elbows
Well-Known Member
Another area of importance covered yesterday. Pages 54-57 of yesterdays transcript (linked to in previous post):
Q: I'd like to ask you now some questions about the level of preparedness of Asian countries for Covid-19, those who had experience of SARS and MERS in their recent history.
What effect do you think having a serious outbreak of those two previous coronaviruses had on countries such as Singapore, Japan, South Korea, Taiwan and Hong Kong?
A: I believe they had a profound effect on those countries. In fact I visited some of those countries during the period after SARS and before the current pandemic, and some of those countries had actually established isolation wards with hundreds of beds in their hospitals, ready for when there should be an outbreak such as this. So they were developing surge capacity in those countries at the same time as they were training their health workers in procedures such as contact tracing. So they appeared to be much better prepared, because of what they had learned from the SARS outbreaks back in 2003.
Q: So you have mentioned two things there, surge capacity within hospitals, training of health workers in contact tracing. Why was that second element so important?
A: That element was important because early in the outbreak countries such as Japan, for example, did not only contact tracing looking forward to see who was in contact with a person who was sick, but also looked backwards to try to find the source of infection, and when they found that, they then did what they called a precision lockdown: they locked down where the source of infection was. That's good basic epidemiology and outbreak control. They did this in countries such as Singapore, in South Korea, in Japan, in Taiwan and other places as well.
Q: That was effective in controlling the spread?
A: It certainly appears it was effective, yes. In fact, they were able to stop outbreaks that -- there were major outbreaks in South Korea, there was a major outbreak around a church event, as there was in Singapore, and those outbreaks were completely contained and stopped, which permitted those countries to let the virus enter at a much lower rate because there were fewer people infected to infect community members.
Q: But to be effective, a precision lockdown has to take place very quickly after knowledge has been gained that the virus is spreading?
A: That's correct, yes.
Q: Before it gets out any further?
A: That's correct.
Q: All right. Those countries who had the ability, because of the training of their healthcare workers, to undergo contact tracing and then to set up a precision lockdown, were more successful in continuing(sic) the early spread of Covid-19?
A: It's my view that they were, and if you look at the results of that today, you will see that their mortality rates are much, much lower than mortality rates -- reported mortality rates in most European countries.
Q: All right. Let's take a look, please, at paragraphs 113 and 114 of your report.
(Pause)
113 and 114, please. Next page. Thank you. If we could highlight those two paragraphs, please.
So just to confirm what you have told us, Professor:
"113. Early in the Covid-19 pandemic, studies in Japan traced contacts of persons with Covid-19 forward for isolation and monitoring, and backward to the source of infection. They then shut down those areas where transmission was shown to be occurring, many times in nightclubs, gyms and other public spaces, until preventative measures could be reinforced at those sites.
"114. Such precision and short-term lockdowns demonstrated that unlike influenza, initial Covid-19 outbreaks could be contained and transmission interrupted. The same was true in Singapore and South Korea in early outbreaks that occurred in religious institutions and nightclubs [which is what you've just told us]. Many Asian countries continued to keep transmission at low levels before vaccines became available by outbreak investigation and precision lockdowns at the source, similar to those used in Japan. [So] As of 19 February 2023 Asian countries had reported fewer Covid-19 deaths per million in the population ..."
And you there give the figures:
"... (Japan 566, South Korea 680, Singapore 294; [which are to be] compared to Italy 3,150, USA 3,344 and the UK 3,038) [thereby] attesting to the effectiveness of their containment strategies, though other factors including the level of comorbidities and obesity may have also played a role."
Thank you very much.
So those figures speak for themselves, really, do they not?
A: Yes.
Q: I'd like to ask you now some questions about the level of preparedness of Asian countries for Covid-19, those who had experience of SARS and MERS in their recent history.
What effect do you think having a serious outbreak of those two previous coronaviruses had on countries such as Singapore, Japan, South Korea, Taiwan and Hong Kong?
A: I believe they had a profound effect on those countries. In fact I visited some of those countries during the period after SARS and before the current pandemic, and some of those countries had actually established isolation wards with hundreds of beds in their hospitals, ready for when there should be an outbreak such as this. So they were developing surge capacity in those countries at the same time as they were training their health workers in procedures such as contact tracing. So they appeared to be much better prepared, because of what they had learned from the SARS outbreaks back in 2003.
Q: So you have mentioned two things there, surge capacity within hospitals, training of health workers in contact tracing. Why was that second element so important?
A: That element was important because early in the outbreak countries such as Japan, for example, did not only contact tracing looking forward to see who was in contact with a person who was sick, but also looked backwards to try to find the source of infection, and when they found that, they then did what they called a precision lockdown: they locked down where the source of infection was. That's good basic epidemiology and outbreak control. They did this in countries such as Singapore, in South Korea, in Japan, in Taiwan and other places as well.
Q: That was effective in controlling the spread?
A: It certainly appears it was effective, yes. In fact, they were able to stop outbreaks that -- there were major outbreaks in South Korea, there was a major outbreak around a church event, as there was in Singapore, and those outbreaks were completely contained and stopped, which permitted those countries to let the virus enter at a much lower rate because there were fewer people infected to infect community members.
Q: But to be effective, a precision lockdown has to take place very quickly after knowledge has been gained that the virus is spreading?
A: That's correct, yes.
Q: Before it gets out any further?
A: That's correct.
Q: All right. Those countries who had the ability, because of the training of their healthcare workers, to undergo contact tracing and then to set up a precision lockdown, were more successful in continuing(sic) the early spread of Covid-19?
A: It's my view that they were, and if you look at the results of that today, you will see that their mortality rates are much, much lower than mortality rates -- reported mortality rates in most European countries.
Q: All right. Let's take a look, please, at paragraphs 113 and 114 of your report.
(Pause)
113 and 114, please. Next page. Thank you. If we could highlight those two paragraphs, please.
So just to confirm what you have told us, Professor:
"113. Early in the Covid-19 pandemic, studies in Japan traced contacts of persons with Covid-19 forward for isolation and monitoring, and backward to the source of infection. They then shut down those areas where transmission was shown to be occurring, many times in nightclubs, gyms and other public spaces, until preventative measures could be reinforced at those sites.
"114. Such precision and short-term lockdowns demonstrated that unlike influenza, initial Covid-19 outbreaks could be contained and transmission interrupted. The same was true in Singapore and South Korea in early outbreaks that occurred in religious institutions and nightclubs [which is what you've just told us]. Many Asian countries continued to keep transmission at low levels before vaccines became available by outbreak investigation and precision lockdowns at the source, similar to those used in Japan. [So] As of 19 February 2023 Asian countries had reported fewer Covid-19 deaths per million in the population ..."
And you there give the figures:
"... (Japan 566, South Korea 680, Singapore 294; [which are to be] compared to Italy 3,150, USA 3,344 and the UK 3,038) [thereby] attesting to the effectiveness of their containment strategies, though other factors including the level of comorbidities and obesity may have also played a role."
Thank you very much.
So those figures speak for themselves, really, do they not?
A: Yes.
