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(March 16, 2020)


A Global Force to Handle COVID-19 with Flu Control Protocols is Required


As COVID-19 is becoming a global issue, most people seem too nervous to notice that the virus is actually showing its flu-like epidemic pattern while more countries reported more cases around the world. Based on the pattern observed, the epidemic could be ended if an international organization steps forward to coordinate a global force to thoroughly implement flu control protocols in most of countries as soon as possible.



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In the end of January, Germany’s first two cases contracted the virus from a colleague who flew in from Shanghai to join the company’s workshop, and then another two colleagues who did not contact the Chinese visitor were tested positive as well soon. This cluster has preliminarily showed the human-to-human transmission of the virus could be very easy, and very similar to what the flu virus does. At the same time, those German patients’ very mild flu-like illness was noticed.



Singapore and Japan offered significant evidence of a larger scale in February. As of February 29, Singapore reported 93 cases, including five clusters and quite a number of patients whose source of infection is not known. It was showing that the spread of the virus could easily happen in the community, exactly like what the flu virus can do. And, just like those German cases, patients in Singapore were fighting with flu-like symptoms only, no severe cases reported.



Excluding the cruise line’s cases, Japan had found more than 250 cases in different cities and prefectures in February. Most of infected people had flu-like symptoms only and six elderly patients died from pneumonia. So, in Japan, the virus was also showing a flu-like epidemic, which usually brings senior people a higher risk of severity and fatality.



That is why the world's leading countries should consider flu control protocols and call for all countries to move forward in the same direction for a sooner ending of the epidemic.



In addition, A BMJ, originally called British Medical Journal, article published on February 18 offers evidence from comparison of case fatality rate (CFR), which is the ratio of deaths from a certain disease to the total number of people diagnosed with this disease for a certain period of time representing a measure of disease severity. SARS had a CFR of around 10%. MERS killed 34%. COVID-19’s overall CFR was around 2%. A collaboration of Hong Kong University and Harvard University also estimated the CFR of COVID-19 is around 1.4%.



Therefore, the COVID-19 virus turns out to be mostly causing flu-like illness only. It does not seem to be a SARS-like or MERS-like super killing bug of the new decade. The scaring death toll number in China could be the result of a medical system collapse caused by too many patients rushing into hospitals, which is the scenario we usually saw during a flu pandemic. So, countries with increasing death tolls, such as Italy and Iran, need international aids.



Although The CFR number of COVID-19 mentioned above is lower than SARS’s and MERS’s, most experts agree the CFR of a seasonal flu is around 0.1% only. Therefore, we still have to take the virus seriously, most importantly, with a right strategy.



Based on its flu-like epidemic pattern, the goal of a global response to COVID-19 should change from containment to mitigation, for example, helping the elderly and people with underlying health conditions to avoid death tragedies. Don't waste resources on finding asymptomatic infections. Make sure that medical institutions are ready for a huge amount of patients. Remind Healthy people to wash hands more often and sick people to stay home. Besides these, Taiwan’s recent experience shows that wearing a mask is an effective extra precaution.



Excluding three small clusters with the index case contracting the virus in January, Taiwan did not report any new domestic case after January 31 until a local woman was tested positive on February 28. Besides washing hands, it is worth to notice that the majority of Taiwanese have been promptly wearing a mask since the epidemic started scaring people in the beginning of January, even though many experts claimed that wearing a mask is not necessary at that time. Although the shortage of surgical masks had caused chaos, the chaotic situation is believed to become a reminder of having most Taiwanese practice good personal hygiene all the time, which is the main preventive measure before we have vaccines and new drugs.



The researches on the virus take time and epidemic control can’t wait. It is necessary to find clues through the epidemiological analysis on the reported cases to help form the proper response strategy. The best solution for now is to follow flu control measures strictly, including public education of good personal hygiene, home or institutional quarantine on sick people, and a flu surveillance network that asks clinics and hospitals to report patients with flu-like symptoms for further virus testing and early advanced treatment, plus a few extra precautions, such as wearing a mask and maintaining healthy immune defense, to carry everybody through. A global force to push the protocols to be implemented worldwide is urgently required.