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WHO-China Joint Mission Report on Coronavirus
(Coronavirus 019 (COVID-19
16 – 24 February 2020
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toc
T signs,symptoms,diseases progression and severity
T HE C HINA R ESPONSE & N EXT S TEPS
T HE G LOBAL R ESPONSE & N EXT S TEPS
F or countries with imported cases and/oroutbreaksofCOVID-19
F or the international community
A WHO-CHennaJoint M ISSIONMEmbers
C D ETAILED T echnical F INDINGS
RESPONSE MANAGEMENT,CONTACT MANAGEMENT CASE,RISK AND COMMUNITY COMMUNICATION
C Prevention and control of cases for case management and infection
LVandalism, Diagnostics and Virology
Researchandevelopment development
A O PERATIONAL & T echnical R ECOMMENDATIONS
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Mission
Goal and goals
The overall goal of the joint mission was to quickly inform the nationality (China) and the international
Planning the next steps in response to the ongoing outbreak of COVID-19
Illness (COVID-191) and next steps in geographic preparedness and preparedness
have not yet been affected.
The main objectives of the joint mission were as follows:
- Improve understanding of the evolving COVID-19 outbreak in China and
the nature and effect of containment measures are ongoing;
- Share knowledge about COVID-19 response and preparedness measures
implemented in countries affected or risking imports of COVID-19;
- Produce recommendations to adjust the containment and response of COVID-19
steps in China and internationally; and
- Setting priorities for a work and research collaboration program
Development to address critical gaps with knowledge and response and readiness tools
Activities.
Friends and work method
The joint mission included 25 national and international experts from China, Germany,
Japan, Korea, Nigeria, Russia, Singapore, United States of America and global health
Organization (WHO). The joint mission was chaired by Dr. Bruce Aylward of WHO and Dr.
and Anyan Liang from the People’s Republic of China. Their full list of friends
The partnerships are available in Appendix A. The joint mission was carried out for 9 days
From February 16-24, 2020. The work schedule is available in Appendix B.
The joint mission began with a detailed workshop with representatives of the entire administration
Firms leading and/or contributing to the China response through
National Prevention and Control Task Force. A series of in-depth meetings were then
Conducted with national-level institutions responsible for management, implementation
and evaluating the response, particularly the National Health Commission and China
Centers for Disease Control and Prevention (China CDC). Gain first-hand knowledge on the subject
Implementation and impact of the field level of the national and local response strategy, under
Visits to Beijing have been a variety of epidemiological and provincial contexts
Sichuan City Hall (Chengdu), Guangdong (Guangzhou, Shenzhen)
and Hobby (Wuhan). Field visits included community centers and health clinics,
State/Province hospitals, COVID-19 dedicated hospitals, transportation hubs (air, rail,
Way), Wet Market, Stocks Pharmaceutical & Personal Protective Equipment (PPE)
Warehouses, research institutions, district health committees and local centers for
1 In the Chinese version of this report, COVID-19 is referred to worldwide as new coronavirusoid pneumonia
NCP, the term by which COVID-19 is best known in the People’s Republic of China.
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Disease control (district and district). During these visits the staff elaborated
Discussions and consultations with provincial governors, mayors, their state of emergency
analysis teams, senior scientists, community workers, public health and community,
and community neighborhood managers. The joint mission summed up the work
Meetings to unify findings, draw conclusions and propose proposed actions.
To achieve its goal, the joint mission gave a special focus to addressing key questions
related to the natural history and severity of COVID-19, the conduction dynamics of the
COVID-19 virus in different definitions, and impact of ongoing response measures in regions
of high (community-level), medium (clustered) and low cases (sporadic or non-case)
Broadcast.
The findings in this report are based on a review of the joint mission on nationality and locality
Government reports, discussions on control and prevention measures with the national state
Local experts and response teams and observations made and insights gained during the site
Visits. The data was generated using information and data collected during the website
Visits and with the consent of the relevant groups. Referrals available to anyone
Information in this report that has already been published in journals.
The final report of the joint mission was submitted on February 28, 2020.
In. Key Findings
The main findings are described in six sections: the virus, the outbreak, the transmission
Dynamics, disease progression and severity, China’s response and knowledge gaps. more
A detailed description of technical findings appears in Appendix C.
Virus
On December 30, 2019, three bronchovalvar rinsing samples were collected from a patient
With pneumonia of unknown etiology – a follow-up definition established following
Outbreak of SARS in 2002-2003 – at the Wuhan Jinintan Hospital. Real-time PCR tests (RT-PCR)
These samples tested positive for the Pan-Betacoronavirus. Using Illumina and Nanupur
In sequence, all the genome sequences of the virus were acquired. Bioinformatics
Analyzes indicated that the virus had traits characteristic of the coronavirus family and belonged to
To the Betacoronavirus dynasty 2B. Align the full-length genome sequence of
COVID-19 virus and other available Betacoronavir virus genomes have shown closest
The connection was with the SARS-like virus strain BatCov RaTG13, identity 96%.
Virus isolation is conducted with different cell lines, such as epithelial cells of the human respiratory tract,
Vero E6, and Huh-7. Cytopathic effects (CPE) were observed 96 hours after vaccination.
Typical crown-like particles observed under a conduction electron microscope (TEM)
With negative spots. The cellular infection of the isolated viruses can be completely
Neutralized by removal collected from convalescence patients. Transgenic ACE2 mice
and a rhesus monkey that has been intrinsically challenged by this multifocal isolated virus
Pneumonia with interstitial hyperplasia. The COVID-19 virus was then discovered
and isolated in the lung and intestinal tissues of the challenging animals.
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Analysis of complete genome sequences of 104 strains of isolated COVID-19 virus
Patients in different localities with the onset of symptoms at the end of December 2019 for
In mid-February 2020, 99.9% of the virus showed no significant mutation (Figure 1).
Fig. 1. Fig. 1. Phylogenetic analysis of the COVID-19 virus and its close reference
Genome
Note: The COVID-19 virus is referred to as 2019-nCoV in the figure, where the intermediate virus WHO announced at the beginning
Outbreak.
Posthumous samples of a 50-year-old male patient from Wuhan were taken from home
Lung, liver and heart. Histological examination showed diffuse bilateral damage to the urinary system
With fibromyoxoid exodates. The lung showed a clear desecration of
Pneumocytes and the formation of the hyalin membrane, indicating acute respiratory distress
Syndrome (ARDS). Lung tissue also exhibited cellular and fibromyoxoid expulsion,
Desquamation of pneumocytes and pulmonary edema. Intermediate mononuclear
In both lungs, inflammatory infiltrations were observed, which are controlled by lymphocytes.
Multi-sweater syncytial cells with atypical enlarged pneumocytes characterized by large
Nuclei, nuclear cytoplasm and ampephophilic nuclei were identified within
Alveolar spaces, showing cytopathic-like and viral changes. There is no clear intranuclear or
Interactylassemial viral inclusions have been identified.
Outbreak
As of February 20, 2020, a cumulative total of 75,465 cases of COVID-19 has been reported
Porcelain. The reported cases are based on the National Reporting System (NRS) between the
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National and provincial health committees. The NRS publishes daily reports on the news
Record confirmed cases, deaths, suspicious cases and contacts. Daily report provided
By each province at 03:00 where they report cases from the previous day.
The epidemic curves shown in Figures 2 and 3 are created using the National of China
Infectious Disease Information System (IDIS) that requires every case of COVID-19
Electronically reported by the attending physician as soon as a case has been diagnosed. this
This includes cases that are reported as asymptomatic and the data are updated in real time.
Separate individual reporting forms are downloaded after 2400 hours per day. Epidemiological curves
For Wuhan, Hobby (outside Wuhan), China (outside of Hubei) and China by the onset of symptoms
Are provided in Figure 2.
Figure 2 Figure 2 Epidemiological curve of laboratory-confirmed COVID-19 cases, by study start date
Disease, reported in China as of February 20, 2020
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Figure 3 shows epidemic curves of laboratory-confirmed cases, by the appearance of symptoms
Separately according to the date of the report, on February 5, 12 and 20, 2020. Figures 2 and 3 illustrate this
The epidemic grew rapidly from January 10-22, reported that cases peaked and survived
Between January 23 and January 27, and since then they have steadily declined, except
The prickon reported on February 1 (note: in a central hospital in Wuhan, a fever clinic
Patients have declined from a peak of 500 per day at the end of January to an average of 50 per day since mid-February).
Fig. 3. Epidemic curves according to the onset of symptoms and the reporting date starting February 5th (top
board), February 12 (middle board) and February 20, 2020 (bottom board) for the laboratory
Confirmed COVID-19 cases all over China
Based on these epidemic curves, the published literature and our visits to the Wuhan website
(Hobby), Guangdong (Shenzhen and Guangzhou), Sichuan (Chengdu) and Beijing, JDC
The task force conducted the following epidemiological observations:
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Demographic characteristics
Of the 55,924 lab-approved cases reported as of February 20, 2020, the median age
is 51 years (range from two days to 100 years; IQR 39-63 years old) in most cases
(77.8%) were aged 30-69. Of the reported cases, 51.1% are men, 77.0% are
Hubei and 21.6% are farmers or workers in the occupation profession.
Zoonotic sources
COVID-19 is a zoonotic virus. From phylogenetic analyzes conducted with full available
Genome sequences, bats appear to be the reservoir of the COVID-19 virus, but intermediate
The host(s) have not yet been identified. However, there are already three important areas of work
that is being carried out in China to inform our understanding of the zoonotic origin of this eruption.
These include early investigations of cases with the onset of symptoms in Wuhan all the way
December 2019, environmental samples from Huanan wholesale seafood market and
other markets in the area, and collects detailed records on the origin and type of wildlife
Species sold in Huanan Market and the destination of those animals after the market
Was closed.
Transfer paths
COVID-19 is transmitted via droplets and acidity during unprotected contact between
Connector and sticker. No airborne spread has been reported for COVID-19 and it has not
believed to be the primary motive for the transfer based on available evidence; However, it can
It is possible to predict whether certain procedures for creating a spray are carried out in health facilities.
Fecal ureters have been shown in some patients, and the virus has been viable
Identified in a limited number of case reports. However, the fecal-oral pathway is not
appears to be a driver for transmitting COVID-19; Its role and significance for COVID-19
It remains to determine. Viral ejaculation is discussed in the technical findings (Appendix C).
Gearbox
In China, the human-to-person transmission of the COVID-19 virus occurs mostly
Families. The joint mission received detailed information from the cluster investigation
And some domestic transfer studies that are located in several provinces.
among 344 clusters comprising 1308 cases (out of a total of 1836 reported cases) in Guangdong
In the province and province of Sichuan, most of the clusters (78%-85%) occurred in families.
Household gearshift studies are currently underway, but preliminary studies are ongoing in
In Guangdong, the secondary strike rate in households is estimated to be between 3-10%.
Contact tracking
China has a COVID-19 case detection policy. For example
Wuhan has more than 1800 teams of epidemiologists, with at least 5 people/staff
Tracing tens of thousands of contacts a day. Contact tracking is rigorous, with high
A percentage of identified close contacts that complete a medical observation. Between 1% and
Subsequently, 5% of connections have confirmed cases of COVID-19 in the laboratory, depending on
Place. For example:
- As of February 17 in the city of Shenzhen, between 2842 identified close ties, 2842
100% were tested and 2240 (72%) completed the medical observation. between
Close contacts, 88 (2.8%) were found to be infected with COVID-19.
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- Starting on February 17, in Sichuan Province, between 25493 identified close ties,
25347 (99%) were monitored and 23178 (91%) completed the medical observation.
Of the close contacts, it was found that 0.9% are infected with COVID-19.
- Starting on February 20, in Guangdong province, between 9939 identified close contacts,
9939 (100%) were replaced and 7765 (78%) completed the medical observation.
Of the close contacts, 479 (4.8%) were found to be infected with COVID-19.
Tests in heat clinics and routine ILI / SARI follow-up
The joint mission systematically investigated COVID-19 testing from routine
Respiratory disease monitoring systems to see if COVID-19 is circulating more broadly
and was not identified in the community in China. These systems may include RT-PCR tests of
COVID-19 in influenza (ILI) and acute respiratory tract infection (SARI)
Monitoring systems as well as checking results among all visitors to heat clinics.
On Wuhan, COVID-19 testing of ILI samples (20 per week) in November and December 2019
And in the first two weeks of January 2020, no positive results were found in the 2019 samples, 1
in the first week of January, and three adults tested positive in the second week of January
January; All children tested were negative for COVID-19 even though their number was positive for
Influenza. In Guangdong, from January 1 to 14, only 1 out of more than 15000 ILI/SARI samples
Tested positive for COVID-19. One hospital in Beijing did not have COVID-19
Positive samples between 1910 collected from January 28, 2019 to February 13, 2020. In A
At a hospital in Shenzhen, 0/40 ILI samples were COVID-19 positive.
Within the Guangdong heat clinics, the percentage of samples tested positive for
The COVID-19 virus has diminished over time from a positive 0.47% peak on January 30 to
0.02% on February 16. In total, in Guangdong, 0.14% from about 320,000 heat clinics
The screenings were positive for COVID-19.
Sensitivity
Because COVID-19 is a newly identified pathogen, there is no previously known immunity
Human beings. Based on the epidemiological characteristics observed so far in China, all of them
The assumption that it is sensitive, although there are risk factors that increase the sensitivity to
Pollution. This requires further study, as well as knowing whether there is a neutralization
Immunity after infection.
Transmission dynamics
Deduce from photos 2 and 3, and based on our observations of the national territory
At provincial / municipal levels during the joint mission, we summarize and interpret the
So far transmission dynamics of COVID-19. It is important to note that broadcasting
The dynamics of each eruption are inherent. Regarding COVID-19, we see four main ones
Types of conduction dynamics at the epidemic growth stage and in post-control control
Period, highlighting what is known about the transfer of children, as follows:
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Broadcast in Wuhan
It is believed that early cases detected in Wuhan are the ones that resulted in infection
The source is because many reported their visit or worked at the Huanan wholesale seafood market. As
As of February 25, no source of animals has yet been identified.
At some point in an early stage of the outbreak, several cases caused a person-to-person transmission
Chains sown for the subsequent community eruption before the implementation of the
Comprehensive control measures put in place in Wuhan. The dynamics probably
The approximate mass operation and radiated from Wuhan to other areas of Hubei province and
China, which explains a relatively high R 0 of 2-2.5.
Cordon sanitary around Wuhan and neighboring municipalities imposed since 23
January 2020 effectively prevented the continued export of infected people to the State of Israel
The rest of the country.
Transmission in Hubei, apart from Wuhan
In the provinces immediately adjacent to Wuhan (Xiaogan, Huanggang, Jingzhou and Ezhao),
The transfer is less intense. For other districts, because of fewer transport and human links
Mobility flows with Wuhan, the dynamics are more coordinated with those observed in the
Other regions of the country. Within my debts, implementation of control measures
(including social distancing) has reduced the communal power of pollution, resulting in
The number of cases reported gradually decreases.
Broadcast in China outside Hubei
Considering the status of Wuhan transport hub and population movement during the new Chinese
Year (chunyun), infected people quickly spread throughout the country and were
Especially concentrated in the cities with the highest volume of traffic with Wuhan. Part of
These imported seeds will produce man-to-person transmission chains with disabilities
Target.
Given the experience of Wuhan/Hubei, a comprehensive set of interventions, including
Aggressive case detection and contacts, isolation and management and extreme society
Distancing, implemented to interfere with transmission networks nationwide. to
On date, most of the recorded cases were imported from or had direct links to Wuhan/Hubei.
Community relay was very limited. Most of the locally created cases were
Grouped, most of which occurred in households, as summarized above.
It is worth noting, the highly grouped nature of domestic transmission may explain a relatively high R 0 (2-
2.5) In the absence of interventions and low case counts confirmed with intensive quarantine
and social distancing measures.
Special settings
We note that cases of transfer occurred in prisons to the health settings
and other closed settings. It is currently unclear what role these definitions play
Teams play in the broadcast. However, they do not seem to be the main motivations of the general
Epidemic dynamics. Specifically, we note:
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(a) Health gears and care settings among healthcare workers (HCW)– The
The joint mission discusses nosocomymic infection in all the places visited during the
Task. As of February 20, 2020, 2,055 COVID-19 laboratory confirmed
Cases reported among HCW from 476 hospitals across China. Rob HCW
Cases (88%) were reported from Hubei.
Oddly enough, more than 40,000 HCW were deployed from other regions of China
Support the response in Wuhan. Despite discrete and limited cases
from nosocomial eruptions (e.g. a nosocomial eruption involving 15 HCW in Wuhan),
The transfer in health frameworks and among healthcare workers does not do so
Seems to be the main COVID-19 transmission feature in China. The Common Mission
It became known that of the HCW infections, most of them were identified early in the outbreak
In Wuhan when the supply and experience with the new disease was lower.
In addition, investigations among HCW suggest that many may become infected
Within the household and not within the framework of health services. Off Hobby, Wellness
Infections of care workers were less common (i.e., 246 of the total 2055 HCW
cases). When exposure in these limited cases was examined, exposure to
For the most part, its traces have been reported for a confirmed case in a household.
The joint team noted that attention to the prevention of infection in health care
Employees are of paramount importance in China. Healthcare tracking
Workers identified factors at the beginning of the outbreak that put HCW at higher risk of
Infection, and this information has been used to change policies to improve
HCW protection.
(b) Broadcast in closed settings – there have been reports of COVID-19 transmission
In prisons (Hobby, Shandong and Zhejiang, China), hospitals (as above) and in a long time
– long-term residential facility. The proximity and connection between people in these settings
And the potential for environmental pollution are important factors, which
Can intensify the transmission. Passing on these definitions justifies further study.
Children
Data on people aged 18 and under indicate that there is a relatively low seizure
Rate in this age group (2.4% of all reported cases). Within Wuhan, among the ILI tests
Samples, no children were positive in November and December 2019 and in the first two
Weeks from January 2020. From available data, and in the absence of seriological results
Studies, it is not possible to determine the degree of infection in children, what role does it play
Children play in the transfer, whether children are less sensitive or present
Clinically differently (that is, usually, easier presentations). The joint mission was informed of this
Infected children were mostly identified through contact tracing in households of
Adults. It should be noted that people interviewed by the Joint Task Force were unable to recall episodes of the series
The transfer occurred from a child to an adult.
The signs, symptoms, progression of the disease and their severity
Symptoms of COVID-19 are nonspecific and disease presentation can range from no
Symptoms (asymptomatic) up to severe pneumonia and death. As of February 20, 2020 and
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Based on 55924 laboratory confirmed cases, typical signs and symptomsinclude: Fever
(87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath
Sore throat (13.9%), headache (13.6%), myalgia or arthritis (14.8%), chills (11.4%),
Nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%) and hemopathization (0.9%),
and pressure congestion (0.8%).
People with COVID-19 usually develop signs and symptoms, including light breathing
Symptoms and fever, on average 5-6 days after infection (average incubation period 5-6
days, range 1-14 days).
Most people infected with COVID-19 have a mild illness and recover. Kind of
80% of the patients approved in the laboratory hadmild to moderate illness, which includes
In cases other than pneumonia and pneumonia, 13.8% have a serious illness (respiratory and respiratory inflammation)
Frequency ≥30 / min, blood oxygen saturation ≤93%, PaO2 / FiO2 ratio <300 and / or lung
Infiltrators> 50% of the lung field within 24-48 hours) and 6.1% are critical (respiratory)
failure, septic shock and/or multiple dysfunction/failure in organs). Asymptomatic infection
Reported, however most of the relatively rare cases are asymptomatic
The date of identification / report continued to develop diseases. The lesson of really
Asymptomatic infections are not clear but appear to be relatively rare and invisible
Be the main motive for transmission.
People at highest risk of serious illness and death include people over the age of 60
And those with basic conditions like hypertension, diabetes, cardiovascular
Diseases, chronic respiratory diseases and cancer. It seems that diseases in children are relatively
rare and mild with about 2.4% of all reported cases
Persons under the age of 19. A very small proportion of those under 19 years old
Developed a serious illness (2.5%) or a critical illness (0.2%).
As of February 20, 2,114 of the 55,924 lab-approved cases have died (raw fatalities).
3.8% ratio[CFR 2 ](note: at least some of them were identified according to the definition of a case that
included lung disease). The total CFR varies by position and intensity
Transmission (i.e. 5.8% in Wuhan compared to 0.7% in other regions of China). China Total CFR
was higher in the early stages of the outbreak (17.3% in cases with the appearance of symptoms between -1
January 10) and reduced over time to 0.7% for patients with symptoms after 1
February (Figure 4). The joint mission noted that the level of care has evolved over the years
The course of the outbreak.
Mortality increases with age, with the highest mortality among people over the age of 80
(CFR 21.9%). CFR is higher in males compared to females (4.7% vs. 2.8%). By
Conquest, patients who reported pensioners had the highest CFR at 8.9%. While
Patients who did not report any complex conditions had a CFR of 1.4%, patients with comorbidity
At much higher rates: 13.2% among those suffering from cardiovascular disease, 9.2% among patients
Diabetes, 8.4% for hypertension, 8.0% for chronic respiratory diseases and 7.6% for cancer.
2 Common Mission recognizes the challenges and biases known as early pandemic gross CFR reporting.
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Figure 4 Figure 4: Ratio of deaths of cases (reported deaths out of all cases) in China
Time and location, as of February 20, 2020
Data on disease progression is available from a limited number of reports
Hospitalized cases (Figure 5). Based on available information, the median time from
The onset of symptoms for laboratory approval decreased from 12 days (range 8-18
days) in early January to 3 days (1-7) in early February 2020, and in Wuhan from 15 days
(10-21) up to 5 days (3-9), respectively. This allows for previous cases and contact
Identification, isolation and treatment.
Figure 5. Pattern of disease progression for COVID-19 in China
Note: The relative size of the boxes to the severity of the disease and the result reflect the rate of reported cases starting at 20
February 2020. The size of the arrows indicates the rate of cases that have recovered or died. Disease definitions are
Described above. In mild cases there is a mild form of pneumonia.
medium
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Using available preliminary data, median time from start to clinical recovery for easy
The cases are about 2 weeks and it is 3-6 weeks for patients with severe or critical illness.
Preliminary data indicate that the time period from the beginning to the development is difficult
The disease, including hypoxia, is a week. Among deceased patients, the time after
The onset of symptoms for the result ranges from 2-8 weeks.
an increasing number of patients have recovered ; As of February 20, 18264 (24%) reported
The cases have recovered. Encouragingly, a February 20 report from the CDC in Guangdong
suggests that out of 125 severe cases identified in Guangdong, 33 (26.4%) have recovered
were discharged from the hospital, and 58 (46.4%) improved and were reclassified as owners
Mild / moderate disease (i.e. + milder pneumonia). Among the most serious cases reported so far,
13.4% died. Early detection of cases and contacts allows for earlier handling.
China’s response
After discovering a cluster of cases of pneumonia of unknown etiology in Wuhan, CPC
The Central Committee and the Council of State launched the national emergency response. A
Key Group Leadership for Epidemic Response and Common Prevention and Control
A mechanismof the Council of State was established. Secretary General Xi Jinping in person
Guided and deployed the prevention and control work and requested the prevention
And controlling the COVID-19 outbreak is a top priority for the government at all levels. Prime minister
Minister Li Ki-yang headed the main leading group for response to the pandemic and got started
Wuhan to review and coordinate the prevention and control work of relevant departments
and provinces (autonomous regions and municipalities) throughout the country. Deputy Prime Minister
Sun Chunlan, who worked on fronts in Wuhan, led and coordinated
The prevention and frontal control of the outbreak.
The preventive and control measures were implemented quickly, already in the initial stages
In Wuhan and other central regions of Hubei, to the current overall national epidemic. It has
Carried outin three main stages, where two important events define the same stages.
First, COVID-19 is included in the statutory report of Grade B infectious diseases and
Borders of infectious diseases quarantined at the border on January 20, 2020, 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 that of the Council of State.
The issuer, on February 8, 2020, the announcement of an orderly resumption of production and renewal
Production in factories, which indicated that it worked in China’s national epidemic control
Enter the stage of prevention and overall control of an epidemic along with recovery
Ordinary social and economic activities.
The first stage
In the early stage of the outbreak, the main strategy focused on prevention
Export of cases from Wuhan and other preferential regions in Hubei province, and prevention
import of bags by other provinces; The overall goal was to control the source
Infection, blocking the transmission and preventing further spread. The reaction mechanism was
An entrepreneur with multi-sectoral involvement in joint preventive and control measures. wet
The markets were closed and efforts were made to identify the zoonotic origin. information
About the epidemic notified the WHO on January 3, and about the complete genome sequences of the
The COVID-19 virus was shared with the World Health Organization on January 10. COVID-19 diagnostic protocols and
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treatment, follow-up, epidemiological investigation, close relationship management, and
Laboratory tests and relevant and epidemiological follow-up activities have been formulated
Investigations conducted. Diagnostic test kits have been developed, and live wildlife
The poultry markets were placed under strict supervision and control measures.
The second stage
In the second phase of the outbreak, the main strategy was to reduce the intensity of the
The epidemic and slow down the increase in cases. in Wuhan and other priority areas of
In Hubei province, the focus was on actively treating patients, reducing deaths and prevention
Export. In other provinces, the focus was on preventing imports, curbing the continent
The spread of the disease and the implementation of common preventive and control measures. National
Wildlife markets have been closed and wildlife breeding facilities have been discontinued. about
On January 20, COVID-19 was included in the reported report of Grade B infectious diseases and
Infectious diseases limits in quarantine, with temperature checks, health
Declarations and quarantine against COVID-19 set up in the city’s transport warehouses
In accordance with the law. On January 23, Wuhan implemented strict restrictions on movement. the
improved protocols for the diagnosis, treatment and prevention and control of epidemics;
The isolation of cases and treatment have intensified.
Steps have been taken to ensure the treatment of all cases, and close ties are isolated
and placed under medical observation. Other measures carried out included the extension
of the Spring Festival holiday, traffic controls and control of transport capacity to
reduce the movement of people; Crowdfunding activities have also been cancelled. information
On the epidemic and on preventive and control measures released regularly. Public risk
communication and health education has been strengthened; Allocation of medical supplies
Compatible, new hospitals were built, reserve beds and relevant premises were used
have been reactivated to ensure that all cases can be treated; Efforts have been made to maintain a
A stable supply of goods and their prices to ensure the smooth operation of the company.
The third stage
The third phase of the outbreak focused on reducing clusters of cases, with thorough control
the pandemic, creating a balance between prevention and control of epidemic, sustainable
Economic and social development, unified command, standard guidance and
Implementation of evidence-based policies. For Wuhan and other priority areas of
Hubei County, the focus was on patient care and transmission disruption,
with an emphasis on concrete steps for the full implementation of relevant metrics for testing,
Admission and treatment of all patients. An approach to risk-based prevention and control was
Adopted using differentiated preventive and control measures in different regions of the region
Country and provinces. Relevant measures have been strengthened in the
Epidemiological investigation, case management and prevention of an epidemic in a high-risk public
Places.
New technologies have been implemented such as the use of big data and artificial intelligence (AI)
Strengthening contact tracing and managing priority populations. Relevant health
Insurance policies were announced as “health insurance payment, off-site settlement, and
Financial compensation”. All provinces provided support to Wuhan and priority areas in
Hubei Province in an effort to quickly curb the spread of the disease and deliver on time
Clinical therapy. The preparation for the pre-school kindergarten was improved and the work resumed in stages and
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Groups. Health and welfare services were provided to returning employees in a targeted manner
In a ‘one-time’ manner. ordinary social actions are reconstructed in a step-like form;
Popular knowledge about disease prevention to improve public health literacy
Skills; and a comprehensive emergency scientific research program is underway
Develop diagnoses, treatments and vaccines, demarcating the spectrum of the region
the disease, and identify the source of the virus.
Knowledge gaps
Since the start of the COVID-19 outbreak, there have been extensive attempts to improve
Understand the virus and the disease in China. It’s amazing how knowledgeable about
A new virus has accumulated in such a short time. However, as with all new diseases, and
Only 7 weeks after the start of this outbreak, key knowledge gaps remain. Appendix D Summary
The unknown unknowns in several regions, including the source of infection, pathogenesis and
Coronavirus, transit, risk factors for infection and disease progression,
Follow-up, diagnosis, clinical management of severely ill and humane patients
Effectiveness of preventive measures and control. The timely fulfillment of this knowledge
Gaps are mandatory to improve control strategies.
III. evaluation
The joint mission drew four main conclusions from its work in China and four main ones.
Inferences from her knowledge of the broader global response to COVID-19.
Recommendations are made in five key areas to inform the ongoing response around the world
and in China.
The response in China and next steps
- In the face of a previously unknown virus, China has become perhaps the most
An effort to contain ambitious, agile and aggressive diseases in history. Strategy
The basis of this containment effort was initially a national approach that
Promoted universal temperature monitoring, masking and hand washing. however
With the development of the outbreak, and knowledge was obtained, scientific and risk-based
An approach has been taken to adjust the application. Specific means of containment were
Adapted to the provincial, provincial and even community context, the ability to
The definition of the character, and the nature of the new transmission of coronavirus.
While the basic principles of this strategy have been consistent since its launch,
Constant renewal of specific aspects for the integration of new knowledge
On the novel novel the novel, the COVID-19 disease and the COVID-19 grocery store, at the same speed
As this knowledge emerged. The incredible speed at which Chinese scientists
And public health experts isolated the causative virus, established diagnostic tools and
Key transfer parameters are determined, such as the proliferation and incubation route
The period provided the vital evidence base for China’s strategy, and achieved invaluable time.
Response.
Page 17 |
17
As amazing, was the uncompromising rigor of implementing the strategy that was supposedly proven
A hallmark in every concept and context in which it is tested. There was also a
A constant focus on improving key performance indicators, for example constantly
Improving the speed of case detection, isolation and early treatment. the
The implementation of these containment measures is supported and enabled by
Innovative and aggressive use of advanced technologies, from transition to online
Medical platforms for routine care and study, for use on 5G platforms for support
Rural response actions.
- Achieving China’s extraordinary coverage with its contagion and perseverance
Means were possible only because of the deep commitment of the Chinese people
for collective action in the face of this common threat. At the community level, this is
Expressed in the incredible solidarity of provinces and cities in the most supported
vulnerable populations and communities. Despite continuous outbreaks on their own
Regions, governors and mayors continue to send thousands of health services
Employees and tons of personnel supplies are essential for Hubei Province and Wuhan City.
On a personal level, the Chinese people responded to this outburst with courage
and conviction. They accepted and adhered to the fullness of containment
Measures – whether to suspend public gatherings, to ‘stay at home’ for a month.
Advice or travel bans. Over site visit for 9 intense days
China, in open discussions from the leading level of the local community and the front
Healthcare providers to leading scientists, governors and mayors, the common mission was
Beaten by the honesty and perseverance that each of them brings to this COVID-19 response.
- China’s bold approach to contain the rapid spread of this new breathing generator
Changed the course of the rapidly intensifying and deadly epidemic. specially
A convincing statistic is that on the first day of teamwork the down payment was
2478 reported cases of COVID-19 in China. Two weeks later, on
On the last day of this mission, China reported 409 recently confirmed cases. This decrease in
Cases of COVID-19 across China are real.
Several data sources support this conclusion, including the steep decline in the heat clinic
visits, opening of treatment beds when patients are discharged, and
Challenges in recruiting new patients for clinical trials. Based on raw comparison
Assault rates in the provinces, the common mission estimates that this is really all
Government and social approach taken in China has been prevented or is occurring
At least delayed hundreds of thousands of cases of COVID-19 in the country. Extensively
Forcibly Reduced COVID-19 Infection in China
has also played a significant role in protecting the global community and making it stronger
The first line of defense against international expansion. However, with this outbreak
There has come great ownership and sacrifice of China and its people, both in man and in material
Conditions.
While the scale and impact of the COVID-19 operation in China was staggering, it was
They also emphasized areas for improving the capacity of the emergency response to public health.
Page 18 |
18
These include overcoming any obstacles to act promptly with early warnings, massively
Detail capability for isolation and care to optimise frontline health protection
Employees handle all settings, to improve collaborative action on priority gaps in
Knowledge and tools and to communicate more clearly key data and developments
International.
- China is already working, and rightly so, to strengthen its economy, to reopen its schools
To return to a more normal look of her company, even while she is working to accommodate the
The remaining chains of COVID-19 transmission. appropriately, science-based,
Taking an informed and scalable approach, with clear recognition and readiness
From the need to respond immediately to any new COVID-19 cases or clusters as a key
Elements of the braking strategy are superior.
Despite the declining number of cases, in all of China every province, city and community
who visited them is urgently escalating their investments in acute care beds and public health
Capacity. It is essential that this continues. Fifty thousand COVID-19 patients infected
Still under treatment, across the country. However, the joint mission has come
Understand the significant knowledge, experience, and capabilities that China has quickly
built during this crisis. As a result, it supports China’s working assumption that in
In most provinces and municipalities it should soon be possible to re-manage life
Cases of COVID-19, using even more tailored and resilient approaches anchored
Very fast case detection, instant activation of central, direct containment activities
Oversight by close leadership and broad community involvement.
When China works to renew a more normal level of activity of society and the economy, so it is
It is essential that the world recognizes and responds positively to rapidly changing changes, and
Decrease, risk of COVID-19 in the country. China’s rapid return to full connectivity with
The world, and full and economic output, are vital to China and the country
World. The world urgently needs access to China’s experience in response to COVID-
19, as well as the material goods it brings to the global response. It’s even more urgent
Now, with COVID-19 outbreaks outside of China, constantly re-examine
Restrictions on travel and/or trade to China that go beyond the recommendations of the
IHR Emergency Committee on COVID-19.
The global response and next steps
- The COVID-19 virus is a new pathogen which is highly contagious, can spread quickly,
And it should be seen as those that can cause enormous health, economically and socially
Effects in any setting. It’s not SARS and it’s not the flu. Building scenarios and
Strategies only based on known pathogens run the risk of not taking advantage of everything possible
Measures to slow the transmission of the COVID-19 virus, reduce diseases and save lives.
COVID-19 is not SARS and it is not the flu. This is a new virus of its own
Properties. For example, COVID-19 transmission in children appears to be limited
Compared to influenza, while the clinical picture differs from SARS. such differences,
Although based on limited data, it may play a role in the apparent efficiency of rigor
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19
Take non-pharmacological public health measures to disrupt man-to-human chains-
Human transmission in a variety of settings in China. The COVID-19 virus is unique among
Human coronavirus combined with a high, significantly lethal transmission
Results in certain groups with high risk and the ability to cause a huge society and economy
Disturbance. For planning purposes, it is assumed that the global population is
susceptible to this virus. Because the animal origin of the COVID-19 virus is unknown at
Today, the risk of bringing repatriates into previously affected areas must be constantly
Considered.
The nature of the novel, and our constantly evolving understanding, of this coronavirus
Requires tremendous agility in our ability to adapt quickly and change our readiness
and planning a response as is constantly done in China. It’s extraordinary
An achievement for a country of 1.4 billion inhabitants.
- China’s uncompromising and rigorous use of non-pharmacological means to contain
Transmitting the COVID-19 virus in several settings provides essential classes for
A global response. This unique and unprecedented response to the country in 2019
China has reversed the escalating cases in two hobby, where it was widespread
Community broadcasting, and import provinces, including family clusters
It seems to have triggered the outbreak.
Although the timing of the outbreak in China was relatively similar throughout Europe
In the country, gear networks have been established in a wide range of settings, starting with mega
Cities in the north and south of the country, to remote settlements. However, the fastest
Adjusting and adapting China’s strategy demonstrated that there could be containment
Optimized and successfully activated in a wide range of settings.
China’s experience strongly supports the efficiency and effectiveness of COVID-19 anchoring-
19 Rapid preparedness and response plans in an in-depth assessment of local risks and
Using a differentiated risk-based containment strategy to manage the outbreak in
Cases free vs. sporadic cases vs. case clusters vs. community level
Broadcast. Such a strategy is essential to ensure a sustainable approach
Reducing socioeconomic impact.
- A large part of the global community is not yet ready, the mindset and materiality
Implement the measures put in place to contain COVID-19 in China.
These are the only indicators that are currently proven to cause disruption or mitigation
Conduction chains in humans. The foundation for these measures is very much
Proactive follow-up for immediate detection of cases, very fast diagnostics
immediate isolation of cases, strict monitoring and quarantine of close contacts, and
Exceptionally high level of understanding the population and accepting these
Means.
Achieving the high quality of an application is required to succeed in this
Measures require unprecedented speed of decision-making, unprecedented speed
Leaders, operational thoroughness by public health systems and company involvement.
Page 20 |
20
Considering the damage that can be caused by uncontrolled transfer, at the community level of
This virus, such an approach undertakes to save lives and achieve the weeks and months
Necessary for testing treatments and developing vaccines. Moreover, as
Most of the new cases outside of China are currently occurring at the high and central intermediate level
Income states, strict commitment to slow down broadcasting in such frameworks with
Non-drug measures are essential to achieving a second line of defense
Low-income countries that have weaker health systems and coping capabilities.
The time that can be obtained through the full implementation of these measures – even if right
Days or weeks – can be invaluable in the eventual reduction of diseases and deaths of COVID-19.
This is evident in the tremendous increase in knowledge, attitudes and even tools that there are
Has only occurred in seven weeks since the virus was discovered quickly
Scientific work done in China.
- Use the time period recorded in strict implementation of COVID-19 containment measures
More effectively to urgently improve global readiness and rapidly develop the specific
Tools necessary to eventually stop this virus.
COVID-19 is spreading at an incredible speed; COVID-19 outbreaks in every setting there are
very serious consequences; And now there is strong evidence that non-medicines
Interventions can reduce and even interfere with transmission. in reference, global and
National preparedness planning is often ambivalent about such interventions. however
To reduce COVID-19 disease and death, near-term preparedness planning must adopt the
Large-scale implementation of high-quality, non-pharmacological public health measures.
These measures must fully integrate the detection and isolation of immediate, strict cases
Monitoring and monitoring close contact with population / quarantine and population / direct community
Engagement.
Huge array of COVID-19 studies, scientific research projects and product R&D efforts
Ongoing in China and around the world. It is essential and should be encouraged and supported.
However, such a large number of projects and products should be prioritized. without
As a priority, it runs the risk of damaging the concentration of attention and resources
Collaboration is required to shorten timelines by precious weeks and months. As you progress
Already done, the urgency of the COVID-19 situation supports even more cruelty
Priority is given to research in the fields of diagnosis, treatment and vaccinations.
Similarly, there is a long list of proposed studies on the origins of COVID-19, natural
History of the disease, and transmission dynamics of the virus. However, the urgency of
Responding to cases and saving lives makes it difficult for policymakers to consider and
Act on such comprehensive lists. This can be addressed by balancing studies with
Immediate public health and clinical needs of the response. Studies can be prioritized in
Terms of the biggest knowledge gaps that can be addressed most quickly
The greatest immediate impact on patient response and management operations. this
suggests prioritizing studies to identify risk factors for moving households,
institutions and the community; Convenience sample for this virus in the population
use of existing tracking systems; age-layered sero-epidemiological surveys; the
analysis of a series of clinical cases; and cluster investigations.
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21
- Main recommendations
For China
- Maintain an appropriate level of emergency management protocols, depending on
On the estimated risk in each area and the recognition of the real risk of new cases
Clusters of COVID-19 with renewed economic activity are movement restrictions
has been raised and schools are reopening;
- Carefully monitor the removal of the stages of current movement restrictions
public meetings, starting with the return of workers and migrant workers,
This was followed by the eventual reopening of schools and the removal of other measures;
- To further strengthen the preparedness of emergency management mechanisms, in the public
Healthcare institutions (e.g. CDC), medical facilities and community involvement
Mechanisms to ensure ongoing capacity for immediate launch of containment
activities in response to a resurgence in cases;
- prioritizing priority for research that quickly informs risk management decisions,
Especially studies in institutions for home and health care, denied stratified by age
epidemiological surveys and rigorous investigation of the animal-human interface;
Establish a centralized research program to quickly track the promising speed
Serological diagnoses and analyzes, examination of potential antiviruses and vaccination
candidates and Chinese involvement in multi-state selected trials; and
- As the country with the most knowledge about COVID-19, further enhance the country
Systematic, real-time sharing of epidemiological data, clinical outcomes
An attempt to inform the global response.
To countries with imported cases and/or outbreaks of COVID-19
- Instantly activate the highest level of nationwide response management
Protocols to ensure the access of the entire government and the whole society
contain COVID-19 with non-pharmacological public health measures;
- prioritize finding an active and exhaustive case and immediate testing and isolation,
strict monitoring of contact and strict quarantine of close contacts;
- Fully educate the general public on the seriousness of COVID-19 and their role in
prevention of its spread;
- Instantly expand COVID-19 gear chain detection tracking, by
Examination of all patients suffering from atypical pneumonia, and a screening test was performed on some of them
patients with upper respiratory diseases and/or recent exposure to COVID-19, and
Adding COVID-19 testing to existing surveillance systems (e.g.
systems for patients with influenza and SARI); and
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22
- Plan multi-sector scenarios and simulations for deployment of
Even stricter measures to break transmission chains as needed (e.g.
Suspension of large-scale gatherings and closure of schools and
workplaces).
To uninfected countries
- Prepare for immediate activation of the highest level of emergency response
Mechanisms for exercising the government-wide and whole-society approach
Essential for early containment of the COVID-19 outbreak;
- Quickly review the national readiness plans in light of new knowledge on the subject
the effectiveness of non-drug measures against COVID-19; Ltd
Quick detection, isolation of large cases and respiratory support capabilities, and
Rigorous monitoring and contact management in national COVID-19 preparedness
response programs and capabilities;
- Improve tracking immediately for COVID-19 as rapid detection is imperative
containing a spread; Consider checking out all patients suffering from atypical pneumonia
COVID-19 virus and adding tests to the virus to track the impact of existing
Systems;
- Start now enforcing strict infection prevention and control implementation
Measures in all health facilities, especially in emergency departments and
Outpatient clinics, because this is where COVID-19 will enter the healthcare system; and
- Quickly assess the understanding of the general population of COVID-19, adjust
Materials and activities to promote national health accordingly, and engage in
Clinical champions for communication with the media.
Public
- Recognize that COVID-19 is a new and touching disease but outbreaks
Can get by with the right response and that the vast majority of infected
people will recover;
- Start now to carefully embrace and practice the most important prevention
Measures for COVID-19 by frequent hand washing and covering your always
mouth and even when sneezing or coughing;
- Update yourself continuously about COVID-19 and its signs and symptoms (i.e. fever
and dry cough), because the strategies and reaction activities will persist
improve as new information about this disease accumulates every day; and
- Be prepared to actively support the COVID-19 response in a variety of ways,
Including the adoption of more reinforcing social distancing procedures
The elderly population is at high risk.
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23
To the international community
- Recognize that solidarity and genuine cooperation are essential between countries
Tackling the common threat that COVID-19 represents and triggers
Principle;
- Quickly share information as required by international health regulations
(IHR) includes detailed information about imported bags to make it easier to contact
detection and information on the means of containment across countries;
- Recognize the rapidly changing risk profile of countries infected with COVID-19
Continuously monitor outbreak trends and control capabilities to reassess each
‘Additional health measures’ that significantly interfere with international travel
and trade.
__________
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24
Appendices
A. Members of the joint mission of WHO and China
Bruce Eilard
Head of the WHO Joint Task Force on China on COVID-19, Senior Advisor to the Director-General,
World Health Organization, Geneva, Switzerland
Wanian Liang
Head of the WHO-China Joint COVID-19 Task Force, Head of National Health Experts Team
Commission
Xiaoping Dong
Director and Researcher, Center for Global Public Health, Chinese Center for Disease Control
and prevention
TIM ECKMANNS
Head of the unit, health-related infections, antibiotic resistance tracking
Consumption, Robert Koch Institute, Berlin, Germany
Dale Fisher
Professor of Medicine, Yong Yong Lu School of Medicine, National University of Singapore,
Singapore, Singapore
Chiqué
IHEKWEAZU
Director-General of the Centre for Disease Control in Nigeria, Nigeria Centers for Disease Control,
Abuja, Nigeria
Clifford LANE
Clinical Director, National Institute of Allergy and Infectious Diseases, US National Institutes
Healthcare, Bethesda, United States
Jung-ku LEE
Professor of Family Medicine, Seoul National University College in Seoul, Republic
of Korea
Gabriel LEUNG
Dean of Medicine, Helen and Francis Zimran Professor of Population Health, University
Hong Kong, Hong Kong SAR, China
Jiangao LIN
Director and Professor, Department of Pulmonology and Health, China-Japan
Friendship Hospital, National Center for Clinical Research for Respiratory Diseases, Beijing
Haying LIU
Deputy Director and Researcher, Institute of Pathogenic Biology, Chinese Academy of Medicine
Sciences, China in Beijing
Natalia
Peshnaya
Head of Department and International Advisor, Infectious Diseases Center, National
Medical Research Center for Pathology and Infectious Diseases, Moscow, Russia
alexander
SEMENOV
Deputy Director, Pasteur Institute in St. Petersburg, St. Petersburg, Russia
Hitoshi
Takahashi
Senior Research Scientist, Center for Influenza Virus Research, National Institute of Infections
Diseases, Tokyo, Japan
Maria
Van Kerhongh
Head of the Unit, Developing and Malicious Diseases, Global Preparedness for Infectious Hazards, World
Health Organization, Geneva, Switzerland
Bin WANG
Deputy Team Leader, Deputy Director General of the Bureau of Disease Control and Prevention,
National Health Commission
Guangfa Wong
Director of Department of Respiratory and Critical Medicine, Peking University
hospital
Fan WU
Vice Dean, Shanghai College of Medicine, Foden University
Zhongze WU
Director of Compliance and Enforcement, Department of Wildlife Conservation,
National Forest and Lands Administration
Zunyou WU
Chief Epidemiologist, Chinese Center for Disease Control and Prevention
Yoni XING
Head of Unit, State Capacity for International Health Regulations, Health Security
Readiness, WHO, Geneva, Switzerland
ChairmanKwok-Yung YUEN, Professor and Co-Director of the State Key Laboratory for Emerging Infectious Diseases,
Department of Microbiology, The University of Hong Kong
Vigong Zhu
Medical Officer, Influenza Division, National Center for Vaccination and Respiration
Disease, U.S. Centers for Disease Control and Prevention, Atlanta, United States
Yong Zhang
Assistant Director and Researcher, National Institute for Viral Disease Control
Prevention, Chinese Center for Disease Control and Prevention.
Leigh Zhu
Head of Research, Emerging Infectious Diseases Branch, Public Health Emergency
Center, Chinese Center for Disease Control and Prevention
Page 25 |
25
In. Summary of the task’s agenda
Dates
place
Tasks
10 – 15 February 2020
(Preliminary team)
beijing
Advanced team and WHO state team meets with national
Fellows and Institutions
16 February 2020
beijing
Meeting with the full international team for a briefing at WHO
Country office
beijing
Workshop at the National Health Commission (NHC) with relevance
Departments of the prevention and joint control mechanism of
Council of State
17 February 2020
beijing
Site visit at Beijing Ditan Hospital
beijing
Site visit at Ankhueli Community and Health Services Station, Anzhen
Street, Chuyang District, Beijing
beijing
Workshop with the Chinese Center for Disease Control and Prevention
18 February 2020
(Guangdong Team)
Shenzhen,
Guangdong
Shenzhen customs at the airport
Shenzhen,
Guangdong
Shenzhen People’s Hospital
Shenzhen,
Guangdong
Shenzhen Center for Disease Control and Prevention
Shenzhen,
Guangdong
Meeting at Tencent
19 February 2020
(Guangdong Team)
Shenzhen,
Guangdong
Qiaoxiang community
Shenzhen L
Guangzhou
Visit Futian high-speed train station and travel to Guangzhou by
train
Guangzhou
Guangzhou Sanatorium
Guangzhou
Guangdong Regenerative Medicine and Health Laboratory
Guangzhou
Guangzhou Wet Market Tiyudongzhihui
Guangzhou
First workshop with the People’s Government in Guangdong Province
20 February 2020
(Guangdong Team)
Guangzhou
Guangdong Provincial Center for Disease Control and Prevention
Guangzhou
Renmin’s Road Campus of Gynecology and Pediatrics in Guangzhou
center
Guangzhou
The Second Workshop with the People’s Government in Guangdong
district
18 February 2020
(Sichuan Team)
Beijing to
Chengdu
Sichuan
Site visit at Chengdu Shuangliu International Airport
Meeting with the Governor of the Sichuan Provincial People’s Government
On-site visit to the main hospital in Yunjan province with a heat clinic
A visit to a site in the home community in the town of Yongen
19 February 2020
(Sichuan Team)
Seminar with the district and municipal authorities
Sichuan Center for Disease Control and Prevention
On-site visit to West China Hospital – Designated COVID-19 Hospital
20 February 2020
(Sichuan Team)
Website visit to Chengdu Women’s and Children’s Hospital
Site visit to a pharmaceutical logistics center
Site visit at Chengdu East Railway Station
Page 26 |
26
Site Visit to Chengdu Medical Center for Public Health – COVID 19
hospital
Sichuan and Guangdong teams reconvene in Guangzhou
21 – 24 February 2020
analysis of key findings; The Joint Mission Meetings of the World Health Organization-China to
End the report
February 22 (Wuhan Team)
Guangzhou L
wuhan
Select team members only
February 23 –
(Wuhan team)
Site visit to Guanggu campus from Wuhan Tunji Hospital
Site visit to the mobile hospital in the Wuhan sports center
Workshop with relevant departments of common prevention
Hubei Province Control Mechanism
Feedback meeting with Minister Ma, NHC at the Wuhan Conference
center
24 February 2020
Guangzhou L
beijing
Ended the report, the WHO and international world health organization’s press conference in Beijing
__________
Page 27 |
27
Gimel. Detailed technical findings
Answer management, case management and contact, risk communication and
Community Involvement
The response structures in China were quickly placed in accordance with an existing emergency situation
Planned and aligned from the top to the bottom. It has been replicated in the four levels of
Government (district district, district / district).
Organizational structure and response mechanism
Activating a national response: COVID-19 prevention and control mechanisms
Initiated immediately after the outbreak was declared and nine working groups were
Established to coordinate the response: a) coordination b) prevention and control of epidemic c)
Medical care d) research e) public communication and i) foreign affairs g) medical
material support h) providing life maintenance and i) social stability. Every workgroup has
Leader at the ministerial level. Emergency response laws and regulations
Responding to public health emergencies, preventing and controlling infectious diseases
have been developed or updated to guide the response.
Enable response in provinces : Each province has established a structure similar to district management
Outbreak. The response is ordered at the levels of a national district, a district,
District/County and the community. By January 29, all provinces across China are underway
The highest level of response to significant public health emergencies.
Response strategy
A clear strategy was developed and the goals were well laid out and moved laterally
All response architecture. This strategy was quickly adapted and adapted to
Outbreak, both in terms of the epidemiological situation over time and in different parts of the
Country.
The epidemiological situation was used to define a location for four areas:
- In no-incident zones, the strategy in these areas is to “completely prevent
Introduction “. This includes quarantine arrangements in the transportation centers,
Tracking temperature changes, strengthening triage arrangements, using
Heat clinics, ensuring normal economic and social operations.
- In regions with sporadic cases, the strategy focuses on “reducing imports,
stopping the transmission and providing appropriate treatment.”
- In areas with community clusters, the strategy is focused on “stopping broadcasting,
preventing exports and strengthening treatment.”
- In areas with community relocation, the most stringent prevention and control
Strategies are implemented, there is an entry and exit of people from these areas
have been discontinued and public health and medical care measures are
Comprehensively reinforced.
Page 28 |
28
Main control measures implemented in China
The main controls implemented in China are as follows and are presented in the
Figures 6A-6D representing the response at the national level and examples of the reaction in the region
Provincial and municipal levels:
Tracking and reporting: COVID-19 is included in the statutory report on infections
Diseases on January 20th and plans were formulated to strengthen diagnosis, monitoring and
Reporting.
Strengthening the ports of entry and quarantine: The Customs Department has launched the
An emergency plan for public health emergencies at ports across the country and restarted the
The system of health declaration cards for entering and exiting cities as well as strict supervision of
The temperature of the entry and exit passengers.
Treatment: For severely or critically ill patients, the principle of “four concentrations” was
Implemented: i.e., concentration of patients, medical specialists, resources and treatment
Special centers. All cities and districts have made the relevant hospitals, increased the number
of designated hospitals, dispatched medical staff and established expert groups for consultation,
To minimize the mortality of seriously ill patients. There are medical resources from all over China
were recruited to support the medical care of patients in Wuhan.
Epidemiological investigation and management of close contact: strong epidemiological
Investigations are being carried out on cases, clusters and contacts to identify their origin
Infect and implement targeted controls, such as contact tracing.
Social distancing : At the national level, the Council of State extended the Spring Festival
Holiday in 2020, all regions of the country were canceled or suspended activities like sports
Events, cinema, theater and schools and colleges in all parts of the country have re-postponed the
Opens after the holiday. Organizations and institutions interfered with their return to work.
Transportation departments are setting up thousands of health and quarantine stations in the country
Service areas, and entrances and exits for passengers at the stations. Hubei Izma Province
The most stringent traffic control measures, such as the suspension of urban public transport,
Including subway, ferry and long-distance passenger transport. Every citizen should wear a
Mask in public. Home support mechanisms were established. As a result of all
These measures, public life is greatly reduced.
Funding and substantial support: The payment of health insurance has been taken over by the state, such as
In addition, work to improve the accessibility and availability of medical materials
Personal protection materials, and ensure basic living materials for affected people.
Emergency materials support: Government restored production and expanded
Production capacity, organized key organizations that have already begun to deviate from the flow
Production capacity, supported domestic enterprises to expand imports and used cross-border
E-commerce platforms and organizations to help import and improve medical materials
Ability to ensure delivery.
Page 29 |
29
0
500
1000
1500
2000
2500
3000
3500
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delicate
pneumonia
Severe
Critical
Inconsistent
Start date
f
u
M
In
the
ro
fc
A
s
the
s
An outbreak announced by the WHC.
NHC and China CDC were involved
In investigation and response
Huanan seafood
Wholesale market
close
Emergency supervision, case investigation, close contact
Market management and exploration initiated,
Technical protocols for Wuhan released
NHC has notified the state of global health and relevant countries and regions
Garden sequence completed by China CDC
Innovative Coronavirus Isolated by China and CDC
China CDC has publicly shared the gene sequence of the
Corona virus
NCIP is incorporated as a reportable disease in the Infectious Diseases Act
Health Law and Quarantine in China
NHC has issued technical protocols for diagnosis and control
Wuhan implemented strict movement restrictions
NHC officially started publishing information about diseases
The Council of State initiated a joint multidisciplinary mechanism
Two new hospitals have been established in Wuhan
Improved entry and isolated
Handling of cases in Hubei
Resumption of work and rehabilitation
Strategy and response adjustment
Who declared PHEIC
First stage
(before January 19, 2020)
Step two
(January 20 – February 7, 2020)
Step three
(after February 8, 2020)
A
In
Page 30 |
30
gimel
Figure 6. COVID-19 pandemic curves and major intervention measures in China
Implemented a) at the national level b) in Guangdong province, c) in Shenzhen
City Hall and d) in Sichuan Province
D
Page 31 |
31
Risk communication (publication of information, public and media communications)
International and interregional cooperation and information sharing: Effective January 3
In 2020, the World Health Situation reported daily information on COVID-19 cases. Full genome
The sequences of the new virus have been shared with the World Health Organization and the international community
Immediately after the pathogen is detected on January 7. January 10th, Expert
A group involving technical experts in Hong Kong, Macau and Taiwan and global health
The staff of the organization was invited to visit Wuhan. A set of primers and nuclear substances for
PCR discovery for COVID-19 was released on January 21.
Daily updates: National Health Commission announces epidemic situation every time
A day and holds daily press conferences to respond to the issues that arise. Also the government
Often invites experts to share scientific knowledge on COVID-19 and address the public
Worries.
Psychological therapy: It is given to patients and the public. governments at all levels,
NGOs and all sectors of society have developed guidelines for an emergency psychological crisis
Intervention and guidelines for self-support and psychological counseling. Hotline
For mental health services established for the public.
IT platform: China took advantage of technology, big data, and AI for COVID-19
Readiness, readiness and response. Authoritative and reliable, medical information
Training, access to online services, provision of educational tools and tools for remote work
Have been developed and used throughout China. These services have increased accessibility
For healthcare, reduce misinformation and minimize the impact of false news.
Social Mobilization and Community Involvement
Civil society organizations (community centers and public health centers) were
Recruited to support prevention and response activities. The community has to a large extent
Received the preventive and control measures and fully participates in the management
of self-isolation and improving public compliance. Community volunteers are
Organized to support self-isolation and help isolated residents at home solve practical lives
Difficulties. Measures have been taken to restrict the movement of the population through a house
Established support. So far, outside of Hubei, 30 provinces have been registered and managed
More than five million people come from Wuhan.
Clinical Case Therapy and Infection Prevention and Control
The main signs and symptoms of COVID-19 include fever, dry cough, fatigue, sputum
Production, shortness of breath, myalgia or arthritis, sore throat and headache. Nausea
or reported vomiting in a small percentage of patients (5%). On February 14th,
China CDC has described the clinical features, results, laboratory and radiological findings of 44
672 cases confirmed in the laboratory. Only 965 (2.2%) were under the age of 20 and there are
Only one death was recorded (0.1%) in this age group. Most of the patients (77.8%) were aged 30-69
Years. Patients over the age of 80 had a CFR of 14.8%. The CFR was the highest among those with
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Communions including cardiovascular, diabetes, chronic respiratory diseases, hypertension
Cancer.
Unlike the effect of A (H1N1) pdm09, it seems that pregnant women are not taller
Risk of serious diseases. In the investigation of 147 pregnant women (64 confirmed, 82
suspected and 1 asymptomatic), 8% had serious illnesses and 1% were critical.
Severe cases are defined as technical spots (≧ 30 breaths / min) or oxygen saturation <93% in
Rest, or PaO2 / FIO2 <300 mmHg. Critical cases are defined as mandatory breathing skills
Mechanical ventilation, shock or other organ failure that require intensive treatment. About
A quarter of the difficult and critical cases require mechanical ventilation while the remaining 75%
Only require an oxygen supplement.
China has the principle of early detection, early isolation, early and early diagnosis
Treatment. Early detection of suspicious cases is critical to containment efforts and occurs
Through the process of temperature checking and questioning at the entrances to many institutions,
Communities, places of excursions (airports, train stations) and hospitals. Many hospitals have
Heat clinics established and maintained since the outbreak of SARS. China
Originally, laboratory tests were requested according to the definitions of the case, which included
Epidemiological link to Hubei or other confirmed cases. However, recently, more
A liberal clinical testing regimenallows doctors to test with a low suspicion index.
Suspicious cases are isolated in single rooms under normal pressure, wearing a surgical mask (for the original
control). Chinese staff wear hat, eye protection, N95 masks, robe and gloves (single-use)
just). In Wuhan it is necessary that most of the suspects be in a group under normal pressure
Insulation department. The staff wears PPE continuously, changing it only when they leave the department.
The PCR test results are returned on the same day. If positive, patients are transferred to them
Specialized hospitals (including ambulances with negative pressure in some cities). All patients,
Including mild and asymptomatic with a positive test. Designed
Hospitals are well known and strategically located with at least one per county/county.
Positive cases are formulated according to gender. Patients tested negative are administered on a basis
Clinical needs. All patients are tested by a breathing multiplier to look for
Diagnoses. This could add to the promise that a negative COVID-19 test reflects a lack
Infection with COVID-19.
In Wuhan there are 45dedicated hospitals, six of which are designated for critical patients,
and 39 for severely ill patients and/or for all patients aged 65 and over. There are 10 more
Temporary hospitals reconstructed from gymnastics and residential exhibition centers
Seriously ill patients. Additional stress measures taken in Wuhan include two new temporary ones
Hospitals with 2600 beds, plus many makeshift hospitals to increase bed capacity. bed
The capacity within Wuhan has increased to > 50,000.
Patients are treated according to the National Clinical Guidelines (6th ed.) published by
National Health Commission of China (NHC). No specific antivirals or immunity
Proven (or recommended) modulation agents to improve results. All patients
Monitored by normal pulse oximetry. The guidelines include supportive care by clinical
Category (mild, medium, severe and critical), as well as the role of debriefing
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Treatments like chloroquine, phosphate, lopinbir/ritonavir, alpha interferon, ribavirin,
Arbidol. Application of invasive intubation / ventilation and ECMO in human patients
Can improve survival. Joint task force said to use ECMO in four patients in one
A hospital with one death and three that seem to be improving. Obviously, although ECMO does
As a very resource intake, any healthcare system will have to carefully weigh the benefits.
There is widespread use of traditional Chinese medicines (TCM), for which the effects must
For full evaluation.
Patients with COVID-19 are not allowed to visit . The staff uses overalls, masks, blindfolds,
And gloves, removing PPE only when they leave the ward.
Patients are discharged after clinical recovery (patient distribution> 3 days, resolution of symptoms and
radiological improvement) and 2 negative PCR tests taken 24 hours apart. Upon liberation,
They are asked to minimize family and social contact and to wear a mask. entity
Expectations for clinical trial results within weeks, which will show more
Treatment opportunities.
There are guidelines for the care of the elderlythat are specifically intended for prevention in people and
Introduction of COVID-19 to nursing homes.
Increased national videoconferencing training programs to inform the best staff
Practice and to ensure the use of PPE. Clinical champions are created to disperse knowledge
and provide local expertise.
The maintenance of normal health activities is maintained by hospital zoning (e.g.
clean/contaminated parts of the wellness facility).
Laboratory, Diagnosis and Virology
The virus found to be the cause of COVID-19 was initially isolated from a clinical sample on January 7.
It is worth noting that within weeks after the virus is detected, the series is reliable
And sensitive diagnostic tools have been developed and deployed. On January 16, the first RT
PCR tests for COVID-19 have been distributed to Hubei. Real-time PCR kits distributed to
All counties on 19 January and delivered to Hong Kong SAR and Macau SAR on 21st
January. Information on viral sequences and PCR fundamentals and testing was shared
With the World Health Organization and the international community by China CDC on January 12, 2020. alleviate
Development and research on the new virus, the COVID-19 virus sequences were
Uploaded to the GISAID database by China.
By February 23, there were 10 COVID-19 detection kits approved in China by the
NMPA, includes 6 RT-PCR kits, isothermal amplification kit, virus sequence product 1
and 2 colloidal gold antibody detection kits. Additional tests enter the test
Emergency approval procedure. Currently, there are at least 6 domestic manufacturers of PCR test
Kits approved by NMPA. Overall, manufacturers have the ability to produce and distribute as
Many of the 1,650,000 tests per week.
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Samples from both upper respiratory tract (URT; nasopharyngeal and oropharyngeal)
Lower respiratory tract (LRT; sputum and uterine muscle, endometrial inhalation, or
bronchial rinsing) are collected for COVID-19 testing by PCR.
The COVID-19 virus was discovered in respiratory, fecal and blood samples. according to
Preliminary data from CDC in Guangzhou as of February 20th, can be discovered first on
Upper respiratory samples 1-2 days before the onset of the symptom and last 7-12 days
Mild cases and up to two weeks in severe cases. Viral RNA was discovered in feces in
Up to 30% of patients from day 5 after the onset of symptoms and indicated up to
4-5 weeks in mild cases. However, it is not clear whether this corresponds with
The presence of an infectious virus. While a virus lives culture from feces in some cases,
The role of stool-through-oral transmission is still not well understood. COVID-19 Lonely
Of the clinical samples using epithelial cells of the human respiratory tract, Vero E6 cell line and HOH-7.
Serological diagnosis is in rapid development but is not yet widely used. Shared
Mission members met with local research teams at the Chinese CDC, Regenerative Guangzhou
Guangdong Medical and Health Laboratory. Teams reported development
Tests for IgM, IgG and IgM + IgG using rapid test platforms using chemolumines. Alyssa
Also development tests.
Research & Development
The Chinese government has initiated a series of major emergency research programs on the subject
Virus genomics, antiviruses, traditional Chinese medicines, clinical trials, vaccines, diagnostics
and animal models. The research includes basic research and human issues
Research. For the purposes of this report, human studies are limited to studies involving IRB
Informed approval and consent. Other forms of human test investigations are included
In the chapters on epidemiology in this report. A focused and powerful study, conducted in
Determining an outbreak has the potential to save many lives by identifying the most
Effective ways to prevent, diagnose and treat diseases.
Because the COVID-19 virus has a 96% genogenic identity to SARS-like coronavirus and
It is very likely that 86%-92% of SARS-like coronavirus, animal source of COVID-19.
This was confirmed by the high number of RT-PCR-positive environmental samples taken
From Huanan seafood market in Wuhan.
At least 8 nucleic acid-based methods for direct detection of COVID-19 and two colloids
Gold antibody detection kits have been approved in China by the NMPA. Several additional tests
Close to confirmation. It will be important to compare the sensitivities and specifics of
These serological tests and in the future. Development of fast and accurate point of treatment tests
The functioning well in field settings are especially beneficial if the test can be combined
Today there are panels in respiratory viruses that are multiple respiratory. It was considerably
Improve early detection and isolation of infected patients and, by extension, detection
of contacts. Rapid IgM and IgG antibody test are also important ways to make it easier for the earliest
Diagnosis. Standard serological tests can be used for retrospective contextual diagnoses
of servic analyses that help to better understand the entire spectrum of COVID-19 infection.
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A variety of reusable drugs and investigational drugs have been identified. Irradiation
Drug libraries approved by NMPA and other chemical libraries have identified new agents.
Hundreds of clinical studies involving remdesivir, chloroquine, favipiravir, chloroquine,
Healing plasma, TCM and other interventions are planned or underway. fast
Completing the most important studies is critical to truly effective identification
Treatments. However, the evaluation of investigative agents requires proper operation,
Randomized, controlled trials with realistic eligibility criteria and appropriate stratification
Patients. It is important to have a degree of coordination between the winners
Studies in China and abroad.
Developingasafe and effective vaccine for respiratory functionwith this high communication
Virus is an important means of controlling an epidemic. Recombinant Protein, mRNA, DNA,
Inactive whole viruses and recombinant vaccines against developing viruses
Some of them are now entering animal studies. The safety of the vaccine raises first concern in the region
Coron virus infection in light of past experience of improving diseases by inactive
Measles vaccine Whole virus and similar reports in animal trials with SARS
Vaccines against virus. It will be important that these vaccine candidates move quickly
Appropriate clinical trials.
The ideal living modelfor studying the ways of transmitting viruses, pathogenesis, antiviral
Treatment, vaccination and immune responses have not yet been found. ACE2 engineered mouse
The rhesus numbing model and model are already used in research laboratories. Systematically
Reference is required to which models can accurately mimic human pollution.
There is a global load on masks, hand hygiene products and other personal protection
Equipment. The relative importance of non-drug control measures including
Masks, hand hygiene, and social distancing require more research to quantify their impact.
There are clear patterns of intrafamily transmission of COVID-19. It is not clear if
or there are no host factors, including genetic factors, that influence sensitivity or
Disease course. COVID-19 has a diverse clinical course and an accurate description of it
The course is not available. In addition, the long-term consequences of COVID-19 are unknown.
An observational cohort study on patients with COVID-19 that has been recorded since then
Diagnosis (with appropriate controls) can provide in-depth information about clinical,
Virological and immunological characteristics of COVID-19. Table 1 summarizes priority
Research areas with immediate long-term goals.
Table 1 Priority Research Areas with Immediate, Intermediate and Long-Term Goals
Immediate goals
Intermediate goals
Long-term goals
Diagnosis: RNA tests, antibody
& Antigen tests, treatment point
Detection
Diagnosis: Multiflex
Diagnostic platforms
Diagnosis: prognostic markers
Treatment therapies: Remdesivir,
favipiravir, chloroquine, plasma,
TCM
Therapeutic: intravenously
Immunoglobulin (IVIg)
Treatment therapies: innovative approaches
(CRISPR-CAS; RNAi; cell-based;
positive views from the library’s screenings)
Vaccines: Animal development
Models
Vaccines: mRNA candidates
Nominated viral vectors
Vaccines: inactive candidates and
Subunit Candidates
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D. Knowledge gaps
Knowledge gaps and key questions that need to be answered to guide control strategies include:
The source of infection
- Animal origin and natural reservoir of the virus
- Live-human interface of the original event
- Early cases whose exposure could not be identified
The pathogenesis and viral development of the virus
Transmission dynamics
- Transmission modes:
o The role of spray transfer in non-health settings
o The role of stool-oral transmission
- Viral ejaculation in different periods of the clinical course in different biological samples
(i.e. upper and lower respiratory tract, saliva, feces, urine)
o Before the onset of symptoms and among asymptomatic cases
o During the symptomatic period
o After the symptomatic period / during clinical recovery
Risk factors for infection
Behavioral and socio-economic risk factors for infection in
o Households/Institutions
o Community
- Risk factors for asymptomatic infection
- Risk factors for nosocomial infection
o Among healthcare workers
o Among patients
Tracking & Tracking
- Govern the migration of the community through existing ones
o ILI tracking
o SARI tracking
- The trend of the outbreak and the dynamics of intervention
o Basic breeding number at different stages of the epidemic
o The relationship of the epidemic to seasonality
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Laboratory and diagnostics
- sensitivity and specificity of various nucleic acids (PCR, NAAT and rapid tests),
Antibody and antigen tests
- Post-infection antibody titris and the duration of protection
- Sero prevalence among
▪ Healthcare workers
▪ General population
▪ Children
Clinical treatment of severely ill and human patients
- ECMO value in human patient management
- Best practices using mechanical ventilation in human patient management
- Reassessment of the role of steroids in managing severely ill and human patients
Patients
- Identifying factors related to successful clinical management and
result
- Determining the efficacy of traditional Chinese medicines (TCM)
- Determining the effectiveness of additional treatment options and investigations (e.g.
intravenous immunoglobulin / IVIg, recovering plasma)
Preventive and control measures
- Key epidemic metrics that inform decision-making based on evidence-based control strategy
and adjustments
- The effectiveness of contraceptives and control of pollution (IPC) in various health
Treatment settings
- Inbound and exit filtering efficiency
- The effectiveness of public health control measures and their socioeconomic impact
o Restriction of movement
o Social distancing
o Closure of schools and workplace
o Wearing a mask in the general public
o Mandatory quarantine
o Voluntary quarantine with active surveillance
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Operational and technical recommendations
Operational / programming recommendations
- reassess the risk and capabilities based on different stages of the outbreak; Confirm
various indicators at the different stages of the reaction; Evaluate differently
stages of reaction; Strike a balance between response and social development
- Initiate scientific evidence in time-based, efficient and flexible multi-sectoral joint
A mechanism, driven by strong government leadership
Technical recommendations
Epidemiology and transmission
- Improved follow-up across the country using existing breathing
Disease systems, including ILI, SARI or pneumonia control systems
- Prioritize early investigations, including home-based transfer studies, ages
Layered sero-epidemiological surveys involving children, case study studies, cluster
Serological studies and studies among healthcare workers
hardware
Continue to share information about patient management, disease progression
Factors leading to serious illnesses and positive outcomes
- Review and analyze the possible causes associated with the severity of the disease, which
May contain:
o Studies in natural history to better understand the progression of the disease in a mild state,
Severe and fatal patients
o Medical chart surveys on the severity of the disease among vulnerable groups, (e.g.
Those with basic conditions, older age groups, pregnant women
children) develop appropriate standards of care
o Evaluation of factors leading to positive outcomes (e.g. early detection
and treatment)
Clinical treatment and prevention and control of infection
- It is necessary to isolate suspected patients who have not yet been tested in a normal situation
pressure rooms; Acceptable for sharing positive cases
- Physicians and all healthcare workers should maintain a high level of clinical alert
For COVID-19
- For affected countries, standardize and rate clinical and IPC training
Development of local (e.g., provincial) specialists
- Be sure to test at the same time for other viral pathogens that support negative COVID-19
test
- Ensure the maintenance of normal and essential services during the outbreak
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- to ensure that there are processes to prevent infection among the most vulnerable,
Including seniors
- Ensure readiness to provide clinical care and meet IPC needs, including:
A. Expected respiratory support requirements (e.g. pulse oximeters, oxygen,
and intrusive support if needed)
In. National guidelines for clinical treatment and IPC, modified for COVID-19
Gimel. National standard training for understanding diseases and the use of common diseases for
HCWs
D. Community Involvement
The. PPE and Pharmaceuticals Databases
And. early detection protocols; Triage, temperature projection, bay holding
(triage, including pulse oximetry)
M. Care protocols including dedicated facilities, patient transport
H. Increased absorption of influenza and pneumococcal vaccine
National Guidelines
I. Laboratory test
- Quick Response Teams
Laboratory and Virology
- Continue to perform complete genome analysis of isolated COVID-19 viruses
Different times and places, to assess the development of the virus
- Conducted pathogenesis studies using COVID-19 biopsy/post-mortem samples
Patients or models of infected animals
- Evaluation of PCR diagnosis of available nucleic acids
- Quickly develop and evaluate rapid diagnoses / point of treatment and serological tests
- Conduct more research to interpret the outcome of positive RNA detection in COVID-19
Feces in patients recovering from COVID-19
- Improve international collaboration, especially in terms of biological and information safety
Sharing for increased understanding of COVID-19 and the consistency of the
virus
Consider tracking pre-inflammatory cytokines using multiflex tests to predict the
Development of “cytokine storm”
Research & Development
- Make an extra effort to find the source of the animal, including the natural one
Buffer and each host an intermediate amplification, to prevent new epidemic hotspots
or the revival of similar epidemics
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- Efforts should be made to consistently evaluate existing and future diagnostic tests
For the detection of COVID-19 using a harmonious standard system for laboratory testing
and a biological database that can be used to evaluate these tests
- Consider establishing a major research program in China to oversee it
This portfolio ensures the most promising research (vaccines, treatments,
pathogenesis) are properly supported and studied first; The dedicated program staff
The clinical study will work on the clinical study site to reduce the
Research workload of clinicians on the spot
- Consider including one or more sites in China in the future continuational and continuation.
international experiments; Need to engage Chinese researchers actively
International experiments
- Continue to develop more animal models, while making great efforts to ensure these
Mimics human infection and virus transmission as much as possible
- Conduct research to determine which of the most common forms of PPE are the most commonly used
Effective in controlling the spread of COVID-19
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