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China: One Year of Covid-19

BLOG - 16 December 2020

People in China are now living an almost normal life. They are now able to travel within borders - domestic flights have exceeded their year-on-year numbers this September - eat in a restaurant and go to the office for work without much concern of Covid-19. The Chinese success in controlling the virus has been widely discussed and analyzed, and has become an official talking point, to demonstrate the superiority of China’s governance model. "When it comes to protecting people's lives, we must do whatever it takes, and we can do whatever it takes", said Xi Jinping at a meeting to commend role models in the country's fight against Covid-19. Indeed, China has taken the strongest measures to contain the spread of the virus compared to the rest of the world, with a mixture of distinctive solutions, from the world’s most severe lockdown in Wuhan to the generalized use of digital tools. It has paid off. Wuhan, the first city that went into lockdown in January and reopened in April, hosted a massive pool party in August. According to the Global Times, this event sends a message to the world that strict anti-virus measures have a payback. 

Containing local and imported contamination 

The message has been well received. Little doubt remains about the Chinese success in containing the virus domestically, even though from time to time, there still are cases of local transmission. So far, no country has entirely eradicated the virus. However, the discussion on the origin of the virus and the Chinese initial mishandling of the crisis continues, as we have seen from a recent CNN report based on leaked Chinese documents. After a full year, access by international epidemiological experts to the sites where the pandemic took off remains problematic. But it is important to note that some merits of the successful management of the outbreak should be attributed to the sophisticated scientific approach as well. For instance, the temporary hospital "Leishenshan", constructed in ten days, was equipped with an advanced interior ventilation system that can effectively prevent the spreading of contaminated air and pollution of the surrounding environment. 

Wuhan, the first city that went into lockdown in January and reopened in April, hosted a massive pool party in August. According to the Global Times, this event sends a message to the world that strict anti-virus measures have a payback.

Despite this success, the Chinese authorities have not let their guard down, following the principle of "guarding against imported cases and a rebound in indigenous cases (外防输入、内防反弹)". China’s borders have remained partially closed with various restrictions on international travel, and it acts swiftly and decisively when local transmission is detected. The city of Qingdao immediately organized a large-scale flow investigation and screening in October, after identifying three asymptomatic infection cases, which led to the testing of the whole city within 5 days. The massive testing was made possible by batch-testing, or 10-in-1 miced testing (10合1混采检测), which pools 10 samples together to be tested in batches. If one batch tests positive, everyone in that group is notified for temporary isolation, then samples are recollected and examined individually. The method has facilitated the rapid screening process in other parts of China as well. 

In addition, restrictions are not only imposed on incoming travelers, but also on imported products (人物并防). On November 9, the State Council issued the "Work Plan of Preventive Comprehensive Disinfection of Imported Cold Chain Foods", to prevent the possibility of cross-border Covid-19 transmission through cold chain foods. This comes shortly after cases related to imported cold chain foods have been identified in Tianjin and Beijing. The plan requires complete disinfection and testing of imported cold-chain foods at the port, and records of those foods have to be kept for at least two years to ensure their traceability. The imports from companies that had products testing positive will be suspended for one week for the first two times, and for four weeks starting from the third time. 

Vaccinated China

As a precautionary measure, in the Zhejiang province, free influenza vaccination is offered to elderly people over 70, to reduce the risk of having the transmission of influenza, which occurs more in the fall and winter, and Covid-19 at the same period. Learning from the experience of the initial outbreak, efforts have also been placed on upgrading fever clinics to strengthen Covid prevention and control capacity. Chinese cities are getting ready for possible small local clusters in the winter and spring seasons. Upgraded fever clinics in Beijing are now equipped with independent CT scan rooms, isolated wards and nucleic acid test labs, and are divided into safe, contaminated and semi-contaminated zones to prevent infections in the hospital. 

The Covid-19 vaccine is now made available for ordinary people in some places. For instance, in Sichuan and Zhejiang provinces, the vaccine is priced at 200 RMB per dose. Epidemic prevention personnel dispatched overseas are also inoculated before departing from China. Inoculation in China started on July 22 (and in some cases even earlier) under the Chinese Vaccine Administration Law, which authorizes emergency vaccination for special groups of people such as medical personnel, epidemic prevention personnel, border inspectors and those who guarantee basic urban operations. To date, none of the Chinese vaccines has completed phase 3 clinical trials. However, the production capacity of vaccines is being ramped up, as it happened at the beginning of the year with the production of masks. According to the Joint Prevention and Control Mechanism of the State Council, China’s annual Covid-19 vaccine production capacity is expected to reach 610 million doses by the end of this year. The goal is to continue to expand the capacity to meet both the domestic and international needs for the Chinese vaccine. Furthermore, a recent China Briefing op-ed even suggests that Chinese guidelines on vaccination in case of significant clusters are in the making. 

From a Chinese to a global health QR code? 

To facilitate the monitoring and verification of individuals when resuming work and other activities, Chinese tech giants (Tencent and Alibaba) have developed the "Health Code" system with the data support of central and local governments. Users are provided with a QR and color (red, yellow or green) code to prove their eligibility for "free movement". However, the central government allowed different cities and provinces to have their own applications that target adequately the local situation.

Therefore, as cross region movements increase, it has become inconvenient for users to navigate through different standards and systems. Attempts to unify various systems started already back in February, but the fragmentation has not been fully solved. On December 10, a notice requiring the establishment of the mutual recognition mechanism and rules of health code was issued. It aims to facilitate cross-provincial mobility and the creation of the "one health code only" system, so that "health" information can be easily transferred between different regions while traveling within China.

Learning from the experience of the initial outbreak, efforts have also been placed on upgrading fever clinics to strengthen Covid prevention and control capacity.

It seems like China is not only aiming to create a unified health code system at home. Xi Jinping called for a "global QR code system" based on nucleic acid test results to facilitate global travel during the November G20 summit. Further details of the proposed system have not been revealed yet, but it is likely to encounter push backs from countries with data privacy concerns. Observers suggest that China might aim to roll out trials of the scheme with its neighborhood first. 

As the world is now shifting its attention to the development and distribution of the Covid-19 vaccine, and discussion about the emergence of China’s "vaccine diplomacy" (after the "mask diplomacy" that we have witnessed earlier this year), one should not overlook China’s continuous domestic effort in both containing the spread, and capacity building for eventual new outbreaks. In sum, further changes related to Covid-19 will occur in all aspects, even though it appears that life in China is back to normal. China’s model is unique, with its distinctive combination of measures. But some lessons can be learnt from it. Among others, China’s strict lockdown has in fact shortened the length of the containment process required elsewhere (for more details, read Institut Montaigne’s April policy paper, Fighting Covid-19: East Asian Responses to the Pandemic)

 

Copyright : Anthony WALLACE / AFP

 

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