布魯斯·艾爾沃德博士是赴華評估中國冠狀病毒防疫工作的世界衛(wèi)生組織專家組組長。

作為世界衛(wèi)生組織專家組此次中國之行的組長，布魯斯·艾爾沃德博士(Bruce Aylward)感覺自己已經(jīng)登上過巔峰——看到了應(yīng)對的可能性。

在2月的一次為期兩周的訪問中，艾爾沃德看到了中國如何迅速遏制一場吞沒武漢、對全國各地構(gòu)成威脅的冠狀病毒暴發(fā)。

中國的新增病例已經(jīng)從2月初的每天3000多例降至約200例。隨著中國經(jīng)濟活動的恢復，這一數(shù)字可能再次上升。但就目前而言，世界其他地方出現(xiàn)的新病例要多得多。

艾爾沃德說，中國的抗疫方式可以被復制，但這需要速度、資金、想象力和政治勇氣。

迅速采取行動的國家仍可能控制住疫情，「因為這還不是全球性的流行病——而是全球都有疫情暴發(fā)，」他補充說。

艾爾沃德?lián)碛?/span>30年抗擊小兒麻痹癥、伊波拉病毒和其他全球衛(wèi)生突發(fā)事件的經(jīng)驗，在接受《紐約時報》采訪時，他詳細介紹了他認為抗擊這種病毒的行動應(yīng)該如何開展。

以下對話經(jīng)過了編輯和精簡。

Q: 我們知道這種病毒的致死率是多少嗎？我們聽到一些人估計它接近1918年導致2.5%患者死亡的西班牙流感，而另一些人則認為它比導致0.1%患者死亡的季節(jié)性流感稍微嚴重一些。遺漏病例數(shù)量可能會影響這一數(shù)據(jù)。

西方國家對無癥狀病例有很大的恐慌。許多人在測試時沒有癥狀，但在一兩天內(nèi)就出現(xiàn)了。

在廣東，他們重新檢測了32萬份原本用于流感監(jiān)測和其他篩查的樣本。不到0.5%的人呈陽性，這個數(shù)字與該省已知的1500例Covid病例大致相同。（Covid-19是由冠狀病毒引起的疾病的學名。）

沒有證據(jù)表明我們看到的只是冰山一角，還有十分之九的冰山是傳播病毒的隱藏殭尸。我們現(xiàn)在看到的就是一個金字塔：大部分都在地面上了。

等到我們可以測試許多人的抗體時，也許我會說，「你猜怎么著？這些數(shù)據(jù)并沒有告訴我們真相。」但我們現(xiàn)有的數(shù)據(jù)并不支持這一說法。

Q:如果無癥狀傳播很少，那是好事。但糟糕的是，這意味著我們所看到的死亡率——從中國部分地區(qū)的0.7%到武漢地區(qū)的5.8%——是正確的，對吧？

我聽過這種說法：「死亡率不是很難看，因為實際上輕癥病例要多的多?！沟?，死亡人數(shù)還是一樣多。實際病死率可能跟湖北省外的統(tǒng)計差不多，就在1%到2%之間。

Q: 兒童情況如何？我們知道他們中很少有住院患者。但他們會被感染嗎？會傳染給家人嗎？

我們還不知道。廣東省的調(diào)查也顯示，20歲以下人群幾乎沒有感染。兒童會得流感，但不會感染這個病毒。至于他們是否感染了但不受影響，是否會傳給家人，我們必須做更多研究。但我問了幾十位醫(yī)生：你是否見過兒童作為主要病例的傳播鏈？答案是否定的。

Q: 為什么？有一種理論認為，青少年經(jīng)常感染已知的四種輕度冠狀病毒，從而得到了保護。

這仍然是個推測。我無法得到足夠的共識，因此也沒有寫進世界衛(wèi)生組織報告。

Q: 這是否意味著關(guān)閉學校毫無意義？

不是的。還是有不確定的地方。如果一種疾病是危險的，而且我們看到了聚集性疫情，那就必須關(guān)閉學校。我們知道這會造成問題，因為你一旦把孩子送回家，你家一半的勞動力就得待在家里照顧他們。但你不能拿孩子冒險。

Q: 中國的病例真的在減少嗎？

我知道有人懷疑，但在我們?nèi)ミ^的每家檢測診所，人們都會說，「現(xiàn)在和三周前不一樣了?！挂咔榉逯禃r每天有4.6萬人要求做檢測；當我們離開時，變成了每天1.3萬人。醫(yī)院都有空病床了。

我看不出任何操縱數(shù)據(jù)的跡象。迅速暴發(fā)的疫情已經(jīng)穩(wěn)定下來，而且降溫的速度比預期要快。粗略計算下來，有數(shù)十萬中國人因為這種嚴厲的應(yīng)對措施而免于罹患Covid-19。

Q: 這種病毒會像新型流感那樣，感染幾乎所有人嗎？

不會——75%到80%的聚集性疫情都是家庭傳播。你可能在醫(yī)院、餐館或監(jiān)獄得上，但絕大多數(shù)都是在家庭傳播中感染的。而且只有5%到15%的近距離接觸者會患病。所以他們會盡快把你和你的親戚隔離開來，并在48小時內(nèi)找出所有你接觸過的人。

Q: 你說不同的城市有不同的反應(yīng)。為什么？

這取決于他們是否出現(xiàn)零病例、零星病例、聚集性疫情或是廣泛傳播。

首先，你必須確保每個人都了解基本常識：洗手、戴口罩、不握手，以及感染癥狀是什么。然后，為了尋找零星病例，他們到處做發(fā)燒檢查，甚至在高速公路上攔住汽車檢查每個人。

一旦發(fā)現(xiàn)聚集性疫情，就關(guān)閉學校、影院和餐館。只有武漢及其周邊城市進入全面封鎖狀態(tài)。

Q: 中國人是如何重新組織起醫(yī)療響應(yīng)的？

首先，他們將50%的醫(yī)療服務(wù)都轉(zhuǎn)移到網(wǎng)上，這樣人們就不用來醫(yī)院看病。你有沒有試過在周五晚上聯(lián)絡(luò)你的醫(yī)生？現(xiàn)在你可以在網(wǎng)上找一個。如果你需要像胰島素或心臟藥物這樣的處方藥，他們可以開藥并送貨。

Q: 但如果你覺得自己感染了冠狀病毒呢？

你會被送到發(fā)燒門診。他們會檢測你的體溫、癥狀、病史，詢問你去過哪里、與任何感染者的接觸情況。他們會給你迅速掃一個CT……

Q: 等等——「給你迅速掃一個CT」？

每臺機器一天大概做200次，一次掃描5到10分鐘。甚至可能是部分掃描。在西方，一家醫(yī)院一般每小時掃描一到兩次。這和做X光不一樣；病人看上去可能是正常的，但CT會顯示出他們要找的「毛玻璃影」。

（艾爾沃德指的是冠狀病毒患者出現(xiàn)的肺部異常。）

Q: 然后呢？

如果你還是疑似病人，你就會被取拭子。但很多人會被告知，「你沒有患上Covid。」來這里的人有感冒的、流感的、流鼻涕的。這些都不是Covid?？纯?/span>Covid的癥狀吧，90%有發(fā)燒、70%有干咳、30%有身體不適，呼吸困難。流鼻涕的只有4%。

Q: 拭子是用來做PCR測試的，對吧？他們做得有多快？直到前不久，我們還得把所有樣本都送到亞特蘭大去。

他們把時間縮短到了四個小時。

Q: 所以人們不會被送回家？

不，他們得等著。不能讓人隨便到處跑，傳播病毒。

Q: 如果結(jié)果是陽性會怎樣？

他們會被隔離。在武漢，一開始從生病到住院需要15天。他們把發(fā)現(xiàn)癥狀到隔離的時間減少到兩天。這意味著受感染的人會更少——這樣就能限制住病毒找到易感者的能力。

Q: 隔離和住院有什么區(qū)別？

輕癥病人會去隔離中心。他們被安置在體育館——多達1000個床位。但重癥和危重病人就會直接去醫(yī)院。有其他疾病或超過65歲的人也可以直接去醫(yī)院。

Q: 什么是輕癥、重癥和危重？我們以為「輕癥」就像輕微感冒那樣的。

不。「輕癥」是檢測陽性、發(fā)燒、咳嗽——甚至可能是肺炎，但不需要吸氧。「重癥」是呼吸頻率上升，血氧飽和度下降，所以需要吸氧或用呼吸機?！肝Ｖ亍故呛粑ソ呋蚨嗥鞴偎ソ摺?/span>

Q: 所以，所謂80%的病例是輕癥，并不是我們所想的那樣。

我是加拿大人。這種病毒就是病毒中的韋恩·格雷茨基（Wayne Gretzky，加拿大著名冰球明星，職業(yè)生涯之初因身體條件不佳而不被看好。——譯注）——人們本來覺得它不夠厲害，傳播速度不夠快，沒法產(chǎn)生那么大的影響。

Q: 醫(yī)院也被區(qū)分開？

是的。最好的醫(yī)院都用來接收重癥和危重的Covid病人。所有擇期手術(shù)都被推遲。病人被轉(zhuǎn)移。其他醫(yī)院被指定為常規(guī)醫(yī)療：還是會有女性需要分娩，還是有人在面對精神創(chuàng)傷和心臟病發(fā)作。

他們新建了兩所醫(yī)院，然后又改建了幾所。如果一間病房很長，他們會在盡頭建一堵帶窗戶的墻，所以就成了一個有「污染」和「清潔」區(qū)的隔離病房。你進去，穿上防護服，治療病人，然后從另一頭出去，脫下防護服。它就像一個伊波拉病毒治療單元，但沒有那么多的消毒，因為它不是體液傳播。

Q: 重癥監(jiān)護的情況怎么樣？

中國很擅長維持病人生命。那里的醫(yī)院看上去比我在瑞士看到的一些還好。我們問：「你們有多少呼吸機？」他們說：「50臺?！雇?！我們問：「有多少ECMO？」他們說：「五臺。」來自羅伯特·科赫研究所(Robert Koch Institute)的團隊成員說：「五臺？在德國，也許能有個三臺。而且只有在柏林?！?/span>

（ECMO是體外膜式氧合機，在肺功能衰竭時提供血液氧合。）

Q: 誰為這一切付費？

政府明確表示：測試是免費的。如果你患了Covid-19，保險滿額后，國家會承擔一切費用。

美國存在速度上的障礙。人們會想：「看醫(yī)生要花100美元。如果進了重癥監(jiān)護室要花多少錢？」這樣會要你的命的。這可能會造成嚴重破壞。這就是全民醫(yī)療保險和安全的相關(guān)之處。美國必須好好思考這一點。

Q: 那么醫(yī)療之外的反應(yīng)呢？

這種反應(yīng)是全國范圍的。他們有一種強烈的意識，「我們必須幫助武漢，」而不是「武漢讓我們落到這種地步」。其他省份派出了4萬名醫(yī)療工作者，其中許多人是自愿的。

在武漢，我們的專列在晚上進站，場面讓人很是傷感——巨大的城際鐵路列車呼嘯而過，窗簾都是遮著的。

我們下了車，另一群人也下了車。我說：「等等，我以為只有我們可以下車?！顾麄兇┲A克，拿著旗子——是一支來幫忙的廣東醫(yī)療隊。

Q: 武漢人如果待在家里，吃飯怎么解決？

1500萬人不得不在網(wǎng)上訂購食物。送貨上門。的確是出了一些問題。但是有位女士對我說：「包裹有時候會少點東西，但是我一點也沒瘦下來?！?/span>

Q: 許多政府雇員被重新安排崗位？

全社會都是這樣。高速公路上的工作人員可能會測體溫、遞送食物或者追蹤接觸史。在一家醫(yī)院，我遇到一個教人們怎么穿防護服的女人。我問：「你是傳染病控制專家？」不，她是一名前臺。這些是她學來的。

Q: 技術(shù)是怎么發(fā)揮作用的？

他們管理著大量數(shù)據(jù)，因為他們試圖追蹤七萬個病例的所有聯(lián)系人。他們關(guān)閉學校的時候，事實上只有學校大樓關(guān)閉了。學校教育轉(zhuǎn)移到網(wǎng)上。

追蹤接觸史的人要填寫電子表格。如果出錯了就會閃黃光。是傻瓜式操作。

我們?nèi)チ怂拇?，那是個很大的地方，但相當一部分是農(nóng)村。他們鋪設(shè)了5G網(wǎng)絡(luò)。我們?nèi)チ耸?，在一個有大屏幕的緊急中心。他們在了解一個群落的情況時遇到了問題。在同一個屏幕上，他們聯(lián)系到了那個縣的總部。還是沒有解決問題。

于是他們派出了外勤隊。這個不幸的隊長在500公里以外，他的手機接到了影片電話，是省長打過去的。

Q: 社群媒體情況怎么樣？

他們讓微博、騰訊和微信向所有用戶提供準確的信息。你們本可以讓Facebook、Twitter和Instagram也這么做。

Q: 這一切在美國難道不都是不可能的嗎？

你看，記者們總是說：「我們的國家可不能這樣做。」人們的思維定勢必須向快速反應(yīng)思維轉(zhuǎn)變。你打算舉手投降嗎？這里面存在真正的道德危險，體現(xiàn)的是你的易感人口對你來說意味著什么。

問問自己：你能做到那些簡單的事情嗎？你能隔離100個病人嗎？你能追蹤1000個聯(lián)系人嗎？如果不做，疫情會在整個小區(qū)里蔓延。

Q: 這一切之所以可能，難道不是因為中國是專制國家嗎？

記者們還會說：「好吧，他們只是出于對政府的恐懼才這么做的，」就好像有個會噴火的邪惡政權(quán)在吞食嬰兒似的。我也和體制外的許多人談過——在旅館里、火車上、夜晚的街頭。

他們被動員起來，就像在戰(zhàn)爭中一樣，是對病毒的恐懼驅(qū)使著他們。他們真的認為自己站在第一線，這是在保衛(wèi)中國其他地區(qū)乃至整個世界。

Q: 中國現(xiàn)在正在重啟經(jīng)濟。如何在不引起新一波感染的情況下做到這一點？

是「階段性重啟」。這意味著不同省份情況不同。

有些省份停課的時間會更長。有些省份只允許那些生產(chǎn)關(guān)乎供應(yīng)鏈重要產(chǎn)品的工廠開工。至于回鄉(xiāng)的民工——是的，成都就有500萬。

首先，你要去看醫(yī)生并得到一個「無風險」的證明。這個證明能用三天。

然后，你要坐火車去你工作的地方。如果是北京，那么你要先自我隔離兩周。你的體溫被監(jiān)測，有時通過電話問詢，有時通過體溫檢查。

Q: 臨床治療試驗是如何進行的？

那些都是雙盲試驗，所以我不知道結(jié)果。幾周后我們應(yīng)該會知道更多。

最大的挑戰(zhàn)是召集參與者。重癥患者的數(shù)量在減少，已經(jīng)存在競爭了。并且每個病房是由不同省份的醫(yī)療團隊負責，所以你必須跟每一個團隊談，確保他們在按正確的程序走。

而且現(xiàn)在記錄在案的試驗有200項——太多了。我告訴他們：「你們得優(yōu)先使用有抗病毒功效的治療?！?/span>

Q: 而且他們在測試中藥？

是的，但是是一些標準配方。并不是坐在床邊現(xiàn)熬的草藥。他們認為這些配方有一些退燒或抗炎的功效。不能抗病毒，但能讓病人感覺舒服些，他們有這個習慣。

Q: 你怎么保護自己？

使用消毒洗手液。我們戴口罩，因為這是政府的政策。我們沒有去見病人或者病人的密切接觸者，或者進入醫(yī)院的感染區(qū)。

我們還保持社交距離。我們在巴士上隔排坐。我們在自己的酒店房間吃飯，或者一人一桌。在會議室里，我們一人坐一桌并用麥克風或者提高音量說話。

這就是為什么我嗓子這么沙啞。但是我測試了，我知道我沒有Covid。

Inside China’s All-Out War on the Coronavirus

Dr. Bruce Aylward, of the W.H.O., got a rare glimpse into Beijing’s campaign to stop the epidemic. Here’s what he saw.

As the leader of the World Health Organization team that visited China, Dr. Bruce Aylward feels he has been to the mountaintop — and has seen what’s possible.

During a two-week visit in early February, Dr. Aylward saw how China rapidly suppressed the coronavirus outbreak that had engulfed Wuhan, and was threatening the rest of the country.

New cases in China have dropped to about 200 a day, from more than 3,000 in early February. The numbers may rise again as China’s economy begins to revive. But for now, far more new cases are appearing elsewhere in the world.

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China’s counterattack can be replicated, Dr. Aylward said, but it will require speed, money, imagination and political courage.

For countries that act quickly, containment is still possible “because we don’t have a global pandemic — we have outbreaks occurring globally,” he added.

Dr. Aylward, who has 30 years experience in fighting polio, Ebola and other global health emergencies, detailed in an interview with The New York Times how he thinks the campaign against the virus should be run.

This conversation has been edited and condensed.

Q: Do we know what this virus’s lethality is? We hear some estimates that it’s close to the 1918 Spanish flu, which killed 2.5 percent of its victims, and others that it’s a little worse than the seasonal flu, which kills only 0.1 percent. How many cases are missed affects that.

There’s this big panic in the West over asymptomatic cases. Many people are asymptomatic when tested, but develop symptoms within a day or two.

In Guangdong, they went back and retested 320,000 samples originally taken for influenza surveillance and other screening. Less than 0.5 percent came up positive, which is about the same number as the 1,500 known Covid cases in the province. (Covid-19 is the medical name of the illness caused by the coronavirus.)

There is no evidence that we’re seeing only the tip of a grand iceberg, with nine-tenths of it made up of hidden zombies shedding virus. What we’re seeing is a pyramid: most of it is aboveground.

Once we can test antibodies in a bunch of people, maybe I’ll be saying, “Guess what? Those data didn’t tell us the story.” But the data we have now don’t support it.

Q: That’s good, if there’s little asymptomatic transmission. But it’s bad in that it implies that the death rates we’ve seen — from 0.7 percent in parts of China to 5.8 percent in Wuhan — are correct, right?

I’ve heard it said that “the mortality rate is not so bad because there are actually way more mild cases.” Sorry — the same number of people that were dying, still die. The real case fatality rate is probably what it is outside Hubei Province, somewhere between 1 and 2 percent.

Q: What about children? We know they are rarely hospitalized. But do they get infected? Do they infect their families?

We don’t know. That Guangdong survey also turned up almost no one under 20. Kids got flu, but not this. We have to do more studies to see if they get it and aren’t affected, and if they pass it to family members. But I asked dozens of doctors: Have you seen a chain of transmission where a child was the index case? The answer was no.

Q: Why? There’s a theory that youngsters get the four known mild coronaviruses so often that they’re protected.

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That’s still a theory. I couldn’t get enough people to agree to put it in the W.H.O. report.

Q: Does that imply that closing schools is pointless?

No. That’s still a question mark. If a disease is dangerous, and you see clusters, you have to close schools. We know that causes problems, because as soon as you send kids home, half your work force has to stay home to take care of them. But you don’t take chances with children.

Q: Are the cases in China really going down?

I know there’s suspicion, but at every testing clinic we went to, people would say, “It’s not like it was three weeks ago.” It peaked at 46,000 people asking for tests a day; when we left, it was 13,000. Hospitals had empty beds.

I didn’t see anything that suggested manipulation of numbers. A rapidly escalating outbreak has plateaued, and come down faster than would have been expected. Back of the envelope, it’s hundreds of thousands of people in China that did not get Covid-19 because of this aggressive response.

Q: Is the virus infecting almost everyone, as you would expect a novel flu to?

No — 75 to 80 percent of all clusters are in families. You get the odd ones in hospitals or restaurants or prisons, but the vast majority are in families. And only 5 to 15 percent of your close contacts develop disease. So they try to isolate you from your relatives as quickly as possible, and find everyone you had contact with in 48 hours before that.

Q: You said different cities responded differently. How?

It depended on whether they had zero cases, sporadic ones, clusters or widespread transmission.

First, you have to make sure everyone knows the basics: hand-washing, masks, not shaking hands, what the symptoms are. Then, to find sporadic cases, they do fever checks everywhere, even stopping cars on highways to check everyone.

As soon as you find clusters, you shut schools, theaters, restaurants. Only Wuhan and the cities near it went into total lockdown.

Q: How did the Chinese reorganize their medical response?

First, they moved 50 percent of all medical care online so people didn’t come in. Have you ever tried to reach your doctor on Friday night? Instead, you contacted one online. If you needed prescriptions like insulin or heart medications, they could prescribe and deliver it.

Q: But if you thought you had coronavirus?

You would be sent to a fever clinic. They would take your temperature, your symptoms, medical history, ask where you’d traveled, your contact with anyone infected. They’d whip you through a CT scan …

Q: Wait — “whip you through a CT scan”?

Each machine did maybe 200 a day. Five, 10 minutes a scan. Maybe even partial scans. A typical hospital in the West does one or two an hour. And not X-rays; they could come up normal, but a CT would show the “ground-glass opacities” they were looking for.

(Dr. Aylward was referring to lung abnormalities seen in coronavirus patients.)

Q: And then?

If you were still a suspect case, you’d get swabbed. But a lot would be told, “You’re not Covid.” People would come in with colds, flu, runny noses. That’s not Covid. If you look at the symptoms, 90 percent have fever, 70 percent have dry coughs, 30 percent have malaise, trouble breathing. Runny noses were only 4 percent.

Q: The swab was for a PCR test, right? How fast could they do that? Until recently, we were sending all of ours to Atlanta.

They got it down to four hours.

Q: So people weren’t sent home?

No, they had to wait. You don’t want someone wandering around spreading virus.

Q: If they were positive, what happened?

They’d be isolated. In Wuhan, in the beginning, it was 15 days from getting sick to hospitalization. They got it down to two days from symptoms to isolation. That meant a lot fewer infected — you choke off this thing’s ability to find susceptibles.

Q: What’s the difference between isolation and hospitalization?

With mild symptoms, you go to an isolation center. They were set up in gymnasiums, stadiums — up to 1,000 beds. But if you were severe or critical, you’d go straight to hospitals. Anyone with other illnesses or over age 65 would also go straight to hospitals.

Q: What were mild, severe and critical? We think of “mild” as like a minor cold.

No. “Mild” was a positive test, fever, cough — maybe even pneumonia, but not needing oxygen. “Severe” was breathing rate up and oxygen saturation down, so needing oxygen or a ventilator. “Critical” was respiratory failure or multi-organ failure.

So saying 80 percent of all cases are mild doesn’t mean what we thought.

I’m Canadian. This is the Wayne Gretzky of viruses — people didn’t think it was big enough or fast enough to have the impact it does.

Q: Hospitals were also separated?

Yes. The best hospitals were designated just for Covid, severe and critical. All elective surgeries were postponed. Patients were moved. Other hospitals were designated just for routine care: women still have to give birth, people still suffer trauma and heart attacks.

They built two new hospitals, and they rebuilt hospitals. If you had a long ward, they’d build a wall at the end with a window, so it was an isolation ward with “dirty” and “clean” zones. You’d go in, gown up, treat patients, and then go out the other way and de-gown. It was like an Ebola treatment unit, but without as much disinfection because it’s not body fluids.

Q: How good were the severe and critical care?

China is really good at keeping people alive. Its hospitals looked better than some I see here in Switzerland. We’d ask, “How many ventilators do you have?” They’d say “50.” Wow! We’d say, “How many ECMOs?” They’d say “five.” The team member from the Robert Koch Institute said, “Five? In Germany, you get three, maybe. And just in Berlin.”

(ECMOs are extracorporeal membrane oxygenation machines, which oxygenate the blood when the lungs fail.)

Q: Who paid for all of this?

The government made it clear: testing is free. And if it was Covid-19, when your insurance ended, the state picked up everything.

In the U.S., that’s a barrier to speed. People think: “If I see my doctor, it’s going to cost me $100. If I end up in the I.C.U., what’s it going to cost me?” That’ll kill you. That’s what could wreak havoc. This is where universal health care coverage and security intersect. The U.S. has to think this through.

Q: What about the nonmedical response?

It was nationwide. There was this tremendous sense of, “We’ve got to help Wuhan,” not “Wuhan got us into this.” Other provinces sent 40,000 medical workers, many of whom volunteered.

In Wuhan, our special train pulled in at night, and it was the saddest thing — the big intercity trains roar right through, with the blinds down.

We got off, and another group did. I said, “Hang on a minute, I thought we were the only ones allowed to get off.” They had these little jackets and a flag — it was a medical team from Guangdong coming in to help.

Q: How did people in Wuhan eat if they had to stay indoors?

Fifteen million people had to order food online. It was delivered. Yes, there were some screw-ups. But one woman said to me: “Every now and again there’s something missing from a package, but I haven’t lost any weight.”

Q: Lots of government employees were reassigned?

From all over society. A highway worker might take temperatures, deliver food or become a contact tracer. In one hospital, I met the woman teaching people how to gown up. I asked, “You’re the infection control expert?” No, she was a receptionist. She’d learned.

Q: How did technology play a role?

They’re managing massive amounts of data, because they’re trying to trace every contact of 70,000 cases. When they closed the schools, really, just the buildings closed. The schooling moved online.

Contact tracers had on-screen forms. If you made a mistake, it flashed yellow. It was idiot-proof.

We went to Sichuan, which is vast but rural. They’d rolled out 5G. We were in the capital, at an emergency center with huge screens. They had a problem understanding one cluster. On one screen, they got the county headquarters. Still didn’t solve it.

So they got the field team. Here’s this poor team leader 500 kilometers away, and he gets a video call on his phone, and it’s the governor.

Q: What about social media?

They had Weibo and Tencent and WeChat giving out accurate information to all users. You could have Facebook and Twitter and Instagram do that.

Q: Isn’t all of this impossible in America?

Look, journalists are always saying: “Well, we can’t do this in our country.” There has to be a shift in mind-set to rapid response thinking. Are you just going to throw up your hands? There’s a real moral hazard in that, a judgment call on what you think of your vulnerable populations.

Ask yourself: Can you do the easy stuff? Can you isolate 100 patients? Can you trace 1,000 contacts? If you don’t, this will roar through a community.

Q: Isn’t it possible only because China is an autocracy?

Journalists also say, “Well, they’re only acting out of fear of the government,” as if it’s some evil fire-breathing regime that eats babies. I talked to lots of people outside the system — in hotels, on trains, in the streets at night.

They’re mobilized, like in a war, and it’s fear of the virus that was driving them. They really saw themselves as on the front lines of protecting the rest of China. And the world.

Q: China is restarting its economy now. How can it do that without creating a new wave of infections?

It’s a “phased restart.” It means different things in different provinces.

Some are keeping schools closed longer. Some are only letting factories that make things crucial to the supply chain open. For migrant workers who went home — well, Chengdu has 5 million migrant workers.

First, you have to see a doctor and get a certificate that you’re “no risk.” It’s good for three days.

Then you take the train to where you work. If it’s Beijing, you then have to self-quarantine for two weeks. Your temperature is monitored, sometimes by phone, sometimes by physical check.

Q: What’s going on with the treatment clinical trials?

They’re double-blind trials, so I don’t know the results. We should know more in a couple of weeks.

The biggest challenge was enrolling people. The number of severe patients is dropping, and there’s competition for them. And every ward is run by a team from another province, so you have to negotiate with each one, make sure they’re doing the protocols right.

And there are 200 trials registered — too many. I told them: “You’ve got to prioritize things that have promising antiviral properties.”

Q: And they’re testing traditional medicines?

Yes, but it’s a few standard formulations. It’s not some guy sitting at the end of the bed cooking up herbs. They think they have some fever-reducing or anti-inflammatory properties. Not antivirals, but it makes people feel better because they’re used to it.

Q: What did you do to protect yourself?

A heap of hand-sanitizer. We wore masks, because it was government policy. We didn’t meet patients or contacts of patients or go into hospital dirty zones.

And we were socially distant. We sat one per row on the bus. We ate meals in our hotel rooms or else one person per table. In conference rooms, we sat one per table and used microphones or shouted at each other.

That’s why I’m so hoarse. But I was tested, and I know I don’t have Covid.

Donald G. McNeil Jr. is a science reporter covering epidemics and diseases of the world’s poor. He joined The Times in 1976, and has reported from 60 countries.