Testing and mass quarantines helped defeat virus,says Dr. Gong Zuojiong
Wuhan, the epicentre of the COVID-19 outbreak, is slowly rebounding after two months in lockdown. On Sunday, Wuhan and surrounding Hubei province reported no infections for the sixth straight day, unthinkable a month ago when the city was reporting daily infections in the thousands. Dr. Gong Zuojiong, Director of the Department of Infectious Diseases at Renmin Hospital of Wuhan University, has been on the frontlines of the COVID-19 fight in the city. In an interview with The Hindu, he says a key lesson from Wuhan’s battle was breaking the chain of transmission through widespread testing and isolating all patients, even those with mild symptoms, away from their homes in central quarantine. Edited excerpts:
What is the present situation in terms of new infections and the current patients you are treating?
At present, COVID-19 has been brought under control through two months of prevention and management in Wuhan and Hubei province. No new patient has been diagnosed right now. However, we are still continuing strict monitoring.
What was your experience during the peak of the crisis?
At the beginning, there were too many patients that needed to be confirmed. The hospital did not have so many beds for the patients’ hospitalisation. We had a shortage of personal protective equipment (PPE). Our hospital dedicated a separate campus, our east campus, as a designated hospital to receive severe and critical patients.
When was the ‘turning point’ achieved?
We reached the ‘turning point’ at the end of February, when the numbers of new confirmed and suspected cases dramatically decreased. Now, we are reporting zero cases.
Besides lockdown, what do you see as the most important measures in tackling the spread? What are the steps do you think should have been done differently?
For prevention and control of a high contagion, the important measures are to manage and control those infected, and break down the transmission. For those cases that were mild and moderate, we found that transferring them to the ark hospital [makeshift hospitals of which 16 were built] is a good method that we would recommend. Also, avoid people gathering. Wearing masks and hand hygiene are also important. In addition, doctors should pay more attention for finding severe cases early in order to diagnose and treat critical cases to reduce the risk of mortality.
Can you explain why centralised quarantine and isolation was followed on such a large scale, as opposed to just home isolation for mild cases?
Quarantine and home isolation depends on different countries’ conditions. In China and India, because we have such a large population, one family may have several members. Cross-infection occurs commonly. For mild and moderate type confirmed cases, the ark hospital is a good quarantine and isolation place, and this helps avoid cross-infection and breaks down the transmission.
What was the scale of testing done in Wuhan? Was it limited or widespread?
I don’t know exactly the scale of testing in the whole of Wuhan city. By the middle of January, when PCR reagents (nucleic acid testing) became available, our hospital alone tested around 1,000 samples daily. Right now, all samples can be examined because the supply of testing materials is enough. Testing for COVID-19 plays an important, even central role, because we want to find new cases and suspected cases as quickly as possible. Only then we can isolate patients and break down the transmission.
In a large population with limited resources, do you see alternatives to widespread testing?
For testing, scientists have different techniques. For example, antibodies detection and different (modified PCR) methods for nucleic acid detection could also be used. And an experienced radiologist could diagnose the suspected cases based on the CT scans.