In this May 15, 2020 file photo, people line up for medical workers to take swabs for the coronavirus test at a large factory in Wuhan in central China’s Hubei province. (Chinatopix Via AP)
(Written by Liyiyu)
The COVID-19 pandemic has lasted for several months in China. When the outbreak began in Wuhan, scientists had no clue about the genetic code of the new virus. The residents of Wuhan were not in a position to realise its severity, risk and health hazards. They did not take enough precautions, allowing the virus to spread fast in the population from early January. The epicentre of this spread was the wet market in Wuhan city in Hubei Province in Central China. The city has a population of 11 million. Follow coronavirus pandemic LIVE updates
As time passed, scientists separated the virus strain and broadened our knowledge about the contagion. China formally sounded the alarm on January 20 and Level-I emergency was declared in several parts of the country. On January 23, Wuhan announced a lockdown of the city. But the problem was that the Chinese New Year was only two days away and the city was full of visitors who had come to celebrate the spring festival. This is the busiest time of the year in Wuhan as well as in other parts of China — people from all walks of life move from one place to another, visit relatives and friends, spend time in various social gatherings, renew social contacts and family ties. The situation was rifer for the virus to spread. The outsiders who had entered Wuhan for the spring festival and lunar New Year contracted the disease from local residents. Those who left the city before lockdown on January 23 carried the virus. By the time lockdown was declared, Wuhan was deserted, shops were closed, there was panic all around and hospitals were overcrowded with patients.
Before declaring a lockdown, three important steps were undertaken that minimised the spread of the disease in Wuhan and other parts of Hubei province. The first was to terminate all inter-state and intra-state bus services. Second, all entertainment centres, including shopping malls, were closed. Third, the government imposed a ban on all public gatherings. These measures and the decision to impose a lockdown on January 23 delayed and controlled the spread of the virus. However, 4.3 million people travelled out of Wuhan and Hubei province between January 11 and 23 to as many as 262 cities in China. Reports of the spread of virus began to pour in from most of these places.
Some travellers from Wuhan province returned to countries in Europe, the US, and various parts of Southeast Asia like Singapore, Thailand, Japan. These countries reported the spread of the infection within a month. Tourists returned home from China as well. The travellers hardly had any symptoms, and even if they had, there were no controls at the entry point. No checks were carried out at the airports.
Italy became a hotspot in February because Chinese businessmen and tourists returned to various cities there. Internal migration within Europe added fuel to the fire. There were visitors from India to Chinese cities such as Wuhan, Hangzhou, Shanghai and Guangzhou as well — mostly businessmen and their employees from cites like Mumbai, Delhi and Kolkata. There used to be six to nine flights between China and India in those days. Some of these travellers seem to have carried the virus back.
The sudden outbreak of the disease caused a shortage of doctors, health workers, and essential items like personal protection equipment (PPE), ventilators, masks, sanitisers and medical equipment. Wuhan city reached a critical stage in early February and its health care infrastructure was about to collapse. It was important for China to quickly resolve the crisis and several urgent steps were taken to combat the disease. It all began in Hubei, the epicentre of the disease. As a first step, several top officials in Hubei and Wuhan were removed from their offices, provinces not affected by the virus sent medical relief teams to help doctors in Hubei, the provincial administration constructed temporary hospitals to deal with the massive influx of patients. A government-led administrative structure at the local-level was formed which relied on the volunteers from the neighbourhoods. The fight against the epidemic went through two phases — the isolation phase and the monitoring phase. In both these phases, there was joint participation of government officials, doctors, health workers and volunteers. They had three goals — testing, tracing as many residents as possible and treatment.
In each area, patients were divided into four groups. Those with severe symptoms, those who were confirmed coronavirus patients, suspected cases, and those who contacted confirmed patients. Contact tracing was a stupendous task in a sprawling city like Wuhan. Severe cases were admitted to the main hospitals in the city, confirmed patients with mild symptoms were sent to the temporary hospitals, suspected cases and contact persons were taken to local hotels.
The next step was to supply medical equipment to hospitals and medical staff. The doctors treating patients faced the threat of getting infected at any time. Initially in the absence of epidemic prevention materials — especially a serious shortage of protective clothing — doctors and nurses ate and drank as little as possible, spent as much time as they could in treating the patients. With allergies and scars, the medical staff went on with this high-risk job day after day.
In the past, infectious diseases such as plague, smallpox, tuberculosis and cholera had ravaged China. The country made full use of the collective memory in dealing with epidemics in the past. Since the outbreak of this epidemic, not only have various anti-epidemic measures been gleaned from history and widely disseminated, but collective memories hidden in the folk culture have been evoked. The internet facilitated conversations, the loneliness and fear caused by the epidemic and lockdown were discussed and appropriate steps were taken.
Among the medical staff, experts such as Zhong Nanshan and Zhang Wenhong led the medical team. They not only played a key role with frontline warriors, but also popularised epidemic prevention knowledge among the masses, suggested some small but effective steps such as frequent hand washing, social distancing, use of masks and reducing the use of elevators, so as to avoid contraction of the virus. They used electronic and social media to reassure people and suggested methods to avoid panic. Wuhan did manage to control the mortality rate. A study by researchers of Johns Hopkins University suggested that three known factors affect mortality in the case of COVID-19 — the size of the population tested, the age structure of the population, and the affordability of the medical system. Right from the beginning, testing received the utmost priority. The relatively young population of Wuhan and Hubei helped to keep the mortality rate under control. The state took care of the entire financial liability of those affected by the virus.
One experiment that paid off at the time of the crisis was the use of a large number of volunteers. In this epidemic, both in urban and rural areas, volunteers have participated in various kinds of epidemic control work. In rural areas, volunteers along with village committee members used loudspeakers to persuade people to wash their hands and wear masks. They set up camps at the intersection of almost every village to persuade those who visit relatives and friends to take precautions, and ask those who return from the city to go for self-quarantine for two weeks. Volunteers delivered food to those living in isolation and cleaned up the garbage from their doorstep. In Wuhan, volunteers joined the local committee members to undertake all kinds of responsibilities arising from lockdown, such as arranging free transportation for the doctors and nurses, providing assistance in the transportation of various relief materials to the people trapped in the closed city, supplying essential drugs and food to the people in quarantine. During the three-month blockade period in Wuhan, most of the work, such as helping residents to buy food and medicine, caring the elderly who were unable to move, transporting materials, transporting medical staff, even feeding pets, was done by the volunteers — the unsung heroes of the battle against corona.
From the middle of March, there was a shift in the Chinese policy. Computers are now being used extensively along with new apps for rapid detection of cases, for medical treatment as well as tracking potential carriers of the virus. China started using big data to draw up a “five-colour epidemic map” that focuses on continuous monitoring of high-risk areas and providing scientific prevention and control methods to the rest. Two months after the use of “big data”, the majority of areas are gradually returning to normal life. China is now all set to deal with the second wave, if any. The virus has taught China a lesson — it showed how destructive a small, invisible matter can be, and how quickly it can spread from one part the country to another, and to the rest of the world.
The writer is Professor of Public Administration, Zhejiang Sci-Tech University, Hangzhou China