What does WHO really want?
This article is a translation of an article posted on Facebook by doctor Yoshihiro Takayama into English.
At a press conference on Wednesday, WHO Secretary-General Tedros reported that he urged countries to conduct thorough testing while stressing "tests, tests, tests!" To stop the transmission of the new coronavirus. did.
Some interpret this as pointing to the inadequate healthcare system in Japan. Or, they even hear criticism that they have colluded with an inspection company. What did you really want to say?
The story goes back a little here ...
When the pandemic influenza spread in 2009, there was criticism in Japan for the use of the government-stocked Tamiflu for prophylactic administration. Some people argued that Tamiflu was suspected of phytotoxicity, and some pointed out the risk of drug resistance.
In the meantime, the WHO issued a statement that "Tamiflu should not be used for preventive use." At that time, I was at the task force, but I remember being quite confused.
I immediately contacted Geneva to confirm my intent. He said, "I am worried that valuable drugs are used for prophylactic administration and are not being used for necessary treatment, mainly in developing countries. On the other hand, Tamiflu in Japan is stored in advance. And does not point out the use of it as a precautionary strategy. "
After that, I learned in cooperation with WHO, but they are worried about developing countries. Of course, it plays a role in coordinating healthcare policies, including in developed countries, but it is not unusual to seek leadership in developed countries.
However, I don't know if Mr. Tedros's remarks pointed out, including Japan, because he has not confirmed it. However, when reading the original text of this speech, the following annotation was attached.
"WHO recommends testing only if symptoms are present in close contacts of confirmed patients."
In Japan, this condition has been cleared. In addition, pneumonia, which cannot be diagnosed even if it is not a close contact, has been included in the examination. Currently, a system is in place that allows doctors to conduct examinations when they deem it necessary. Well, you didn't talk about Japan. In fact, Tedross has just praised the Japanese medical system at a press conference on the 13th.
Rather, I think I'm worried about developing countries where the inspection system is not in place. Immediately following this commentary, "WHO has shipped about 1.5 million test kits to 120 countries. We will work with companies to ensure that those in need can be tested."
There is a possibility that the rapid spread of the new coronavirus will occur in developing countries. I'm really worried because I'm a board member of an international NGO supporting Africa. We are worried that local staff will not be able to receive necessary medical care due to infection, but we are also worried that they may spread the disease while traveling between urban and rural areas.
Nowadays, strengthening the inspection system in developing countries is a very important phase. We must catch the epidemic in the area as early as possible and call on them to protect high-risk people. This is incomparably more important than those who live in developed countries and have guaranteed medical access. It's no surprise that WHO calls "test, test, test !"
Well, but to Africans, "Thanks for being worried about emerging infectious diseases. By the way, we're more worried about our AIDS and tuberculosis, even more seriously. Is it returned?
Take a second mind and return to our rich medical system.
Of course, I do not believe that the PCR testing system in Japan is sufficient. There are still cases (regions) where tests have not been performed, even though doctors consider it necessary. Therefore, it is necessary to strengthen the inspection system in the future so that such cases (regions) will decrease.
However, we are also opposed to abusing tests and overconfident results. In particular, asymptomatic individuals should not be tested. As any clinician knows, most laboratory tests only have an auxiliary role in diagnosis. Hesitate to use in low-sensitivity situations because of the risk of misjudgment. That's why we, doctors, ask questions, see them, and choose tests depending on the condition.
In the future, the indication of the test should be left to the judgment of the doctor. Don't tell them that you want to do more testing or that you want to see all the cases. Not testing or treating unnecessary patients is a basic rule of the insurance system, not only for the new coronavirus. I hope that doctors will continue to make appropriate decisions regarding the indications for testing.
The original is the following Facebook post:
This text was translated from Japanese to English by Google Translate.
We also use Grammarly to check grammar and wording.
Read the full speech of Secretary-General Tedros here.
WHO Director-General's opening remarks at the media briefing on COVID-19 - 16 March 2020
Good afternoon everyone.
In the past week, we have seen a rapid escalation of cases of COVID-19.
More cases and deaths have now been reported in the rest of the world than in China.
We have also seen a rapid escalation in social distancing measures, like closing schools and canceling sporting events and other gatherings.
But we have not seen an urgent enough escalation in testing, isolation and contact tracing – which is the backbone of the response.
Social distancing measures can help to reduce transmission and enable health systems to cope.
Handwashing and coughing into your elbow can reduce the risk for yourself and others.
But on their own, they are not enough to extinguish this pandemic. It's the combination that makes the difference.
As I keep saying, all countries must take a comprehensive approach.
But the most effective way to prevent infections and save lives is by breaking the chains of transmission. And to do that, you must test and isolate.
You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don't know who is infected.
We have a simple message for all countries: test, test, test.
Test every suspected case.
If they test positive, isolate them and find out who they have been in close contact with up to 2 days before they developed symptoms, and test those people too.
[NOTE: WHO recommends testing contacts of confirmed cases only if they show symptoms of COVID-19]
Every day, more tests are being produced to meet global demand.
WHO has shipped almost 1.5 million tests to 120 countries. We're working with companies to increase the availability of tests for those most in need.
WHO advises that all confirmed cases, even mild cases, should be isolated in health facilities, to prevent transmission and provide adequate care.
But we recognize that many countries have already exceeded their capacity to care for mild cases in dedicated health facilities.
In that situation, countries should prioritize older patients and those with underlying conditions.
Some countries have expanded their capacity by using stadiums and gyms to care for mild cases, with severe and critical cases cared for in hospitals.
Another option is for patients with mild disease to be isolated and cared for at home.
Caring for infected people at home may put others in the same household at risk, so it's critical that care-givers follow WHO's guidance on how to provide care as safely as possible.
For example, both the patient and their caregiver should wear a medical mask when they are together in the same room.
The patient should sleep in a separate bedroom to others and use a different bathroom.
Assign one person to care for the patient, ideally someone who is in good health and has no underlying conditions.
The care-giver should wash their hands after any contact with the patient or their immediate environment.
People infected with COVID-19 can still infect others after they stop feeling sick, so these measures should continue for at least two weeks after symptoms disappear.
Visitors should not be allowed until the end of this period.
There are more details in WHO's guidance.
Once again, our key message is "test, test, test".
This is a serious disease. Although the evidence we have suggests that those over 60 are at the highest risk, young people, including children, have died.
WHO has issued new clinical guidelines, with specific details on how to care for children, older people, and pregnant women.
So far, we have seen epidemics in countries with advanced health systems. But even they have struggled to cope.
As the virus moves to low-income countries, we're deeply concerned about the impact it could have among populations with high HIV prevalence, or among malnourished children.
That's why we're calling on every country and every individual to do everything they can to stop transmission.
Washing your hands will help to reduce your risk of infection. But it's also an act of solidarity because it reduces the risk you will infect others in your community and around the world. Do it for yourself, do it for others.
We also ask people to express their solidarity by refraining from hoarding essential items, including medicines.
Hoarding can create shortages of medicines and other essential products, which can exacerbate suffering.
We're grateful to everyone who has contributed to the COVID-19 Solidarity Response Fund.
Since we launched it on Friday, more than 110,000 people have contributed almost 19 million U.S. dollars.
These funds will help to buy diagnostic tests, supplies for health workers and support research and development.
If you would like to contribute, please go to who.int and click on the orange “Donate" button at the top of the page.
We're also grateful for the way different sectors of society are coming together.
This started with the SafeHands Challenge, which has attracted celebrities, world leaders and people everywhere demonstrating how to wash their hands.
This afternoon WHO and the International Chamber of Commerce issued a joint call to action to the global business community. The ICC will send regular advice to its network of more than 45 million businesses, to protect their workers, customers, and local communities, and to support the production and distribution of essential supplies.
I'd like to thank Paul Polman, Ajay Banga and John Denton for their support and collaboration.
WHO is also working with Global Citizen to launch the Solidarity Sessions, a series of virtual concerts with leading musicians from around the world.
This is the defining global health crisis of our time.
The days, weeks and months ahead will be a test of our resolve, a test of our trust in science, and a test of solidarity.
Crises like this tend to bring out the best and worst in humanity.
Like me, I'm sure you have been touched by the videos of people applauding health workers from their balconies or the stories of people offering to do grocery shopping for older people in their community.
This amazing spirit of human solidarity must become even more infectious than the virus itself. Although we may have to be physically apart from each other for a while, we can come together in ways we never have before.
We're all in this together. And we can only succeed together.
So the rule of the game is: together.
This photo of Mt. Fuji has nothing to do with the text.