The COVID-19 epidemic is currently a global challenge. At a critical moment when the number of confirmed cases is soaring in the U.S. and as China remains vigilant for a possible rebound, a symposium on the “Response of the Chinese and US healthcare systems to the COVID-19 Outbreak” was held jointly by Wuhan University, Harvard University, the Taikang Public Health and Epidemic Prevention Fund, and other important research institutions on April 5.
Using Taikang Insurance Group’s web conferencing platform, top academics from China and the U.S shared their observations on the pandemic in an objective, professional and responsible manner. They exchanged ideas, among other things, prevention and control measures employed during the epidemic, China’s successful experience, latest vaccine and drug development, improvement of the public health system, international cooperation in the battle against the contagion, non-governmental support.
Participants included Tang Qizhu (Vice President of WHU), Prof. Winnie Yip (from the Practice of Global Health Policy and Economics at the Harvard T.H. Chan School of Public Health and Director of the school wide China Health Partnership), Academician Wang Chen (President of the Chinese Academy of Medical Sciences & Peking Union Medical College and an Academician of the Chinese Academy of Engineering), Dr. Harvey V. Fineberg (former President of the U.S. National Academy of Medicine), Margaret Hamburg (Chair of the Board of the AAAS and former Commissioner of the FDA), Prof. David Blumenthal from Health Care Policy at Harvard Medical School and also President of the Commonwealth Fund, Lu Mai (Vice Chairman of the China Development Research Foundation and Secretary-General of the China Development Forum), Mao Zhenhua (Dean of the Dong Fureng Economic and Social Development School at WHU and Director of the Institute of Economic Research at Renmin University of China), Prof. William C. Hsiao from professor of economics at the Harvard T.H. Chan School of Public Health and also a foreign consultant for the Expert Committee on Health Policy and Management Research at the National Health Commission of China, and Chen Dongsheng (Founder, Chairman and CEO of Taikang Insurance Group).
Tang Qizhu, Vice President of WHU, extended a sincere welcome to the participants. He said that the highly contagious nature of this novel coronavirus has turned this epidemic into a particularly severe threat and also into the biggest challenge confronting humanity since World War II. It requires all countries to join forces and take advantage of their respective strengths to contain the spread, treat patients and conduct scientific research. He expressed his wish for the meeting to identify better solutions to combating the virus in future.
Chen Dongsheng, the Founder, Chairman and CEO of Taikang Insurance Group, pointed out that the experience of uniting the government, the citizens, the medical system, the volunteers, and the communities in fighting the epidemic in Wuhan offered some inspiration to the world. Chinese corporations like Taikang Insurance Company which were founded and have grown since the beginnings of the economic reform period more than 40 years ago were capable of quickly mobilizing global resources to deliver relief supplies to Wuhan and the worst-affected countries. This symposium, for example, was made possible by Taikang Insurance Group’s Public Health and Epidemic Prevention Fund, which is worth RMB 100 million
Prof. Winnie Yip from the Practice of Global Health Policy and Economics at Harvard T.H. Chan School of Public Health and also Director of the school-wide China Health Partnership, gave consideration to three urgent issues. The first concerns decision-making in the face of uncertainty posed by a sudden epidemic outbreak. Besides, how can crucial scientific knowledge acquired in relevant research be utilized for a better understanding of this virus? Finally, how can commonalities between the different public health systems in China and the U.S. be identified and the sharing of knowledge ensured? This would be for the benefit of other countries as well.
Wang Chen, Academician of the Chinese Academy of Engineering and President of the Chinese Academy of Medical Sciences & Peking Union Medical College, regarded the lockdown of Wuhan and the extension of the Spring Festival holiday as critical to the containment of the virus. Fangcang makeshift hospitals were established to ensure that all suspected and confirmed cases could be admitted and treated effectively with lower density. By so doing, the limited medical resources could be reallocated so that the severe cases could be treated in designated hospitals. The development of effective drugs remains an urgent task. In China, the anti-AIDS drugs Lopinavir and Ritonavir were used in treatment, and rigorous randomized controlled trials of Remdesivir were conducted, which are due to conclude soon. It is especially important to carry out epidemiological investigations of nucleic acids and serum antibodies in order to identify the number of asymptomatic patients and herd immunity levels. Although vaccine development is the most promising solution, we must be aware of its complexity, especially the safety aspect. The outbreak of COVID-19 calls for global cooperation, with priority given to increasing test rates. Wang hoped that, through this epidemic, all countries would realize that health care is of great significance to people’s basic livelihood as well as national security and social stability, which in turn underlies social and economic development.
Dr. Harvey V. Fineberg, President of the Gordon and Betty Moore Foundation and former President of the U.S. Institute of Medicine (now National Academy of Medicine), said that every country, including China and the USA, should draw lessons from this pandemic. He suggested the government and institutions engage in comprehensive reflection on the pandemic, including aspects such as timing and content of decisions made, and whether they were made based on a thorough understanding of the situation. Meanwhile, joint efforts shall be made to learn from the lessons and be better prepared for possible epidemics in the future. This pandemic is sweeping across the whole world, and final victory will not be achieved until it has been resolved globally. In this sense, collaboration between China and the U.S is crucial.
Margaret Hamburg, Chair of the Board of the American Association for the Advancement of Science (AAAS) and former Commissioner of the U.S. Food and Drug Administration (FDA), remarked that it was necessary to foster cooperation in the scientific community. This means creating an environment that facilitate “capability sharing”, which goes beyond simply sharing the results of scientific research. There remain many unanswered questions about COVID-19, including the range of infections, its characteristics, and most importantly, how medical resources will be scheduled and allocated, and what precautions must be taken to prepare for the next round in the epidemic. For the United States, targeted research is urgently needed. It requires more flexible financial support and more feasible research methods. When it comes to vaccine development, it is essential to ensure the quality in mass production. That entails quality supervision, which is costly but indispensable. In our response to the spread of the virus, we must constantly collect data and learn lessons, so that we can respond to the risks based on the existing information. These endeavors, such as scientific research, are vital to the combat against the current epidemic and another possible one in the future.
Peng Zhiyong, Medical Director of the Department of Critical Care Medicine at Zhongnan Hospital of WHU, suggested that medical resources should be better employed in the early stage of an epidemic. In order to do so, hospitals, policy makers, and health care workers need to give a prompt estimation of case numbers, especially of acutely ill patients likely to be admitted in future. In this way, medical resources can be better mobilized in a short time, particularly ICU beds, so that more patients can be saved.
Prof. Ke Lan, Director of the State Key Laboratory of Virology at WHU, shared some facts about COVID-19. In drug research, WHU has discovered eight compounds that can significantly inhibit the activity of the coronavirus in vitro and the research is continuing. Observation has shown that the virus load of aerosols in an open public place is very low, or not measurable, which can provide useful information for environmental disinfection. As to the diagnosis, the golden rule is to use the fluorescent quantitative PCR technology. In the early stage of the epidemic, the identification should be based on as many detections as possible, such as nucleic acid, imaging, and serology, with the CT (pulmonary imaging) diagnosis as an auxiliary method to ensure that all potential patients are tested. Prof. David Blumenthal, President of the Commonwealth Fund and a Professor of Health Care Policy at Harvard Medical School, believed that systematic consideration is necessary. To begin with, what is the epidemic situation worldwide? The spread of the virus is increasing at an exponential rate in the United States, with more than 270,000 confirmed cases and over 7,000 deaths by April 5. He thought that the number of people killed by the disease in most countries would continue to grow. Second, when and how should the limited resources be used to fight the epidemic? They were worried that available ICU beds would be inadequate in the most affected areas. There is also a huge shortage of critical medical facilities. Last, what are the biggest challenges for the global health system today? What are its limitations? He was convinced that there was a lot to share and learn from each other in science and clinical treatments.
Lu Mai, Vice Chairman of the China Development Research Foundation, divided the Chinese experience into six aspects. First, quick identification of the pathogens and sharing of the information with the world, while continuously improving the testing capability. Second, constant refinement of treatment guidelines. Third, strict tracking of close contacts. Fourth, close collaboration between the government and the public so that people trust the government and hence follow its policies. Fifth, give full play to the government’s efficient mobilization and management. Sixth, ensure medical supplies.
Mao Zhenhua, Dean of the Dong Fureng Economic and Social Development School at WHU and the Director of the Institute of Economic Research at Renmin University of China, mentioned that the implementation of the “all suspected and confirmed cases shall be admitted and treated” scheme was essential to the Wuhan’s achievements in containing the virus. The program “to test all the people who should or are willing to” should also be promoted to avoid the risk of a possible rebound. Since there are roughly 1.3 million college students in Wuhan, he recommended that universities there replace traditional teaching with online courses this semester.
Prof. Mao Zongfu from the Global Health Institute at WHU, noted that there were mainly four reasons for running out of medical resources during the epidemic in Wuhan. They are the lack of understanding of the new disease which resulted in poor judgment, insufficient capacity in Wuhan to treat the infected patients, “health gatekeepers” of the grassroots communities losing ground early in the outbreak, and panic among the citizens as well as disorder among the patients after the lockdown. Furthermore, he revealed three pieces of experience from it, including seizing the window period of the spreading as soon as possible with reference to former epidemics, prioritizing the allocation of medical resources with the highest speed and quality during the period, and offering authoritative scientific information to the public to build up their confidence.
William C. Hsiao, a member of the U.S. National Academy of Science and a Professor of Economics at the Harvard T.H. Chan School of Public Health, declared the threat that the virus posed to public health a top priority, and that it should be made priority of decision and policy making for China and other countries. Humanity’s future will never be immune to newly emerging viruses, and an epidemic breaks out almost every three to five years. Therefore, we must constantly learn from the experience with pandemics, conduct empirical reviews, and engage in rigorous future planning for emergency response. During the outbreak of COVID-19, neighborhoods and the scientific community worldwide have demonstrated a spirit of cooperation which has found vivid expressions in the research on biological characteristics of the virus and the sharing of experience to contain its spread. The ultimate purpose is to bring scientists together across borders to prepare for the future.
Rewritten by Zhou Siyan
Edited by: Cao Siyi, Shen Yuxi, Sylvia & Hu Sijia
