Coronavirus: How the Chinese govt used a 'social nuclear weapon' to fight the virus and bring it under control
The number of new cases has plummeted the last few weeks in China and according to a Yale University expert, the reason is because the country has used a "social nuclear weapon" to fight and halt the spread of COVID-19.
"The Chinese government has essentially used a social nuclear weapon in its efforts. The Chinese have had the most COVID-19 cases so far (80,859), but the number of new cases has dropped from 100's per day a month ago to approximately 46 per day — in a country of 1.4B people. This is an astonishing achievement from a public health point of view," tweets Dr Nicholas Christakis, Sterling Professor of Social and Natural Science, Internal Medicine and Biomedical Engineering, Institution for Social and Policy Studies, Yale University.
According to figures released on March 11, China reported 24 new cases of confirmed infections and 22 new deaths. So far, 80,778 people have fallen sick from the new coronavirus and 3,158 have died in China. The numbers have soared in other countries such as South Korea, Italy, Iran, France, Spain, Germany and the US.
The Chinese National Health Commission also reported that Wuhan — the epicenter of the outbreak in China — closed its last makeshift hospital on the afternoon of March 10, after 15 such hospitals were cleared of patients.
The last batch of 49 patients left the Wuchang makeshift hospital at 3.30 pm on March 10. Wuchang was Wuhan's first makeshift hospital repurposed from the Hongshan Stadium.
"We can get a sense of how strong something is by getting a sense of what sort of force is required to stop it, to borrow a Newtonian physics metaphor. COVID-19 requires a powerful force to stop. This is clear from the Chinese response," says Dr Christakis.
The action
On January 23, Chinese officials shut down travel in and out of Wuhan, including closing the airport. Subsequently, China enforced lockdowns in other affected cities. This placed at least 50 million people under a mandatory quarantine.
"We quantified what the Chinese government has been able to achieve. Beginning January 23, they imposed movement restrictions (typically with people staying at home, leaving just once a week) on provinces with >930M people," says the analysis by the Yale University researcher and his team.
The imposition of "such public health measures on such a scale for such a duration" has never been seen before, says Dr Christakis. According to him, these aggressive measures and widespread responses can be attributed to an authoritarian government in China.
"China has a collectivist culture and an authoritarian government, both of which have allowed this enormous, widespread response. It is well suited to fight a pandemic if it indeed takes in factual information and responds rationally," he says.
The expert, however, warns that the same culture and authoritarian government that has contributed to its success in fighting COVID-19 in China is difficult to reproduce elsewhere. "The USA must prepare to combat the virus using tools at its disposal. It will not be easy," he adds.
Lawrence Gostin, a global health law scholar at Georgetown University, tells Science that "China is unique in that it has a political system that can gain public compliance with extreme measures," but "its use of social control and intrusive surveillance are not a good model for other countries."
Dr Christakis writes that most Chinese cities are still implementing aggressive measures — such as quarantine at the community-level, depending on the severity level of the situation in their cities. "This is called 'closed-off management' by the government and media," he adds.
He explains that common features of "closed-off management" include checking the movement of people and vehicles with an exit-entrance permit, checking the body temperature at the entrance of the community, disinfection of vehicles, food delivery and permits for only one person per household to go out.
Some of the licenses for personal travel in China, for example, have slogans that say, "It is everyone's responsibility to fight the virus," says the expert.
He says that while the Chinese government has started to lift restrictions slowly, it is implementing other inventive procedures, on a large scale. For instance, elevators in a Beijing building only allow four people at a time, as marked by tape on the floor.
"The sign in the elevator says: 'No more than four people in the elevator. Please be patient and wait for the next elevator'. Below, it says 'Let's unite together to fight the virus in this special period'. This type of collectivist slogan is very common throughout China now," says Dr Christakis.
The analysis goes on to say that in many Chinese cities, workers have been organized on a vast scale to deliver food to homes.
"Residents can only go out to shop if they have a permit and shops are open at limited times. In Chongqing, for example, only one person per household can go out shopping, only occasionally," he says.
Schools have moved online. "Jokes circulate: Parents complain to upstairs neighbors: 'Could you please have your kids stop jumping? It is too noisy and our kids are taking an online math class now.' The neighbors reply: 'Oh sorry! But my kids are taking a sports class now'," writes Dr Christakis.
(Hong Gi-won/Yonhap via AP)
The Takeaway
In its report, the World Health Organization (WHO)-China joint mission states that in the face of a previously unknown virus, "China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history."
"The strategy that underpinned this containment effort was initially a national approach that promoted universal temperature monitoring, masking, and hand washing. However, as the outbreak evolved, and knowledge was gained, a science and risk-based approach was taken to tailor implementation,” says the team.
According to the findings, specific containment measures were adjusted to the provincial, county and even community context, the capacity of the setting and the nature of novel coronavirus transmission there.
During a media briefing, Dr Bruce Aylward, team-lead of the mission, says China was able to change the course of the disease due to the country's aggressive response and collective action.
"You know what China did, the real impact that it had? The implications are you can actually affect the course of this disease. You can change the shape of this, but it takes a very aggressive and tough program. It was a striking thing to see. In 30 years of doing this business, I’ve not seen this before and nor was I sure it would work," says Dr Aylward.
"Achieving China's exceptional coverage with and adherence to the 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," says the report.