Special collection of articles highlights China's response to covid-19

Today, The BMJ is launching a special collection of articles on China's response to covid-19 - what it was, how it worked, why traditional public health measures played such a vital role, and how other countries can learn from this experience to protect their populations, in particular in future pandemics.  

China was the first reported country affected by the covid-19 and held the world's interest as it battled to understand and contain a new pathogen. But China has reported only 0.05% of the total number of global cases despite making up 19% of the world's population.

China mobilized quickly and within two months had contained and eliminated local infections in the country. A new collection of articles written by people involved in the response sheds light on China's experience and makes policy recommendations.

The collection will be launched at a special event on 4 December 2021 at the Public Health Challenges and Opportunities after covid-19 -- Symposium on System Construction of Disease Prevention and Control.

Du Bin and colleagues analyze China's early response and the role of China's centrally coordinated national campaign, fast mobilization of 42,000 healthcare workers to Wuhan, efficient local coordination and allocation of healthcare resources, and rapid capacity building for general and critical care of infectious diseases.

"New technologies greatly assisted. For example, rapid nucleic acid testing made it possible to diagnose patients early, detect asymptomatic infections, and assess the potential risk to the entire population. Mobile phones were used to trace and manage close contacts", they write. "Given the high prevalence of asymptomatic and pre-symptomatic SARS-CoV-2 infections, and the possibility of covert long-distance transmission through cold chain logistics, containment would not have been possible without these new technologies."

The authors explain that recent experience of successfully containing a highly infectious disease is limited, particularly when hundreds of thousands of people are infected and require urgent medical assistance as happened in Wuhan, the original epicenter of the epidemic in China.

But they warn that successful containment has also left China's population almost entirely vulnerable, and thus suggest the country needs to persist with strong public health measures until population immunity is established through vaccination.

As such, they call for the sharing of information on how the elimination of an emerging disease with pandemic potential is possible by using non-pharmaceutical interventions alone.  They believe that this would be critically important when the next emerging infectious disease with a pandemic potential strikes and argue that with joint international efforts such epidemics can and should be contained locally so as to avoid catastrophic consequences worldwide.

The collection of 11 papers explores several key dimensions of China's response to covid-19, including its testing and vaccination strategies,  containment methods, and the role of pandemic modeling and surveillance.

This special collection of articles by leading experts documents China's response, which has attracted such fascination around the world. We hear first-hand how that response helped control SARS-CoV-2, and offers a blueprint for other countries seeking to emulate China's strategy. There are many lessons in these papers, and the most striking themes are how old school public health and modern technology were both essential to China's success, but that there remains an overriding need for global collaboration in this and future pandemics."  

Dr Kamran Abbasi, Executive Editor, The BMJ

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