A brief account of China’s response to the COVID-19 epidemic

In the few former colonising countries known as the West, a number of irresponsible media outlets wasted time trying to criticise China while the World Health Organisation (WHO) was urging the countries in question to act. So it is worth going over the facts in relation to the epidemic.

I begin with three points consistently made by WHO:

1. China`s complete transparency and assistance of other countries throughout.
2. The achievement of containing and preventing the disease in China, especially when there was a real danger it could get out of control, is unprecedented in human history.
3. Other countries should follow the China Model.

Although these points were hard to believe by the chattering classes in the West, the WHO made these recommendations from the perspective of medical science and not politics.

How did the WHO come to make these points? Let us follow the course of events, which are freely available on Chinese media outlets, which are not afraid at all of the truth.

In late December about 10 doctors reported cases of an unknown or SARS- like virus. These were immediately reported to WHO and thorough investigation was undertaken in China and by WHO. One doctor, Li Wenliang, posted two notices, sent from his colleagues engaged in the investigation, on wechat and weibo, and the local police reprimanded him for inappropriate use of social media. Importantly, he was not silenced or fined but kept working and he was by no means the only one involved in the research. I must admit, I am in two minds about this move. Of course, the Western media made a big brouhaha about a supposed ‘whistleblower’ who was ‘silenced’, but this was a clear distortion of the actual situation. Why am I in two minds? On the one hand, I am all in favour of responsible social media practices, and the need to curtail severely the spreading of rumour and gossip. On the other hand, should a qualified doctor make medical information available during an ongoing investigation of a new disease? There is much debate in China about this question as I write and I do not have a clear answer.

I recommend that you read this report of the 40-day investigation of the matter by the National Supervisory Commission (on China Daily). The report noted that there are very strict laws concerning the verification, release and reporting of epidemic information. Li had not followed those laws and provided some incorrect information at the time. Thus, the actions by the local police at the time had followed the law. At the same, Li – as a member of the CPC – had acted in good faith and for the social good. The report also finds that two of the police officers involved had followed substandard procedures. Thus, a sincere apology was given to Li’s family and the official letter of reprimand rescinded.

No system is entirely perfect: a few other local officials were found not to be up to the task of dealing with an emergency (including the mayor of Wuhan). Widespread criticism was made, very openly. An inspection team was quickly dispatched to Wuhan and the incompetent local officials dismissed and replaced. It would be like a prime minister going to Hawaii during a bush fire emergency (think of Australia). Upon return, he would be out of a job. Clearly, the early mistakes in China were incidental and not systemic.

Meanwhile, WHO sent a team to China, the sequence of the unknown virus was identified in a record 7 days by a Chinese laboratory, a diagnostic kit was developed by a German lab, and a full diagnosis was possible by 20 January. The WHO notes that this was the fastest identification made in the case of a new disease. The plan developed was a WHO-China joint plan, and the WHO urged the rest of the world to act immediately since China had given the world an opportunity to change the course of the disease. Unfortunately, too many countries did not listen and we find ourselves in the current situation.

In China, the ability of its socialist system to control and manage a new edpidemic is now history. Through widepsread testing (1.6 million a day), integration of AI, 5G and big data, it was able to keep the epidemic to a miniscule fraction of one percent of the whole population. As for the population itself, the old Chinese cultural – and socialist – reality of the greater social good kicked in and almost everyone cooperated (those who did not soon did so). Notably, public health was paramount, and not the economy. Of course, the economy too would benefit from a focus on public health, as China’s staged resumption – as I write – of production indicates. By contrast, the totally inept response in a place like Australia seeks to prioritise the economy and make public health a secondary issue. This will have greater economic repercussions, as more get infected.

As for the China Model, we can also note that those countries that followed it to some degree (Singapore and South Korea come to mind, but also – to its credit – Denmark, which still has a strong and able public sector, despite efforts to erode it over the last few years) have been able to control the epidemic.

A brief account, I must admit, but it explains why the WHO has made its three points consistently throughout: complete transparency; unparallelled containment of an epidemic, and the China Model for dealing with such an outbreak.

The China Model: Bruce Aylward, head of WHO-China joint mission

Here are a series of sections from news conferences and interviews by Bruce Aylward, who is head of the World Health Organisation – China joint mission. They concern the COVID-19 outbreak. There are some overlaps between them, but the first deals with the immense collective response by the whole Chinese population, where the social good is paramount:

The second and third urge the rest of the world to follow China’s example and experience, of what is called the ‘China Model’:

There is also an interview on the China Daily website, where Aylward explains how the differentiated approach in China works. In each area, the response is tailored to what is needed. Not only has this experience been learned through the poverty alleviation project, but it also provides a model for how to deal with COVID-19 outbreaks elsewhere. It is worth noting that even Canada is following the China Model. It is unfortunate that in Australia the regime had thrown up its hands and said it is unable to do anything, which is really admitting that the health system in Australia – after years of cutbacks – is now in a pretty bad condition.

The final interview has Aylward finish by saying, ‘If I had COVID-19, I would want to be treated in China’. I cannot agree more.

 

The China Model: World Health Organisation Report

A distinct feature of what they call the ‘China Model’ is that it is not forced upon others. The Chinese simply seek to do the best possible in any situation, after which they assess their capabilities and undertake measures to improve even more. If other countries wish to follow the China Model, they may do so, although Chinese expertise always advises those countries to do so in light of their own situation and characteristics. As most countries in the world have turned their backs on the neo-liberal ‘Washington Consensus’, more and more are looking closely at the China Model and seeking to implement its features. This is particulalry the case in Africa and Central Asia, but also in Latin America.

An excellent recent example is China’s response to the outbreak of the Coronavirus Disease 2019 (COVID-19). The World Health Organisation has certainly paid attention to the Chinese model in this case, consistently stressing the unprecented level of response and expertise. Indeed, the WHO is promoting the Chinese response as a new model for other countries where the epidemic has taken hold, as well as for future epidemics.

Let us pay attention to a recent WHO report on measures taken. The report observes:

In the face of a previously unknown virus, China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history.

The report identifies 10 measures that it recommends other countries should follow:

1. Monitoring and reporting

COVID-19 was included in the statutory reporting of infectious diseases, and plans were formulated to strengthen diagnosis, monitoring and reporting.

2. Strengthening ports of entry and quarantine

The customs authorities launched an emergency plan for public health emergencies at ports across the country, and restarted the health declaration card system for entry and exit into cities, as well as strict monitoring of the temperature of entry and exit passengers.

3. Treatment

For severe or critical patients, the principle of “Four Concentrations” was implemented: i.e. concentrating patients, medical experts, resources and treatment into special centres.

All cities and districts transformed relevant hospitals, increased the number of designated hospitals, dispatched medical staff and set up expert groups for consultation so as to minimise mortality of severe patients.

Medical resources from all over China have been mobilised to support the medical treatment of patients in Wuhan.

4. Epidemiological investigation and close contact management

Strong epidemiological investigations are being carried out for cases, clusters and contacts to identify sources of infection and implement targeted control measures, such as contact tracing.

5. Social distancing

At the national level, the State Council extended the Spring Festival holiday in 2020, all parts of the country actively canceled or suspended activities like sporting events, cinema and theatre, and schools and colleges in all parts of the country postponed re-opening after the holiday.

Enterprises and institutions have staggered their return to work.

Transportation departments set up thousands of health and quarantine stations in national service areas, and in entrances and exits for passengers at stations.

Hubei province adopted the most stringent traffic control measures, such as suspension of urban public transport, including subway, ferry and long-distance passenger transport.

Every citizen has to wear a mask in public.

6. Funding and material support

Payment of health insurance for patients with the disease was taken over by the state, as well as work to improve accessibility and affordability of medical materials, provide personal protection materials and ensure basic necessities for affected people.

7. Emergency material support

The government restored production and expanded production capacity, organized key enterprises that have already started to exceed current production capacity, supported local enterprises in expanding imports and used cross-border e-commerce platforms and enterprises to help import medical materials and improve the ability to guarantee supplies.

8. International and interregional cooperation and information sharing

From 3 January, information on COVID-19 cases has been reported to the WHO daily.

Full genome sequences of the new virus were shared with the WHO and the international community immediately after the pathogen was identified on 7 January.

On 10 January, an expert group involving Hong Kong, Macao and Taiwan technical experts and a World Health Organisation team was invited to visit Wuhan.

A set of nucleic acid primers and probes for PCR detection for COVID-19 was released on 21 January.

9. Daily updates

The National Health Commission announces the epidemic situation every day and holds daily press conferences to respond to emerging issues.

The government also frequently invites experts to share scientific knowledge on COVID-19 and address public concerns.

10. Social mobilisation and community engagement

Social organisations (community centres and public health centres) have been mobilised to support prevention and response activities.

The community is fully participating in the management of self-isolation and enhancement of public compliance.

Community volunteers are organised to support self-isolation and help isolated residents at home to solve practical life difficulties.

Measures were taken to limit the movement of the population through home-based support.

Conclusion

Maria van Kerkhove, technical lead for the WHO’s Health Emergencies Program observed: ‘everyone in China knows their role in the COVID-19 outbreak …they know how to protect themselves and their families, as well as what they need to do collectively to bring the epidemic under control’.

And on Chinese assistance, in light of their experience and expertise, with other countries, van Kerkhove observed: ‘This is an excellent example of peer-to-peer sharing what has been done, what can be done in other countries, and having direct interaction with another country … That direct interaction is what we want to see more and more happen. So having China share its experience with other countries is nothing short of excellence’.

Not bad praise for China’s socialist model.

The superiority of China’s socialist system (World Health Organisation)

By now the superiority of China’s socialist system is apparent to most countries in the world, as well as to the World Health Organisation. As the WHO expert, Bruce Aylward, observes, China’s scientifically based, differentiated and highly coordinated response to the coronavirus outbreak has actually changed the course of the epidemic. We are now at the point where infections are dropping in China, recoveries (also using TCM) are almost 12 times the death rate, and life is beginning to return to normal. And guess what: the majority of countries in the world may already have been impressed with China’s socialist model, but they are even more so now.

I do not usually copy articles from newspapers these days, but this one is worth noting, from Xinhua News.

GENEVA, Feb. 25 (Xinhua) — China has changed the course of the COVID-19 outbreak, Bruce Aylward, an epidemiologist who led an advance team from the World Health Organization (WHO), said here on Tuesday, noting a rapidly escalating outbreak in China has plateaued and come down faster than previously expected.

It’s a unanimous assessment of the 25-member team which has conducted a nine-day field study trip to China’s Beijing, Guangdong, Sichuan and Hubei, stressed Aylward.

Recalling details of the study trip in China, Aylward said he was impressed by China’s pragmatic, systemic and innovative approach to control the COVID-19 outbreak.

China has taken “differentiated approach” for different situations of sporadic cases, clusters of cases, or community transmission, which makes a massive scale of epidemic control work without exhausting its response, said Aylward.

Moreover, the WHO expert praised Chinese phenomenal collective action, stressing “it’s never easy to get the kind of passion, commitment, interest and individual sense of duty that help stop the virus.”

“Every person you talked to (in China) has a sense that they’re mobilized like in a war against the virus and they are organized,” said Aylward, who was particularly impressed by thousands of health care workers volunteering to go into Wuhan, the epicenter of the novel coronavirus outbreak.

Aylward pointed out China has also repurposed machinery of government, for example by forming a central leading group on the epidemic, dispatching a central guiding team, which ensures the prevention and control of the virus.

Besides, Aylward highlighted that China’s pragmatic approach is “technology-powered and science-driven”.

“They are using big data, artificial intelligence (AI) in places,” Aylward said, adding that China has managed massive amounts of data in finding each COVID-19 cases and tracing contacts, as well as been able to make consultation of regular health services done online, by which the capacity of hospitals could be intensively used for COVID-19 cases.

Aylward was aware that China has issued six versions of national treatment guidelines for COVID-19, representing fast scientific evolvement in understanding of the new virus.

“It’s a science-driven agile response as well at a phenomenal scale,” He said.

What is the best way to deal with human-animal disease cycles?

The recent outbreak of COVID-19 set me thinking about human-animal disease cycles. This is a problem as old as human communities.

About 12,000 years ago, human beings began the long process of moving towards collective living in villages. It took a long time, perhaps 4,000 years, and entailed the slow domestication of animals and plants. During this period, hunting remained a crucial feature in human food supply – what we now call ‘game’ meat. Why so long? Domestication takes some effort: originally wild animals need to mutate, through restriction of movement, controlled breeding, regulation of feeding, and extension of lactation. The first animals – in Asia, which usually leads human development – were what we now know as domesticated sheep and goats. In the process of mutation, wool became longer and more amenable to human use (by selective breeding through which plucking during annual moulting gave way to non-moulting wool that could be shorn), and the animals became smaller than their wild relatives. Meanwhile, hunting of the gazelle, onager, aurochs, hare, fox, and wild sheep and goats continued for a long time alongside the herding of domesticated animals, but the shift had been made.

However, this process of collective and semi-settled living and domestication of animals (and plants) also brought with it a whole series of new diseases. Why? Many diseases require different hosts for their life cycles, and with human beings and animals living in close proximity, humans became more and more part of the cycles. To be sure, this was already the case with the hunting of wild animals, in which the eating of ‘game’ meat brought its own risks. But with daily interaction between human beings and sheep, goats, pigs (where water was plentiful) and the rare bovine, a series of new diseases arose. Plagues were common, small populations were regularly decimated, and life expectancy was short (about 30 years).

In our world, we are supposed to have overcome these ‘primitive’ realities. Not so.

Hunting is still common in many parts, especially for ‘real men’. In the United States, Canada and Australia – for example – you can (with a gun license) go out and shoot wildlife, cut it up, take it home and eat it. Go to a fancy restaurant in Sydney or Copenhagen and you can buy an expensive dish of ‘game’ meat. Or go to the simplest barbeque, and it will be the men who stand around the barbeque cooking the ‘kill’ (even if it comes from a butcher).

In regard to disease cycles between domesticated animals and human beings, these continue to abound. Think of the ‘swine flu’ (H1N1), of which the most recent version appeared in North America in 2009, especially the United States of America. Or the avian influenza, which makes its way from the wild bird population, into the domestic bird population, and into human beings. Or the Middle-East Respiratory Syndrome (MERS), which appears to have entered into the human population in 2012 via camels (and perhaps originally bats).

As for transmission from the ‘wild’ population, we have of course the coronavirus (influenza) from bats with both SARS and the recent Novel Coronavirus. But more notable is HIV/AIDS, which came through from primates into human beings and became a pandemic, originating in the United States.

Obviously, these disease cycles are a reality of human communities and their association with animals. They will continue as long as these two realities continue, so the question is how one deals with them. Let me take two comparable examples, one negative and one positive.

The first is the outbreak of ‘swine flu’ (H1N1), which appeared first in the United States (or perhaps Mexico). The World Health Organisation initially called it ‘North American Influenza’. The response by the regime in the United States was shambolic and slow. Schools remained open, workplaces did not use face masks, and U.S. airlines took virtually no measures, relying instead on previous and ineffective practices of looking for individuals with flu-like symptoms, not providing face masks even for cabin crew, and relying on the aircraft’s air-cleaning systems. Other airlines did take measures, especially from Eastern Asia. I recall arriving in Shanghai in 2009, and before we were allowed to disembark, all passengers were checked by health officials (one passenger had a temperature and those up to three seats around were quarantined). Perversely, the U.S. regime issued a travel warning for ‘restrictive’ measures instituted by Chinese medical experts. The result: by the time the pandemic had run its course, about 30,000 people died in the United States and up to 579,000 worldwide.

Obviously, this is an example of how not to deal with an outbreak.

Ten years later, we have the Novel Coronavirus outbreak in China. In this case, the Chinese government moved quickly, mobilising all of the state’s significant resources to contain the outbreak, communicating directly with WHO on a daily basis and sharing all information. Wuhan, the epicentre of the outbreak, went into lock-down, all post Spring Festival travel was halted across a country of 1.4 billion, and from villages to cities people undertook the necessary measures to contain the virus’s spread. How was this possible? It has nothing to do with ‘authoritarian’ measures, but everything to do with the primary focus in China on the common good. Everyone contributes. The outcome: at the time of writing, about 10,000 people have been infected, only those with underlying conditions have died (in the low hundreds), and more and more leave hospital after recovering – and this is before a vaccine has been developed.

So effective were the measures that the World Health Organisation promoted them as a new model for dealing with diseases arising from the human-animal cycle (see also here).