Feasibility of Coronavirus Disease 2019 Eradication
The coronavirus disease 2019 (COVID-19) pandemic, caused by the 2019 novel coronavirus (2019-nCoV), has posed an unprecedented global health crisis. On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic, highlighting its widespread transmission and severe impact. The disease, characterized by acute respiratory symptoms, has shown high susceptibility among all populations. Early epidemiological estimates suggested a basic reproduction number (R0) of 2.3, with a serial interval of 7.5 days, indicating its rapid spread. By April 18, 2020, the global tally of confirmed cases exceeded 2.2 million, with over 150,000 deaths reported.
The trajectory of the COVID-19 epidemic can be divided into four distinct stages: the pre-outbreak stage, the outbreak stage, the inflection point, and the decrement stage. In China, the epidemic’s progression was meticulously tracked from the first reported case on December 8, 2019, to the last reported case on March 17, 2020. The pre-outbreak stage lasted for 5 to 6 serial interval units (SIUs), each spanning 8 days. This was followed by the outbreak stage, which lasted approximately four SIUs before reaching the inflection point. The inflection point stage lasted for one SIU, after which the decrement stage continued for two SIUs until the number of new cases reached zero.
The outbreak in Wuhan, China, demonstrated a rapid increase in confirmed cases, with the number of cases doubling every SIU during the initial outbreak stage. The mortality rate in Wuhan peaked at 7.28%, significantly higher than in other parts of China. This surge in cases overwhelmed healthcare facilities, leading to a shortage of medical resources and necessitating difficult decisions regarding patient prioritization. The deployment of 32,572 medical staff to Wuhan played a crucial role in mitigating the crisis and reducing mortality rates.
The “China Solutions” implemented to control the outbreak included several key strategies: early detection, early diagnosis, early isolation, and early intervention; centralized medical management based on disease severity; mandatory 14-day quarantine for close contacts; widespread use of medical masks; cancellation of unnecessary gatherings; and containment of communities with COVID-19 cases. These measures effectively curbed the transmission of the virus and prevented family clusters of infection.
The concept of “herd immunity” has been proposed as an alternative strategy to manage the pandemic. This approach suggests allowing a significant portion of the population to become infected naturally, thereby developing immunity. However, achieving herd immunity would require 60% to 70% of the population to be infected. Given the high proportion of severe and critical cases (approximately 15%) and the death rate (around 2%), this strategy would result in staggering morbidity and mortality. For instance, it is estimated that the United States could experience 2.2 million deaths, while Great Britain could see 510,000 deaths.
The success of China’s containment strategies provides valuable lessons for other countries grappling with the pandemic. The absence of newly diagnosed cases in Wuhan since March 18, 2020, underscores the effectiveness of these measures. However, the prevention and control of imported cases remain a significant challenge for China. To address this, China customs has implemented a series of strategies, including 14-day quarantine and testing for 2019-nCoV nucleic acid or specific IgM/IgG antibodies.
In conclusion, the experience in China offers hope that COVID-19 could be the first pandemic human infectious disease to be eradicated through scientific management and effective control tactics. The general population is strongly urged to wear medical masks in public during the pandemic period. This simple measure not only protects the wearer from infection but also impedes the transmission route from infected individuals, thereby safeguarding others.
doi.org/10.1097/CM9.0000000000000936
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