Written especially for the New Cold War website, as well presenting some hard facts, this piece by Professor Mick Dunford provides details and demographics of how, through the extraordinary efforts of its government and people, China is winning the battle against the novel Corona virus.
By Mick Dunford, Feb 11, 2020
At present, information about the pneumonia outbreak that originated in Wuhan around December 6 in central China is far from complete so that one must exercise caution in discussing it. The outbreak came on top of Seasonal flu and Avian Flu. In Wuhan in early December patients appeared with flu like symptoms. Only once these people tested negative for known pathogens was it realized that a new pathogen was causing similar respiratory system infections.
On December 30, the infection of a number of people with a SARS-type pathogen was mooted on social media. Eight doctors were asked and agreed not to spread rumours. Of these doctors one, Li Wenliang, contracted the illness and subsequently and tragically died, prompting an outpouring of public anger and criticism of the Wuhan authorities (although the district CDC (Centre for Disease Control and Prevention) had already been informed). On February 8, an investigation team was sent by China’s Supervisory Commission to investigate the case. Clearly some officials may find themselves in deep trouble. In every province, Government officials were told at an early stage that any suppression of information would be severely punished.
On January 30 and in the first days of February in Huanggang, which is close to Wuhan which was the second most affected city, the Health Commission head had already been dismissed along with six officials, while another 337 were punished for insufficient effort in combating the virus. On February 10, 2020, the Party secretary and head of Hubei Provincial Health Commission were removed from office. The mayor of Shanghai, Ying Yong, was appointed as the new Party chief of Hubei Province.
Earlier, on December 27, Zhang Jixian, a specialist of respiratory diseases and critical care from Wuhan Zhong Xi Hospital, had identified a new type of pneumonia which she reported to the District CDC. Once it was clear from the examination of patient genome sequences that a new pathogen (the nCov19) was involved, the authorities acted very quickly: the DNA of the pathogen which is not an evolved SARS was quickly sequenced and shared with international health and disease organizations. Initially it was thought that it originated from a seafood market that also sold wild animals, although the first case did not originate from this location. On January 22, it was announced that person to person transmission was possible, and soon after that the fever is transmissible before symptoms such as a high temperature had appeared. As the illness quickly spread, it was also realized that the new pathogen was highly contagious: in February in Hong Kong one person from the Chinese mainland infected four people in the course of a family dinner; other cases of extraordinarily rapid transmission were noted. As the days passed some existing anti-viral medications were found to be relatively effective against this Corona virus.
In January 23, in Wuhan public bus and subway transport was suspended along with outbound air, rail, waterway and road passenger transport. These steps occurred however on the eve of the Chinese New Year which sees millions of people travel in a vast human migration: many, including migrant workers, return to their home towns to spend the new year with their families; some travel for family reunions in the places where their children live and work; and some take holidays in China or abroad.
Wuhan is a city of some 11 million people. When Wuhan was locked down, five million had already left. Some 600-700,000 has returned to nearby Huanggang which is the second most affected city. Official media pointed to a response that should perhaps have been faster. On February 3, 14 cities in Central China’s Hubei implemented lockdown and traffic control in the city centres, while throughout the country governments were asked to search for and register people from Wuhan.
In January health services and personnel in Wuhan were overwhelmed with patients and were short of protective hazmat suits, hospital beds and quarantine facilities. To support Wuhan, extraordinary efforts were made. Two new hospital with 10,000 beds were constructed from scratch. Huoshenshan hospital was completed in ten days. Once opened it was placed under military rule. Leishenshan quickly followed. Other facilities were turned into temporary hospitals. Medical personnel, equipment and relief supplies were sent to Wuhan from across China and from some other counties. In the last few days the number of medical staff from the armed forces sent to Hubei and Wuhan reached 6,600 and the total reached more than 20,000. Very quickly it was decided that treatment was to be free. As from the first week of February every city in Hubei province has been assigned a ‘partner province’ (duikou zhiyuan) which will offer partner assistance.
Very quickly public health emergencies were declared at the highest level in one province after another. Every residential community was mobilized to register returnees, to collect travel information and to check temperatures for signs of fever, while the authorities went to great lengths to find people who had been in contact with those affected. People were asked to stay indoors and, as the extended New Year holiday came to an end, to work at home. People chose to do so even if the local regime was not strict, effectively isolating themselves and contributing to the combat against the novel Corona virus.
The regimes implemented varied in their strictness in accordance with local conditions. In Wenzhou in East China’s Zhejiang Province only one family member was allowed to go out every other day for grocery shopping. In Zhengzhou in Henan Province it was once every five days, while people could only go to workplaces with approved disinfection arrangements, amid efforts to contain the COVID19 epidemic.
In Beijing the number of entrances/exits to residential blocks were reduced to one or two. Anyone returning was registered. Only residents were allowed to enter except in exceptional circumstances. Deliveries had to be collected from these entrances. Collective areas and lifts were regularly disinfected. Communities arrange for social workers to shop and care for special groups, those facing difficulties and those under quarantine. Whenever one goes out one was expected to wear a mask. In some places it is compulsory. Supermarkets, stores and other places screened the temperature of customers seeking to enter.
Media, social media, letters, notices and service hotlines provided advice, instructions as to what one should do to protect oneself from the virus, and if one developed symptoms (including not travelling by public transport to hospitals). Masks were in short supply yet severe punishments were imposed if people were over-charged for them. In Beijing supplies of groceries were plentiful. In a sense the whole of the population was mobilized in what amounted to a people’s war against what Xi Jinping called this ‘devil’.
Transport restrictions were imposed. On January 25, interprovincial passenger transport on Beijing roads was suspended. Tours were stopped. Swimming pools, gyms and theatres were all closed. If one did go out, one found the streets largely quiet and deserted. Travellers were checked and sometimes contact information collected in case it was discovered that they had travelled with someone carrying the pathogen. Anyone with a high temperature was not permitted to fly to another country.
The economic impact is clearly huge: very quickly new year gatherings and markets were cancelled with a major impact on those whose incomes derive from the normally soaring consumer expenditure across the Chinese New Year. Beijing’s Temple Fairs were all cancelled. The epidemic has seen a large drop in production and consumption and has interrupted supply chains, with the extended closure of factories, offices and shops and the absence of millions of high spending tourists and holidaymakers at tourist destinations. The 2020 World Athletics Indoor Championship due to take place in Nanjing in March was postponed for one year. Concerts scheduled for May have been cancelled (Wuhan) or postponed. Universities and schools postponed examinations and delayed the planned start of the new term. Once the extended new year holiday came to an end, schools and universities implemented distant teaching programmes. It all amounts to a major economic sacrifice on the part of China, although it will also have had adverse impacts of parts of the world that rely on Chinese visitors and their expenditure.
While many governments and WHO officials praised China and its government for the promptness, transparency and effectiveness of its response and its attempt to prevent the serious export of cases overseas, in some parts of the world and in particular in some western countries the response was very different. France, the UK, the US, Japan and South Korea sought to evacuate their nationals from Wuhan and advised them, wherever they were, to leave or not to go to China. Some countries closed their borders. National airlines stopped flying to China (possibly in part for commercial reasons).
While one might understand this type of caution, although it was against WHO and International Civil Airline Organization (ICAO) advice, sadly what occurred in the western media was something inexcusable: the publication and dissemination of extraordinary xenophobic attacks on China, its people and its government. Is there no opportunity on which they will not seize to denigrate China? Coverage included completely unjustifiable accusations. It was claimed for example that China was deliberately under-reporting the extent of the epidemic. Deliberate is a word for which they had no reliable evidence, though it is absolutely clear that in any epidemic under-reporting is inevitable as people do not declare that they are ill, and as medical staff and test equipment are limited and as criteria are difficult to establish and can change. This coverage also included deliberate misrepresentation as reports were selective and completely failed to deal with the representativeness of particular issues they covered. In this way they generated panic in their own countries and encouraged xenophobic behaviour. In some case facts were distorted: Chinese culinary habits were condemned by using photographs taken in parts of the world far distant from China.
Most disgustingly it was for some parts of the western media something to laugh about. Under the cloak of so-called freedom of speech, a Danish cartoon ridiculed China by replacing the stars on the Chinese flag with images of the novel coronavirus. The Wall Street journal declared that ‘China is the real sick man of Asia’. On its front page Der Spiegel alleged ‘Corona-Virus-Made in China’, while a French publication announced a ‘Yellow Alert’ to which many citizens in France and abroad responded.
When 2009 H1N1 swine flu emerged in the United States, an international emergency was declared. This pathogen eventually infected 60 million people, and in that year killed a minimum of 18,449. But according to the final numbers reported in 2012 by the Centre for Disease Control and Prevention the final death toll was close to 300,000. It took six months for the US to declare a national emergency. Xenophobic criticism of the US was absent. Other countries did not close their borders to US citizens. Why is the treatment of China so different?In the last five days the increase in confirmed cases has declined day by day in mainland China excluding Wuhan (see Figure 1). On February 11, thankfully the number of new cases in Wuhan diminished with experts suggesting the epidemic may peak outside Wuhan this month. (In Wuhan the numbers then increased due to a change in clinical diagnosis methods used to confirm cases). On the evening of February 10, confirmed infections on the Chinese mainland reached 42,638. The number of suspected cases stood at 21,675. A total of 187,728 people who have had close contact with infected patients were still under medical observation. The number of deaths stood at 1,016, a death rate of 2%-4%. While 7,333 patients remained in a serious condition, a total of 3,996 people had been cured and discharged from hospitals.
China, through the extraordinary efforts of its government and people, is winning the battle against this novel Corona virus. In this success a collective ethos and the mobilization of the whole of society to support places struck by misfortune have played a significant role. In this way it is also helping protect the rest of the world. Clearly there is still much to be done, but China will emerge all the stronger with an improved disease prevention and control system as a result of what it will have learnt.
[updated on Feb 13, 2020]
Mick Dunford is Emeritus Professor of Economic Geography, University of Sussex. He first visited China in 2006, and has worked in China for six months each year since 2010. Since leaving Sussex he has lived and worked in Beijing, and has travelled widely throughout China.