Containing sporadic COVID-19 outbreaks the Chinese way

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With the coronavirus pandemic far from over and scientists' warning of a winter surge, China has formulated a response to small-scale clusters to secure its success in controlling the disease.

Applied in Beijing in June, Dalian in July, Qingdao and Kashgar in October, and the current outbreaks in Tianjin, Shanghai and the border city of Manzhouli, mass testing and contact tracing are containing them.

And it is working. No COVID-19 deaths have been reported in China since April 16, according to the National Health Commission (NHC).

In this aerial photo taken on Nov. 21, 2020, residents line up waiting to take nucleic acid tests in the Binhai New Area in north China's Tianjin Municipality. [Photo/Xinhua]

Mass testing

On Nov. 21, Zhou Xiaofeng arrived at a stadium in the morning sleet in the Binhai New Area of Tianjin with his pregnant wife, 4-year-old daughter and mother-in-law.

Local authorities had started nucleic acid tests on all residents in the Binhai New Area after the city confirmed five locally transmitted COVID-19 cases the day before.

Zhou's family was led to a courtesy lane. "It took just over 10 minutes from arriving at the stadium to completing the tests," said Zhou. He had been worrying about his family catching cold and was relieved to see attentive and thoughtful staff members.

The family was among almost 2.47 million people tested as of 10 p.m. Monday. The results were all in by 10 a.m. on Tuesday and all tested negative.

Medical staff guide residents at a nucleic acid testing site in Qingdao, east China's Shandong Province, Oct. 14, 2020. [Photo/Xinhua]

"The breakthrough in nucleic acid testing is key to turning the tables on sporadic outbreaks, gaining valuable time for containing the virus," said NHC director Ma Xiaowei.

A central government group overseeing the epidemic response in Hubei, the State Council inter-agency task force and the NHC held several meetings to discuss three key issues in mass nucleic acid testing: organization, equipment and funds.

The increasing testing capacity supported speedy mass testing.

In October, the city of Qingdao in east China's Shandong Province, blitzed a sporadic outbreak with 10.92 million tests over five days.

"The maximum daily testing capacity was only about 2,000 in February in Qingdao, and it is more than 260,000 now," said Deputy Mayor Xue Qingguo.

Some of the samples were taken to neighboring cities for analysis, as this must be done within 12 hours of collection. Batch testing, which combines samples from up to 10 people in a single test, was adopted to boost efficiency.

Contact tracing

Contact tracing has a long history in the fight against infectious diseases.

Health authorities and local governments have spared no effort to track patient zero, trace and cut transmission routes, and implement community-based quarantine.

In October, more than 30 epidemiologists and about 800 police officers in Qingdao analyzed more than 10,000 hours of video footage and a large amount of trajectory data to determine the infection source and transmission route.

According to the Chinese Center for Disease Control and Prevention, living novel coronavirus was detected and isolated from the outer packaging of imported frozen cod in Qingdao. It is the first time in the world that living novel coronavirus was isolated from the outer packaging of cold-chain food, ringing alarms about a possible new infection source.

To handle the latest cluster in Shanghai, health authorities prioritized sample testing of food, objects and environments linked to the confirmed cases, with more than 130,000 cold-chain food samples collected and tested.

A staff member collects swab samples from an agricultural product for COVID-19 test in a temporary trading area at the Xinfadi wholesale market in Beijing, capital of China, Aug. 6, 2020. [Photo/Xinhua]

They confirmed airport freight staffers did not have contact with imported cold chain food and their source of infection is assumed to be imported aviation containers.

A series of unconventional strict social prevention and control measures have been taken, requiring enormous political courage and vision. Expert suggestions have been quickly translated into concrete actions.

During the June outbreak in Beijing, it was found that, on average, quarantine required 100 rooms for every confirmed case. Quarantine sites were rented, and designated hospitals were rebuilt and expanded.

Widespread public adherence made a difference in curbing the outbreak swiftly.

People took government advice seriously, practicing social distancing and self-quarantine if necessary. Community workers and volunteers regularly disinfected public spaces, checked temperatures, and registered visitors. Grid management and neighborhood watches enabled the cities to detect and isolate suspected cases and their close contacts as soon as possible.

Never give up

Du Bin, an intensive care expert from Peking Union Medical College Hospital, has been confronting the virus head-on from Wuhan to Qingdao. "We cannot give up," he said, noting that experience can only be gained when doctors stick with every severe case.

A local resident gives a thumb-up to Ekebar Emet, a volunteer at the frontline of epidemic prevention and control, in Tianshan District of Urumqi, northwest China's Xinjiang Uygur Autonomous Region, Aug. 3, 2020. [Photo/Xinhua]

China has been pooling experts and resources to treat every patient. In October, three patients in Qingdao were under severe conditions. The NHC immediately sent three national intensive care experts to Qingdao, each leading a team for each patient.

The NHC also allocated 9,000 milliliters of convalescent plasma from recovered COVID-19 cases to treat the seriously-ill Qingdao patients.

Chinese doctors have been treating the seriously ill with convalescent plasma and prescribing long-used common drugs rather than experimental and controversial ones. Traditional Chinese medicine is widely used in prevention, treatment and rehabilitation.

China currently has five vaccines in phase-three clinical trials. Zhang Wenhong, head of Shanghai's expert team for COVID-19 clinical treatment, said that the vaccines are expected to join the battle soon.

"There is no reason why we cannot control the outbreaks in winter," he said.