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Has China Really Stamped Out Its Coronavirus Crisis?

People wearing protective masks in a subway tunnel during evening rush hour in Beijing on March 10.
People wearing protective masks in a subway tunnel during evening rush hour in Beijing on March 10.

Words like "draconian" and "Mao-style social controls" have been used to describe Chinese officials' restrictions on society in central China in their battle against the deadly coronavirus.

Few would disagree that once Chinese officials fully acknowledged the danger posed by the coronavirus and accompanying COVID-19 illness -- many accuse them of initially covering up a key insight into the outbreak in Wuhan in January -- they ruthlessly quarantined, isolated, and surveilled hundreds of millions of citizens.

On March 20, WHO Director-General Tedros Adhanom Ghebreyesus said that "Wuhan provides hope for the rest of the world, that even the most severe situation can be turned around."

It was, in the words of a joint UN-Chinese mission of epidemiologists, "perhaps the most ambitious, agile, and aggressive disease containment effort in history."

And, some argue, something that could likely only be done in an authoritarian country like China.

But evidence made available this week suggests that the harsh measures worked -- at least for now.

A major breakthrough was marked in China's three-month epidemiological battle with the previously unknown virus on March 18, when official figures showed no new local transmissions of the coronavirus and only a few dozen new cases, all of them infections that came from abroad.

One day later, with governments elsewhere still rushing to tighten societal controls as the global pandemic raged, the COVID-19 death toll in Italy alone eclipsed the 3,245 killed by the disease so far in China.

Chinese scientists even asserted on March 19 that a new study in Wuhan showed an average symptomatic patient's chance of dying was 1.4 percent, "substantially lower" than some indicators had previously suggested.

Six other countries -- Italy, Spain, Germany, the United States, Iran, and France -- now have a higher number of active COVID-19 cases than China -- where 71,150 people had recovered by March 20 and 6,569 were still fighting the disease.

Collectively, the news appears to buttress the confidence expressed in a "final report" by the joint mission of World Health Organization (WHO) and Chinese infectious-disease experts on coronavirus and COVID-19 that raised eyebrows for its seemingly effusive conclusions.

"China's bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic," the mission reported in late February, with the rate of new infections in China cresting and cases in Italy -- which was destined to become a new European epicenter -- just starting to creep out of the single digits.

Second Wave?

But even amid such praise and signs that 1.4 billion Chinese have cleared a major infectious hurdle, experts caution that intermittent returns to mass lockdowns there are nearly inevitable for at least the next year.

A second wave of infections is likely, they say, in China and anywhere else that manages to stifle the initial outbreak, which by March 20 had afflicted more than 250,000 people worldwide and killed more than 10,500.

"Of course, we must exercise caution -- the situation can reverse," the WHO's Ghebreyesus added.

The recent good news also threatens to overshadow harsh criticism of Chinese officials' alleged refusal to share potentially lifesaving information with outside scientists and the country's public as the outbreak ballooned from the first confirmed case on December 1. It was also admonished for its censorship of citizen warnings and punishment of those who spoke out when time was of the essence to blunt the outbreak.

Such warnings and criticisms have not prevented Beijing from turning outward to offer expertise and deliver planeloads of masks, ventilators, and other medical equipment.

A nurse attends to a baby with COVID-19 at an isolation ward in Wuhan Children's Hospital on March 16.
A nurse attends to a baby with COVID-19 at an isolation ward in Wuhan Children's Hospital on March 16.

Within a month of its peak infection rate, China and some prominent Chinese citizens have mostly pivoted from infighting and finger-pointing over perceived failures at containing the budding pandemic to pledging or providing assistance to the United States, Europe -- which WHO calls the outbreak's current "epicenter" -- and other populations around the world.

It is part of what has been described as a "coronavirus propaganda war" fed by what Politico says is "a not-so-subtle PR campaign" from Beijing.

That has been countered in the United States by reminders that include fostering a semantic spat amid some officials' insistence, particularly within U.S. President Donald Trump's administration, on referring to it as "the Chinese Virus."

"Look, the disinformation campaign that [Chinese officials] are waging is designed to shift responsibility," U.S. Secretary of State Mike Pompeo, who has repeatedly called the coronavirus the "Wuhan virus," told reporters on March 17.

He went on: "We know this much: We know that the first government to be aware of the Wuhan virus was the Chinese government. That imposes a special responsibility to raise the flag, to say, 'We have a problem, this is different and unique and presents risk.' And it took an awful long time for the world to become aware of this risk that was sitting there, residing inside of China."

New And Unfamiliar Foe

The coronavirus is thought to have first jumped from animals to humans around the third week of November 2019, according to genetic analysis, with the first cases spotted in heavily populated Wuhan, in Hubei Province.

There are no approved vaccines for the easily transmissible coronavirus, and treatment of the pneumonia-like COVID-19 illness that it causes is so far limited to supportive care and experimental stabs with existing agents.

Any widespread introduction of a proven, safe vaccine is still at least a year to 18 months away, most experts say.

In late January, much of the focus was on China's secrecy as outsiders tried to assess the global threat.

China's ruling Communist Party acknowledged on February 3 -- when the death toll was around 400 and new infections were mounting rapidly -- that the outbreak would be "a major test of China’s system and capacity for governance."

The Communist Party this week publicly condemned officials' treatment of a doctor who recognized the significance of the coronavirus outbreak soon after its outset.

A photo of Wuhan's deserted streets taken on March 10.
A photo of Wuhan's deserted streets taken on March 10.

Opthamologist Li Wenliang was himself infected in early January and died of COVID-19 a month later, after protesting at the apparent unwillingness of officials to acknowledge the rapidly spreading problem. But his online protests helped raise a public hue and cry against official secrecy and silence, and appeared to help shake Chinese officials into action.

In early February, with coronavirus infections spiking in China and spreading to more than a dozen other countries, tens of millions of Chinese were tuning in to a state-owned CCTV live stream of the whirlwind, 10-day construction of hospital facilities to house around 2,600 COVID-19 patients.

More around the world watched the Wuhan Huoshenshan Hospital and Leishenshan Hospital projects via news agency feeds. Chinese viewers gave construction equipment relatable nicknames like "Little Yellow" and "Little Blue," according to Nikkei Asian Review, but it was a clear official signal of the urgency of the situation and the perilous days and weeks ahead.

"While it is probably fair to say that China's initial denial of the seriousness of the coronavirus outbreak centered in Wuhan allowed that city to be widely infected, they eventually put very stringent public health measures into place, including an almost complete 'lockdown' of that city and others in China," Dean Winslow, infectious-disease physician at Stanford Health Care in California, told RFE/RL.

Caught In The Middle

The big Chinese clampdown combined aggressive quarantines, ruthlessly enforced lockdowns, and invasive surveilling through cutting-edge "big data" tools and artificial intelligence.

Even the WHO's Ghebreyesus, in the "congratulating" Chinese response he gave in January, stressed the antivirus measures' "severe social and economic impact...on the Chinese people."

The New York Times calculated that at least 760 million Chinese were subjected at some point to a degree of household isolation.

Facial-recognition, artificial intelligence (AI), and other "big data" efforts were also a focus to achieve what WHO described as "contact tracing and the management of priority populations."

Human Rights Watch (HRW) complained loudly about the heavy-handedness of the Chinese lockdown, arbitrary detentions and other brutality, and the unfolding measures' list of unintended victims, including a disabled boy who died from neglect after his relatives were forced into quarantine.

HRW urged restraint by Beijing in a January 30 report, China: Respect Rights in Coronavirus Response.

Haunting tales emerged of the tight thermal imaging, facial recognition and AI software, and other surveillance efforts being used by China.

One Hubei restaurant owner was visited late night by police when he returned from the coronavirus hot spot to his home in Sichuan so they could order him to quarantine himself for two weeks, Al-Jazeera reported. When he went out to pick vegetables, he was quickly chased down by police who'd clearly employed neighborhood cameras and facial-recognition tools to spot his transgression.

'That's Not Strict'

From France to the Czech Republic and even Italy, officials outside China have grappled more publicly with the trade-offs between the need for monitoring and for the public to observe "social distancing" and other public protections, on the one hand, and a reluctance to seem heavy-handed in their enforcement on the other.

During an information-sharing visit to northern Italy on March 19, visiting Chinese Red Cross official Sun Shuopeng boasted of Wuhan's "decreasing trend" of infections "after one month since the adoption of the lockdown policy" there. "Here in Milan, the hardest-hit area by COVID-19," he said, "there isn't a very strict lockdown."

One of the leading criticisms of the Chinese response and its feasibility for the West has been that pulling off the same degree of invasiveness and control would be difficult in societies where personal liberties and professional ambitions are more robustly protected.

"There has to be a balance between protecting people's lives and their livelihoods," Time magazine quoted an infectious disease expert at the University of Hong Kong, Ben Cowling, as saying.

Other critics draw a parallel between Chinese officials' uncompromising approach to public lockdowns and evidence that they initially covered up evidence of the animal-to-human infection that started the outbreak, whitewashed increasingly disturbing figures on its spread, and failed to adequately inform the public of the risks.

Word that authorities shuttered the Shanghai laboratory that made one of the most significant scientific breakthroughs as the coronavirus outbreak was mounting into a pandemic for "rectification," has already fed accusations of a continuing cover-up. Officials did not explain the closure, which came the day after the lab published the coronavirus's gene sequence on an open platform.

"I thought there was no way those numbers could be real," Science magazine quoted Tim Eckmanns, epidemiologist at the Robert Koch Institute in Germany and a member of the WHO-China mission, as saying in connection with their fact-finding.

Just One Battle

The mission concluded in that instance that indeed the "decline in COVID-19 cases across China is real," and this week's statistics seem to bear that out.

But whether it will stay that way remains a major question for China and the rest of the world as efforts to stamp out the pandemic continue.

In Wuhan on March 19, officials reported no locally transmitted new cases for a second straight day.

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Some of Hubei Province's lockdowns were lifted or eased this week, checkpoints dismantled, and travel bans within the region rescinded.

The WHO urged Chinese officials to "carefully monitor the phased lifting of the current restrictions on movement and public gatherings" for any sign of new or remaining chains of COVID-19 transmission.

Officials, it stressed, should show "a clear recognition and readiness of the need to immediately react to any new COVID-19 cases or clusters as key elements of the containment strategy are lifted."

"Obviously time will tell," Stanford's Winslow said. "My understanding is that they are not abandoning all public health measures [such as social distancing, discouraging large gatherings, etc.] so their response may, indeed, be adequate to prevent a 'second wave' as was seen in the 1918-1919 Spanish Flu pandemic."

Britain's Imperial College COVID-19 Response Team, whose March 16 report has been credited with inciting the British and U.S. governments to stronger action to reduce social contacts to fight the pandemic, also warned of the vulnerability of "suppression" efforts through so-called NPIs, or nonpharmaceutical interventions, like self-isolation and the closing of social-gathering points.

"The main challenge of this approach is that NPIs [and drugs, if available,] need to be maintained -- at least intermittently -- for as long as the virus is circulating in the human population, or until a vaccine becomes available," it said.

Michael Osterholm, who warned in his 2017 book, Deadliest Enemy: Our War Against Killer Germs, that earlier coronaviruses like SARS and MERS were "harbingers of things to come," last week called it "like trying to stop the wind."

He added: "What we saw in China, what I'm convinced [of], as are many of my colleagues, [is] as soon as they release all these social distancees, these mandated stay-at-homes -- they haven't left their homes in weeks and weeks kind of thing -- when they get back to work [and] they're on planes, trains, subways, buses, crowded spaces, manufacturing plants, even [in] China [the coronavirus] is going to come back again."