II. Well-Coordinated Prevention, Control and Treatment
The coronavirus caught China unawares. Putting people's lives and health first, the Chinese government has acted swiftly to fight the virus and provide medical treatment for patients. It has adopted the most thorough, rigorous and comprehensive prevention and control measures, enforced quarantine and isolation on a scale never seen before, and mobilized medical resources across the country. It has ensured that all those in need have been tested, quarantined, hospitalized or treated. With these measures in place, China has prevented a wider spread and further development of the virus. "The time that can be gained through the full application of these measures [in China] – even if just days or weeks – can be invaluable in ultimately reducing Covid-19 illness and deaths," says Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (Covid-19) published on February 28, 2020. 1
1. Centralized and Efficient Command
Under the strong leadership of the CPC Central Committee with Xi Jinping at its core, China has put in place an efficient system under which the central authorities exercise overall command, while local authorities and all sectors follow the leadership and instructions of the central authorities, perform their respective duties, and cooperate with each other. This highly efficient system has made it possible for China to win its all-out people's war against the virus.
General Secretary Xi Jinping takes charge of Covid-19 response. Attaching high importance to Covid-19 prevention and control, Xi Jinping assumed full command over the control efforts from the very beginning. He highlighted the need to put people's lives and health first, to firm up confidence, strengthen solidarity, adopt a science-based approach, and take targeted measures. He called for a nationwide effort to block the spread of the virus and defeat it.
Xi Jinping has chaired 14 meetings of the Standing Committee of the Political Bureau of the CPC Central Committee, 4 meetings of the Political Bureau, meetings of the Central Commission for Law-based Governance, Central Cyberspace Affairs Commission, Central Commission for Further Reform, and Central Commission for Foreign Affairs, and a meeting with prominent non-CPC figures. At these meetings, he heard briefings from the Central Leading Group for Novel Coronavirus Prevention and Control and the Central Steering Group, adjusted response measures in view of the evolving.
Covid-19 dynamics, and made decisions on overall plans for strengthening control efforts and international cooperation.
He inspected community response and Covid-19 research in Beijing, and visited Wuhan to guide frontline response. He made inspection tours to Zhejiang, Shaanxi and Shanxi provinces where he was briefed on progress in coordinating epidemic prevention and control with economic and social development, and in poverty alleviation. He has closely followed developments in China's virus control and made timely decisions accordingly.
Government departments have made well-coordinated control efforts. Premier Li Keqiang, as head of the Central Leading Group for Novel Coronavirus Prevention and Control, has chaired more than 30 meetings of the leading group to discuss key issues concerning Covid-19 control and economic and social development, and important decisions were made at the meetings. He visited Wuhan and inspected China CDC, the Institute of Pathogen Biology CAMS & PUMC, Beijing West Railway Station, Beijing Capital International Airport, and the National Distribution Center for Major Anti-epidemic Medical Supplies.
The Central Steering Group responded swiftly to guide Hubei Province and Wuhan City to intensify their control efforts. It thus helped contain the virus and hold a strong first line of defense against the virus.
The Joint Prevention and Control Mechanism of the State Council has played the coordinating role and held regular meetings to keep abreast of the situation, dispatch medical teams, and allocate supplies, and it has made timely adjustments to control policies and priorities in response to new developments. Through its mechanism for promoting the return to work, the State Council has strengthened guidance and coordination, removed barriers in the industrial and supply chains, and ensured the resumption of normal daily life.
Local authorities and other stakeholders have lived up to their responsibilities. Emergency command mechanisms headed by leading Party and government officials were established in provinces, cities and counties across the country, forming a top-down system with unified command, frontline guidance, and coordination between departments and among provinces. Local authorities and other stakeholders have implemented each and every one of the decisions, plans and prohibitions of the central authorities, and strictly and effectively enforced all response measures. Thus, an effective and well-functioning whole-of-the-nation control mechanism is in place.
2. A Tight Prevention and Control System Involving All Sectors of Society
The Chinese New Year is marked by enormous population flows in dense groups. In view of this fact, the Chinese government quickly mobilized the whole of society and galvanized the people into a nationwide response. A targeted, law- and science-based approach was adopted, and public health emergency response measures were rolled out on an unprecedented and extensive scale across the country. Through the strictest social distancing and flexible, people-centered social management, China put in place a prevention and control system involving governments at all levels and the whole of society, and launched a people's war on the virus applying non-medical means that has effectively blocked its transmission routes.
Strong measures were taken to control sources of infection.The Chinese government defined a set of requirements: early detection, reporting, quarantine and treatment with a focus on the four categories of vulnerable people (confirmed cases, suspected cases, febrile patients who might be carriers, and close contacts). It had also taken measures to ensure that they were hospitalized, treated, tested or quarantined as appropriate. It has done everything in its power to reduce infections to the minimum.
While keeping all its outbound routes closed, Wuhan carried out two rounds of community-based mass screening of its 4.21 million households, leaving no person or household unchecked and ruling out all potential sources of infection.
The Chinese government redoubled efforts to increase the capacity of nucleic acid testing, supply more test kits, and approve more testing institutions. As a result, the testing period was shortened and the quality enhanced, ensuring that all those in need could be tested immediately and as appropriate. In Hubei Province, the testing period was shortened from 2 days to 4-6 hours, and the daily capacity expanded from 300 samples in the early stage of the epidemic to more than 50,000 in mid-April. Such advances made early detection and confirmation of infection possible and reduced the risk of transmission.
To identify the four categories of vulnerable people, community grid-based screening was carried out across the country. All residents were requested to report their health condition on a daily basis. Community workers for their part visited households door-to-door to collect and verify this information. Temperature checking was made a routine at all places. Work was done to strengthen the monitoring and online reporting of cases identified at fever clinics of medical facilities - all such cases had to be reported online to higher authorities within 2 hours; their test results sent back to the reporting clinics within 12 hours; and on-site epidemiological investigation completed within 24 hours - so that confirmed cases and asymptomatic carriers would be identified and reported without delay. Epidemiological tracing and investigation were enhanced to precisely detect and cut off virus transmission routes. As of May 31, a total of more than 740,000 close contacts had been traced and handled as appropriate.
Breaking the chains of transmission through early intervention. The strictest closure and traffic restrictions were enforced on all outbound routes from Wuhan and Hubei. International passenger flights, and ferries and long-distance passenger transport services in many parts of the province were suspended, as were road and waterway passenger services bound for Wuhan from other places of the country. Airports and railway stations were closed and intra-city public transport halted in Wuhan and many other parts of Hubei. All these restrictions effectively stopped the virus from spreading nationwide, especially in rural Hubei where public health infrastructure was relatively weak.
Areas outside Hubei took a differentiated approach to traffic control. The provinces abutting Hubei built traffic control "isolation zones" around the province, preventing the virus from spreading beyond Hubei. Other parts of China adopted a targeted, tiered, and region-specific approach. They exercised a dynamic control over urban and rural road transport services and strengthened health and quarantine measures for domestic routes.
Rigorous measures were taken to prevent public gatherings and cross-infection. The Chinese New Year holiday was extended, public gatherings were canceled or postponed, and the spring semester was postponed in schools. Cinemas, theaters, internet cafés, and gyms were all closed. Strict procedures had to be followed in essential public facilities, including bus stations, airports, ports, farmers markets, shopping malls, supermarkets, restaurants and hotels, and in enclosed transport vehicles such as buses, trains and planes. All persons were required to wear masks and undergo temperature monitoring when accessing these venues or vehicles. In addition, all such facilities had to be disinfected, meet certain hygiene standards, ensure good ventilation, monitor visitors' temperature, and control the number of passengers or visitors at a given period of time.
Government services were provided online and through prior reservation, non-physical-contact delivery or services were extended, people were encouraged to stay at home and work from home, and businesses were encouraged to telecommute - all these measures effectively reduced population flows and public gatherings. Clear signs urging people to maintain at least one meter of distance and avoid close contact could be seen in all public places.
Strict health and quarantine measures were enforced at points of entry and exit across China to prevent inbound and outbound spread of the virus. The strictest-ever measures were applied at border control to suspend non-urgent and nonessential outbound travel by Chinese citizens.
The community-based line of defense was well guarded. Communities and villages made up the first line of defense in epidemic prevention and control, a major barrier to inbound cases and local transmission. They served as the mainstay in China's Covid-19 response. Residents and villagers were mobilized to help manage communities. Strict access control and grid-based management were exercised in communities, and human and material resources were channeled down to the community level to reinforce implementation of targeted measures. Task forces comprising both full-time and part-time community workers were set up, while officials at the sub-district/township and community/village levels, health workers of community medical facilities, and family doctors all performed their duties as a team. Through all these efforts, communities and villages were turned into strongholds, securing full implementation of response measures down to the lowest level.
To deal with the four categories of vulnerable people, a number of measures were taken in accordance with the law, such as tracing, registering, and visiting each individual, placing them under community management, and transferring them, if necessary, to designated medical facilities for quarantine or treatment as per due procedures. Community actions were taken to keep local areas in good condition and promote health education.
In Wuhan, rigorous 24-hour access control was enforced in all residential communities. No residents were allowed to leave and no non-residents allowed to access the community area other than for essential medical needs or epidemic control operations. Community workers were responsible for the purchase and delivery of daily necessities according to residents' needs. This approach was also applied in communities and villages in other parts of China, where all residents had to register and undergo temperature checking when leaving or entering the residential area or village.
Education programs were conducted to raise public awareness of the need for personal protection and enhance the sense of social responsibility. People observed self-quarantine at home and 14-day self-isolation after cross-region travel. They strictly followed personal protection measures such as wearing a mask when going out, maintaining proper social distancing, avoiding crowds, frequent handwashing, and regular ventilation. The tradition of the Patriotic Public Health Campaign which was initiated in the 1950s, with an emphasis on sanitation and personal hygiene, was also encouraged, along with a healthy, environment-friendly lifestyle .
A multi-level, category-specific, dynamic and targeted approach was adopted. China also applied a region-specific, multi-level approach to epidemic prevention and control. To better prevent and control the epidemic, each region at or above the county level was classified by risk level on the basis of a comprehensive evaluation of factors such as population and number of infections in a given period of time. There are three levels of risk: low, medium, and high. Regions could take measures according to the risk level, which was dynamic and adjusted in light of the evolving situation.
In response to Covid-19, a low-risk region was requested to remain vigilant against any potential inbound transmission while fully restoring normal order in work and daily life; a medium-risk region had to prevent inbound and local transmission while restoring normal work and daily life as soon as possible; and a region classified as high-risk was obliged to prevent any spread in its jurisdiction or beyond, enforce strict control measures, and focus on containment. Once the situation stabilized, provincial-level authorities could step up efforts to restore order in work and daily life in areas under their jurisdiction, while adapting to the new normal of Covid-19 control by establishing a sound long-term epidemic response system that ensures early detection, quick response, targeted prevention and control, and effective treatment. Every effort has been made to stem the virus spread in the capital of Beijing to safeguard public health.
Appropriate measures were implemented to prevent any cluster outbreaks in key locations, major organizations, and priority population groups, and manage the aftermath of any such outbreaks. The elderly, children, pregnant women, students, and health workers were to be well protected as a priority.
Health management of priority population groups was enhanced. Protective measures were intensified in medical facilities, communities, office buildings, shopping malls and supermarkets, passenger terminals, transport vehicles, child-care centers and kindergartens, elementary and secondary schools, colleges and universities, nursing homes, charity houses, mental health institutions, and first-aid stations. These measures were implemented nationwide, covering all population groups, locations, and communities, and leaving no areas unattended and no hidden dangers unaddressed.
To control any inbound infections from overseas, China has strictly enforced its border health and quarantine rules to ensure a full, closed cycle of management of all arrivals, from their entry at the border to the doorstep of where they would stay. Sustained, meticulous efforts have been made to prevent both inbound cases and a recurrence in domestic cases.
Legal safeguards for epidemic prevention and control were strengthened. China listed Covid-19 as a Class B infectious disease, but addressed it with measures applicable to a Class A infectious disease under the Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases. It also applied control and quarantine measures under the Frontier Health and Quarantine Law of the People's Republic of China consistent with relevant provisions of international law and other domestic laws. Standing committees of some sub-national people's congresses launched emergency legislation procedures as per the national legal framework, empowering local governments to introduce interim emergency administrative rules relating to healthcare and epidemic control.
The Law on Prevention and Treatment of Infectious Diseases and measures for its implementation have been strictly enforced, and guidelines have been promulgated on controlling the disease, combating epidemic-related crimes in accordance with the law, and protecting people's lives and health. Law and order, and market supervision have been strengthened. Price gouging, hoarding and profiteering, production and sales of counterfeit or sub-standard products, and any other crimes impeding response efforts have been punished by law. Quality and price control of anti-epidemic supplies has been reinforced, and stronger measures have been taken against deceptive and illegal advertising, ensuring social order and stability. Supervision on administrative law enforcement has been intensified during epidemic control to ensure that the law is enforced in a strict, impartial, procedure-based, and non-abusive way. Legal disputes associated with the epidemic have been resolved in accordance with the law, and legal guarantees and services have been provided for Covid-19 response and for businesses returning to work. The government has also made greater efforts to raise public legal awareness and guide people to act within the parameters of the law.
Prevention and control efforts have been based on science. Covid-19 is a new virus and it will take time for humanity to understand it completely. In its quest for victory over the coronavirus, China has been mapping its own route to success - one based on reliable experience, tailored to its national conditions, and rooted in sound epidemiological practice.
China values the role of experts in virology, epidemiology, clinical medicine and related fields. China's response has been professional because its response measures were based on timely analyses and assessments by scientists and public health experts, whose views and proposals were fully respected.
China has given full support to factual and scientific research on virus infection, pathogenesis, transmission routes and transmissibility while maintaining exchanges and communication with the WHO and other countries and regions.
With a growing body of knowledge of the virus, China has modified and optimized its response measures in a timely manner to make them more effective. It has developed a Covid-19 prevention and control protocol and updated it five times based on assessments of the evolving epidemic dynamics. The protocol provides a set of reliable standards for case monitoring, epidemiological investigation, management of close contacts and of those suspected of exposure to infection, and procedure-based tests in laboratories. China has also published 15 technical manuals on epidemic prevention and control for key population groups, locations and organizations, 6 work plans on psychological counseling for people affected by Covid-19, and 50 specific technical guidelines. All of this has ensured that China's prevention and control efforts are more targeted and science-based.
3. An All-Out Effort to Treat Patients and Save Lives
From the outset, China's goal in its medical response to Covid-19 has been to improve the patient admission and cure rates and reduce the infection and fatality rates. The infected were treated in dedicated medical facilities where medical specialists from all over the country and all the necessary medical resources were concentrated. Both traditional Chinese medicine and Western medicine were applied. A condition-specific and category-based approach was applied to medical treatment of patients. Severe cases were treated by the best doctors using the most advanced equipment, and critical supplies were pooled to save lives at all costs. It is through such efforts that the Covid-19 fatality rate in China has dropped sharply. Early medical intervention has made it possible to have patients with mild symptoms cured without delay, thus significantly reducing the risk that their condition might worsen.
Pooling premium resources to treat severe cases. The sudden appearance of Covid-19 in Wuhan put an overwhelming strain on its medical resources. There was a severe shortage of hospital beds in the early stage as the number of infections surged. By directing resources to Wuhan, China expanded the capacity of designated hospitals to deal with severe cases and increased the number of beds. Patients in severe and critical condition were gathered for treatment and intensive care at the best hospitals with the greatest capacity for accommodating patients with infectious respiratory diseases. Two hospitals with 1,000-plus beds each - Huoshenshan and Leishenshan - were built as specialist hospitals for treating infectious diseases, and a number of designated and general hospitals were expanded or remodeled. The number of beds for severe cases quickly increased from around 1,000 to more than 9,100. Hospitals were able to admit large numbers of patients who were seriously ill.
The treatment strategy for severe cases was improved, and tailored treatment provided to individual patients. Inspection teams consisting of top experts were organized to regularly inspect Wuhan's designated hospitals and evaluate patients in critical condition and their therapeutic regimen. For those with serious underlying medical conditions, who accounted for more than 80 percent of all severe cases, case-by-case treatment was prescribed after consultation with a multidisciplinary team consisting of experts on infection, respiratory diseases, heart and kidney diseases, and intensive care. In addition, a set of standards were formulated for nursing patients in severe and critical condition, and such measures as high-flow nasal cannula oxygen therapy, non-invasive and invasive mechanical ventilation, and ventilation in a prone position were adopted. Expert consultation on complex, severe and critical cases, and fatal cases, and other core medical security systems were strictly implemented. Those who have been cured and discharged from hospital have received rigorous health monitoring, and patients in severe condition have been given quality medical treatment.
The plasma of convalescent Covid-19 patients has been collected to set up an emergency plasma reserve, and convalescent plasma therapy has been applied in clinical treatment. As of May 31, convalescent plasma had been collected from 2,765 recovered patients, and 1,689 patients had been treated with the therapy, with positive results.
Early intervention for patients with mild symptoms. China has been quick to have patients with mild symptoms admitted to designated medical facilities for early medical intervention, and has done its best to prevent mild cases from worsening. The national clinical treatment network has been expanded to include more than 10,000 hospitals dedicated to the treatment of Covid-19 patients. A national network of medical treatment coordination has also been formed to provide technical support through online consultation.
In Wuhan, faced with surging infections and considering that 80 percent of cases were mild, the city government mobilized resources to repurpose stadiums and exhibition centers into 16 temporary treatment centers. With some 14,000 beds, these centers were able to admit all confirmed mild cases for treatment. This helped to reduce infections and virus transmission in communities and prevent mild cases from worsening. The 16 treatment centers received a total of more than 12,000 patients; 8,000 and more were cured and discharged; and more than 3,500 were transferred to hospitals. While in service, these facilities had zero cases of infection, death, or relapse.
Temporary treatment centers, or Fangcang shelter hospitals, are a major innovative solution that provided enough beds to admit all confirmed cases, thus turning the tide in the battle against Covid-19. An article in The Lancet wrote, "To relieve the huge pressure on the healthcare system, Fangcang shelter hospitals have also been crucial."2
Reviewing diagnostic and therapeutic plans and applying effective ones on a broad scale. China's diagnostic and therapeutic plans for Covid-19 have been developed and improved through clinical practice, medical research, experimentation and regular reviews. Based on scientific knowledge and accumulated evidence, R&D results and the diagnostic and therapeutic regimens that proved effective were incorporated in the national diagnosis and treatment plans. These include seven versions of the diagnosis and treatment protocol, three editions of the protocol for severe and critical cases, two editions of the manual for mild case management, two editions of convalescent plasma therapy treatment protocol, and one rehabilitation treatment program for patients discharged from hospitals. All these protocols and plans have contributed to science-based treatment of patients and the establishment of standards for medical treatment.
In Diagnosis and Treatment Protocol for Covid-19 (Trial Version 7), information on pathological changes, clinical symptoms, criteria for diagnosis, therapies, and criteria for patient discharge was added or updated. The protocol states that asymptomatic cases may be contagious. It also notes that plasma from convalescent cases may work in treating the infected. This edition has been adopted or used for reference in a number of countries.
Concerning discharged patients, quarantining, monitoring of their health and rehabilitation, and reexamination and re-testing have all been strengthened. Integrated medical services covering treatment, rehabilitation and health monitoring have been put in place. Differentiated treatment approaches have been adopted for children and pregnant women, among other groups.
Leveraging the unique strength of traditional Chinese medicine (TCM). Both TCM and Western medicine were used and traditional Chinese and Western drugs administered. China has leveraged the unique strength of TCM in preemptive prevention, differentiated medication, and multi-targeted intervention, and at every step of Covid-19 treatment and control. The etiology and pathogen of the disease were analyzed and confirmed through TCM methodology, as were the principles and methods of treatment. A set of TCM diagnosis and treatment protocols were developed to cover the entire process of medical observation, treatment of mild, moderate, severe, and critical cases, and recovery, and they have been applied nationwide.
TCM hospitals were used in the treatment of Covid-19 patients, and TCM teams took charge of and ran some wards for patients in severe condition at designated hospitals and some treatment centers. All the other shelter hospitals had resident TCM experts. TCM has played its part in the entire process of Covid-19 response, from early intervention to administering case-specific treatment. TCM drugs and treatment methods were used for early intervention and treatment of patients with mild symptoms; for patients with severe symptoms they were used in combination with Western medicine; for those under medical observation for fever and those who had been in close contact with confirmed cases they served to improve immunity; they helped to strengthen the constitution of those who had recovered. A national TCM coordination network was formed to offer guidance to patients recovering from the disease.
Chinese herbal formulas and drugs were administered to 92 percent of all confirmed cases. In Hubei Province, more than 90 percent of confirmed cases received TCM treatment that proved effective. Jinhua Qinggan Granules, Lianhua Qingwen Capsules/Granules, Xuebijing Injection, Lung Cleansing and Detoxifying Preparation, Dampness Resolving and Detoxifying Preparation, Lung Diffusing and Detoxifying Preparation, and other TCM drugs and herbal formulas have proved effective in treating different types of Covid-19 patients. They have significantly reduced the incidence rate, prevented cases with mild symptoms from worsening, increased the cure rate, lowered the fatality rate, helped nucleic acid turn negative, and sped up the rehabilitation of recovered Covid-19 patients.
Providing free treatment for patients. Government funds for Covid-19 control were made available in advance to ensure that patients could receive timely treatment and local authorities could proceed smoothly with measures for medical treatment and epidemic control. As of May 31, a total of RMB162.4 billion had been allocated by governments of all levels to fight the virus.
Policies for medical insurance were quickly adjusted, with clear provisions for confirmed or suspected Covid-19 patients. They could get treatment with delayed settlement of accounts. All Covid-19 patients, confirmed or suspected, received subsidies from state finance for any medical bills not covered by basic medical insurance, serious disease insurance, or the medical assistance fund. In the case of patients receiving treatment in places where they were not registered for basic medical insurance, their medical bills related to Covid-19 were paid by the local insurance fund first and settled later.
As of May 31, the medical bills of 58,000 inpatients with confirmed infections had been settled by basic medical insurance, with a total expenditure of RMB1.35 billion, or RMB23,000 per person. The average cost for treating Covid-19 patients in severe condition surpassed RMB150,000, and in some critical cases the individual cost exceeded RMB1 million, all covered by the state.
Strengthening infection control at medical institutions and ensuring personal protection for health workers. A set of technical manuals and normative documents on infection control were developed to regulate the layout of key areas in medical institutions and the consultation and treatment process, including clean zones, partially contaminated zones, contaminated zones, and separate passages for medical staff and patients. Health workers received training in workplace infection control, and nationwide supervision was strengthened to ensure control measures were implemented to the letter. Targeted guidance was given to the hardest-hit areas, hospitals at a higher risk of infection among staff, and areas and hospitals under the greatest pressure in treating patients. A major effort was put into the sorting, collection, storage and removal of medical waste, and the treatment of the remains of the deceased.
All emergency medical teams coming to Wuhan and Hubei from other parts of China had at least one infection control expert. Thanks to this arrangement, there have been no cases of infection in the teams. Since February there has been a sharp drop in the number of reported infections among medical staff nationwide. Health workers have been cared for and their needs attended to. A series of policies and measures have been introduced to ensure their wellbeing, such as psychological counseling and staff rotation, to ease their physical and psychological stress, help them stay healthy, and allow them to continue the fight on the front line.
4. China Has Released Information in an Open and Transparent Manner as Required by Law
While making an all-out effort to contain the virus, China has also acted with a keen sense of responsibility to humanity, its people, posterity, and the international community. It has provided information on Covid-19 in a thoroughly professional and efficient way. It has released authoritative and detailed information as early as possible on a regular basis, thus effectively responding to public concern and building public consensus. Its experience is something other countries can draw on in their fight against the virus.
A strict system of information release has been established. China has released information on Covid-19 in a timely, open and transparent manner as required by law. Strict regulations are in place to see there is no withholding of information, underreporting, or delay in reporting cases of infection. On December 31, 2019, the Wuhan government began to release coronavirus information in accordance with the law, and gradually increased the frequency of release. Since January 21, 2020, the NHC has provided daily updates on nationwide cases on its official website and social media platform, and provincial health departments have done the same on local cases. Starting from February 3, the NHC has released the information simultaneously on its English-language website.
A tiered news release mechanism has been formed.At both national and local levels, a tiered information release mechanism has been formed to circulate authoritative information through various channels and platforms, both onsite and online, in order to address domestic and international concerns on virus control, medical treatment, and scientific research. By May 31, the Joint Prevention and Control Mechanism and the Information Office of the State Council had held 161 press conferences during which officials from more than 50 government departments appeared over 490 times and answered more than 1,400 questions from Chinese and foreign media. One hundred and three press conferences had been held in Hubei and 1,050 in the other provinces.
Covid-19 statistics have been updated in accordance with the law. In the early stage of Covid-19 control, there were late, incomplete and erroneous reports of Covid-19 cases in Wuhan due to unverified deaths at home, inadequate hospital capacity, hospitals being overwhelmed, and incomplete recording of deaths. After the domestic spread of Covid-19 had been brought under control, the city updated the number of confirmed cases and deaths based on big data application and an epidemiological investigation to ensure accuracy of the data, and released the results in an open and transparent manner in accordance with the law.
Covid-19-related information is provided through various channels and platforms. The NHC's official Chinese and English websites and its social media platform have special sections where Covid-19-related information is released on a daily basis, including information on relevant policies, progress in China's containment efforts, updates on disease prevention and control, and clarifications that refute rumors. Information on local Covid-19 control has been promptly released on government websites and social media platforms of all provinces. To disseminate knowledge about its Covid-19 response, China has released relevant information through platforms for popularizing science, and through the media and the internet. Leading medical experts have offered advice on routine self-protection to help the public see Covid-19 in a rational way and forestall panic. The media has expanded public outreach and sent a positive message in combating the virus, and public opinion has played its role of oversight to help solve problems affecting virus control.
5. Science and Technology Underpin China's Efforts
Science and technology are the sharp blade that humanity wields in the battle against disease. Such battles could not have been won without scientific advances and technological innovation. Confronted by Covid-19, a previously unknown virus, China has exploited the pioneering role of science and technology and fully applied the results of scientific and technical innovation in recent years. Top scientific research resources have gathered from around the nation to support virus control. Focusing on the main battlefield of Wuhan and coordinating efforts in the most severely-affected areas and across the rest of the country, China pinpointed key R&D areas for different stages of virus control. The close coordination between scientific research, clinical application, and frontline virus control, and between enterprises, universities, and research institutes, has given powerful support for the war against the virus.
Key progress has been made in scientific research. Following the principles of safety, effectiveness and availability, China has accelerated the R&D and application of medicines, vaccines, and new test kits. To meet the urgent needs of frontline virus control, and to ensure traceability of infection sources, diagnosis and treatment of patients, and prevention and control of infections, China has pooled resources from enterprises, universities, and research institutes, directing them to focus on five areas - clinical treatment, new medicines and vaccines, testing techniques and products, viral etiology and epidemiology, and animal model construction. Top research resources from around the nation have been galvanized to work on these tasks in pursuit of early results and application. A total of 83 emergency R&D programs have been initiated. Vaccines are being developed in five categories - inactivated vaccines, recombinant protein vaccines, live attenuated influenza vaccines, adenovirus vaccines, and nucleic acid-based vaccines. To date, four inactivated vaccines and one adenovirus vaccine have been approved for clinical trials. While scientists in China and abroad have kept up with mutual developments, China leads the world in the development of certain types of vaccines. Research teams have also been assembled to trace the origin of Covid-19.
Scientific R&D has been integrated with clinical treatment and epidemic control. Having promptly developed nucleic acid test kits, China has also introduced a range of high-sensitivity, easy-to-use test equipment and reagents. Its R&D of reagents covers nucleic acid testing, gene testing, and immunological testing.
Putting existing medicines to new use, China has searched for effective medicines and new therapies, and summarized clinical experience based on rigorous in vitro experiments and pathogenic research. Ten types of medicine, including chloroquine phosphate, tocilizumab, finished TCM drugs, and herbal preparations, as well as convalescent plasma therapy, have been adopted in treatment plans. Approval for clinical trial has been given to four medicines, and guidelines formed or expert consensus reached in five areas. Clinical treatments have been trialed, and diagnosis and treatment methods and medicines that have proven clinically effective have been rolled out at a faster pace. Biosecurity has been strengthened at laboratories, as has the management of blood samples for Covid-19 testing and biological samples for laboratory testing.
Big data and artificial intelligence have been used in epidemic control. China has fully utilized big data, artificial intelligence, and other new technologies in research and analysis to forecast the trend of Covid-19 developments. These tools have also been exhaustively applied in epidemiological investigations to find every infected person and track every close contact for quarantine. A database has been set up in accordance with the law to provide data services for virus risk control, precisely identify different groups at risk, predict risk factors in different areas, and facilitate the orderly flow of people and the resumption of business operations. Via online platforms based on 5G technology, epidemiological teams in remote mountainous areas have been able to engage in real-time discussion with top experts thousands of miles away. With authorization from the public, health QR codes and digital travel records have been employed as permits for making trips, going to school or work, and accessing certain public venues, and for other daily errands. The results shown on the codes and records provide a base for travel control and differentiated response measures, which has made risk identification and targeted control possible in different areas and at different levels. Applying big data technology, an "epidemic map" has been created to display the specific names and locations of the communities where cases have been reported and the number of infections that has been ascertained. The map has made it easier for the public to guard against infection.
Through the battle against Covid-19, China has accumulated valuable experience in responding to major public health emergencies, and deficiencies in the national response system have been exposed. Summarizing this experience and learning from lessons, China will adopt a series of important measures to reinforce weak links. China will:
•reform and improve the disease prevention and control system;
• establish a major epidemic prevention, control and treatment system adapted to both times of peace and times of crisis;
• improve the emergency supply system;
• strengthen the new strategy of pooling nationwide resources for breakthroughs in core technologies;
• continue to implement initiatives to improve public sanitation; and
• improve the public health system.
China will make solid efforts to build capacity and improve its response to major public health emergencies, and better safeguard people's lives and health.
1 Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (Covid-19), February 28, 2020.
http://www.who.int/publications-detail/report-of-the-who-china-joint-mission-on-coronavirus-disease-2019-(covid-19).
2 The Lancet: "Sustaining Containment of COVID-19 in China", April 18, 2020.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30864-3/fulltext.
