"As far as I know, trying to contain a city of 11 million people is new to science.” This was how Dr. Gauden Galea, the World Health Organization’s country representative in China, described the situation facing the city of Wuhan when asked late last week for his update on the coronavirus outbreak.
It was clear from Galea’s remarks that the total containment of Wuhan, the city where I have lived for the past few decades, was not a course of action the WHO had recommended. Nor did the organization have any clear view on whether such an action would prove effective in limiting the spread of the disease. “It has not been tried before as a public health measure,” he said, “so we cannot at this stage say it will or will not work.”
I am now one of 11 million people in Wuhan who are living through this grand experiment, a measure that, Galea also said, shows “a very strong public health commitment and a willingness to take dramatic action.” From inside the curtain that now encloses my city, I wish to offer my thoughts on this “dramatic action,” and to judge what we have actually seen and experienced in terms of commitment to public health.
Closing Up the Cities
At 2AM on January 23, authorities in Wuhan suddenly issued the order to close off the city. According to the order, from 10AM that same day, all public buses, subways, ferries, long-distance buses and other transport services would be suspended; the airport and train stations would be shuttered. At this point, the WHO might have had reservations about the necessity and effectiveness of this strategy – but in any case, is was irreversible, and it would soon extend to neighboring cities as well.
In less than two days, up to noon on January 24, a total of 14 cities in Hubei province would be brought into the quarantine zone. These cities, with a population of around 35 million, include: Huanggang (黄冈) and E’zhou (鄂州), were quickly brought under the order for closure. More cities followed: Chibi (赤壁), Xiantao (仙桃), Zhijiang (枝江), Qianjiang (潜江), Xianning (咸宁), Huangshi (黄石), Enshi (恩施)、Dangyang (当阳), Jingzhou (荆州), Jingmen (荆门) and Xiaogan (孝感).
This was no longer a city under lockdown, but effectively an entire province under quarantine.
Galea and other foreign experts have expressed a sense of awe about the boldness of the quarantine in Hubei province. Over the weekend, the New York Times quoted Dr. William Schaffner, an expert on infectious disease from Vanderbilt University, as saying that the lockdown is a “public health experiment, the scale of which has not been done before.” Schaffner was clearly astonished: “Logistically, it’s stunning, and it was done so quickly.”
China’s capacity to impress with such grand gestures calls to mind talk of the “Chinese miracle,” often used to describe the performance of the country’s economy over four decades. But is it fair to regard this case of large-scale quarantine also as a “Chinese miracle” in public health?
Shutting People’s Mouths
Everyone must understand, first of all, that this epidemic was allowed to spread for a period of more than forty days before any of the abovementioned cities were closed off, or any decisive action taken. In fact, if we look at the main efforts undertaken by the leadership, and by provincial and city governments in particular, these were focused mostly not on the containment of the epidemic itself, but on the containment and suppression of information about the disease.
The early suppression of news about the epidemic is now fairly common knowledge among Chinese, and many people view this failure to grapple openly with the outbreak as the chief reason why it was later seen as necessary to take the “dramatic action” of closing down my city and many others.
The direct cause of all of this trouble is of course the new coronavirus that has spread now from Wuhan across the globe and has everybody talking. Up to January 24, in Hubei province alone, there were 549 admitted cases of the virus. Among these there have been 24 deaths. But the real numbers are still unknown.
According to reports from Caixin Media, one of China’s leading professional news outlets, the entire situation began on December 8, with the discovery of the first known case of an infected patient in Wuhan, a stall operator from the Huanan Seafood Market. The Huanan Seafood Market is a large-scale wet market, with an area about the size of seven football pitches and more than 1,000 stalls. The market has a constant flow of customers, making it the ideal place for the spread of infectious disease. A seafood market only in name, it sells a wide array of live animals, including hedgehogs, civet cats, peacocks, bamboo rats and other types of wild animals. At this market, the nearly inexhaustible appetite, and insatiable greed and curiosity of Chinese diners is on full display.
The number of infected people rose rapidly, reaching 27 people within a short period of time. Health professionals in Wuhan began suspecting in early December that this was an unknown infectious disease, not unlike the Severe Acute Respiratory Syndrome (SARS) that emerged in southern China in 2003. The ghost of SARS seemed to wander Wuhan in December, and rumors spread farther and farther afield of a new disease on the prowl.
China is a society closely monitored by the government, and the shadow of Big Brother is everywhere. Social media in particular are subject to very close surveillance. So when the authorities detected chatter about the re-emergence of SARS, or of a similar unknown outbreak, they took two major steps initially. First, they tried to ensure that this new outbreak remained a secret; second, they put the stability preservation system into effect (启动稳控机制). On December 30, the Wuhan Health Commission (武汉市卫建委) issued an order to hospitals, clinics and other healthcare units strictly prohibiting the release of any information about treatment of this new disease. As late as December 31, the government in Wuhan was still saying publicly that there were no cases of human-to-human transmission, and that no medical personnel had become infected.
by Da Shiji, China Media Project | Read more:
Image: uncredited
It was clear from Galea’s remarks that the total containment of Wuhan, the city where I have lived for the past few decades, was not a course of action the WHO had recommended. Nor did the organization have any clear view on whether such an action would prove effective in limiting the spread of the disease. “It has not been tried before as a public health measure,” he said, “so we cannot at this stage say it will or will not work.”
I am now one of 11 million people in Wuhan who are living through this grand experiment, a measure that, Galea also said, shows “a very strong public health commitment and a willingness to take dramatic action.” From inside the curtain that now encloses my city, I wish to offer my thoughts on this “dramatic action,” and to judge what we have actually seen and experienced in terms of commitment to public health.Closing Up the Cities
At 2AM on January 23, authorities in Wuhan suddenly issued the order to close off the city. According to the order, from 10AM that same day, all public buses, subways, ferries, long-distance buses and other transport services would be suspended; the airport and train stations would be shuttered. At this point, the WHO might have had reservations about the necessity and effectiveness of this strategy – but in any case, is was irreversible, and it would soon extend to neighboring cities as well.
In less than two days, up to noon on January 24, a total of 14 cities in Hubei province would be brought into the quarantine zone. These cities, with a population of around 35 million, include: Huanggang (黄冈) and E’zhou (鄂州), were quickly brought under the order for closure. More cities followed: Chibi (赤壁), Xiantao (仙桃), Zhijiang (枝江), Qianjiang (潜江), Xianning (咸宁), Huangshi (黄石), Enshi (恩施)、Dangyang (当阳), Jingzhou (荆州), Jingmen (荆门) and Xiaogan (孝感).
This was no longer a city under lockdown, but effectively an entire province under quarantine.
Galea and other foreign experts have expressed a sense of awe about the boldness of the quarantine in Hubei province. Over the weekend, the New York Times quoted Dr. William Schaffner, an expert on infectious disease from Vanderbilt University, as saying that the lockdown is a “public health experiment, the scale of which has not been done before.” Schaffner was clearly astonished: “Logistically, it’s stunning, and it was done so quickly.”
China’s capacity to impress with such grand gestures calls to mind talk of the “Chinese miracle,” often used to describe the performance of the country’s economy over four decades. But is it fair to regard this case of large-scale quarantine also as a “Chinese miracle” in public health?
Shutting People’s Mouths
Everyone must understand, first of all, that this epidemic was allowed to spread for a period of more than forty days before any of the abovementioned cities were closed off, or any decisive action taken. In fact, if we look at the main efforts undertaken by the leadership, and by provincial and city governments in particular, these were focused mostly not on the containment of the epidemic itself, but on the containment and suppression of information about the disease.
The early suppression of news about the epidemic is now fairly common knowledge among Chinese, and many people view this failure to grapple openly with the outbreak as the chief reason why it was later seen as necessary to take the “dramatic action” of closing down my city and many others.
The direct cause of all of this trouble is of course the new coronavirus that has spread now from Wuhan across the globe and has everybody talking. Up to January 24, in Hubei province alone, there were 549 admitted cases of the virus. Among these there have been 24 deaths. But the real numbers are still unknown.
According to reports from Caixin Media, one of China’s leading professional news outlets, the entire situation began on December 8, with the discovery of the first known case of an infected patient in Wuhan, a stall operator from the Huanan Seafood Market. The Huanan Seafood Market is a large-scale wet market, with an area about the size of seven football pitches and more than 1,000 stalls. The market has a constant flow of customers, making it the ideal place for the spread of infectious disease. A seafood market only in name, it sells a wide array of live animals, including hedgehogs, civet cats, peacocks, bamboo rats and other types of wild animals. At this market, the nearly inexhaustible appetite, and insatiable greed and curiosity of Chinese diners is on full display.
The number of infected people rose rapidly, reaching 27 people within a short period of time. Health professionals in Wuhan began suspecting in early December that this was an unknown infectious disease, not unlike the Severe Acute Respiratory Syndrome (SARS) that emerged in southern China in 2003. The ghost of SARS seemed to wander Wuhan in December, and rumors spread farther and farther afield of a new disease on the prowl.
China is a society closely monitored by the government, and the shadow of Big Brother is everywhere. Social media in particular are subject to very close surveillance. So when the authorities detected chatter about the re-emergence of SARS, or of a similar unknown outbreak, they took two major steps initially. First, they tried to ensure that this new outbreak remained a secret; second, they put the stability preservation system into effect (启动稳控机制). On December 30, the Wuhan Health Commission (武汉市卫建委) issued an order to hospitals, clinics and other healthcare units strictly prohibiting the release of any information about treatment of this new disease. As late as December 31, the government in Wuhan was still saying publicly that there were no cases of human-to-human transmission, and that no medical personnel had become infected.
by Da Shiji, China Media Project | Read more:
Image: uncredited
