What China had to do to start stopping COVID-19
(maps and graphics at link)
https://threadreaderapp.com/thread/1237020518781460480.html
Nicholas A. Christakis
Sterling Professor of Social & Natural Science at Yale. Physician. Author of Blueprint: The Evolutionary Origins of a Good Society. Luckily wed
If we want to understand how powerful an opponent SARS-CoV-2 (COVID-19) is, let’s take a look what has been required to stop it in China. The Chinese government has essentially used a social nuclear weapon in its efforts. Let’s talk about this, to understand what US is facing. 1/
The Chinese have had the most COVID19 cases so far (80,859), but the number of new cases has dropped from 100's per day a month ago to ~46 per day now — in a country of 1.4B people. This is an astonishing achievement from a public health point of view. who.int/docs/default-s… 2/
We can get a sense of how strong something is by getting a sense of what sort of force is required to stop it, to borrow a Newtonian physics metaphor. COVID-19 requires a powerful force to stop. This is clear from the Chinese response. 3/
Of course, China has a collectivist culture and an authoritarian government, both of which have allowed this enormous, widespread response. It is well suited to fight a pandemic, if it indeed takes in factual information and responds rationally. (Evokes Chernobyl @clmazin) 4/
Ably assisted by some Chinese students in my lab #HNL, we quantified what Chinese government has been able to achieve. Beginning January 23, they imposed movement restrictions (typically with people staying at home, leaving just once a week) on provinces with >930M people! 5/
The imposition of such public health measures on such a scale for such a duration has never been seen before. Here are links to the websites for many of the provinces into which China is divided, indicating what the rules for movement, imposed on 930M people, have been. 6/
Most Chinese cities are still implementing these types of quarantine at the community-level, now over *six weeks* in, depending on the severity level of the situation in their cities. This is called "closed-off management" 封闭管理 by the government and media). 7/
Common features of "closed-off management” include: movement of people & vehicles is checked with an exit-entrance permit; body temperature at entrance of community is checked; disinfection of vehicles; food delivery; permits for only one person per household to go out. 8/
The licenses for personal travel in China, being used by many millions of people, look like this. Some of them have a slogan “It is everyone’s responsibility to fight the virus.” 10/
In many cities, workers have been organized on a vast scale to deliver food to homes; residents can only go out to shop if they have a permit; & shops are open at limited times. In Chongqing, for example, only one person per household can go out shopping, only occasionally. 11/
Schools have moved online. Jokes circulate: Parents complain to upstairs neighbors: "Could you please have your kids stop jumping? It is too noisy and our kids are taking an online math class now.” The neighbors reply: "Oh sorry! But my kids are taking a sports class now.” 12/
As a result, the Chinese have dropped the Re (the Effective Reproductive Rate) of COVID19 from ~3.8 new cases per extant case to ~0.32. When this number is below 1.0, the epidemic extinguishes (at least it will, for a while, within China). medrxiv.org/content/10.110… 13/
My lab, #HNL, has been studying this topic in another way, along with Chinese collaborators. We are also developing forecasting tools. NB @BillGates @niranjanbose (with gratitude). More about that in a future thread. 14/
The Chinese government is slowly beginning to lift restrictions, but it is continuing to implement many quite inventive procedures, on a large scale. For instance, elevators in a Beijing building only allow four people at a time, as marked by tape on the floor. 15/
The sign in the elevator says: "No more than four people in the elevator. Please be patient and wait for the next elevator.” Below, it says "Let's unite together to fight the virus in this special period." This type of collectivist slogan is very common throughout China now. 16/
Currently, some provinces are adjusting their emergency level downwards according to their risk-level evaluations. As of March 2, 7 provinces adjusted to second-level, 9 provinces to third-level, 4 provinces to just the within-province emergency level.
全国20省份下调疫情防控应急响应级别
7省份由一级响应调整为二级，9省份由一级响应调整为三级，还有4省份针对省内不同风险程度，分区分级精准防控。
http://www.bjnews.com.cn/news/2020/03/02/697916.html
17/
China has a collectivist culture and an authoritarian government, so its success fighting COVID-19, while deeply impressive, will not be easy to reproduce elsewhere. The USA must prepare to combat the virus using tools at its disposal. It will not be easy. 18/
Here is a map and a timeline describing the imposition of "closed off management" restrictions at the provincial level across China as part of the effort to cope with #COVID19. 19/
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