UpakarPoudel
Chinese hospitals overflowing with COVID-19 patients a few weeks ago now have empty beds in all corona isolation Hospitals in Wuhan. Trials of experimental drugs are having difficulty enrolling enough eligible patients. And the number of new cases reported each day has plummeted the past few weeks.The spread of the novel coronavirus has led governments across the world to implement extraordinary measures to rein in the pandemic and cushion its serious economic impact. Worse, while the daily growth of local cases in China has been kept to double digits for days, the increase of cases outside of the country is still in its explosive stage, and shows no signs of abating, particularly in the United States and the worst-hit countries in Europe and the Middle East.Despite the unmistakable seriousness of the situation, some countries have tried to play down the risks, and the measures they have taken are not only insufficient to control the pandemic at home, but also not enough to prevent themselves from being the source of virus transmission to other countries.What was framed as a disaster for the Chinese government at the start of the pandemic has now earned it plaudits for arresting the spread of the virus within the country and for demonstrating its international leadership in supporting the rest of the world. This U-turn has shown China’s capacity for administrative enforcement and campaign-style mass mobilisation to combat the epidemic.
• Though the coronavirus was first discovered last year in the city of Wuhan, where officials initially tried to cover up the outbreak, China has sought to emphasize the positive role it has played in controlling the global spread of the disease. With the number of new domestic cases dwindling, China has now turned its attention to controlling new infections coming into the country from overseas, where the pandemic continues to spread. Hangzhou, the capital of Zhejiang Province, reacted quickly to COVID-19 before the city had any confirmed cases.
• The city used big data and information technology, like QR codes, to track and stop the spread of the coronavirus.
• Careful planning and clear communication lessened the impact of COVID-19 compared to Wuhan.
As COVID-19 continues to spread around the world, the measures implemented in China may be instructive for other countries now struggling to control the virus.
Hangzhou, the capital city of Zhejiang Province, more than 1,000 miles away from Wuhan, the epicenter of COVID-19, implemented multiple control and prevention measures from the very beginning of the outbreak.
Here, what we must learn From China
Strong Leadership
After the outbreak of the epidemic, the Central Committee has attached great importance to the issue and made swift deployments. Government authority officially personally commands the people's war against the epidemic. They have been paying constant attention to the epidemic prevention and control work and made oral or written instructions every day.
Timely Strategy & Political Courage.
Under Authority command China launched a people's war against the epidemic, with Wuhan and Hubei as the main battlefield. Lines of defense were set up. Personnel and resources were mobilized across the country. On curbing the spread, early detection, reports, quarantine and treatment are stressed. On treating patients, pooling together patients, experts, resources, as well as centralized treatment are underscored. All urban public transportation, including city buses, ferries and metro lines were suspended and outbound channels at the airport and rail stations closed in Wuhan, home to more than 10 million people. China took "serious measures at the epicenter, at the source," which not only protected Chinese people, but also prevented the spread of the virus to other countries. “Because of this strategy, if it weren't for China's efforts, the number of cases outside China would have been very much higher.
Keep the public well informed
China has provided continuous, clear communication to the public. In Hangzhou, for example, the major news outlet provides daily updates on the number of COVID-19 cases and clinical treatment outcomes, plans to be implemented and guidelines and procedures to follow. As the nation-wide lockdown runs into its 4th week, the Government of Nepal – at all three tiers – and humanitarian partners including UNICEF, have been gearing up efforts to prevent the local transmission of COVID-19 among communities. Concerns are especially high in the SudurPaschim and Karnali Provinces, given the number of cases that have tested positive in the former recently, and the high inflow of people returning from India and other countries into the latter public should be made alert. Zhejiang University School of Public Health has been fully engaged since the beginning of the outbreak. They developed an easy-to-understand educational materials for students and the public with information about COVID-19 and how to prevent the spread. They speak on television news and write online papers. They believe it’s the responsibility of all public health experts to provide factual and scientific information to people and to lead the way in fighting the disease.
Speed and accuracy are the keys to identification and detection
Within a week of identifying the unknown virus, China successfully sequenced it and reported the genetic information to the World Health Organization (WHO). In comparison, it took a couple months for SARS to be identified and sequenced in 2003, and a few years in the case of HIV in the 1980s.The identification of a virus’s genetic sequence is critical to develop a vaccine and therapeutic treatments. The rapid identification of COVID-19 allowed scientists around the world to immediately start developing test kits, treatment options and vaccines.
One of the critical tools in controlling a major epidemic is having specific, reliable, accurate and fast detection methods to screen infected and non-infected people. During the early days of the outbreak in Wuhan, there were no test kits available, and screening depended on laboratory nucleic acid sequencing analysis, a labour-intensive and costly method. The National Medical Products Administration of China took immediate action to speed up the work of biotech companies to develop detection kits. The first kit was introduced on 13 January, with a sufficient supply available two weeks later.
Government should made the right decisions at the right time, the right place, for the right people.
The experience in China reinforced the importance of listening to science, Doctor’s, Health workers and public health experts during pandemic events. And overreacting is better than not reacting.
China’s unprecedented systematic and proactive risk management, based on collaboration between government officials and health experts, has proven to be effective in containing and controlling COVID-19 but in our country Nepal doctors will be punished if they haven’t answer the phone of leaders during their duty time as they were beaten by the police force while returning to duty from home.The timely release of disease-related clinical data to the public and WHO helped many around the world prepare for the spread. For example, analyzing more than 40,000 cases in China, we know 80% of COVID-19 infected patients won’t need medical intervention, while 20% would need medical treatment and care. More cases must be tested as soon as possible to overcome the pandemic spread
Zhejiang Province was the first to raise the risk management response to the highest level in the early days of the outbreak, when there were no confirmed cases.
Here are lessons from china’s Province to control the spread of COVID-19
• Provide clear guidance about the degree and scope of lockdowns to all.
• Track implementation down to individuals, apartments, houses, communities, organizations, public facilities and city management.
• Keep essentials like food and supplies flowing through organized, government-controlled arrangements.
• Designate infectious disease care and management facilities to isolate, monitor and treat positive cases.
• Establish electronic recording and tracking systems and local response teams to handle identified cases 24/7.
• Establish centralized reporting and communication channels to keep citizens informed.
Big data and information technology are important to avoiding a rebound
Hangzhou, where Alibaba is headquartered, was one of the first cities to use big data and information technology in the prevention and control of COVID-19. They named the approach “one map, one QR code, and one index.”
It’s been two weeks since select businesses and organizations have been allowed to reopen to workers. Here are policies they implemented:
• Businesses reopened in several phases based on priorities. For example, healthcare-related facilities were allowed to open first.
• Restrictions were eased based on track records.
• Health QR codes were established for everyone in the city and everyone who entered the city. The green code allows you to move freely. The yellow code requires a seven-day self-quarantine. The red code requires a 14-day self-quarantine. The yellow and red codes can be turned green after the quarantine time. This health surveillance system has been applied in most cities in Zhejiang Province, and will be implemented in other provinces.
• Each individual must monitor and record their temperature and update their profile daily in order to maintain their health status level.
Evaluate medical resources and response systems of country. Are we ready for a pandemic? How much stock do we need? Do we have enough health care personnel, and how do we protect them?
People in China are courageous and united in the effort to combat COVID-19. The higher mortality rate in Wuhan was attributed in part to the lack of medical resources available at the time of immediate need. Wuhan’s lack of disaster control management response mechanisms led to poor disease containment, widespread cross-infection in patients and healthcare workers in hospitals and weeks of chaos.
In drastic contrast, government officials in Different Province were well prepared to mobilize immediately and allocate resources and manage and monitor the evolving epidemic in a proactive fashion with impressive results. In Hangzhou, 204 public health physicians have been investigating cases, identifying close contacts, and making sure they remain under surveillance. Also in Hangzhou, doctors completed the world’s first double-lung transplant surgery on a COVID-19 patient.
The shortage of protective medical supplies and lack of knowledge about COVID-19 were the main factors causing the large number of healthcare workers to contract the virus in the early weeks of the outbreak in Wuhan. Over the past 6-8 weeks, however, 31 medical teams consisting of more than 42,000 doctors and nurses were sent to Wuhan to combat the outbreak. (Zhejiang Province sent 1,985 healthcare workers and, as of today, not one is infected.) Two new hospitals with over 1,000 beds each were built in less than 10 days in Wuhan.
At the same time, however, we also need to consider other types of patients suffering from major non-infectious epidemiological diseases such as cancer, hypertension and diabetes.
Implementation of preventive measures in communities, schools, businesses, government offices and homes can influence the trajectory of this epidemic.
In fighting COVID-19, everyone is equal. Everyone has the same responsibility and shares the same risk. COVID-19 is very contagious and capable of asymptomatic spread, so it’s even more important to mobilize all of society and get everyone involved in the process. The successful implementation of prevention and control measures in China, a city of 10 million people, is an example for other parts of the world to follow. Again, the key to success is to make everyone responsible, get every unit involved and hold officials accountable. We also need to change how we have been living and be responsive to new challenges.
Careful planning and clear guidance are helpful. China has allowed employees to go back to work in several phases. Many businesses, organizations, schools and universities are successfully implementing computer-based online learning using technology like Zoom meetings, which could be models for future development.
During an epidemic, it’s advisable to avoid large gatherings and multiple person-to-person contacts. China might have lost billions of dollars by essentially stopping all business, but in the end, this will have been a wise decision and correct action.
- Poudel is a Radiological Technologist.