Monthly Archives: April 2020

Apr 05

What Did China Really Do to Respond to Coronavirus, and Was it Effective? — An actual first-hand report from someone in China

By Mitchell Blatt | China , Living in China , Society

  • China implemented harsh quarantines
  • Forcibly put intercity travelers into 14 day self-isolation
  • Used cell phone data to do contact tracing

You don’t have to believe the Chinese Communist Party. You don’t have to believe the numbers. Just look with your own eyes to see how China responded to coronavirus.

I would just like to give you an explanation of what happened in most of the country—with videos, photos, and first-hand reporting—because I have lived in China for six years, deeply immersed myself in the country and the culture, more so than many reporters and certainly more so than bloggers who have never stepped foot in China who are writing and speculating based on second- or third-hand information.

I stayed in Nanjing during the outbreak, the capital of Jiangsu province in the east, which was not one of the hardest hit regions, but major cities like Nanjing are where hundreds of millions of Chinese people stayed during the outbreak. I don’t claim to know in detail what happened in Wuhan or how many people died, numbers that the C.I.A. is reportedly questioning.

But how many people got infected and died is a separate question from the question of whether China’s conducted an aggressive response. China did in fact enact particular measures that were put in place to limit interactions between people, identify and track cases, and quarantine infected people.

China put Wuhan and sixteen other cities under complete quarantine, and provincial and city governments in enacted lockdowns on many cities. For example, in Hangzhou, only one person was allowed to leave the house every two days to shop for produce. (See my reporting: Zhejiang: Land of Opportunity Under Semi-Quarantine (Thanks to Coronavirus).)

It might be hard for Americans to visualize what it actually means to be prevented from leaving one’s house, because, while 41 states have “stay-at-home” orders (and nine still don’t) in place now, such orders are not practically enforced in most places. While Georgia’s governor Brian Kemp has finally issued a “stay-at-home” order in name only on April 3, for example, the governor forced local mayors to open beaches.

Neighborhood Checkpoints and Individual Quarantine

In China, there were checkpoints set up around residential neighborhoods. People had to be registered before entering or leaving. Not only did the checkpoints manned by “temporary party committees” allow for neighborhoods to be observed and managed, they also allowed the authorities to make sure that self-isolation was observed. Anyone returning from one city to another city after Spring Festival was required to self-isolate for 14 days, and the party members and/or volunteers on the neighborhood committee would make sure of it. (See my reporting: I Am Watching China Wage a ‘People’s War’ Against Coronavirus (65,000 Cases and Growing).)

You can see what the checkpoints look like in my video from the streets of Nanjing. (It’s cued up at the 5:44 mark.)

Now you might look at these fences and the close monitoring of communities as a kind of heavy-handed Chinese authoritarianism. That is a much different response than to deny that China took effective measures.

However, other democracies in Asia also have quarantine regimes that are stricter than in the United States. A man in the country of Taiwan, for example, has been fined $33,000 for breaking quarantine and going to a nightclub. Arriving passengers at Korean airports are being taken to government-specified locations and made to be quarantined.

In the United States, however, passengers from Italy were not so much as having their temperatures checked up until the travel ban was issued on March 14. Americans arriving from Italy to this day still do not have to be quarantined and did not have to track their temperatures on an app with results submitted to health authorities, as was the case in Korea.

When I arrived from China, my temperature was taken at the arrival gate, and I was given papers telling me to self-isolate for 14 days, and I did self-isolate for 14 days, but there was no enforcement mechanism to make sure I did.

Contact Tracing

China also used individual cell phone data to trace the contacts of infected people and quarantine those contacts who had been infected. Again, Americans might protest the use of individual cell phone data as a violation of their privacy—more Chinese authoritarianism—but that is entirely different from suggesting China did not take aggressive measures.

As I said in my video on February 22,

“You can come in [to the park] if you scan the QR code. … The reason you need to scan the QR code is so that if it is found somebody who has coronavirus visited this park, then they [i.e. the authorities] know to get in contact with you and check to see that you are okay or not. … Each [of the three codes] is marked with the name of the phone company: China Unicom, [China Mobile], etc. … If you use the phone signal [as opposed to wifi], they know your phone’s location, they know your phone’s previous location…”

My summary on the spot in the video is in line with what has been reported by both Chinese and American sources:

The Paper: 沈阳在公交地铁部署实名乘车系统,便于寻找确诊病例同车人 (Shenyang’s Metro and Public Transit Dept Develops Real Name Ride Hailing System, Making it Convenient to Find People who Rode in the Same Car as Infected Cases) 

Business Insider: “The country implemented large-scale contact tracing in the early 2000s. … During the SARS outbreak in 2002-2003, China set up large-scale surveillance systems that included contact tracing, a front-line public-health strategy that involves identifying and following up with people who may have come into contact with an infected person.”

Forbes: “China has spent years building a vast surveillance state to digitally track its population, a system that has come to the fore in its attempts to monitor and control the spread of coronavirus. … When coronavirus first hit China, the country repurposed its surveillance state into a contact tracing and quarantine enforcement machine. The infrastructure was in place. Facial and license plate recognition, contact tracing and phone tracking, proximity reports from public transportation, apps to determine quarantine status and freedom of movement, and social media to inform on rule-breakers.”

The Guardian: “Getting into one’s apartment compound or workplace requires scanning a QR code, writing down one’s name and ID number, temperature and recent travel history. Telecom operators track people’s movements while social media platforms like WeChat and Weibo have hotlines for people to report others who may be sick.”

China Travel Writer/CTW Weekly: “Any passengers who rode in train cars with people who were found to have contracted coronavirus are urged by Chinese authorities, in calls promoted in the press, to visit a disease prevention and control center in their hometown.”

Business Insider: “”In America, you have to stay at home, but there’s no police,” said Huang. “There’s no one actively enforcing that rule, but in China, you have what are basically security guards on patrol of every residence to make sure they don’t violate the government containment measures. That’s a kind of approach I think can’t be copied here in the United States.””

Effective Measures

It is clear that taking such measures to close businesses, quarantine people and trace contacts would prevent cases compared to allowing people to continue to congregate in public places and spread the disease. You don’t really need to prove it with science, but scientists have done so, anyway. Twenty-one scholars, including some from the University of Oxford, Harvard, Cal Davis, Peking University, and Hong Kong University, tried to estimate the effects in a report published in Science and estimated that the number of confirmed cases was 96% fewer than “expected in the absence of interventions.” Their study compared data from different provinces, all within China, so that is to say that cities and provinces within China had fewer confirmed cases than other Chinese cities and provinces that acted later or less aggressively. Undercounting of raw numbers wouldn’t affect comparisons of intracountry data if the numbers were undercounted on the same scale in each province.

Could China have done anything to stop coronavirus at the start? Jim Geraghty of the National Review wrote, “According to a New York Times study of cellphone data from China, 175,000 people leave Wuhan that day [January 1].”

Should China have quarantined tens of millions of people before they knew what was happening? No one knew the full extent of coronavirus and how easily-transmissible it was at the time. In some instances, China is criticized for being too authoritarian. But in other instances China is criticized for being not authoritarian enough

(The suggestion that Chinese people were fleeing Wuhan is also unsubstantiated. People leave and enter major cities all the time, and in January everyone was going to their ancestral hometowns for Spring Festival, an annual tradition no different than Americans traveling for Thanksgiving or Christmas.)

(Plus, again, with the fact we only know now that asymptomatic people can transmit the disease, there would have been many people who had no reason to suspect they had the then-mystery virus who were traveling.)

It wasn’t until later that it was found that coronavirus could spread in asymptomatic and pre-symptomatic cases. The fact that it takes multiple days to show symptoms and continues to spread during that period makes coronavirus very different from the virus that caused the 2003 SARS outbreak.

In fact, American media frequently misreported into March that coronavirus probably can’t spread among those who aren’t sick, misinforming many ignorant millennials (and Americans of all ages) who went to bars in Manhattan and beaches in Florida. The American government adopted an arbitrary “6 foot” rule and the Surgeon General scolded Americans for wearing masks. Now scientists report that coronavirus can travel 24 feet, and the CDC is recommending Americans wear masks.

Could it be that we simply don’t know everything about novel coronavirus because it is a newly-discovered virus?

Maybe we should have assumed that coronavirus can travel through coughing and breathing—or at least acted as if it could—just like we should have assumed any disease can be transmitted between humans and taken precautions even before it was scientifically proven.

The Wuhan police did take doctors in for questioning and made them sign statements that they spread “false information,” as I have written. (See my article: Breaking: Wuhan Whistleblower Li Wenliang Awarded $117,000 After Dying from Coronavirus.) 

Anyone who has expertise in the relevant medical and scientific subjects can take a look at this article/timeline by Caixin Global and see if make their determination as to whether China’s policies slowed down the identification of the virus. 

The relevant time periods are from around late December when doctors began to notice and investigate the cluster of pneumonia caused by an unknown source and an as-yet-undiscovered virus that caused symptoms similar to the flu. On December 27, a company sequenced most of the virus and found that it was similar to, but not the same as, the 2002-03 SARS virus. On January 3, China’s National Health Commission “ordered labs to transfer any samples they had to designated testing institutions, or to destroy them,” in the words of the Caixin Global journalists. Two days later, professors at Fudan University identified novel coronavirus, it was reported.

But that day, Professor Zhang Yongzhen of Fudan University in Shanghai received biological samples packed in dry ice in metal boxes and shipped by rail from Wuhan Central Hospital. By Jan. 5, Zhang’s team had also identified the new, SARS-like coronavirus through using high-throughput sequencing. 

Zhang reported his findings to the Shanghai Municipal Health Commission as well as China’s National Health Commission, warning the new virus was like SARS, and was being transmitted through the respiratory route. This sparked a secondary emergency response within the Chinese Center for Disease Control and Prevention (CDC) on Jan. 6. 

On Jan. 9, an expert team led by the CDC made a preliminary conclusion that the disease was caused by a new strain of coronavirus, according to Chinese state broadcaster CCTV. 

The technical aspects of how viruses are tested and how diseases are identified and what kind of regulations should govern labs are topics I know little to nothing about, and I suspect some other journalists and bloggers might not know about those topics either. So I’ll avoid analysis of whether China’s discovery period from late December to January 9 was fast or slow.

If China’s government made mistakes in December and January that might have allowed the virus to spread further than it otherwise would, other countries, including the United States also made mistakes. The U.S. shut down the CDC epidemiologist position, among the responsibilities of which was monitoring and training Chinese to monitor outbreaks, in China in July 2019 and shut down its pandemic response team in 2018. The U.S. also waited longer than nine days to put any kind of travel regulations on flights coming in from Europe or declare a state of emergency when it was already clear that coronavirus had been spreading in foreign countries.

Most countries made some mistakes—particular when viewing responses from hindsight—but to no country could have identified every case on day one and implemented the kind of quarantines on day one that other countries won’t even implement four month later. Debating whether or not the virus could have been contained at this point is all speculation.