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    Top Advisor to Chinese CDC on Country’s Post-COVID Reopening

    Before becoming an advisor to China’s top health authorities, Lance Rodewald spent 12 years as head of immunization services at the American CDC. Here’s how he thinks a global reopening could play out.
    Oct 23, 2020#Coronavirus#Q&A

    SHANGHAI — Lance Rodewald is a conspicuous presence in a convention hall. A senior advisor to the Chinese Center for Disease Control and Prevention, he’s one of the few foreign faces at this week’s global science and technology forum in Shanghai, which most of his peers are attending virtually due to continued travel restrictions during the COVID-19 pandemic.

    As the former director of the U.S. CDC’s immunization services division for over a decade, Rodewald is in the unique position of being intimately familiar with both China’s disease control network and the American system it’s based on.

    Sixth Tone sat down with Rodewald on Friday for the weeklong Pujiang Innovation Forum to hear how he thinks global communities might begin to reopen and reconnect, even as COVID-19 continues to plague much of the planet. The interview has been edited for brevity and clarity.

    Sixth Tone: How would you judge the success of China’s border control measures during the pandemic?

    We can see that virtually all new infections discovered in China these days are imported. If, instead of being quarantined, new arrivals were just allowed to go into the communities, there would, with each individual, be the potential for a local outbreak.

    One of the key lessons we’ve learned from pandemic control is that if the virus circulates within the community, it becomes very difficult to protect vulnerable people. So I think China probably has the best and strongest border control anywhere in the world. It’s strict and cautious, but also effective: People get tested before they come to China to make sure they're negative for the virus. They get tested when they arrive, and then again during their two weeks of mandatory quarantine.

    This is all to make sure that these travelers are not infected before they’re allowed to go into the community. The contact tracing and testing works.

    Sixth Tone: What’s the next step? It’s not like everything’s going to stay closed forever.

    I don’t think so. You want to have normal international commerce, normal international exchange, and regular visits in and out. But this is something that’s yet to be figured out.

    You can see that China’s internal travel restrictions are significantly reduced, right? There are huge traffic jams in Beijing; the bike paths are full; children are in school and at college. So the domestic part is opening up. But whether to open up the international part involves some very complicated decisions.

    The recent change in visa rules allowing certain foreigners to enter China is clearly a signal that there is interest in reopening the country. Every step has to be carefully thought through, carefully evaluated and carefully monitored.

    Sixth Tone: In a pandemic, is there an ethical question in deciding to open the borders?

    It involves a trade-off between somebody raising the risk of others getting seriously ill, versus opening the economy that everybody depends on for their livelihoods. It’s a hard call, and clearly an ethical question.

    If the borders were just suddenly opened, there would be a lot of local outbreaks that would have to be stopped. Curbing these clusters requires a huge amount of effort and huge expense. These events are disruptive. Moreover, once the virus starts to circulate in communities, it can be very hard to protect vulnerable populations, such as the elderly. I think there’s a strong desire — in China and throughout the world — to protect high-risk populations.

    Sixth Tone: Do you consider an effective vaccine a necessary precondition before countries open up?

    I do think vaccines will play a role in making these decisions, maybe even a major role.

    The vaccines almost certainly will be able to prevent people from getting seriously ill. They may also prevent infection, which can help stop transmission of the virus. So vaccination is likely to be part of opening up international travel, because the people who would be coming in would be far less likely to bring the virus with them if they’ve been vaccinated.

    Because large-scale trials have yet to wrap up and announce their results, we don’t know the exact characteristics of the vaccines yet. There’s still so much that needs to be learned and evaluated. And a lot of this will have to be learned as the pandemic goes on and evolves.

    Sixth Tone: Will the world ever return to “normal,” the way it was before the pandemic?

    I’m an optimist. I think science programs, vaccines, treatment, and non-pharmaceutical interventions will defeat the virus. China has shown that it’s possible to defeat this virus. And I think this can happen globally, especially with the addition of vaccines. It’s not going to be easy, it’s not going to be fast — but I think eventually the pandemic will be defeated.

    So in that sense, the world may return to a similar state to the way it was before, where you don’t have to have all the non-pharmaceutical interventions like social distancing and border closures. But honestly, we don’t know when the next pandemic will hit. This may be a once-in-a-hundred-years event, or it could happen next year or next month. So part of going back to normal, I think, means learning lessons about preparedness, identification, detection, and response.

    People would really like to see this virus gone. With work, effort, science, and innovation, we will get there. I don’t think isolationism will become the new normal after the pandemic has passed, because countries want to be together in this world.

    Editor: David Paulk.

    (Header image: Lance Rodewald gives a speech during the Pujiang Innovation Forum in Shanghai, Oct. 23, 2020. Courtesy of Pujiang Innovation Forum)