Containment of nCoV is, and should be, the highest priority in China. This requires gov, health care/PH system & the public to work together to ID those w/ sx, get them tested rapidly, get them isolated (home or hospital), provide good med care while keeping HCWs protected. (2/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
We don’t know what overall CFR will be w/ nCoV-that requires more data, time. SARS-like illness has been seen in some, but we don’t know what % of nCoV pts will get severe disease. We all hope it'll be far less than SARS, but we don’t know enough to predict %. (4/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
But given uncertainties + very high stakes, part of global & national planning efforts should now be aimed at possibility that nCoV containment could fail. (6/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Global and national leaders should be looking ahead to what must be done to prepare for the possibility nCoV can’t be contained, even as we continue to work as hard as possible to contain it in China and beyond. (8/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Crash vaccine development. Top of list because would so dramatically change response and outcomes. @NIAID & @CEPI working on vaccines, as are others. All pharma+biotech companies that could have a vaccine or therapy candidate of relevance should be enlisted in the effort. (10/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Global plan for mass manufacturing of vaccine when it is created. This should be planned for multiple places in the world concomitantly. Cannot have a successful vaccine come out of only one place and remain only in that country. It will need to be broadly distributed.(12/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Urgent serology development programs. Need this to help determine severity of nCoV. If many have been exposed and are immune, but never had disease, this suggests asymptomatic spread and that disease will be mild in many. We need serology testing. (14/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Rapid clinical trials for antivirals. There isn't much evidence current antivirals will be useful, but there should be in vitro studies, clinical trials to study all reasonable candidates. Other med interventions that have sound theoretical basis should be studied quickly. (16/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Hospital infection control plans. Beyond protecting health care workers, hospitals will need administrative plans, equipment, engineering controls where relevant, to care for higher number of patients at same time they are working to prevent resp spread of disease. (18/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Good accurate info needs to flood out the bad, the harmful rumors, the conspiracy info. Govs may need to partner w traditional and social media to get factual info out to people. (20/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
If nCoV spreads widely in the world, it will be in strong interest of all countries, to keep trade going despite the pandemic– global economy is highly interdependent. Govs would need to work w/ orgs like WTO and travel industry orgs like IATA to keep goods, people moving.(22/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Overall in this Planning effort, countries will need to take some actions on their own. Others will require international coop. e.g. many countries don't have capacity to develop, make vaccines, Dxs, masks, et al so will need to work w/ countries that do. (24/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
Other elements of this Plan will require close cooperation between countries, global business and international orgs. Organization of the elements of this Global Planning effort will be hard and consuming. (25/x)— Tom Inglesby (@T_Inglesby) January 26, 2020
