COVID-19: How did Wuhan do it?
First epicentre of health crisis shows way to mass testing, recovery
Highlights
- Wuhan is the city from where COVID-19 emerged, and triggered an unprecedented global health crisis.
- Initial containment actions floundered — as doctors, who blew the whistle about “atypical pneumonia”, were muzzled and punished by local officials.
- The officials were replaced and punished; the new executives appointed took deliberate actions to push the virus back.
- Wuhan, a city of 11 million, is returning to "normal" but its approach is not necessarily replicable everywhere.
- Without a good vaccine, the economy of Wuhan, and the rest of the world, is likely to go on prolonged uncertainty.
- Seeking an answer to the biggest question of them all — did the coronavirus come from nature, or leaked from a lab? — could only start in Wuhan.
DUBAI: Many Wuhan residents still feel sad talking about the pandemic. Chinese media reported that the pandemic claimed more than 4,500 lives in the city.
The situation, however, is slowly getting better. Emblematic of Wuhan story is Wakanda Youth, a Starbucks wanna-be with several shops in Hubei's provincial capital.
It operated a chain of coffee shops, each selling around 500 cups a day pre-COVID. During the 76-day lockdown (starting January 23, 2020), all of Wakanda’s shops were shut. On April 8, when the COVID-19 lockdown was lifted, Wakanda re-opened some.
It’s been more than 100 days since the lockdown was lifted. It now operates two shifts, but business is nowhere near pre-COVID times. Meanwhile, Wakanda staff deliver 500 free cups of coffee to nearby hospitals daily. This spirit of community has become part of Wuhan's new reality.
Wakanda’s story offers a window into life in the city today, as told by state-run media outlet CGTN, in a sort of charm offensive. As of July 16, 2020, Wuhan is slowly returning to “normal”. Traffic on the roads is back. People are shopping and offices humming. Residents say the fear is gone, only inconvenience.
Dead man on Wuhan street
It's a far cry from the day the world saw the haunting picture of a dead man lying on the street of Wuhan. No one dared touch or help him — for fear of being infected. That was January 31, 2020.
The dreadful sight is iconic of the health crisis that followed. Hubei accounted for most of China's 85,921 coronavirus cases and 4,653 deaths.
The media described the lockdowns in Wuhan (with its 11 million inhabitants) as “draconian”. Later, the same sort of measures swept the rest of the world, like a wave.
From Wuhan, the virus has spread to over 210 countries and territories, bringing the world’s economy to its knees. As of July 27, 2020, the coronavirus has killed nearly 650,000 people, with confirmed cases crossing 16.3 million. The US, Brazil, India, Russia and the UK are the hardest-hit countries.
Meanwhile, a ruckus erupted, especially after one of the Wuhan whistle-blowers, Dr Li Wenliang, died of COVID-19. Wuhan hosts two major high-security biosafety research facilities that studied bat coronaviruses.
From mid-January 2020, as it emerged that no drug seemed to work against the illness, Beijing shut down domestic flights from Wuhan, though flights to the rest of the world remained open.
From there, the narrative became muddled. The Chinese government and WHO told the world the virus emerged from a Wuhan wholesale seafood market. Two studies published by Chinese scientists contradicted this Beijing-WHO narrative.
Warning against cover-up
It is public knowledge that Wuhan hosts two major high-security biosafety research facilities that studied bat coronaviruses. At least previous incidents of SARS virus "escaping" from a high-security lab in Beijing were reported in 2004.
Meanwhile, in early 2020, a ruckus erupted after one of the Wuhan whistle-blowers, Dr Li Wenliang, died of COVID-19.
Beijing acknowledged the snafu, especially the muzzling of doctors. On January 21, 2020, China's top leaders warned lower-level officials not to cover up the spread of the novel coronavirus, with a grave threat to anyone who does it.
Anyone who concealed new cases, Beijing warned, would be nailed on the pillar of shame for eternity.
Anyone who concealed new cases, Beijing warned, would "be nailed on the pillar of shame for eternity".
On February 13, 2020, President Xi Jinping sacked Hubei's provincial leadership.
To stem any further damage, the city marshaled its quick-build capabilities, building a new 1,000-bed COVID-19 hospital in 10 days.
Quarantine ends
On March 24, Wuhan reported no new cases for a week. On April 8, 2020, after a 76-day lockout, the Chinese government ended Wuhan’s quarantine. It was seen as triumphant moment for China.
Technology played a key role in contact tracing: Anyone who has a "green" code on a widely-used smartphone health app was allowed to leave the city.
As factories and offices resumed operations, however, consumers were slower to return. The residents were cautious.
In May, the restrictions came back. As people started to venture out more, a spike in infections again put the city in danger, despite social isolation.
Testing a city’s population on a broad scale posed a logistical nightmare, yet the new city officials were undeterred.
In the early weeks of the outbreak, the Chinese government struggled to find enough testing kits. Now, it has ramped up testing capacity. Residents lined up under red tents to get swabbed.
To implement mass testing, here's what city officials did, among others:
- The city reportedly spent hundreds of millions of dollars for COVID-19 mass testing
- Officials mobilised thousands of medical and other workers for a city-wide campaign to curb new infections.
- Wuhan medical workers with test swabs went everywhere — construction sites, markets and on door-to-door visits to reach older residents.
- Officials warned in public announcements that residents who refused to get tested would see their government-issued health codes downgraded, potentially limiting a person’s right to work and travel. Other disincentives for those refusing to get tested: not being allowed to enter supermarkets or banks.
- Those who refuse testing would have their "green" code will turn "yellow", causing a major inconvenience.
- The local government tested the total population of 11 million in just two weeks.
- Since then, the city has not reported any cases.
- The government did not charge residents for the tests.
Result: Samples pooled, 90% covered
To speed up the process, lab technicians pooled samples together to be tested in batches. The government, keen to restore public confidence to restart the economy, has covered the cost of extensive tests.
Results were published within two to four days and effort has largely succeeded. For example, on June 1, 2020, of the 60,000 people tested, no cases of asymptomatic infections were found.
The drive has reached more than 90% of the city’s population. The test results confirmed that Wuhan has indeed tamed the outbreak.
It’s not be a straightforward success: the tests found some 200 cases, mostly asymptomatic.
International media reports acknowledge that Wuhan’s mass testing may have eradicated the coronavirus. The all-out campaign paid off. Six months out, Wuhan has been declared "COVID-free".
1.47 million tests in one day
Laboratories reportedly went from processing around 46,000 tests a day, on average, before the drive, to as many as 1.47 million tests in one day.
This is in contrast to, say, New York, which has tested 1.7 million people since March 4, according to COVID Tracking Project.
How crowding was avoided
Health authorities elsewhere have given the lame excuse that testing is "useless", stating anyone could be COVID-free today, and test positive tomorrow.
Some Chinese experts also criticised Wuhan's resolve, saying it’s impossible to accurately test that many people in such a short period. Even the chief epidemiologist of China’s Center for Disease Control and Prevention, Wu Zunyou, suggested that it is "not necessary" to test everyone.
The Wuhan government heard none of that. To ensure the testing drive would not be a source of infections, city officials did the following.
- ■ The tests were organised systematically and in an orderly fashion.
- ■ Each resident was given a time slot to avoid crowding.
- ■ Testing was conducted in open spaces.
- ■ Residents had to have their temperatures screened, wear masks and keep a distance from one another.
- ■ Medical workers were required to change or disinfect their gloves after each test.
Wuhan’s approach may not be necessarily replicated everywhere. However, the key to this mass testing is the "Wuhan solution" — through an efficient "batch testing".
How Wuhan's batch testing worked
Wuhan health official devised an innovative batch testing method, simply by combining a number of swabs from different people into a plastic tube to be analysed — using just one test.
A negative result means all the samples from one batch can be cleared. Now, if the batch comes back positive, medical workers can return to each person in the group to test them individually.
In Wuhan this method worked incredibly well, because the rate of infection was already low. In places infections are high, this may not be possible as most of the groups would have to be retested.
Now, in certain places in the US, like the San Francisco Bay Area, this batch testing method has been adopted, though not at the same scale as Wuhan. Meanwhile, Beijing district also announce they will adopt the Wuhan batch testing method -- with teachers and students -- in batches of three prior to school reopening.
Recovery
Following the coronavirus disaster, in Wuhan’s recovery guaranteed? Will it rise again? To be sure, the coronavirus is neither the first nor the last disaster to hit China.
The country is one of the countries most affected by natural disasters. It had six of the world's top 10 deadliest natural disasters. The top three hit China hardest:
- 1931 China floods (death toll up to 4 million)
- 1887 "Yellow River" flood (death toll up to 2 million)
- 1556 Shaanxi earthquake (death toll 0.83 million)
Harvard economist Yukon Huang, also former country director of the World Bank in China, has said conventional wisdom on China is "often wrong".
In his book, Cracking the China Conundrum" Huang laid down an in-depth analysis of the dynamics at play in China’s economic growth and sheds light on why so many China watchers have missed the big story.
Will China’s rapid growth and transition towards a market-oriented economic system — coupled with a major disaster — lead to massive changes to the Chinese political and social system?
Huang does not believe so.
Even if growth slows, or goes into negative territory, he said the economy remains fundamentally sound. A mighty China, which makes most of the things the world needs, is something the world must learn to accept — or match with innovation, he said.
Local protests, which the Chinese Communist Party count in the thousands each year, does not erode the party’s power, argues the Harvard professor. Instead, he explained, the protests tend to be about domestic issues or localised corruption: in reality, they are appeals to the central government in Biejing, to intervene, make things better and save the day.
That seems to be what had happened in Wuhan, community protests led to the dismissal of the city government leaders who initially tried to silence the local doctors who blew the whistle on the coronavirus.
And the bold moves by local executives who replaced them seems to have made things better in the city, even as the world struggles to cope with the disaster that jumped from its bosom.
TAKEAWAYS
- The coronavirus pandemic emerged in Wuhan, and went on tormenting the rest of the world.
- Pandemics had occurred in the past, including the Spanish Flu, which killed multiple-fold millions more (1918-20), as well as Ebola (1976, re-emerged in 1994), SARS (2002), and MERS (2012).
- If reports about Wuhan’s turnaround is true, and can be verified, then the city may have indeed demonstrated what it takes to overcome a plague.
- Even in today’s hyperconnected world, certain situations can remain shrouded in darkness, even those that directly affect us all.
- Instead of trade or travel, there is only torment — and an utter inability to comprehend why this is so.
- Science cannot always explain everything here and now; it’s one of those things when all can do is lament.
- With greater collaboration, scientists may be able to do ferret out the answers sooner, instead of later.
- As we weep within, cocooned in frustrating self-isolation, so can we only wonder and beg for healing — of a world infected by virulent mistrust.
- Perhaps, as Wuhan has demonstrated, out of this darkness, there will emerge a whole new world of possibilities, a reset of our common humanity.