Via Science: Not wearing masks to protect against coronavirus is a ‘big mistake,’ top Chinese scientist says. Excerpt and then a comment:
Chinese scientists at the front of that country’s outbreak of coronavirus disease 2019 (COVID-19) have not been particularly accessible to foreign media. Many have been overwhelmed trying to understand their epidemic and combat it, and responding to media requests, especially from journalists outside of China, has not been a top priority.
Science has tried to interview George Gao, director-general of the Chinese Center for Disease Control and Prevention (CDC), for 2 months. Last week he responded.
Gao oversees 2000 employees—one-fifth the staff size of the U.S. Centers for Disease Control and Prevention—and he remains an active researcher himself. In January, he was part of a team that did the first isolation and sequencing of severe acute respiratory syndrome 2 (SARS-CoV-2), the virus that causes COVID-19. He co-authored two widely read papers published in The New England Journal of Medicine (NEJM) that provided some of the first detailed epidemiology and clinical features of the disease, and has published three more papers on COVID-19 in The Lancet.
His team also provided important data to a joint commission between Chinese researchers and a team of international scientists, organized by the World Health Organization (WHO), that wrote a landmark report after touring the country to understand the response to the epidemic.
First trained as a veterinarian, Gao later earned a Ph.D. in biochemistry at the University of Oxford and did postdocs there and at Harvard University, specializing in immunology and virology. His research specializes in viruses that have fragile lipid membranes called envelopes—a group that includes SARS-CoV-2—and how they enter cells and also move between species.
Gao answered Science’s questions over several days via text, voicemails, and phone conversations. This interview has been edited for brevity and clarity.
Q: What can other countries learn from the way China has approached COVID-19?
A: Social distancing is the essential strategy for the control of any infectious diseases, especially if they are respiratory infections. First, we used “nonpharmaceutical strategies,” because you don’t have any specific inhibitors or drugs and you don’t have any vaccines. Second, you have to make sure you isolate any cases. Third, close contacts should be in quarantine: We spend a lot of time trying to find all these close contacts, and to make sure they are quarantined and isolated. Fourth, suspend public gatherings. Fifth, restrict movement, which is why you have a lockdown, the cordon sanitaire in French.
Q: The lockdown in China began on 23 January in Wuhan and was expanded to neighboring cities in Hubei province. Other provinces in China had less restrictive shutdowns. How was all of this coordinated, and how important were the “supervisors” overseeing the efforts in neighborhoods?
A: You have to have understanding and consensus. For that you need very strong leadership, at the local and national level. You need a supervisor and coordinator working with the public very closely. Supervisors need to know who the close contacts are, who the suspected cases are. The supervisors in the community must be very alert. They are key.
Q: What mistakes are other countries making?
A: The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.
Q: What about other control measures? China has made aggressive use of thermometers at the entrances to stores, buildings, and public transportation stations, for instance.
A: Yes. Anywhere you go inside in China, there are thermometers. You have to try to take people’s temperatures as often as you can to make sure that whoever has a high fever stays out.
And a really important outstanding question is how stable this virus is in the environment. Because it’s an enveloped virus, people think it’s fragile and particularly sensitive to surface temperature or humidity. But from both U.S. results and Chinese studies, it looks like it’s very resistant to destruction on some surfaces. It may be able to survive in many environments. We need to have science-based answers here.
Dr. Gao's argument for masks as a default preventative is the most persuasive I've seen yet. I'm keenly aware, as a member of COVID-19's preferred target demographic, that I could be spreading this stupid virus while I'm still feeling fine, even if a mask wouldn't necessarily protect me from being infected by someone else. I would welcome counter-arguments.
