China’s lonely fight to eliminate coronavirus

More than 2,000km away and 18 weeks after China’s first mass quarantine, residents in the city of Shulan in the far north-east of the country have suddenly discovered what the people of Wuhan endured.

After detecting a small cluster of cases last week, authorities put in place a full lockdown of the city of 700,000 people in China’s Jilin province.

Transport to and from the area was cut off and residents were instructed to stay inside. After the virus spread rapidly from Wuhan, authorities are not taking any chances.

“I have really experienced the hardship that the people of Wuhan felt at the start of the year,” a social media user called Dengaide Meigui posted on Weibo, a Twitter-like service. “I really want to cry. I don’t know how long we will have to live our days like this.”

Many people in China are asking similar questions: how long will lockdowns persist in a country that has boasted about its ability to control the virus that is still ravaging the US and Europe? 

As nations across Asia attempt to return to normal life, governments are devising plans for how to manage small, inevitable outbreaks while also keeping economies on track. Experts have warned that coronavirus will probably become endemic and officials should adopt strategies that allow life to continue alongside a small number of new cases.

But China is charting its own path: it appears to be entering into a long and lonely fight to exert complete control over coronavirus, despite warnings that the disease will continue to re-emerge.

“The Chinese policy of shutting down large populations — that is zero tolerance,” said William Schaffner, medical director at the Maryland-based National Foundation for Infectious Diseases. “In contrast, other countries have more tolerance for low-level transmission and some frequency of serious illness, hospitalisation and deaths.”

Shulan is one of several new outbreaks that has entailed the lockdown of millions of people. Nearby Jilin City, home to more than 4m, was also put into partial quarantine after a local transmission was detected.

A medical worker collects a sample in Shulan, where a cluster of new cases was discovered © Zhang Nan/Xinhua/AP

The clusters in northern China have given the clearest picture yet of how China plans to deal with outbreaks.

China’s National Health Commission has issued a number of instructions for what it calls “normalised prevention”, a rough strategy that includes shutting down areas where new cases are discovered. 

But the extent of the lockdown — ranging from the closure of a housing development to that of an entire city — is largely left to local officials, who said locking down their area was one of the few recourses they had to stop contagion.

“Local authorities do not have the expertise to fight the epidemic,” an official in Guangdong province told the Financial Times. “Now we just meet to learn from [Chinese president] Xi Jinping’s speeches . . . The central government did not give us what we really need for our work. We need professionals, not bureaucrats.”

China’s lockdown model for handling new outbreaks contrasts sharply with other countries in the region.

In Korea, for example, a recent cluster of new cases in Itaewon, a bar and nightclub district in Seoul, resulted in the shutting of businesses there and aggressive contact tracing.

More than 65,000 people were eventually tested. But the area itself was not locked down. Experts pointed out that by the time an area could be effectively locked down, the virus had already spread to other places.

“Isolating Itaewon would have been closing the barn door after the horse had bolted,” said Jerome Kim, director-general of Korea’s International Vaccine Institute. He noted that lockdowns were a preliminary measure meant to buy more time for a nation’s health system, not a long-term strategy. Korea has prepared to deal with a low number of cases in the coming months.

“The government recognised the need to loosen up the economy again, and to begin to get the country back to work,” Dr Kim said. “It knows that there will be outbreaks and has to be ready to deal with them promptly.”

Ryan Manuel, a public health expert and the chief Asia strategist for Silverhorn Investment Advisors, said China’s local officials had to face the difficult choice between keeping their economies running and preventing new outbreaks.

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Given the high stakes and potential punishment for new outbreaks, officials will almost always adopt the strongest measures.

“This is a classic regulation problem for China,” Mr Manuel said. “Are you better off shutting a whole city down or meeting your economic indicators?” 

Even with the relatively swift lockdowns of Shulan and Jilin City, six local officials in the area were removed from office this week — a clear signal that central leaders will not tolerate even the smallest outbreak.

“I don’t think anywhere is going to succeed in elimination because the virus is going to keep coming back,” said Benjamin Cowling, a professor of epidemiology at the University of Hong Kong. “Other areas of Asia are looking at suppression.”

Additional reporting by Xueqiao Wang in Shanghai

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