Wuhan City in Hubei Province was the center of the COVID-19 epidemic in China and the subsequent pandemic in the rest of the world. The disease first emerged in late 2019 as a cluster of unidentified and suspected pneumonia cases that seemed to stem from Huanan Seafood Market. On 8 January 2020, the pathogen behind the emerging outbreak was identified. It was a novel coronavirus that later earned the official label SARS-CoV-2. The specific disease is now called the coronavirus disease 2019 or COVID-19.
The ballooning number of recorded cases starting from January and the rising death toll warranted national response and global concern. Note that the virus had spread to all provinces in mainland China by January 29 and the death toll was over 700 by February 8. Xi Jinping, the Chinse Community Party General Secretary, warned about a “grave situation” confronting the country. There was also a concern over the upcoming Chunyun period, a high peak travel season that lasts for 40 days and associated with the Chinese New Year.
Nonetheless, although COVID-19 halted social, political, and economic activities in China, the number of newly confirmed cases outside the mainland exceeded those from within for the first time on February 25. It also reported zero locally transmitted case for three straight day on March 21, thus shifting the global attention to Italy which has now become the new epicenter of the pandemic. A report published by the U.S. Congressional Research Services indicated that the COVID-19 epidemic in the country peaked and plateaued between January 23 and 27, thus declining afterwards.
China essentially responded to the COVID-19 situation with brute force. This response has received both criticisms and admirations. On one side of the argument, the lockdowns had been slammed for being too harsh. However, as the country recovers, its response and measures have now been considered for replication by other countries. Note that Taiwan has also received praises for its strict but effective response while South Korea has been praised for its response strategy focused on mass testing, contact tracing, and individual quarantine protocols instead of widespread lockdowns.
Understanding The Response of China to the COVID-19 Pandemic
Initial Response Through Case Investigation and Disease Identification
The World Health Organization and other foreign governments have praised China for the initial measures undertaken by the Chinese government. Note that health care professionals and researchers began workin on relevant actions while the mysterious disease was spreading in Wuhan around late 2019
It is also worth mentioning that China has been familiar outbreaks caused by infectious pathogens. In fact, the SARS outbreak of 2002-2003 prompted the creation of a world-class laboratory in Wuhan for investigating and responding to pathogenic threats.
Nonetheless, on December 27, a local hospital notified the local Center for Disease and Control Prevention or CDC and health commissions about the impending outbreak. The CDC confirmed the case on December 31 after two emergent notice letters from the Municipal Health Commission of Wuhan circulated on the Internet. China subsequently notified the World Health Organization.
Researchers were already working on identifying the pathogen behind the mysterious disease during the first week of January 2020. Health officials also ruled out the recurrence of SARS. On January 7, Chinese researchers successfully identified the pathogen as a novel coronavirus that belonged to the coronavirus family. Furthermore, the sequence of the novel coronavirus was soon published by Chinese researchers on an open-access database, thereby sharing it to research institutions around the world for further scrutiny.
Measures Undertaken to Contain the Emerging Outbreak in Wuhan
Because Wuhan was the epicenter of the COVID-19 epidemic in China, initial response and measures were directed and concentrated toward Hubei. Note that the province was home to more than 60 million people. For example, the local government shut down the Huanan Seafood Market on January 1 and the national government placed Wuhan and 15 other Hubei cities under lockdown on January 23 to contain the virus, thereby restricting inward and outward movements by suspending flights and trains, and blocking roads.
The looming public health emergency was initially called the Wuhan pneumonia outbreak. However, despite the emerging threat, the local government of Wuhan argued that there was still no clear sign of human-to-human transmissions. The number of reported cases also remained at 41 between January 6 and 17. Local authorities explained that the frozen case number was due to the absence of testing kits for the new coronavirus.
Numbers swelled to 136 on January 20 as mainland cities such as Beijing and Shanghai reported their first cases. Authorities at Wuhan stopped claiming that there was a low risk of continuous human-to-human transmission. However, the National Health Commission still maintained that the outbreak should be manageable and preventable.
Take note that although Hubei was under lockdown in terms of transportation, the overall response of the local government has been criticized for being late and too slow. Before the travel bans, a sizeable number of people had already moved out of the province and to other cities in the mainland and other countries.
Both the Chinese government and WHO also received criticisms for downplaying the threat of the brewing global COVID-19 pandemic. A report by Emily Rauhala of The Washington Post mentioned that some groups think that both parties created a false sense of security in the early weeks of the outbreak through public reassurance, as well as allegations of delayed disclosure and undercounting of cases.
Some experts estimated that the virus might have been contained within Hubei if China employed expansive measures a week earlier. There was also a delay in the dissemination of relevant information, especially the disclosure of actual case numbers that prevented national authorities and WHO from understanding the gravity of the brewing threat.
Expansive Nationwide Response and Measures of China to the COVID-19 Epidemic
Several public health emergency declarations were raised across Chinese provinces. In Hubei, for example, the local government launched a Class 2 Response on January 22. Zhejiang province, followed by Guangdong and Hunan provinces, announced a Class 1 Response on January 23. All provinces of mainland China subsequently announced a Class 1 Response on January 29.
The public health declarations of the provincial governments allowed them to requisition relevant resources needed to control the COVID-19 epidemic. These provinces also received authority to organize and coordinate medical response, launch investigations, issue compulsory ordinances, manage human movement, develop and publish reports, and sustain social stability.
China responded to the COVID-19 treat further by canceling or delaying numerous events, as well as other social and political activities. These included festivals, sporting events, tourism, and education. The Ministry of Civil Affairs also canceled registrations for marriages. Some government activities to include local parliament session were suspended temporarily.
Because provinces and cities were placed under a lockdown or extreme quarantine measures, internal movements were also monitored. Several villages were cut off from the general community. Some cities imposed strict home quarantine ordinances and checkpoints to control the movement of the people. The shutting down of businesses or limiting of activities in non-essential sectors and industries was also part of the Chinese response to the epidemic.
To lessen the economic impact of the COVID-19 epidemic, the Chinese government rolled out several fiscal and monetary policies. For example, most factories resumed operations around the middle of February but they were obligated to follow strict protocols. The central government also required financial institutions to adjust their credit policies by adjusting payment deadlines and writing off those who missed their dues. Local governments also monitored retailers and the price of goods.
Specific Scientific, Medical, and Healthcare Measures in China During the Epidemic
The scientific community in China contributed immensely to the identification of the virus, which was later named SARS-CoV-2, as well as in the understanding the signs and symptoms of, and treatment options for COVID-19. Chinese researchers also published their research on numerous journals, thus making their findings available for further scrutiny by the global scientific community.
Remember that Chinese scientists were able to isolate the virus from an infected patient and perform genome sequencing on January 7. The sequence became available to the World Health Organization on January 12, thus facilitating laboratories from different countries to produce specific diagnostic RT-PCR tests for novel infections.
There was also a Joint Mission formed by WHO and China. The goal of this partnership was to create rapid development and dissemination of information relevant to the response to the disease. Furthermore, it also aims to prepare geographic areas not yet affected by providing informed plans or strategies.
Another remarkable response of China to the COVID-19 epidemic was the building of 16 temporary hospitals in Wuhan. Laboratories were also constructed to process more samples. As an example, the city was able to erect two makeshift facilities in 10 days that can accommodate a total of 2500 hospital beds. A report by Sophie Williams explained that the construction involved using expertise from the 2002-2003 SARS outbreak and onboarding competent engineers from across the country.
Health screening and tracking were used. In several entry points across the country, people were checked for temperatures. Contact tracing was also implemented using big data analytics. In provinces were cases were higher, people were obligated to record their temperature and update their health profile daily. The database was monitored closely by local health authorities of involved provinces.
To control price surges from hoarding and shortages of supplies such as face masks and protective gears, the central and local governments implemented strict price monitoring and empowered factories to increase production output.
Because Wuhan was the epicenter of the epidemic, medical workers from military universities, as well as from different provinces, were sent to the city to assist local hospitals and healthcare workers. Across the nation, the central government provided financial assistance for the healthcare needs of COVID-19 patents, as well as those who have direct contact with them. Photo credit: Zhizhou Deng/Adapted/CC2.0
FURTHER READINGS AND REFERENCES
- Boseley, R. 2020, February 18. “China’s Handling of Coronavirus is a Diplomatic Challenge for WHO.” The Guardian. Available online
- J. 2020. “Chinese Researchers Reveal Draft Genome of Virus Implicated in Wuhan Pneumonia Outbreak.” Science. DOI: 10.1126/science.aba8829
- Cyranoski, D. 2020. “What China’s Coronavirus Response Can Teach The Rest of the World.” Nature. DOI: 1038/d41586-020-00741-x
- Rauhala, E. 2020, February 9. “Chinese Officials Note Serious Problems in Coronavirus Response. The World Health Organization Keeps Praising Them.” The Washington Post. Available online
- Hui, D. S. et al. 2020. “The Continuing 2019-nCoV Epidemic Threat of Novel Coronaviruses to Global Health – The Latest 2019 Novel Coronavirus Outbreak in Wuhan, China.” International Journal of Infectious Disease. 91(2020: 264-266. DOI: 1016/j.ijid.2020.01.009
- Salaam-Blyther, T. 2020, March 19. “COVID-19: Global Implications and Responses.” Congressional Research Services. United States Congress. Available via PDF
- Williams, S. 2020, January 31. “Coronavirus: How Can China Build A Hospital So Quickly.” BBC. Available online
- Wu, X., Xu, X., & Wang, X. 2020, March 12. “6 Lessons From China’s Zhejiang Province and Hangzhou on How Countries Can Prevent and Rebound from an Epidemic Like COVID-19.” World Economic Forum. Available online