the isolated viruses could be completely neutralized by the sera collected from convalescent patients. Transgenic human ACE2 mice and Rhesus monkey intranasally challenged by this virus isolate induced multifocal pneumonia with interstitial hyperplasia. The COVID-19 virus was subsequently detected and isolated in the lung and intestinal issues of the challenged animals.
The report went on to define COVID-19 as a zoonotic virus, detailing that analysis shows bats being the reservoir of the virus, but the intermediate host(s) have yet to be identified. “However, three important areas of work are already underway in China to inform our understanding of the zoonotic origin of this outbreak,” the report then explains. “These include early investigations of cases with symptom onset in Wuhan throughout December 2019, environmental sampling from the Huanan Wholesale Seafood Market and other area markets, and the collection of detailed records on the source and type of wildlife species sold at theHuananmarketand the destination of those animals after the market was closed.“
The report also details that human-to-human transmission in China is laregely occurring in families, by ‘close unprotected contact between an infector and infectee.’ The following portion of the Joint Mission report details the response by the Chinese government.
Upon the detection of a cluster of pneumonia cases of unknown etiology in Wuhan, the CPC Central Committee and the State Council launched the national emergency response. A Central Leadership Group for Epidemic Response and the Joint Prevention and Control Mechanism of the State Council were established. General Secretary Xi Jinping personally directed and deployed the prevention and control work and requested that the prevention and control of the COVID-19outbreakbe the top priority of government at all levels. Prime Minister Li Keqiangheaded the Central Leading Group for Epidemic Response and went to Wuhan to inspect and coordinate the prevention and control work of relevant departments and provinces (autonomous regions and municipalities) across the country. Vice Premier Sun Chunlan, who has been working on the front lines in Wuhan, has led and coordinated the frontline prevention and control of the outbreak.
The prevention and control measures have been implemented rapidly, from the early stages in Wuhan and other key areas of Hubei, to the current overall national epidemic. It has been undertaken in three main phases, with two important events defining those phases. First, COVID-19was included in the statutory report of Class B infectious diseases and border health quarantine infectious diseases on20January2020, which marked the transition from the initial partial control approach to the comprehensive adoption of various control measures in accordance with the law. The second event was the State Council’s issuing, on 8 February 2020, of The Notice on Orderly Resuming Production and Resuming Production in Enterprises, which indicatedthatChina’s national epidemic control work had entered a stage of overall epidemic prevention and control together with the restoration of normal social and economic operations.
The Joint Mission credits the Chinese effort to combat the virus stating, “China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history. The strategy that underpinned this containment effort was initially a national approach that promoted universal temperature monitoring, masking, and hand washing. However, as the outbreak evolved, and knowledge was gained, a science and risk-based approach was taken to tailor implementation.” While stating that these measures are only possible due to the commitment to take aggressive and collection action in face of the virus.
The recommended steps for countries with imported cases and/or outbreaks of COVID-19 are as follows according to the Joint Mission:
1. Immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed to contain COVID-19 with non-pharmaceutical public health measures;
2. Prioritize active, exhaustive case finding and immediate testing and isolation, painstaking contact tracing and rigorous quarantine of close contacts;
3. Fully educate the general public on the seriousness of COVID-19 and their role in preventing its spread;
4. Immediately expand surveillance to detect COVID-19 transmission chains, by testing all patients with atypical pneumonias, conducting screening in some patients with upper respiratory illnesses and/or recent COVID-19 exposure, and adding testing for the COVID-19 virus to existing surveillance systems (e.g. systems for influenza-like-illness and SARI);and
5. Conduct multi-sector scenario planning and simulations for the deployment of even more stringent measures to interrupt transmission chains as needed (e.g. the suspension of large-scale gatherings and the closure of schools and workplaces).