Full Text: Fighting COVID-19: China in Action
I. China's Fight against the Epidemic: A Test of Fire
The Covid-19 epidemic is a major public health emergency. The virus has spread faster and wider than any other since the founding of the People's Republic in 1949, and has proven to be the most difficult to contain. It is both a crisis and a major test for China. The Communist Party of China (CPC) and the Chinese government have addressed the epidemic as a top priority, and taken swift action. General Secretary Xi Jinping has taken personal command, planned the response, overseen the general situation and acted decisively, pointing the way forward in the fight against the epidemic. This has bolstered the Chinese people's confidence and rallied their strength. Under the leadership of the CPC, the whole nation has followed the general principle of "remaining confident, coming together in solidarity, adopting a science-based approach, and taking targeted measures", and waged an all-out people's war on the virus.
Through painstaking efforts and tremendous sacrifice, and having paid a heavy price, China has succeeded in turning the situation around. In little more than a single month, the rising spread of the virus was contained; in around two months, the daily increase in domestic coronavirus cases had fallen to single digits; and in approximately three months, a decisive victory was secured in the battle to defend Hubei Province and its capital city of Wuhan. With these strategic achievements, China has protected its people's lives, safety and health, and made a significant contribution to safeguarding regional and global public health.
As of 24:00 of May 31, 2020, a cumulative total of 83,017 confirmed cases had been reported on the Chinese mainland, 78,307 infected had been cured and discharged from hospital, and 4,634 people had died. This demonstrates a cure rate of 94.3 percent and a fatality rate of 5.6 percent (see charts 1, 2, 3 and 4).
China's fight against the epidemic can be divided into five stages.
Stage I: Swift Response to the Public Health Emergency
(December 27, 2019-January 19, 2020)
As soon as cases of pneumonia of unknown cause were identified in Wuhan City, Hubei Province, China acted immediately to conduct etiological and epidemiological investigations and to stop the spread of the disease, and promptly reported the situation. In a timely manner, China informed the WHO and other countries, including the US, of the developing situation, and released the genome sequence of the novel coronavirus. After community spread and clusters of cases emerged in Wuhan, and confirmed cases were reported in other Chinese regions, which were due to virus carriers traveling from the city, a nationwide program of epidemic prevention and control was launched.
(1) December 27, 2019: Hubei Provincial Hospital of Integrated Chinese and Western Medicine reported cases of pneumonia of unknown cause to the Wuhan Jianghan Center for Disease Prevention and Control. The Wuhan city government arranged for experts to look into these cases through an analysis of the patients' condition and clinical outcome, the findings of epidemiological investigations, and preliminary laboratory testing results. The conclusion was that they were cases of a viral pneumonia.
(2) December 30: The Wuhan City Health Commission (WCHC)issued Urgent Notice on Treatment of Patients with Pneumonia of Unknown Cause. Upon learning of developments, the National Health Commission (NHC) acted immediately to organize research into the disease.
(3) December 31: The NHC made arrangements in the small hours to send a working group and an expert team to Wuhan to guide its response to the situation and conduct on-site investigations.
The WCHC website carried its Information Circular on the Pneumonia Cases in Wuhan, confirming 27 cases and urging the public to stay away from enclosed public places with poor ventilation and venues where large crowds gathered. The commission also suggested the use of face masks when going out. From that day on, the WCHC began to release updates on the disease in accordance with the law.
(4) January 1, 2020: The NHC set up a leading group on the disease response. The next day, it formulated Guidelines on Early Detection, Early Diagnosis and Early Quarantine for Prevention and Control of Viral Pneumonia of Unknown Cause. The Chinese Center for Disease Control and Prevention (China CDC) and the Chinese Academy of Medical Sciences (CAMS) received the first batch of samples of four cases discovered in Hubei and began the pathogen identification process.
(5) January 3: The WCHC issued Information Circular on Viral Pneumonia of Unknown Cause, reporting a total of 44 cases.
Under the direction of the NHC, China CDC and three other institutions carried out parallel laboratory testing of the samples to identify the pathogen. The NHC and the Health Commission of Hubei Province jointly formulated nine documents, including Diagnosis and Treatment Protocol for Viral Pneumonia of Unknown Cause (for Trial Implementation).
From that day on, on a regular basis, China began to update the WHO, relevant countries, and regional organizations, as well as its own regions of Hong Kong, Macao and Taiwan, on the development of the disease.
(6) January 4: The head of China CDC held a telephone conversation with the director of the US CDC, briefing him about the new pneumonia. The two sides agreed to keep in close contact on information sharing and cooperation on technical matters.
The NHC and related health departments in Hubei Province produced Treatment Manual for Viral Pneumonia of Unknown Cause.
(7) January 5: The WCHC updated information on its website, reporting a total of 59 cases of the viral pneumonia of unknown cause. Laboratory tests ruled out respiratory pathogens as the cause, such as influenza, avian influenza, adenovirus, the Severe Acute Respiratory Syndrome coronavirus, and the Middle East Respiratory Syndrome coronavirus.
China sent a situation update to the WHO. The WHO released its first briefing on cases of pneumonia of unknown cause in Wuhan.
(8) January 6: The NHC gave a briefing on cases of pneumonia of unknown cause in Wuhan at a national health conference, calling for greater efforts to monitor, analyze and study them, and prepare for a timely response.
(9) January 7: Xi Jinping, general secretary of the CPC Central Committee, presided over a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee and issued instructions on the prevention and control of a possible epidemic of the pneumonia of unknown cause in Wuhan.
(10) January 7: China CDC succeeded in isolating the first novel coronavirus strain.
(11) January 8: An expert evaluation team designated by the NHC initially identified a new coronavirus as the cause of the disease. The heads of the China and US CDCs held a telephone discussion on technical exchanges and cooperation.
(12) January 9: The NHC expert evaluation team released information on the pathogen of the viral pneumonia of unknown cause, and made a preliminary judgment that a new coronavirus was the cause.
China informed the WHO of developments and the initial progress that had been made in determining the cause of the viral pneumonia. The WHO released on its website a statement regarding a cluster of pneumonia cases in Wuhan, indicating that the preliminary identification of a novel coronavirus in such a short period of time was a notable achievement.
(13) January 10: Research institutions including China CDC and the Wuhan Institute of Virology (WIV) under the Chinese Academy of Sciences (CAS) came up with an initial version of test kits. Wuhan immediately began to test all relevant cases admitted to local hospitals to screen for the new coronavirus.
The heads of the NHC and China CDC held separate telephone conversations with the head of the WHO about China's response to the disease, and exchanged information.
(14) January 11: China started to update the WHO and other parties concerned on a daily basis.
(15) January 12: The WCHC changed "viral pneumonia of unknown cause" to "pneumonia caused by the novel coronavirus" in an information circular on its website.
China CDC, the CAMS and the WIV, as designated agencies of the NHC, submitted to the WHO the genome sequence of the novel coronavirus (2019-nCoV), which was published by the Global Initiative on Sharing All Influenza Data to be shared globally.
(16) January 13: Premier Li Keqiang chaired a State Council meeting and announced requirements for epidemic prevention and control.
(17) January 13: The NHC held a meeting to provide guidance to Hubei and Wuhan authorities, advising them to further strengthen management, step up body temperature monitoring at ports and stations, and reduce crowded gatherings.
The WHO issued on its website a statement on the discovery of novel coronavirus cases in Thailand, recognizing that China's sharing of the genome sequence of the virus had enabled more countries to rapidly diagnose cases.
An inspection team from Hong Kong, Macao and Taiwan visited Wuhan to learn about the prevention and control of the disease.
(18) January 14: The NHC held a national teleconference, specifying arrangements for epidemic prevention and control in Hubei and Wuhan, and for emergency preparations and response across the country. The NHC cautioned that there was great uncertainty about the new disease, and that more research was needed to understand its mode of transmission and the risk of human-to-human transmissibility. Further spread could not be ruled out.
(19) January 15: The NHC unveiled the first versions of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia, and Protocol on Prevention and Control of Novel Coronavirus Pneumonia.
(20) January 16: As the optimization of the Polymerase Chain Reaction (PCR) diagnostic reagents was completed, Wuhan began to screen all patients treated in fever clinics or under medical observation in the 69 hospitals at or above the level of grade two in the city.
(21) January 17: The NHC sent seven inspection teams to different provincial-level health agencies to guide local epidemic prevention and control.
(22) January 18: The NHC released the second version of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia.
(23) January 18 and 19: The NHC assembled a high-level national team of senior medical and disease control experts and sent them to Wuhan to study the local response to the epidemic. In the middle of the night of January 19, after careful examination and deliberation, the team determined that the new coronavirus was spreading between humans.
Stage II: Initial Progress in Containing the Virus
(January 20-February 20, 2020)
The situation became most pressing with the rapid increase in newly confirmed cases in China. As a crucial step to stem the spread of the virus, the Chinese government took the decisive measure to close outbound traffic from Wuhan. This marked the beginning of an all-out battle to protect Wuhan and Hubei from the epidemic.
The CPC Central Committee set up a leading group for novel coronavirus prevention and control and sent the Central Steering Group to Hubei. A joint epidemic prevention and control mechanism and in due course a mechanism to facilitate resumption of work were set up under the State Council. Resources were mobilized nationwide to assist Hubei and Wuhan. Major public health emergency responses were activated across China.
The most comprehensive, stringent and thorough epidemic prevention and control campaign was launched nationwide, and initial progress was made in curbing the spread of the virus (see Chart 5).
Chart 5. Daily Figure for Newly Confirmed Cases on the Chinese Mainland
(January 20-February 20)
(1) January 20: President Xi Jinping, also general secretary of the CPC Central Committee and chairman of the Central Military Commission, gave important instructions on fighting the novel coronavirus. He emphasized that people's lives and health must come first and resolute efforts should be taken to stem the spread of the virus. He called for prompt release of information on the epidemic and enhanced international cooperation.
(2) January 20: During an executive meeting of the State Council, Premier Li Keqiang decided to take more steps for epidemic prevention and control. A decision was taken to classify the novel coronavirus pneumonia as a Class B infectious disease in compliance with the Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases, but to apply to it the preventive and control measures for a Class A infectious disease.
(3) January 20: The State Council convened a teleconference to plan for nationwide prevention and control of the disease.
(4) January 20: The NHC held a press conference for the high-level expert team, at which it was confirmed that the virus could transmit from human to human.
(5) January 20: The NHC made a statement on implementing the above State Council decision and bringing the pneumonia under quarantinable infectious disease management in accordance with the Frontier Health and Quarantine Law of the People's Republic of China. The NHC also released Protocol on Prevention and Control of Novel Coronavirus Pneumonia (Edition 2).
(6) January 22: Xi Jinping ordered the immediate imposition of tight restrictions on the movement of people and channels of exit in Hubei and Wuhan.
(7) January 22: The NHC issued Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 3). The State Council Information Office held its first press conference on the novel coronavirus.
The NHC was notified by the United States about its first confirmed case.
The 2019 Novel Coronavirus Resource database was officially launched by the China National Center for Bioinformation, which released the novel coronavirus genome and provided information on variation analysis to the international community.
(8) January 23: At around 2 a.m. Wuhan City Novel Coronavirus Prevention and Control Command Center issued the No. 1 public notice declaring temporary closure of the city's outbound routes at its airports and railway stations at 10 a.m. the same day. The Ministry of Transport issued an emergency circular suspending passenger traffic into Wuhan from other parts of the country by road or waterway. The NHC and five other government departments also issued Notice on Preventing the Transmission of Novel Coronavirus Pneumonia via Means of Transport. From January 23 to January 29, all provinces and equivalent administrative units on the Chinese mainland (hereafter all provinces) activated Level 1 public health emergency response.
(9) January 23: Researchers of the WIV, Wuhan Jinyintan Hospital and the Hubei Provincial CDC discovered that the whole genome sequence of the 2019-nCoV shares 79.5 percent of the SARS-CoV sequence.
The Novel Coronavirus National Science and Technology Resource Service System, jointly set up by the National Microbiology Data Center and the National Pathogen Resource Collection Center, released the first electron microscope image of the virus and its strain information.
(10) January 24: Dispatch of national medical teams to Hubei and Wuhan began. In the ensuing period, a total of 346 medical teams composed of 42,600 medical workers and 965 public health workers from across the country and the armed forces were dispatched.
(11) January 25: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He called for resolute efforts to win the battle to contain the virus with "confidence and solidarity, a science-based approach and targeted measures". He urged Hubei to make epidemic control its top priority and apply more rigorous measures to stem the spread of the virus within the province and beyond. All confirmed patients, he said, must be hospitalized without delay, and severe cases must be sent to designated hospitals with sufficient medical resources so that they could be treated by medical experts. A decision was taken at the meeting that the central Party leadership would set up a leading group for novel coronavirus prevention and control under the Standing Committee of the Political Bureau. It was also decided that the central Party leadership would send a steering group to Hubei to oversee epidemic control on the ground.
(12) January 25: The NHC released six sets of guidelines on disease prevention: for general use, tourism, households, public places, public transport and home observation.
(13) January 26: Premier Li Keqiang, also member of the Standing Committee of the Political Bureau of the CPC Central Committee and head of the Central Leading Group for Novel Coronavirus Prevention and Control, chaired the group's first meeting.
The General Office of the State Council issued the decision to extend the Chinese New Year holiday of 2020 and postpone the opening of all universities, colleges, secondary schools, elementary schools and kindergartens.
The National Medical Products Administration fast-tracked approval of four novel coronavirus test kits made by four companies to boost capacity for producing virus nucleic acid test kits.
(14) January 27: Xi Jinping issued an instruction calling on all CPC organizations and members to bear in mind the supremacy of the people's interests and the Party's founding mission, strengthen confidence and solidarity, take a science-based approach and targeted measures, and lead the people in implementing the decisions made by the central Party leadership.
(15) January 27: Li Keqiang paid an inspection visit to Wuhan on behalf of Xi Jinping, where he gave guidance on virus control and expressed appreciation to frontline health workers. The Central Steering Group arrived in Wuhan on the same day to strengthen overall guidance of and supervision over the prevention and control of the disease at the front line.
(16) January 27: The NHC released Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 4).
The head of the NHC discussed epidemic prevention and control with the head of the US Department of Health and Human Services (US HHS) in a telephone call.
(17) January 28: Xi Jinping met with WHO Director General Tedros Adhanom Ghebreyesus in Beijing. He said, "The virus is a devil, and we must hunt it down. The Chinese government has been providing timely updates on the epidemic in an open, transparent and responsible way. We have responded to the concerns of various parties and enhanced cooperation with the international community." He expressed China's readiness to work with the WHO and the international community to safeguard public health both in the region and globally.
(18) January 28: The NHC released Protocol on Prevention and Control of Novel Coronavirus Pneumonia (Edition 3).
(19) January 30: The NHC notified the US through the official channel that American experts were welcome to join the WHO-China Joint Mission on Coronavirus Disease. The US replied and expressed its appreciation on the same day.
(20) January 31: The WHO declared the novel coronavirus outbreak a public health emergency of international concern. The NHC released Guidelines on Treating Novel Coronavirus Patients with Severe Symptoms in Designated Hospitals.
(21) February 2: Under the guidance of the Central Steering Group, Wuhan began to adopt measures to put four categories of people – confirmed cases, suspected cases, febrile patients who might be carriers, and close contacts – under classified management in designated facilities. The policy of ensuring that all those in need are tested, isolated, hospitalized or treated was implemented. Actions were taken to conduct mass screenings to identify people with infections, hospitalize them, and collect accurate data on case numbers.
(22) February 2: The head of the NHC sent a letter to the head of the US HHS to further exchange views on bilateral cooperation on public health and epidemic prevention and control.
(23) February 3: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He required that epidemic control measures be improved and strengthened and that the principle of early detection, reporting, quarantine and treatment be strictly observed. He called for saving lives by raising admission and cure rates and lowering infection and fatality rates.
(24) February 3: The Central Steering Group sent to Wuhan 22 national emergency medical teams from all over China, and gave the order to construct temporary treatment centers.
(25) February 4: The head of China CDC took a telephone call from the head of the US National Institute of Allergy and Infectious Diseases in which they exchanged views on the novel coronavirus.
(26) February 5: Xi Jinping chaired the third meeting of the Commission for Law-based Governance under the CPC Central Committee. He stressed the importance of putting the people's lives and health first, and the need to raise China's overall capacity of law-based disease prevention and control through the joint efforts of the legislature, law enforcement agencies, the judiciary and the public. This would ensure that epidemic prevention and control is conducted in compliance with the law.
(27) February 5: The State Council through its Joint Prevention and Control Mechanism strengthened coordination, which made it possible for the supply of medical N95 masks to exceed Hubei's requirement.
(28) February 5: The NHC released Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 5).
(29) February 7: Through its Joint Prevention and Control Mechanism, the State Council issued Notice on Delivery of Duties for Effective Prevention and Control of the Disease.
The NHC released Protocol on Prevention and Control of Novel Coronavirus Pneumonia (Edition 4).
(30) February 8: The NHC gave briefings on China's epidemic control efforts and measures at a meeting of the APEC health working group. It also gave briefings to Chinese diplomatic missions overseas on the guidelines for prevention and control, diagnosis and treatment, monitoring, epidemiological investigation and laboratory testing of the novel coronavirus.
Heads of Chinese and US health authorities further exchanged views on arrangements for American experts to join the WHO-China Joint Mission on Coronavirus Disease.
(31) February 10: Xi Jinping inspected prevention and control work in Beijing. He also talked by video link to doctors from Wuhan Jinyintan Hospital, Wuhan Union Hospital and Huoshenshan Hospital where novel coronavirus patients were being treated. He called for strengthening confidence and taking more decisive measures to stem the spread of and win the people's all-out war against the virus. He emphasized that top priority must be given to Hubei and Wuhan, as they were the decisive battlegrounds. Victory in Wuhan would ensure victory in Hubei, and ultimately victory across the country. No effort would be spared in saving lives. The infected should be treated in designated hospitals by top-level doctors and with all necessary resources guaranteed. Strict measures must be taken to forestall inbound and intra-city transmissions, neutralize all sources of infection and stem the spread of the virus to the greatest extent possible.
(32) February 10: A mechanism was established to organize pairing assistance from other provinces to Hubei’s cities other than Wuhan for treatment of the infected. Assistance from 19 provinces was rendered to 16 cities in Hubei.
(33) February 11: Thanks to strengthened coordination under the State Council Joint Prevention and Control Mechanism, the supply of medical protective suits to Hubei exceeded its needs.
(34) February 11: China CDC experts had a teleconference at the request of flu experts from the US CDC, during which they shared information on novel coronavirus prevention and control.
(35) February 12: At a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee, Xi Jinping noted that China’s novel coronavirus prevention and control had reached the most crucial stage. Key epidemic control tasks must be fulfilled, and greater attention must be given to the hardest-hit and high-risk areas. He called for improvements in key links in disease control to raise the admission and cure rates and lower the infection and fatality rates. Hospital capacity must be boosted to ensure admission and treatment for all patients. The best medical resources and technologies should be pooled to treat all infections, particularly the most severe cases. He urged those provinces and cities with large population inflows to strengthen cross-region joint prevention and control and society-wide efforts to contain the virus.
(36) February 13: The head of the NHC received a letter from the head of the US HHS on arrangements concerning bilateral cooperation on public health and novel coronavirus prevention and control.
(37) February 14: Xi Jinping chaired the 12th meeting of the Commission for Further Reform under the CPC Central Committee. He emphasized that protecting people's lives and health is a high priority on the CPC's governance agenda. Immediate, science-based and targeted measures must be taken to stamp out the virus. Experience and lessons must be drawn to enhance preparedness in the future. Swift actions must be taken to address problems, plug loopholes, and reinforce weak links. He also emphasized the need to improve both the mechanism for preventing and controlling major epidemics and the national public health emergency response system.
(38) February 14: All provinces and equivalent administrative units other than Hubei saw a continuous drop in newly confirmed cases for the 10th consecutive day.
(39) February 15: The State Council Information Office held its first press conference on novel coronavirus prevention and control in Wuhan. By that day, seven types of test reagents had been approved for market launch, and progress had been made in drug screening, development of therapeutic regimens and vaccines, and animal model construction.
(40) February 16: The WHO-China Joint Mission on Covid-19, consisting of 25 experts from China, Germany, Japan, ROK, Nigeria, Russia, Singapore, the US and the WHO, started its nine-day field visit to Beijing, Chengdu, Guangzhou, Shenzhen and Wuhan.
(41) February 17: Through its Joint Prevention and Control Mechanism, the State Council issued Guidelines on Taking Science-based, Targeted, Region-specific, and Tiered Measures for Covid-19 Prevention and Control. Local authorities and government departments were required to take measures matching the corresponding levels of emergency response and ensure an orderly return to work and normal life.
(42) February 18: Nationwide, the daily number of newly cured and discharged coronavirus patients exceeded that of newly confirmed cases, and the number of confirmed cases began to drop.
The NHC sent a reply to the US HHS on further arrangements concerning bilateral health and anti-virus cooperation.
(43) February 19: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. The meeting heard reports on coronavirus prevention and control, and studied plans on strengthening virus control while promoting economic and social development.
(44) February 19: The NHC released Diagnosis and Treatment Protocol for Covid-19 (Trial Version 6).
(45) February 19: For the first time in Wuhan, newly cured and discharged cases outnumbered newly confirmed ones.
Stage III: Newly Confirmed Domestic Cases on the Chinese Mainland Drop to Single Digits
(February 21-March 17, 2020)
China had made significant progress: The rapid spread of the virus had been contained in Wuhan and the rest of Hubei Province, the situation in other parts on the mainland had stabilized, and the daily figure for new cases had remained in single digits since mid-March. As the situation evolved, the CPC Central Committee decided to coordinate epidemic control with economic and social development, and organize an orderly return to normal work and daily life (see Chart 6).
Chart 6. Daily Figure for Newly Confirmed Cases on the Chinese Mainland
(February 21-March 17)
(1) February 21: Xi Jinping chaired a meeting of the Political Bureau of the CPC Central Committee. He pointed out that while significant progress had been made in containing the epidemic, the turning point had not yet arrived at the national level. Wuhan and the entire province of Hubei still faced a grave and complex threat. He instructed that differentiated control measures be adopted to address the problems in different regions, to defend Hubei and its capital city, to step up support to regions with insufficient capacity, and to make an all-out effort to ensure the safety of Beijing, the national capital. He required that the economic and social order be managed in parallel with the anti-epidemic endeavor, and called for an orderly return to normal work and daily life.
(2) February 21: Through its Joint Prevention and Control Mechanism, the State Council issued Guidelines on Covid-19 Prevention and Control Measures for Resumption of Work.
The NHC released Protocol on Prevention and Control of Novel Coronavirus Pneumonia (Edition 5).
(3) February 21: Most provinces and equivalent administrative units started to downgrade their public health emergency response level in light of the local situation, and gradually lifted traffic restrictions. By February 24, all provincial trunk highways had reopened, and order was restored to the transport networks with the exception of those in Hubei and Beijing.
(4) February 23: President Xi spoke to 170,000 officials nationwide by video link, at a meeting on coordinating epidemic control with economic and social development. He emphasized that this epidemic, given the speed and scope of its spread, represented the most challenging public health emergency in China since the founding of the People's Republic, and that it was both a serious crisis and a major test.
He acknowledged the arduous efforts of all involved, welcoming the fact that control measures were producing increasingly positive results, but noting that the overall situation remained complex and serious, and this stage would be crucial in curbing the spread. The people must maintain their faith in ultimate victory and make unremitting efforts in all of their prevention and control work. He encouraged the nation to turn pressure into strength and adversity into opportunities, and steadily resume normal work and daily life. He demanded a redoubled effort to stabilize the six fronts -- employment, finance, foreign trade, inbound investment, domestic investment, and market expectations, called for stronger policies to unleash the full potential and maintain the strong momentum of China's development, and urged the nation to achieve the goals and tasks set for this year's economic and social development.
(5) February 24: The WHO-China Joint Mission on Covid-19 held a press conference in Beijing, during which team members agreed that China had achieved notable success in slowing the spread of the virus and blocking human-to-human transmission, at least delaying and possibly preventing hundreds of thousands of infections. "This approach, what we call an 'all-of-government, all-of-society' approach, very old-fashioned, too old in some ways, has probably, definitely reverted, and probably prevented at least tens of thousands, but probably hundreds of thousands of cases of Covid-19 in China".
By February 24, the daily number of new infections on the Chinese mainland had remained below 1,000 for five consecutive days, the number of existing confirmed cases had kept dropping for almost a week, and the daily figure for discharged patients was now equal to or had surpassed that of new infections in all provincial-level administrative units.
(6) February 25: China started to tighten up border quarantine, conducting a strict check of health and body temperature, and carrying out medical inspection, epidemiological investigation, medical screening, and sample monitoring of all inbound and outbound travelers, in order to minimize the cross-border spread of the epidemic.
(7) February 26: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He told the meeting that the national situation in epidemic control was turning for the better and economic and social development was quickly returning to normal, while Wuhan and Hubei as a whole still faced a grave and complex situation, and the possibility of an epidemic resurgence must not be overlooked in other regions.
He called for a greater effort to marshal the resources of the whole country to reinforce Wuhan and Hubei. He emphasized the need to make an accurate assessment of the epidemic dynamics and the conditions facing economic and social development, and focus on the main problems and the key elements of these problems, so as to ensure an overall victory in the battle against the virus, and achieve the goals of building a moderately prosperous society in all respects and of the country's poverty alleviation.
(8) February 27: The daily figure for new cases in Hubei other than Wuhan, and in other places on the mainland outside Hubei, both dropped to single digits for the first time.
(9) February 28: Through its Joint Prevention and Control Mechanism, the State Council released Notice on Furthering Differentiated, Region-specific and Tiered Prevention and Control Measures.
(10) February 29: The WHO-China Joint Mission on Covid-19 released a report about its field study trip in China. The report described China's control efforts. It said, "In the face of a previously unknown virus, China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history… As striking, has been the uncompromising rigor of strategy application that proved to be a hallmark in every setting and context where it was examined… Achieving China's exceptional coverage with and adherence to these containment measures has only been possible due to the deep commitment of the Chinese people to collective action in the face of this common threat. At a community level this is reflected in the remarkable solidarity of provinces and cities in support of the most vulnerable populations and communities."
(11) March 2: President Xi inspected several scientific institutions in Beijing, observing their research and development on Covid-19 prevention and control. He said that this work must be taken as a major and pressing task and proceed as speedily as possible, while abiding by the rules of science and ensuring safety, so as to provide strong scientific and technological support for overcoming the epidemic.
Xi Jinping pointed out that saving as many lives as possible, by every possible means, was the number one priority. Research on and development of medicines and medical equipment should be integrated with clinical treatment, with the twin goals of raising the cure rate and lowering the fatality rate. Development of vaccines should be expedited through multiple approaches, so as to make them available for clinical trial and application as quickly as possible.
The president said that biosecurity should be an important part of the holistic approach to national security, and he called for efforts to enhance China's scientific research capacity regarding epidemic prevention and control and public health.
(12) March 3: The NHC released Diagnosis and Treatment Protocol for Covid-19 (Trial Version 7), which made modifications in the determination of transmission routes and clinical symptoms, updated diagnostic criteria, and emphasized the integration of traditional Chinese medicine and Western medicine in treating the disease.
(13) March 4: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He emphasized the need to quickly bring order to economic and social development in the context of epidemic control, improve relevant measures, and consolidate and extend the country's hard-won progress. Wuhan and Hubei must continue their epidemic control, and continue the measures for preventing the virus from spreading within their local area or beyond.
(14) March 6: Xi Jinping attended a symposium on securing a decisive victory in poverty alleviation. He pointed out that the solemn pledge to lift all rural people living below current poverty line out of poverty by 2020 had been made by the CPC Central Committee to the whole nation, and it must be fulfilled on schedule. He called for greater determination and intensity in advancing poverty alleviation, and highlighted the need to offset the impact of the epidemic in order to clinch a complete victory over poverty - a cause of such tremendous importance to China and all of humanity.
(15) March 6: The daily increase in the number of domestic cases on the Chinese mainland dropped below 100, and fell further to single digits on March 11.
(16) March 7: The NHC released Protocol on Prevention and Control of Covid-19 (Edition 6).
(17) March 10: Xi Jinping went to Wuhan to inspect work on epidemic control. He acknowledged that the situation in Hubei and Wuhan was improving and that hard work had delivered important results, and pointed out that the task remained arduous. He encouraged the people to persevere in their efforts and win the battles against the virus in Hubei and Wuhan. He praised residents in Wuhan for considering the national interest and the general situation. They had proved themselves indomitable and resilient, and they had consciously subordinated their needs to the overall interests of epidemic control, joined the battle against the epidemic, and made a huge contribution.
He pointed out that there were two fronts in the battle against the epidemic: the hospital and the community - the life-saving front and the epidemic prevention and control front. Communities should play their key role in epidemic prevention and control, and every community should serve as a bastion of defense against the virus. He called for a general mobilization, putting in place a defense line across the whole of society and relying on the people to win the battle.
(18) March 11: WHO Director General Tedros Adhanom Ghebreyesus announced, "We have therefore made the assessment that Covid-19 can be characterized as a pandemic."
(19) March 11 to 17: The daily increase in the number of domestic cases on the Chinese mainland remained in single digits. The epidemic peak had passed in China as a whole, with the number of new cases steadily declining and the epidemic comfortably under control.
(20) March 17: Forty-two medical teams from around the country left Wuhan, having completed their mission there.
Stage IV: Wuhan and Hubei - An Initial Victory in a Critical Battle
(March 18-April 28, 2020)
By making critical advances in the city of Wuhan, the main battleground against the virus, China initially halted the spread of Covid-19 on the mainland. Restrictions on outbound traffic from Wuhan City and Hubei Province were lifted, and all Covid-19 patients in Wuhan hospitals were discharged. China won a critical battle in defending Wuhan and Hubei against Covid-19, which was a major step forward in the nationwide virus control effort.
During this period, sporadic cases were reported, and more infections were caused by inbound arrivals carrying the virus which continued to spread overseas. In response to the evolving Covid-19 dynamics, the CPC Central Committee adopted an approach to prevent the coronavirus from entering the country and stem its domestic resurgence. Efforts were made to consolidate gains in virus control, promptly treat cluster cases, and get the country back to work sector by sector. Care and support were given to Chinese citizens abroad (see Chart 7).
Chart 7. Daily Figure for Newly Confirmed Cases on the Chinese Mainland
(March 18-April 28)
(1) March 18: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He emphasized the need to take rigorous steps to stop inbound cases, so that hard-won gains in virus control would not be lost. He urged stronger measures to protect the health of Chinese citizens overseas.
(2) March 18: The State Council issued Decision on Implementation of Measures to Stabilize Employment by Offsetting the Impact of Covid-19.
(3) March 18: For the first time, no new domestic cases were confirmed on the Chinese mainland. By March 19, no new cases had been confirmed for seven days outside of Hubei Province.
(4) March 25: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee to hear briefings about virus control and current economic conditions and discuss virus control measures and ways to sustain economic growth.
(5) March 25: Hubei lifted outbound traffic restrictions and removed all health checkpoints on highways across the province except in Wuhan. With the exception of Wuhan, work and life gradually returned to normal in the whole province, and people could now leave Hubei if they had a "green" health code to show that they were not infected.
(6) March 25: Confirmed inbound cases were reported in 23 provinces, signaling the need to curb the spread of the virus.
(7) March 26: President Xi attended the G20 Extraordinary Leaders' Summit on Covid-19 and delivered a speech titled "Working Together to Defeat the Covid-19 Outbreak".
(8) March 27: Xi Jinping chaired a meeting of the Political Bureau of the CPC Central Committee. He called for a timely improvement in China's Covid-19 control measures in response to changing Covid-19 dynamics, both domestic and globally, with a shift in focus to preventing inbound cases and domestic resurgence, so as to sustain the positive momentum in virus control.
He stressed the need to speedily resume work and normal life while continuing Covid-19 prevention and control, in order to minimize the losses caused by Covid-19 and fulfill the goals of economic and social development set for the year. Provided that prevention and control protocols were duly observed, support should be given to get Hubei back to work in an orderly manner, and help enterprises create jobs, keep their employees, and ensure their livelihoods.
(9) March 29 to April 1: Xi Jinping made an inspection tour to Zhejiang Province to review its Covid-19 control and economic and social development.
He stressed that guarding against inbound infections should be the top priority for the country both now and in the foreseeable future and that control must be targeted and effective so as to build a strong line of defense against inbound cases.
He emphasized the need to remain sensitive to changes, respond to them with well-judged actions, be ready to adjust the approach when necessary, and identify and seize opportunities in the current crisis.
He urged a steady return to work in more sectors while strictly continuing virus control measures and resolving problems hindering the return to work, so as to restore the operation of complete industrial chains.
(10) April 1: Chinese customs began nucleic acid testing (NAT) on inbound arrivals at all points of entry - air, water and land.
(11) April 4: A nationwide ceremony was held on the traditional Tomb-sweeping Day to pay tribute to all those who had given their lives in fighting Covid-19, and others who had died of the novel coronavirus.
(12) April 6: Through its Joint Prevention and Control Mechanism, the State Council issued Notice on Prevention and Control Measures for Key Locations, Organizations and Population Groups, and Manual for Management of Asymptomatic Virus Carriers.
(13) April 7: The Central Leading Group for Novel Coronavirus Prevention and Control issued Guidelines on Resumption of Work while Preventing and Controlling Covid-19; and the State Council released Guidelines on Covid-19 Prevention and Control Measures for Localities at Different Risk Levels to Resume Work. Region-specific and tiered measures for Covid-19 control were adopted to pave the way for a return to normal work in different locations.
(14) April 8: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He reiterated the need to stay alert against potential risks and be prepared, both in thinking and action, to respond to long-term changes in the external environment.
He warned against any relaxation of the efforts to both stop inbound cases and forestall domestic resurgence of cases. Targeted measures should be taken to manage asymptomatic cases, build a strong line of defense and plug any loopholes that might cause a resurgence of the virus. Control at land and sea points of entry should be tightened to minimize domestic cases caused by inbound arrivals carrying the virus.
(15) April 8: Wuhan lifted its 76-day outbound traffic restrictions; and local work and daily life began to return to normal.
(16) April 10: The number of patients in severe or critical condition in Hubei dropped to double digits for the first time.
(17) April 14: Premier Li Keqiang delivered a speech at a special meeting attended by leaders of ASEAN nations, China, Japan, the Republic of Korea on fight against the novel coronavirus. He shared with these leaders China's experience in coordinating the fight against the virus with its efforts to continue economic and social development. He proposed to strengthen cooperation on the fight against the virus, on efforts to resume economic development, and on policy coordination among the participating countries.
(18) April 15: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee to hear briefings on virus control and current economic conditions, and discuss virus response measures and ways to sustain economic growth.
(19) April 17: Xi Jinping chaired a meeting of the Political Bureau of the CPC Central Committee. He called for full implementation of virus control measures to prevent both inbound cases and domestic resurgence and to build positive momentum in Covid-19 control.
He emphasized the need to follow the general principles of pursuing stable performance and making new progress, returning to work while continuing Covid-19 control, restoring economic and social order, fostering new growth areas, and actively promoting development.
(20) April 17: Wuhan City Novel Coronavirus Prevention and Control Command Center released Briefing on Modifying the Figures of Confirmed Covid-19 Cases and Fatalities in Wuhan. By midnight on April 16, the total number of confirmed cases in the city had been revised up by 325 to 50,333, and the number of deaths up by 1,290 to 3,869.
(21) April 20-23: Xi Jinping made an inspection tour to Shaanxi Province. He urged local officials to pursue steady performance, make new progress, and act according to the new development philosophy. He called on them to carry out the following tasks: stabilizing employment, finance, foreign trade, inbound investment, domestic investment, and market expectations, and guaranteeing jobs, daily living needs, food and energy, industrial and supply chains, the interests of market players, and the smooth functioning of grassroots government. By so doing, China could offset the adverse impact of Covid-19 and fulfill the goals of eliminating poverty and achieving moderate prosperity.
(22) April 23: Premier Li Keqiang chaired a video conference on the economic situation in some provinces and cities in order to promote economic and social development in these regions.
(23) April 26: The last hospitalized Covid-19 patient in Wuhan was discharged.
(24) April 27: Xi Jinping chaired the 13th meeting of the Commission for Further Reform under the CPC Central Committee. He pointed out that the CPC leadership and China's socialist system had played a critical role in Covid-19 control and the resumption of business activities in China. As the environment for development became more complicated, China should be more resolute in furthering reform and improving its governing systems, and it should fully leverage its strengths to deal with risks and challenges.
(25) April 27: The Central Steering Group returned to Beijing from Hubei.
Stage V: Ongoing Prevention and Control
(Since April 29, 2020)
Sporadic cases have been reported on the mainland, resulting in case clusters in some locations. Inbound cases are generally under control. The positive momentum in Covid-19 control has thus been locked in, and nationwide virus control is now being conducted on an ongoing basis. China has made vigorous efforts to resume work and reopen schools. The ongoing control measures passed the test of the travel peak during the May Day holiday.
With the approval of the CPC Central Committee, an inter-departmental contact group under the Joint Prevention and Control Mechanism of the State Council was dispatched to Hubei to oversee local virus control (see Chart 8).
(1) April 29: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He concluded that thanks to arduous efforts, China had won a vital battle in defending Wuhan and Hubei against the novel coronavirus, and achieved a major strategic success in the nationwide control efforts. At the same time, he emphasized that virus control should continue in key regions and target key groups, with a focus on inbound cases.
(2) April 30: The public health emergency response was lowered to Level 2 in the Beijing-Tianjin-Hebei region.
Chart 8. Daily Figure for Newly Confirmed Cases on the Chinese Mainland
(April 29-May 31)
(3) May 1: The WHO announced that given the current international Covid-19 dynamics, the novel coronavirus still remained a "public health emergency of international concern".
(4) May 2: The public health emergency response was lowered to Level 2 in Hubei.
(5) May 4: An inter-departmental contact group under the Joint Prevention and Control Mechanism of the State Council was dispatched to Wuhan with the approval of the CPC Central Committee.
(6) May 6: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He pointed out that under the strong leadership of the Central Committee and with the support of all the people, the Central Steering Group had been working with the people of Wuhan and other parts of Hubei Province. They had done their utmost in the fight to curb the spread of the virus and erected a first line of defense for the nation, making a significant contribution to beating the virus.
He said the contact group should guide and support follow-up work in Wuhan and other parts of Hubei and advise on the rehabilitation and psychological counseling of patients in recovery, to ensure that the gains would be consolidated.
(7) May 7: Through the Joint Prevention and Control Mechanism, the State Council released Guidelines on Conducting Covid-19 Prevention and Control on an Ongoing Basis.
(8) May 8: The CPC Central Committee held a meeting to hear the views and proposals from the central committees of China's eight other political parties, representatives of the All-China Federation of Industry and Commerce, and prominent figures without party affiliation. General Secretary Xi chaired and addressed the meeting.
He said that when the novel coronavirus struck, catching the country unawares, the CPC Central Committee gave its full attention to the matter. Putting people's lives and health first, it swiftly adopted a series of policies on prevention and control of the virus and treatment of the infected. It took the country over a month to achieve initial success in curbing the spread of the virus, about two months to bring the daily figure of new domestic cases on the mainland down to single digits, and three months to win a decisive victory in defending Wuhan City and Hubei Province. For China, with a large population of 1.4 billion, this achievement did not come easily.
(9) May 11-12: Xi Jinping made an inspection tour to Shanxi Province to be briefed on what had been done in the province to conduct Covid-19 prevention and control on an ongoing basis while promoting economic and social development, and to consolidate gains in poverty alleviation.
He urged local officials to act according to the new development philosophy for making steady progress, and carry out supply-side structural reform. They were required to stabilize the six fronts (employment, finance, foreign trade, inbound investment, domestic investment, and market expectations), and guarantee the six priorities (jobs, daily living needs, food and energy, industrial and supply chains, the interests of market players, and the smooth functioning of grassroots government).
He called on local officials to overcome the adverse impact of the virus, accelerate high-quality economic transformation, and meet the goals of eliminating poverty and achieving moderate prosperity in all respects.
(10) May 14: Xi Jinping chaired a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee. He urged that Covid-19 control be strengthened in key areas and key places to prevent its resurgence, and that targeted measures be taken where case clusters had recently occurred. Flexible and effective measures should be adopted to respond to evolving Covid-19 dynamics overseas, and key sectors and weak links in the prevention of inbound infection should be shored up.
(11) May 15: Xi Jinping chaired a meeting of the Political Bureau of the CPC Central Committee to discuss the draft Report on the Work of the Government, which the State Council would submit to the forthcoming Third Session of the 13th National People's Congress for deliberation.
He pointed out that to fulfill the tasks of the year, the nation must carry out Covid-19 prevention and control as well as promoting economic and social development to reach the goal of achieving moderate prosperity in all respects.
He said that while conducting control on an ongoing basis, the country should continue to deliver steady performance, act according to the new development philosophy, conduct supply-side structural reform, promote high-quality development through further reform and opening up, and continue the three critical battles against poverty, pollution and major risks. There should be solid progress in stabilizing the six fronts and guaranteeing the six priorities. Domestic consumption must be expanded, and economic development and social stability must be maintained, so as to fulfill the goals of eliminating poverty and achieving moderate prosperity in all respects.
(12) May 18: President Xi delivered a speech titled "Fighting Covid-19 through Solidarity and Cooperation, Building a Global Community of Health for All" at the opening of the 73rd World Health Assembly.
(13) May 21-27: The Third Session of the 13th National Committee of the Chinese People's Political Consultative Conference was held in Beijing. May 22-28: The Third Session of the 13th National People's Congress was held in Beijing.
