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Coronavirus outbreak: As death toll mounts, China enters 'wartime' mode with house searches and round-up of sick

The steps include ordering medical workers to mobilize into round-the-clock shifts to go to each home in Wuhan, check the temperature of every resident and interview close contacts of any infected patients
UPDATED FEB 7, 2020
An empty street in Wuhan, China (Khamis Hassan Bakari via AP)
An empty street in Wuhan, China (Khamis Hassan Bakari via AP)

With the number of deaths and new infections increasing every day, China is in a wartime mode to fight the Wuhan coronavirus. 

The country has reportedly started intense containment measures in Wuhan, Hubei province -- the epicenter of the outbreak -- to check the spread of the deadly coronavirus by ordering house-to-house searches, rounding up the sick and quarantining them in centers.

Stating that the city and the country face wartime conditions, the measures were said to have been announced by Vice Premier Sun Chunlan as she visited Wuhan on Thursday, reports The New York Times. “Set up a 24-hour duty system. During these wartime conditions, there must be no deserters, or they will be nailed to the pillar of historical shame forever,” Sun was quoted as saying by The New York Times.

The steps include ordering medical workers to mobilize into round-the-clock shifts to go to each home in Wuhan, check the temperature of every resident and interview close contacts of any infected patients.

According to the report, the city’s authorities have “raced to meet these instructions” by setting up makeshift mass quarantine shelters. “But concerns are growing about whether the centers, which will house thousands of people in large spaces, will be able to provide even basic care to patients and protect against the risk of further infection,” reports NYTimes. 

A government worker sprays disinfectant on a residential building in Wuhan. (Chinatopix via AP)

China shut down by virus

Wuhan had already been in a lockdown mode. On January 23, Wuhan authorities sealed off the motorways and shut down all public transport to stop the coronavirus outbreak from spreading. Unless residents had a special reason, the government said they should not leave Wuhan, the sprawling central city of 11 million people.

Back then, Wuhan's public health authorities had said they are in a “state of war”. They added, “Strictly implement emergency response requirements, enter into a state of war and implement wartime measures to resolutely curb the spread of this epidemic. Homes must be segregated, neighbors must be watched,” said a committee of Wuhan's top officials, according to NPR. While it may sound unbelievable to quarantine a city of millions, the idea was that such a measure could work because movement within and between cities in China relies heavily on public transport infrastructure.

Shortly afterward, at least 10 other cities in China were under quarantine orders, most of them located in the areas surrounding Wuhan. 

As the number of deaths and infections went up, China instituted the largest quarantine in human history, locking down more than 50 million people in the center of the country. Those who have recently been to Wuhan were being tracked, monitored, turned away from hotels and placed into isolation at their homes and in makeshift quarantine facilities.

A security guard takes the temperature of a customer at the entrance of a Walmart store in Beijing.
(AP Photo/Mark Schiefelbein)

On January 25, a televised meeting of the Politburo Standing Committee, China’s ruling inner circle of power, ordered officials to carry out “prevention and control work”. The emphasis was on “monitoring, screening, and warning.” Since then, millions of local officials and officers have mobilized to monitor, screen and warn — and restrict, to varying degrees — in a governance approach that Beijing calls “blanket-style tracking,” reports AP.

Despite these stringent measures, the number of infections and deaths have gone up steadily. The World Health Organization (WHO) also declared the novel coronavirus outbreak a public health emergency of international concern.

According to current estimates released by China’s National Health Commission, there have 31,161 reports of confirmed cases and 636 deaths so far. This includes 73 new deaths -- 69 in Hubei province, 1 in Jilin province, 1 in Henan province, 1 in Guangdong province and 1 in Hainan province -- in the past 24 hours. 

Further, in the last 24 hours, China has reported 3,143 new cases of confirmed infections (including 2,447 in Hubei province), 4,833 new cases of suspected infections (including 2,622 in Hubei province), and 962 new serious cases (including 918 in Hubei province). “There still remained 28,985 confirmed cases (including 4,821 in serious condition) and 26,359 suspected cases. So far, 314,028 people have been identified as having had close contact with infected patients. 186,045 are now under medical observation,” said the Commission.

Many experts believe that deaths and infections in China are undercounted because hospitals and laboratories are under severe strain to test for the virus. 

Will these measures work?

The final verdict is not out yet on whether such intense quarantine measures will work in containing the spread of the disease. China’s extreme quarantining has already been questioned, and some experts believe such measures could also be disruptive.

In this January 28, 2020 file photo, a man wearing a face mask waits for his food at an empty restaurant in Beijing. (AP Photo/Mark Schiefelbein, File)

According to one expert, though effective, sealing off an entire city or region should always be a last resort. “It will surely have a negative social impact and damage the economy,” said Fei Chen, Senior Lecturer, architecture, University of Liverpool, in The Conversation.

One study, which looked at such containment efforts after the H1N1 influenza outbreak in 2009, said that such efforts may not help.

“After the emergence of H1N1 influenza in 2009, some countries responded with travel-related controls during the early stage of the outbreak in an attempt to contain or slow down its international spread. These controls along with self-imposed travel limitations contributed to a decline of about 40% in international air traffic to/ from Mexico following the international alert. However, no containment was achieved by such restrictions and the virus was able to reach pandemic proportions in a short time,” said the study. 

Vageesh Jain, NIHR Academic Clinical Fellow in Public Health Medicine, UCL, argues that such a “geographical lockdown of this magnitude is not just superfluous” but also introduces new health problems into the mix. “Some, looking in from the outside, may welcome mass quarantine. But in reality, it is no better than the usual public health response of isolating cases and potentially high-risk contacts of cases. Going further to isolate those who have any theoretical risk of disease may allay public fear and provide the illusion of intervention, but it cannot be considered an evidence-based practice,” he wrote in The Conversation. 

Nicholas Evans, a bioethicist at the University of Massachusetts in Lowell, told Stat News that quarantine measures could lead to more cases of the infection since one is “essentially locking someone up with someone else” with the disease. 

During the 2003 SARS outbreak, Canadian officials in Toronto quarantined 100 people for every case of SARS. A CDC analysis later found that the maximum number of people who should have been quarantined per SARS case was four, reports Stat news. 

The key is to keep the people informed as to why such intense steps are being taken. “An integral part of any public health response has to be accurate and frequent communication. Fear and misinformation can be more harmful than the virus we are fighting against — it’s important to focus on the facts about the virus and the risk [to the public],” said Dr. Oxiris Barbot, New York City’s public health commissioner. 

The World Health Organization (WHO) published a report on managing epidemics in 2018, in which it recommends revisiting traditional control measures. “We have also seen that many traditional containment measures are no longer efficient. They should, therefore, be re-examined in the light of people’s expectations of more freedom, including freedom of movement. Measures such as quarantine, for example, once regarded as a matter of fact, would be unacceptable to many populations today,” said the report. 

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