Is China losing control of the coronavirus outbreak? I Inside Story
controlof the corona virus
outbreakthe number of cases in the epicenter rises sharply and Communist Party leaders handling the response have been sacked it's a change of strategy needed this is inside
storyhello there and welcome to the program I'm Nick Clark
China's president is admitting shortfalls in the response to the corona virus
outbreakin Xi Jingping is promising to fix problems and loopholes in the health system solutions cannot come too soon nearly 65,000
coronaviruscases are recorded worldwide 99% of them in
Chinathe epicenter of the
outbreakthat's Hubei Province reported a sharp increase in new cases but the World Health Organization says that's because doctors are using a broader definition to diagnose the infected who bears Communist Party chief is among four local leaders to be sacked tens of millions of Chinese are running out of food and patients 80 cities have been in lockdown for a month leaving everyone trapped at home as Katrina you now reports empty streets and an increasingly empty fridge there are plenty of vegetables but not much meat for the Wong families next meal during the
coronaviruslockdown speaking via video call from corbeil function told us his family was doing its best not to panic well we go home with pre disinfection liquid all over our bodies when we go out we wear a mask we don't know if we go out we come back with a virus stuck on our clothes so with this in fact every day he lives in...
Jing Minh a city neighboring Wuhan the epicenter of the virus
outbreakfor three weeks the family's been ordered to stay indoors movement is increasingly restricted once every three days one family member is allowed to leave the house to pick up groceries supplies and produce unlimited shoppers stand in lines one meter apart waiting to enter it's been almost a month since Wang saw his daughters who are staying with relatives in southeast
ChinaI feel relieved that my wife and daughters are not there who by now we chat online every day they're doing okay just worry about me the vast majority of confirmed Crono virus cases more than 50 thousand are in Hubei Province patients have been sharing videos on social media of life inside makeshift hospitals in quarantine sent at least 1700 medical staff are among the infected elsewhere in
Chinapeople aren't taking any chances Wang Qishan hopes who Bay's leaders will learn their lesson from the
outbreakat the beginning nobody paid enough attention everyone saw it was under
controluntil it was too late and looks forward to life under lockdown coming to an end Katrina you al-jazeera Beijing all right let's bring in our guests in Hong Kong we have dr. john nichols who's a clinical professor in pathology at the university of hong kong he is also an expert in flu viruses from Oxford in the United Kingdom we have a dr. Peter drobik who's a global health specialist and director of the University of Oxford...
skull Centre for social entrepreneurship and in Colchester in the UK as well dr. sung-joo who's reader in modern hi
storyat the University of Essex among research there is
China's health system welcome to you all dr. niccole's if I could start with you first of all before we get into the nitty-gritty of the question in hand let's just spend a little time with you and an assessment of where we're at with this virus are we really any nearer understanding where we are with this virus and its impact globally and in
Chinawhat kind of threat is it well that's a very long question which is difficult to answer but certainly now that in Hong Kong we've had the samples of the virus we've been able to actually start growing it in the laboratory and we're now able to actually infect normal human tissues in a culture system to try to react actually see which part of the body this vast replicates which will help us to determine where it may spread to was it looking to see within the
coronaviruses of where this virus will life we don't think it's nearly as severe as one like SARS or MERS but the question is it how much more severe is it than the other circulating corona viruses which were in the environment so hopefully the laboratory point-of-view will get a better idea about where this actual severity of this infection and this virus lies in terms of the what's happening across the border and in
Chinait's a very complex situation but...
as you indicated there's very similar similarities with with SARS is that during the SARS
outbreakin 2003 which unfortunately we were involved with the number of health care workers becoming infected is a repeat of what we saw in the in the SARS
outbreakand that's a big concern because we get sick health care workers that also impede on the ability for the health care system to manage am i right in saying that this virus appears less lethal than the SARS virus but but more infectious that's right you're totally right is that if you look at the overall mortality and morbidity at this stage it is much less lethal than the sad or the MERS
coronavirusand that actually is one of the things which we've tried to do here is to the public be more aware of that this is not as going to be as severe in terms of mortality that's leading to a very high degree of anxiety on that but ever certainly it's it's causing a major concern about the impact on how was the health care system one right and one very finite quick final question on this the viruses don't like heat do they so does that mean that this could be seasonal as the seasons change that this will this virus will disappear well this is not the 64 million dollar but one was the 64 billion dollar question pre look at the historical evidence is that the seasonal
coronaviruses sorry the one's the milder ones who have a seasonal influence they sent a peak in the winter and they decrease in the...
summer and so the hope is that this virus will do the same in SARS we saw that the the
outbreaks stopped in about May or June dance could that be have been due to the population of being more aware and changes in social hygiene or the weather we severely hope that the weather will be an impediment for the vast on the other hand it means that if this would mean that the virus could go down to the southern hemisphere will become much cooler a lot of unknowns at the moment it's certainly very much here at the moment dr. Sun jus let's look at the situation in
Chinaitself and how it's been dealt with there has
Chinadone enough in your opinion in my opinion
Chinahas done enough on it depends which way you look at it there is some from the start there was really - a public health intervention and how the you know the crisis being handled it's largely political so the approach was very good authoritarian and the measures on which was introduced was largely to assure social stability to example to
controlthe laboratory to prevent the information as the Chinese Communist said to leak out all the rumors and so lots of work which was carried out in
ChinaIndonesia initial state was to conceal the information and yeah so on TV so when we see now that we've seen that they're sacking of officials is this is this just a scapegoating by the leadership covering up a what is or could be an overloaded health system it's well it bows yeah it's obviously the...
Chinese health care system it's is weak it's overloaded inefficient expensive and chaotic the sack of the official yeah it's a scapegoat it's a normal practice for communists Authority see you in Ocala for and to to be held accountable for its weak inefficient health care system so it was the young can on the the people on the ground who were incapable or for handling the crisis or their misdeeds which led to the problem right Peter drawback it's easy to level criticism isn't it but isn't it a very difficult situation in dealing with an
outbreaklike this anyway and then this virus itself is different because it can spread before symptoms show themselves absolutely and this is of course as a new virus in the human population and so we're still learning about the dynamics of how it spreads and how easily it spreads and so there were so many and still really remains so many unknowns that it's very difficult to predict and so obviously after a slow start there the response in
Chinahas been quite extraordinary in terms of the lengths that have been gone to to isolate millions of people to build field hospitals and we don't yet know if those things will work but it of course has been quite an aggressive response and internationally they've been promising signs of cooperation and while the number of cases outside of
Chinacontinued to rise though those numbers do remain small and the WHI of course said the World Health Organization...
they've they've extolled the virtues of
China's response what do you make of that yeah again they've taken really unprecedented measures in in terms of trying to
outbreakand I think at this time what's really required is unprecedented sharing of information transparency and international cooperation so we've seen
Chinaallowing experts internationally from whu-oh and elsewhere to come in and provide support where it's needed sharing of scientific information is incredibly important you know viruses don't respect borders and and so anything that suppresses the sharing of information or secrecy really favors the virus and so cooperation is what we need and do you think the actions of the w-h-o itself a satisfactory there's been a lot of criticism over the years it's been building up about how the wao operates and the time has come for reforming it's it's systems to handle emergency situations like this do you think it's pushed back on those criticisms by this response yeah I think that WTO response or involvement has been has been appropriate and in generally laudatory in helping to to share information and to fight some of the epidemics of mission formation that we've seen to promote cooperation and try to marshal resources we need to remember is that WH o as a body is really more of a coordinating body and has very little power on its own to enact public health measures but really to work with and influence...
countries on the ground to do so and that I think they've been doing a nice job dr. niccole's we saw this this big spike this huge spike in reported cases in Hubei province on Thursday and that's because the criteria for reporting the cases was changed just tell us a little bit more about that and what that means and and what it means as to how we should interpret the figures that are coming out of
Chinaokay yeah so basically what's changing is that before the way in which they're trying to isolate the virus there's no way there's two normal ways in which you detect whether persons got a vast either look for the virus itself using thing called an antigen protection kit we're looking for opponents of a virus or you're looking for the vasogenic makeup using the RNA it's an RNA virus using a thing called PCR so right now there's no rapid antigen test for detecting the chronotron so they're forced to use the PCR and it that is got a few problems with how you take the sample and because also this stage it's still unclear in which part of the respiratory tract device is replicating and where you're taking the sample could lead to a bit of a problem so the way in which you can change it is to actually try and get the more severe cases so then moving towards using chest x-rays which will actually so if the patient isn't got earth clinical signs of in pneumonia they can be easily be brought in and then managed so in a way is...
trying to triage the more the more severe cases who actually needed and treatment and also because this means that you know because many more facilities have got chest x-rays and you can get a fast turnaround and I think it's a good way in which you can actually get a good idea of what we call the the denominators because right now when the young unanswered questions about this virus if we talk about what's called the tip of the iceberg is is what we're seeing in hubail wuhan is this just the clinical severe cases and there's a large large proportion who is can only get very mild symptoms so this is a way to try and classify you know to what degree of severity this virus is I think it was emphasized that this rise in the number of cases wasn't a number of people becoming sick but actually the number of being being classified with that so in general I think it's very appropriate when you have problems with the diagnostic kids not enough kids trying to use a tool which allows a more better evaluation of who really needs to be admitted and treated right so they kind of casting the net wider to a degree doctors feel exactly right doctor things you there that we've had this rash of announcement from the Chinese government today about improving the response to major diseases we alluded to them earlier about how it's exposed loopholes and how the Chinese government will close these loopholes and with this kind of disparity in figures that we heard...
about this week do you did you trust the Chinese government to do what is necessary are you satisfied with the figures coming out of
ChinaI was going to say something about the Chinese statistics Chinese and from my experience working the archive and nuclear the Chinese sticks you know kind of to do is disease prevention etc and I I would say the Chinese stick sticks are not reliable on I can tell you why because some those ones quite often on those people on the grassroots level those ones who are responsible for collecting the statistics the data and they are you either they they don't have enough time they over or they don't have the capability they'd just been called you know kind of in especially way since like such a major
outbreakwho is such a huge number and a lot of people being recruited to the work they had no previous experience and so and they and the data they collected it was unreliable in that case in some cases they some they simply didn't have time so they just write down anything and when these frickin goes up to the next level that experts or their superior and they have these wells to bury files on sticks those data's but they have no means of doing it and and so what they do is they massage the feet and the data to make it look like it's more or less right yeah then it goes to the next level the you know the the professional authority and the when they don't want to you know kind of is efika to make them look bad they want...
to show that they're in comfort of the situations so um you know kind of over-reporting success or aren't a report in you know kind of a failure or you know casualties and more practice okay well there's certainly been a change your tone from the from the transparency that we saw in January and it's now given way to the state media not touching on the negative and accentuating the positive dr. drawback what do you make of this if prevention into a moral crusade yeah so you know connectivity to reporting on the good stories yeah the success the touching stories right and doctor driver what's your view on this area if it seems that we can't trust the data the statistics are being massaged and changed and and in that case it changes the whole parameters of how we deal with this yeah absolutely I mean it's it's it's it's important that we have is accurate data as possible and suppressing any information if that's happening is obviously going to really hamper response w-h-o can play a role in invalidating some of the statistics so I don't know if those reports are true obviously that's that's very difficult right and in your view is is what's been this combined effort from the whu-oh and the Chinese government is it enough to stop this epidemic spreading well I hope so when time will tell again it's it's difficult to understand the trends both because we have some questions about the validity of the data as has...
been pointed out but also because this reclassification of cases over the last couple of days has caused a spike in the number of reported cases so it's difficult to understand whether we are near a leveling off of cases or a tipping point or not it appears that that's not the case yet at least within the epicenter of the epidemic and Hubei Province dr. Nichols Adele if you want to come back on that but also want to ask you about it moving it on to the prospects of a vaccine and where we are with that okay so I just want to follow up is that you know I think that we look more at the cases which are occurring outside mainland
Chinawe actually get you know you have the people than the resources I think that that is will probably be a better indicator of the actual disease severity and the natural hi
storyof the of this viral
outbreakrather than the over works and the overloaded system across and mainland
Chinaso that's why I think we should not be separating out you know grown-up cases worldwide but just said but look into those are naturally region so that might give us a better idea of the of what the true nature of this disease is and the vaccine I think really think that those who think there can be vaccine in about six months I've been watching too much Hollywood because in reality to get a vaccine you have to make sure that it works is that it's got no side effects and the disease model in animals we're contested which shows is efficacious the...
route of administration the can you scale it up and this and the side effects so I think the last thing which we want to be brush brushing a vaccine into a population to getting side-effects and then you get such a negative reaction like like we saw in the Philippines with the
outbreakof things like measles which occurred after fear about one of the the vaccine so this current
outbreakreally will not be able to have any hope for a vaccine and the problem is also in the past I think there's been limited success of
coronavirusvaccine with influenza there's a long hi
storyof getting reliable vaccines but with corona virus I think we're dealing with that totally new ballpark and dr. Dre Beckham some school of thought that for every case that is reported there's seven or eight more out there is that your view of how things work it's difficult to know for sure again because we're getting incomplete information from within
ChinaI think as dr. Nichols suggested outside of
Chinaparticularly in countries with more robust health systems the numbers are likely much more accurate I think it's it's probably fairly safe to assume that the the overall number of cases is is higher than what has been reported so far particularly because of the number of mild cases that may go unrecorded whether that's seven or eight times or more or less than that you know there are there are mathematical models but I couldn't say right and doctors and Julia within...
Chinawhat are you hearing about the general response to how the government has handled this is their satisfaction is how will they come out at the end of all this well you mean on people's responsibles the government's response the people's response out of the population at large how do they regard how the government has responded to this
outbreakwell people has been very divided and some you know kind of fun there's a different reaction in today's and some you can on the same page with the government they say this as political to take and they see this as you know kind of
China's rise and they want to you know concern be very much the sort of being you know kind of like to these governments to to disease and on there's lots of people also don't trust the both the political system and the health system and and there's lots of panic since what panic and fear and yeah obviously distrust and so which makes the the prevention and
controlof the virus even more difficult people don't trust the system don't trust governments they are not less likely to do what they've been told to do okay very very quickly a dr. Nichols and it's going to jump in there these
outbreaks do appear pretty frequently in
coronavirusSARS in 2003 bird flu etc in 30 seconds or so can use outlined why that is it's because this is where you get a high population density and wild animals and basically also you'll see in had we also have a ones...
like a rural economy very close to a economy so that allows the intermingling of viruses from one host to another I think from the bat to an intermediate host to humans to be very United very likely but having said that even though Xi Jinping might be able to close down the the wildlife markets in in