WHO Report: China COVID-19 approaches rapid and effective

COVID-19 Identification Classification

A team of international scientists and medical doctors traveled to China in mid-February to investigate the Chinese methods for containing COVID-19. This was before the World Health Organization (WHO) and United Nations classified COVID-19 officially as a pandemic. Following their investigation there were media interviews streamed live by Xinhua News Agency, and a report published on the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Their analysis and evaluation led them to state:

“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. Specific containment measures were adjusted to the provincial, county and even community context, the capacity of the setting, and the nature of the coronavirus transmission there.”

Background

The first Western media exposure on COVID-19 were videos of people suddenly collapsing on streets, sidewalks, and stores. One man fell totally face-down, which made him look like a figure out of a crisis action scene. However, as more clips on the outbreak (known as novel coronavirus pneumonia in China) were uploaded on YouTube, it became clear that these were not dramatizations. Even the first doctor who reported on the new illness in December 2019, and who was admonished for it by the Chinese government, fell victim and passed away.

After Dr. Li’s report caught the attention of Chinese media and many more cases developed in Wuhan, the PRC declared a national lockdown. Coming amid the month-long Chinese New Year celebrations in January 2020, it was clearly a shock. What Western media did not know was that almost from the start, Chinese authorities took aggressive action on containment also because it did not know what it was dealing with. Was the illness a new plague? Was it a released bioweapon? How deadly would it become?

However miraculously enough, by mid-February, China’s actions, including mass quarantines, national lock-down, intensive spraying of chlorinated disinfectants, and a pandemic-control bureaucracy that seemingly arose overnight, as well as the erection of new hospitals or fever clinics, the growth curve flattened and attenuated. However by this time WHO and other nations were becoming aware of COVID-19 cases developing in Italy, Iran, Canada, and elsewhere. Epidemiologists and public health officials in the know knew they had to act quickly and be prepared for its arrival in their own country, so they wanted to study China’s tactics.

In fact, due to the Far East’s experience in dealing with the SARS epidemic of 2000s, China was forced to develop a national pandemic bureaucracy. Even if that bureaucracy had lain dormant, the methods and means were present under the right leadership; and fortunately, President Xi had that kind of experience as well as focus. Everyone in the nation, overnight, were called to abandon their celebrations and instead, focus on the emergency at hand.

Investigative Agenda

The goals of the WHO-China Joint Mission on COVID-19 are stated in the report from the two-week investigation including a week of field briefings and tours. WHO Advisors, medical experts, and public health directors from Switzerland, Germany, Nigeria, Singapore, Korea, Russia, United States, and Japan took part. The mission was led by Dr. Bruce Aylward of WHO and Dr. Wannian Liang of the People’s Republic of China. The team of 25 would gain a detailed understanding of the evolving outbreaks in China; types and effectiveness of rigorous non-pharmaceutical public health measures; the disease profiles and effects on most vulnerable populations; responses and preparedness at national to state and local levels, and within hospital settings; and recommendations or expertise to share with the international community based on what worked; as well as identifying gaps in knowledge, response, readiness, and research.

China Priorities Model

Since the spread of COVID-19 to the United States which began exploding in numbers in mid-March, everyone has become aware of the general nature of this disease. With a two-week average incubation period, recognizable symptoms include fever, dry cough, and difficulty breathing. The illness can present in approximately 8/10 people as merely flu-like or severe flu-like, or even like a cold with ague and fever. However for about 2/10 people, particularly for those with pre-existing conditions, such as cancer, liver, high blood pressure, heart, or weakened immune systems, COVID-19 can become deadly with people developing rapidly severe contagious-type pneumonias.

In China, treatment has included traditional medicines, anti-malarials such as chloroquine, and new medications such as ribavirin are being investigated. (There have been unconfirmed reports by global citizens with various qualifications from homeopathy to medical practitioners that certain medicines, such as taking ibuprofin, can severely exacerbate COVID-19 fever. Various news sources also report that medications such as kratom, hydroxychloroquine, and even ivermectin are tried). However in China most likely therapies are used to reduce pneumonia, and as a last resort more drastic measures such as oxygen hook-ups, and finally intubation to ventilators are applied.

Early and rapid identification made the contagion controllable through use of artificial intelligence platforms and fever monitoring stations. For instance, fever monitoring stations are set up at entrance and exit from apartment buildings, stores, and transit stations. The national intelligence service is able to track phone networks to identify COVID-19 carriers based upon contact with the patient, and place them in self-quarantine. There is a consistent replication of pandemic emergency organization structure patterned from the national levels down to state and municipal levels for rapid relays in daily briefings and new control measures. Cooperation includes using AI and many field researchers for remote counseling, screening, data-gathering, modeling, and mapping of cases and profile descriptions.

The most obvious priority of the government was based in pragmatism: to control the spread, reduce number of cases, and reintroduce people back to work in stages as quickly as possible. In this most Western nations have now adopted the China CDC approach: wash hands frequently, report if there are symptoms, wear face protection, and self-quarantine as needed or required. However the requirement of temperature monitoring stations, and entrance and exit controls are largely nonexistent in the West. In contrast, in China, social distancing and temperature monitoring, as well as travel passes are standard protocol. Again, due to the past SARS and bird-flu type outbreaks, as well as environmental air pollution, the use and donning of face masks and PPE by and among the general population is much more common than in the West.

Figure 5, COVID-19 Classification to Recovery

WHO-China Joint Presentation, https://youtu.be/r8dIi_13COM

International Priorities

The most obvious accomplishment was the cementing of future relationships among a small but committed international group of scientists and health officials for the purpose of studying and containing this kind of epidemic. Shared findings include the genome-sequencing of the virus, although there are obvious knowledge gaps, such as the animal origin and natural reservoir of the virus, the human-animal interface of the original event, and early cases whose exposure could not be identified. There are many risk factors for infection that need to be documented and evaluated, and surveillance and monitoring of outbreaks must continue to prevent re-infection or prepare for seasonality.

Based upon the report, there are many different types of tests and treatments being developed. Ideally pretests should be rapid, for instance, the measurement of the presence of antibodies (called serological tests). (Since the report was issued in February 28, 2020, New York state has developed ten-minute drive-through testing stations). In China, as of 23 February, there were 10 kits approved in China by the NMPA.

Aside from familiarizing themselves with the disease from statistical models and visits to various regional hospitals and clinics, and learning about the disease patterns and progressions as well as treatment options, methods, and outcomes, the state visitors learned how the Communist Party Committee as a political organ can be effective in phasing in prevention and control measures. By recognizing China’s agile and ambitious response, it bolsters the necessary global response in coordination and collaboration. Their recommendations have an emphasis on professionalism and realism:

“Much of the global community is not yet ready, in mindset or materially, to implement the measures that have been employed to contain COVID-19 in China. These are the only measures that are currently proven to interrupt or minimize transmission chains in humans. Fundamental to these measures is extremely proactive surveillance to immediately detect cases, very rapid diagnosis and immediate case isolation, rigorous tracking and quarantine of close contacts, and an exceptionally high degree of population understanding and acceptance of these measures.”

What could be witnessed from foreign video footage is that for the most part in China people were voluntarily cooperative, and that there were few incidents of security personnel using monitoring stations or their general authority to harass or selectively profile or imprison “undesirables or deplorables.” Unfortunately there is a manic cultural fear and distrust of government in the United States, such as among the land poor and urban minorities, due to excessive use of force.

“The time gained by rigorously applying COVID-19 containment measures must be used more effectively to urgently enhance global readiness and rapidly develop the specific tools that are needed to ultimately stop this virus.”

This might imply a willingness to set aside differences, postpone all warring factions, and lift the imposition of all types of economic sanctions; however, one wonders how certain multinationals balk at ceasefires and which profit by sectarianism.

Nevertheless the Joint Mission’s major recommendations embrace an all-of-government and all-of-society approach for COVID-19 containment, prevention, education, management, and recovery. It also prioritizes emergency management protocols, mechanisms, and sharing of information about COVID-19 affected countries. In conclusion it states:

“For the international community, recognize that true solidarity and collaboration is essential between nations to tackle the common threat that COVID-19 represents and operationalize this principle; rapidly share information as required under the International Health Regulations (IHR) including detailed information about imported cases to facilitate contact tracing and inform containment measures that span countries;”

In fact, since February many Western institutions of renown are developing COVID-19 information websites and attempting to coordinate virtual research and developments. States and municipalities have also published press releases and daily updates. However few if any institutions in the United States are recognizing the efforts undertaken in China due to the still ongoing “trade war” with China. Arguably this has also hampered relations in the area of medical diplomacy (presently the U.S. leads the world in COVID-19 with 645,000 cases and 28,600 deaths).

Summary: Five things China did right to contain COVID-19

In the United States, the war general himself is arguably augmenting upon the number of deaths occurring; and a maximum amount of disinformation and distraction, “bread and circus” style, continues to pervade any possible administrative culpability whether from insider profiteering on masks, medical equipment, or testing; even benign negligence to guarantee reduced insurance and pension payouts. The official media is trying to pin the blame on China as the source of COVID-19 and for not doing enough to quickly inform WHO. The PRC media is forced to strike the balance against all smokescreen attacks.

Here is how CGNA tacitly describes the means and methods used to contain the contagion in a way that to date no country has thus far managed to:

https://youtu.be/fvXhcWXfOyg
Resources:
1) World Health Organization, https://www.who.int/health-topics/coronavirus
2) “China has changed course of COVID-19 outbreak: WHO expert,” New China TV, https://youtu.be/r8dIi_13COM
3) “Five things China did right to contain COVID-19,” Facts Tell, CGTN, https://youtu.be/fvXhcWXfOyg


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