Tuesday, March 17, 2020

Wuhan Virus: Unlike Australia, Singapore, Taiwan and Hong Kong took measures as early as January to screen entrants from China,and have since successfully controlled the spread of the virus: Australian Govt's preoccupation with preserving unpopular immigration and multicultural policies may have led to present social and economic disaster.

by Ganesh Sahathevan

Chief Medical Officer Professor Brendan Murphy speaks during a press conference updating on the novel coronavirus at Parliament House in Canberra.
Chief Medical Officer Professor Brendan Murphy speaks during a press conference updating on the novel coronavirus at Parliament House in Canberra. His words and actions may be the basis of a number of class actions for economic loss Source: AAP

As previously reported: 

City of Sydney Lunar New Year 2020 Festival became an obvious security risk by mid-Jan if not earlier-NSW Premier to blame, and Chief Medical Officer Brendan Murphy's politicking may have contributed to the debacle
Compare the Australian response to that of Singapore, Taiwan and Hong Kong, who acted on the facts ,without any regard to  accusations of racism and xenophobia which seem to be uppermost in the minds of Australian politicians and civil servants. As reported by the New York Times: 

And so Singapore, Taiwan and Hong Kong might be more instructive examples. All three places were especially vulnerable to the spread of the infection because of close links with mainland China — especially in early January, as they were prime destinations for Chinese travelers during the upcoming Lunar New Year holiday. And yet, after all three experienced outbreaks of their own, the situation seems to have stabilized.

As of midday Friday, Singapore had 187 cases confirmed and no deaths (for a total population of about 5.7 million), Taiwan had 50 confirmed cases including 1 death (for a total population of about 23.6 million) and Hong Kong had 131 confirmed cases including 4 deaths (for a total population of about 7.5 million).

Since identifying the first infections (all imported) on their territories — on Jan. 21 in Taiwan and on Jan. 23 in both Hong Kong and Singapore — all three governments have implemented some combination of measures to (1) reduce the arrival of new cases into the community (travel restrictions), (2) specifically prevent possible transmission between known cases and the local population (quarantines) and (3) generally suppress silent transmission in the community by reducing contact between individuals (self-isolation, social distancing, heightened hygiene). But each has had a different approach.

Singapore, an island, could readily take aggressive measures to block the arrival of the infection from China — and it did. Three days after the Chinese authorities alerted the world about the outbreak in Wuhan, Singapore started referring inbound travelers from Wuhan with a fever and respiratory symptoms for further assessment and isolation. It was also one of the first countries to cancel all inbound flights from Wuhan after identifying its first imported case.

Travelers coming from affected areas were placed under mandatory quarantine; three university hostels were promptly converted into facilities to host them. The government compensated individuals and employers for any workdays lost.

The Singapore authorities undertook especially intensive efforts to trace the contacts of people known to be infected. Hospital staff went to great lengths to interview patients about their recent whereabouts; when information was unclear or unavailable, the Ministry of Health retrieved additional data from transport companies and hotels, including by consulting CCTV footage.

Large gatherings have been suspended. But to minimize social and economic costs, schools and workplaces have remained open. The Singaporean Ministry of Education — on an extensive FAQs web page — calls the closing of schools “a major, major decision” that would “disrupt many lives.” Instead, students and staff are subjected to daily health checks, including temperature screenings.

Public-health campaigns were also reinforced to further improve Singapore’s already exemplary standards of cleanliness and public hygiene. A special government task force recently recommended five personal hygiene habits:using a tissue when coughing or sneezing; using designated serving spoons during group meals; using trays when eating or drinking to limit contamination in case of spills; keeping public toilets clean and dry; and regular hand washing. From the outset, the government has recommended the use of masks only for people who already are unwell.

Taiwan, also an island, took a slightly different tack. Instead of promptly banning travel from China, it undertook a comprehensive effort to screen newcomers from suspect areas. As soon as early January — just days after the news of the outbreak in Wuhan — Taiwanese medical authorities would board incoming flights from Wuhan and inspect and screen travelers on the planes.

It was only after the first imported case was identified on Jan. 21 that four major airlines suspended flights between Taiwan and Wuhan. A ban on all but flights from Beijing, Shanghai, Xiamen and Chengdu was implemented three weeks later.

Taiwan has also taken a rather mixed approach in its efforts to reduce transmission within the community.

Some state-run facilities have been used for quarantines, but home quarantine has been the predominant method of isolation even when state facilities were available. To ensure compliance, the government has enforced strict penalties against anyone who breaks an isolation order, including fines up to about $33,200.

Organizers of mass events were encouraged to defer or cancel events; some religious institutions suspended services. It was announced that elementary schools and high schools would remain closed after the end of the Lunar New Year holidays, but only for two weeks. In fact, classes resumed on Feb. 25.

The Taiwanese authorities also oversaw the controlled distribution of surgical masks from existing stockpiles through community stores, having also fixed their price. Taiwan’s main health messages — “Wear a surgical mask when coughing or sneezing,” “Wash hands thoroughly with soap” and “Avoid crowded places, including hospitals” — were displayed prominently on the Centers for Disease Control’s website.

As of Friday, about 58 percent of all confirmed cases in Taiwan were believed to have resulted from local transmission. This is an important marker of success for Taiwan’s containment strategy: In many other places, local cases outnumbered imported infections by a far greater margin.

Hong Kong adopted yet another approach, presumably in part because, unlike Taiwan and Singapore, the city shares a border with mainland China and is formally part of China, as a Special Administrative Region. (An average of 300,000 people crossed the border every day last year.) The authorities here focused less on completely blocking the entry of possibly infected people into the territory than on preventing transmission within the community.

On Jan. 3 — again, very soon after the first declared case in Wuhan — existing temperature-screening stations at ports of entry were expanded, and local clinicians were asked to report to the city’s health authorities any patient with a fever or acute respiratory symptoms and a history of recent travel to Wuhan.

But it took five days after the first imported case for travel restrictions to be placed on visitors from Wuhan and other affected areas and for six of the territory’s 14 border crossings with the mainland to be closed. (Another five crossings were closed later.) The number of visitors to Hong Kong from mainland China fell to a daily average of 750 in February.

Starting on Feb. 5, anyone coming across the border — or arriving from elsewhere who had been in mainland China in the preceding 14 days — was required to undergo a mandatory 14-day period of self-quarantine.

Extensive efforts have also been made to track down and quarantine the close contacts of confirmed cases. And in the event transmission might occur before an infected person displayed any symptoms, tracing included all contacts starting two days before the onset of the patient’s illness.

Of Hong Kong’s 40,000 hospital beds, some 1,000 are negative-pressure beds, allowing confirmed cases to be properly isolated. Holiday camps and newly constructed public-housing units that were still vacant were rapidly repurposed into quarantine facilities.

As of March 12, 62 of the city’s 131 confirmed cases were thought to have resulted from close contact with other confirmed cases. More than 24,700 people were still under quarantine this week.

Hong Kong has also deployed very extensive measures to encourage social distancing. As early as Jan. 28, many civil servants were asked to work from home for the following month. Most large-scale events have been canceled or postponed. On Jan. 27, all kindergartens and schools were closed until Feb. 16; the decision was extended several times, most recently to at least April 20. Many classes have been conducted online.

Although it’s still not clear whether or how much children contract and spread Covid-19, they are known major contributors to the transmission of influenza, and Hong Kong has been effective in stemming outbreaks of the flu by suspending classes four times over the past 12 years (in 2008, 2009, 2018 and 2019). Closing schools is a very invasive measure, but Hong Kong has a social structure that helps cushion some of the burden: Many families with two working parents already rely on domestic helpers or grandparents for child care.

The government has mounted a public-education campaign to promote hand hygiene and environmental hygiene. Nearly everyone in Hong Kong wears a face mask in public.

Had Australia begun screening entrants from China as early as January and taken more concrete steps to manage the return of students from China the economic and social disaster that is unfolding may have been averted. 


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