Medical workers in Zhongnan Hospital of Wuhan University in Wuhan, Central China's Hubei province, on Jan 24, 2020. (Photo: Xinhua)
Since it was first recorded in late December 2019 in Wuhan, China, the COVID-19 pandemic has spread rapidly around the world. With exponential growth, the number of daily new cases has steadily increased - more than 2.6 million confirmed cases and 180,000 deaths in the first four months of 2020. However, few countries have shown initial success in restraining the outbreak.
On January 23, the central government of China imposed an unprecedented lockdown on the city of Wuhan, which restricted human mobility in and out of the city and represented the most extensive quarantine in public health history. Several days after the Wuhan lockdown, all other cities in Hubei and major cities in China introduced similar control measures to slow the spread of the virus.
China has successfully contained the outbreak domestically, even though it is incredibly challenging to control the spread of the virus in a populous, urbanized country. The Wuhan lockdown, which is only being relaxed after 76 days as the number of new infections in China has fallen, is being emulated by a growing number of governments. For instance, the United Kingdom has backed off its initial strategy of building “herd immunity” due to the high hospitalization rates. Singapore also introduced so-called “circuit breaker” measures to close schools and office spaces.
Mandatory lockdown in Wuhan is effective in several ways to reduce mobility and delay the spread of the virus. First, social distancing measures help prevent the spread of the virus from the source city. Within the first weeks after the Wuhan and Hubei lockdowns, partial lockdowns have been implemented to different degrees in other cities, from establishing checkpoints in building entrances and quarantine zones, shutdowns on public transport as well as limits on the movement of people in and out as well as within cities. Research has found that cities which adopt stringent control measures can flatten the upward trajectory of the virus. Population inflows from the epicenter contributed to the spread of infection only before social distancing measures were applied.
Second, the stringency of control measures is key to halt domestic transmission, and cooperation between individuals and governments is critical. Lockdowns in China are different from social distancing measures and travel advisories imposed in other countries in North America and Europe. Lockdowns imposed in China have been strictly enforced and monitored, which require a high level of understanding of the cooperation between individuals and local governments. At the same time, control measures in Western countries are mostly voluntary and not strictly enforced due to the belief of individual freedom of movement. However, voluntary quarantines or herd immunity may not be an adequate approach in fighting the coronavirus, because those approaches would lead to high rates of hospitalization and bring pressure to over-extended healthcare systems. At the moment, the Chinese approach is more effective in fighting the coronavirus. Lockdown is economically costly, but it is an effective way to get the virus under control, which is a prerequisite to restarting the economy.
Currently, China also faces challenges in the fighting of coronavirus. One comes from individuals with asymptomatic infections who travel domestically. After the ease of travel restrictions in Wuhan, the Chinese government has continued strict control measures to prevent a second wave of infections, particularly from asymptomatic transmissions. The asymptomatic transmissions have become the recent focus in the continuing fight against the spread of the coronavirus, given that the number of asymptomatic, undiagnosed infections is a largely unknown factor at present. According to recent studies, the asymptomatic ratio ranges from 17.9 to 41.6 percent. Second, China faces an increased risk of disease outbreak when the country reopens its borders to foreign travelers. People may be vulnerable to foreign travelers who come from countries that have achieved “herd immunity” through mass infection.
In order for the nation to reopen safely, the Chinese government should continue its efforts in stringent infection controls. At the same time, it should conduct widespread testing and provide improved contact tracing to monitor the spread of the disease closely.
Transparency and reliability of information is crucial during a pandemic. To prevent a panic that may have tragic consequences, governments should provide the public with open, transparent, and detailed information about their COVID-19 situation.