Health and Healthcare Systems

'Over-reacting is better than non-reacting' - academics around the world share thoughts on coronavirus

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A health worker washes her hands during a demonstration of preparations for any potential coronavirus cases at a hospital in Harare, Zimbabwe, March 11, 2020. Picture taken March 11, 2020. REUTERS/Philimon Bulawayo - RC20IF98P1HL

Preparing for coronavirus: A health worker washes her hands at a hospital in Harare, Zimbabwe Image: REUTERS/Philimon Bulawayo - RC20IF98P1HL

Ceri Parker
Previously Commissioning Editor, Agenda, World Economic Forum
Jaci Eisenberg
Head of Alumni Relations, World Economic Forum
  • The World Health Organization has labelled COVID-19 a pandemic.
  • Academic experts recommend public health measures such as 'social distancing' to curb the spread.

It's official: COVID-19 is now a pandemic, spreading so quickly that any tally of infections and deaths rapidly becomes out of date. Cases outside of China have increased 13-fold in the last two weeks, with the global number of infections surpassing 126,000 on March 12.


What is the World Economic Forum doing about the coronavirus outbreak?

As countries from Itay to Iran, from Sweden to South Africa, struggle to contain the virus, it is more important than ever to turn to expert advice from institutions such as the World Health Organization. Regular hand-washing with soap is one of the key steps we can take to protect ourselves.


The World Economic Forum has collected insights from academics within leading universities for a global take on how Covid-19 is spreading, and what measures should be taken to fight the pandemic.

'Social distancing is our current best defense against COVID-19'

Michelle A. Williams, Dean of the Harvard T.H. Chan School of Public Health, USA

On March 10, Harvard University announced its plans to move all teaching online starting March 23, the day after our spring break. Public reactions to this and similar moves at other universities have been mixed, with some praising the action and others considering it outsized or unduly cautious. But in fact, social distancing - successfully practiced by some cities during the influenza pandemic of 1918 - is our current best defense against the cascading effects of COVID-19.

coronavirus covid-19
Flatten the curve: how coronavirus could evolve depending on our response Image: Slide provided by Michal Caspi Tal, PhD, of Stanford Medical School

We can no longer hope to contain the virus' global spread. Nor can we wait for the development of a vaccine that is still 18 months away, or waste undue resources on contact tracing. Our current focus must be on flattening the curve-slowing down the virus' spread, alleviating its effects on health care systems, and saving lives. The most effective way to do so is through social distancing, which includes restricting travel and cancelling large-scale events such as concerts, conferences, and yes, university classes.

During the 1918 influenza epidemic, extreme social distancing in St. Louis saved untold lives, while in Philadelphia, the stubborn refusal to cancel a World War I parade resulted in a rapid and avoidable spread of the disease. Today, the immediate inconveniences of such restrictions are dwarfed by the positive outcomes already seen in countries such as Singapore and China.

coronavirus covid19 history spanish flu
A tale of two cities amid the devastating Spanish flu outbreak Image: Slide provided by Michal Caspi Tal, PhD, of Stanford Medical School

Social distancing alone will not mitigate COVID-19's impact. We must also make testing free and readily available and guarantee paid leave for all sick and quarantined workers, among other actions. During such an uncertain time, we must also prioritize mental health. But we are past the point of timidity.

Only through stringent social distancing can we currently hope to temper the proliferation of this novel virus and lower death rates from both COVID-19 and other unrelated illnesses.

Meantime, as we move to protect the health of our family, friends, and colleagues, we must also give respect and care to the caregivers. For as proven time and again, it is the frontline health care and public health workers, whether in the field, in clinics, or in international relief settings, who serve as a vital first line of defense in protecting the health of populations.

'A significant proportion of the global population could be infected'

Professor Yik-Ying TEO, Dean, Saw Swee Hock School of Public Health, National University of Singapore

Individual responsibility sits at the heart of managing the current situation with COVID-19, as our actions determine whether the transmission chain is successfully halted or regrettably magnified.

  • The simple but effective message of regular hand-washing can minimise infection risk to oneself from the inadvertent exposure to the virus through contact with surfaces and subsequent contact with the face.
  • Avoid going to crowded places, especially those that are in enclosed environments with poor natural ventilation.
  • If unwell, one should minimise any interactions with other people.
  • Avoid any non-essential travel to places with reports of community transmission.
  • Be socially responsible in sharing accurate and evidence-based information on social media, and avoid starting or forwarding unverified news report or fake news to others in the community.
  • Make an effort to stay updated on the latest developments of the situation in the local vicinity.
  • Be mindful that the situation may continue for an extended period, thus to continue to maintain good personal habits such as regular exercises and appropriate nutrition for a robust constitution and a resilient state of mental wellbeing to tide through this global crisis.

It is increasingly clear that the onward transmission of COVID-19 will continue in many countries, eventually progressing to community spread. There have been several projections by epidemiological modellers on the anticipated population impact, where in the absence of effective containment or a viable and safe vaccine, a significant proportion of the global population could be infected.

coronavirus covid global spread
The global spread of COVID-19 Image: World Economic Forum

While this prediction may eventually come true, what is important is the time scale that this takes place over: whether it is in a matter of 6-9 months which will completely overwhelm many health systems, or over many years which will allow health systems to cope adequately.

Regardless, there are still countries with weaker health systems where there is a need to ensure healthcare workers are first and foremost protected, with adequate supply and proper training on the use of personal protective equipment; as well as to allow such countries to mount a viable and sustainable response involving community primary care to manage the mild cases, in addition to advanced intensive hospital care of the very sick.

'Over-reacting is better than non-reacting'

Xifeng Wu, MD, PhD, Dean and Professor of School of Public Health, Zhejiang University, Hangzhou, China. Read a full article by Xifeng Wu and colleagues.

The experience in China taught us again that in dealing with pandemic events, the right thing to do is to believe science and public health experts. Overreacting is better than non-reacting.

coronavirus covid-19 china
How the epidemic progressed in China Image: Florian Krammer via Michal Caspi Tal

China’s unprecedented measurement to contain and control the spread of COVID-19 has proven to be effective. The timely release of disease-related clinical data to the public and the World Health Organization have helped many across the world to get prepared for the spread of COVID-19. For example, now we know from more than 40,000 cases in China that 80% of COVID-19 infected patients don’t need medical intervention while the other 20% would need medical treatment and care.

Zhejiang province was the first to raise the risk management response to the highest level in early days of the coronavirus outbreak, when there was no confirmed case. Here are a few points about the tools implemented in control spread of the COVID-19 in Hangzhou:

  • Provide clear guidelines with the degree and scope of such city-wide lockdown measurement.
  • Ensure implementation tracks down to individual person, apartment, house, community, organizations, public facilities, and city management.
  • Keep living activities flowing, i.e., food and supplies, through organized and government-controlled arrangement.
  • Designate infectious disease care and management hospital facilities to isolate, monitor, and treat COVID-19 positive cases.
  • Establish electronic recording and tracking systems and local response team to handle identified cases 24/7.
  • Centralized reporting and communication channels to keep citizens updated.
'Focused, effective communication and shared trust are essential'

Landon Myer, epidemiologist, University of Cape Town

The rapid spread of the COVID-19 virus (SARS CoV-2) is an emerging public health issue of clear global concern. Relatively little of the epidemiology of COVID-19 is new to us – after all, respiratory viruses moving from animals to humans is a fairly regular occurrence and COVID-19 is the third new human coronavirus of the 21st century.

At this time we know that the vast majority of COVID-19 infections lead to mild disease that typically resolves spontaneously, though there is greater concern for older people and individuals with significant co-morbidities. However the massive popular attention that has accompanied the COVID-19 outbreak is perhaps the most novel, and potentially concerning, aspect of this epidemic. New reports seem to disseminate globally in a matter of minutes, while social media and informal news sources have facilitated the spread of misinformation and rumour about the virus and its impact.

coronavirus myth
The World Health Organization is working to bust myths on coronavirus Image: WHO

In the context of an emerging epidemic, this is far from harmless gossip as it hinders the implementation of effective public health interventions to contain the spread of infection and mitigate the impact of disease.

Basic public health interventions are clearly effective: the public health response of Chinese public health authorities has been largely successful and massively impressive, and demonstrates the ability of simple, systematic interventions such as rapid case detection, contact tracing, appropriate quarantining, and other measures.

However these interventions can only be implemented with focused, effective communication and shared trust between public health agencies and the populations they serve. Rumour and misinformation undermine that communication and trust, instead fuelling paranoia, fear, panic and stigma – popular phenomena which are well known to help fuel the spread of many infectious diseases.

'If we continue with business as usual, this will blow up really quickly'

Michal Caspi Tal, PhD, Instructor at Stanford Medical School

The below is extracted from 'A talk given about Coronavirus for non virologists' at Stanford University on March 9, 2020. You can watch the full talk on YouTube below. Dr Tal has made the slides public here.

This is not going to be a zombie apocalypse and panic literally never helps but what we do need is a cautionary response that reduces the spread… Working from home and trying to avoid large gatherings are a very appropriate response...

If you think of how many beds we have (in the US), how many masks we have, how many resources we have that people who get very sick are going to need, what you see is if we do nothing, if we institute no drastic protective measures, continue with business as usual, this will blow up very quickly. And then what’s going to happen is we will exceed the capacity of the current health system. More people will need beds in the ICU than we have beds.


By instituting protective measures, even if we can’t create a situation where else people get infected, if we have them get infected over a long period of time, we can try to keep it under the control of what we can manage with our current healthcare system in place.


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