For the first time in months, the Chinese province of Hubei, where the coronavirus first emerged, is getting attention for a good reason. COVID-19 cases there have dropped to practically zero, and last week authorities lifted travel restrictions in and out of the province, some 60 days after much of it was dramatically locked down. Now scientists and the rest of the world are watching closely to see whether easing the intense measures to keep people apart results in an emergence of new cases. An early analysis suggests that, so far, these fears have not come to pass.
It’s time to relax the lockdown, but we need to be alert for a potential second wave of infections, says Ben Cowling, an epidemiologist at the University of Hong Kong, who will be following the situation in China. If a second wave comes, Cowling would expect to see it emerge by the end of April.
How things unfold in Hubei and across China will be relevant to many European nations and some US states that have restricted travel inside their borders, closed most businesses, schools and universities and told people to stay at home, in an attempt to halt the pathogen’s spread. Modelling of the UK outbreak suggests that the country’s social distancing measures, including school and university closures, might be needed for large parts of the next two years to keep the proportion of people with severe COVID-19 infections in hospital at manageable levels.
But if China can show that it can lift its lockdown without a significant re-appearance of COVID-19, it might be possible that such protracted restrictions won’t be necessary.
Chinese provinces will now use extensive testing and contact tracing to pinpoint new infections, and will maintain some social-distancing practices to prevent a resurgence. The country has also closed its borders to everyone but citizens to prevent cases from being imported. Returning residents will be quarantined for 14 days.
But some researchers say that the situation in China is different because its government acted aggressively, using social-distancing measures to slow down the spread and extensive testing and isolating of infected people to stamp out potential transmission sources. This strategy helped the country contain the outbreak. But other nations, such as Italy and Spain, have focused mainly on slowing the virus through social distancing without intensive testing and contact tracing. They will face more challenges when trying to return to life before the pandemic, says Cowling.
China is still implementing extensive COVID-19 monitoring nationwide. Provinces issue all residents a QR code, a type of barcode containing information that is revealed when scanned, based on their health details and travel history. If a person has remained in areas considered safe in China or has been quarantined and tested negative for the disease, they are assigned a green status’ the lowest risk which allows them to cross provincial borders, enter hospitals and residential areas, and ride the subway and trains.
The measure not only keeps infected people from mingling with others, but if a new infection is detected, the government can track that person’s movements and pinpoint people they might have come in contact with. Cowling calls this an advanced form of test and trace that will allow China to identify as many infected people as possible as quickly as possible, and then isolate them.
The big question is whether that will be enough to stop a new outbreak. Cowling thinks other cities would have trouble if required to do the number of tests that Wuhan did, which at its peak reached about 10,000 tests per day. There is a danger in focusing too much on testing and isolation, he says, and adds that social-distancing measures will still be important.
Most of the countries now facing raging outbreaks, including Italy, Spain and the United States, are relying on social-distancing policies and getting people to stay home. China implemented those measures, but it also built new hospitals and conducted extensive testing. Then, officials went door to door to check people’s temperatures. They tested anyone with a fever, and isolated positive cases. The extra work allowed them to stop the virus, says Cowling. People are following China, but not in exactly the same way, he says.
2020 Springer Nature Limited