Never Lowering the Guard
Sporadic cases test urban epidemic control capabilities
At eight months pregnant, a woman from Xi’an, capital of Shaanxi Province in northwest China, lost her baby after being left waiting outside a local hospital for two hours due to expired nucleic acid test results, on January 1. Her heartbreaking experience occurred when the city was under closed-off management, introduced nine days earlier aiming to curb increasing COVID-19 cases.
Public outcry quickly triggered an official response. Liu Shunzhi, head of the Xi’an Health Commission, apologized at a press conference. The hospital was ordered to offer compensation, with those accountable suspended from duty or removed from office.
As Xi’an put the spread, the largest in a big city since the lockdown of Wuhan in January 2020, under control in just about a month, issues that cropped up during that period have sparked debate on how to improve urban epidemic prevention.
Lockdown governance
From December 9, 2021, to January 8, 2022, the city registered 1,989 locally transmitted cases. By late December, 10 of the 11 districts in Xi’an saw infections and a spreading trend. Stringent containment measures such as a city-level lockdown and numerous rounds of mass nucleic acid testing have proved effective.
While imposing these measures, local authorities should take residents’ needs and livelihoods into consideration, Yin Zhi, a professor of urban planning at Tsinghua University, told Beijing Review. “I consider it of great importance to people’s wellbeing,” Yin said, underlining the need to guarantee supplies and medical services.
The case of the pregnant woman, as well as other treatment delays, was unacceptable, Yin said.
During a press briefing in January, Xi’an authorities stressed no hospital should deny patients treatment. In addition, “green passages,” or easy access, should be made available to critically ill patients demanding immediate care and women who are pregnant or in labor.
The lack of sufficient food supply became yet another problem in the first few days after the lockdown was announced.
Ren, a Xi’an resident who asked to be identified only with her surname,
told Beijing Review, “In the very beginning, all the food I had at home were the snacks I had already purchased. It seemed the sudden increase of cases had caught the city off guard.”
The government encourages residents to store a proper quantity of emergency necessities, but many urban dwellers, especially young people who are used to ordering in their meals, tend not to keep sufficient food supply in their apartments.
During a lockdown, the government should ensure logistics companies continue operations to deliver food and other necessities on condition that workers are screened and test negative, Yin said.
Xi’an, known worldwide for its Terracotta Warriors, hosted the 14th National Games, the first major multi-sport event in China since the COVID-19 outbreak, in September 2021. Organizers adopted a string of anti-virus measures including vaccinations, nucleic acid testing, and health monitoring to ensure the safety of all participants.
COVID-19 prevention in Xi’an was successful during that high-stake period and the city should make the best possible practices a daily routine, Yin said.
A practical strategy
The Xi’an lockdown is by no means a negative example of China’s COVID-19 response playbook. One common misconception of the country’s strategy is that it intends to achieve zero infections.
“Currently, we are not capable of ensuring there will be no more new domestically transmitted infections, but we are capable of and confident in stamping out local infection clusters as quickly as possible,” Liang Wannian, head of the National Health Commission’s COVID-19 leading task force, said during an interview with China Central Television.
China’s policy means whenever local infections occur, prompt measures will ensue to stem the spread of the virus and avoid new cases, Liang said.
Yin echoed the official, saying this strategy minimizes the impacts of possible resurgences. If they are not curbed as soon as possible but are allowed to spread, the social and economic consequences will be even graver, he said.
While the number of daily infections in China is far lower than that in many other countries, preventing cross-border virus transmission in port cities is the top priority, Yin said.
The recent locally transmitted COVID-19 cases were mostly first detected in cities with international airports or seaports. For example, the viral genome sequencing of the new cases in Xi’an has identified them as strains of the highly contagious Delta variant, which are highly homologous with cases from an inbound flight on December 4, 2021. The Omicron variant that appeared in Tianjin, a coastal city in north China, in January, too, came from overseas as the latest global strain hadn’t occurred in the nation prior to its confirmation there.
China has set great store by port of entry management, practicing caution when it comes to international flights and focusing on those with the highest risk of viral contamination, such as cold chain workers and airport staff, Yin said.
“Cities need to prepare a science-based tool kit to tackle the virus, including the ability to trace close contacts, offer treatments, mobilize local communities, and ensure normal transportation,” Yin explained.
Many cities do well in regular prevention, he said. Shanghai, for example, does a good job at data-based tracing; it can swiftly and precisely locate any close contacts and seal off a smaller area to prevent a bigger spread, Yin said.
The upcoming Spring Festival and the Olympic and Paralympic Winter Games Beijing 2022 are likely to intensify pressures on COVID-19 prevention and control measures. China therefore should keep its guard up, he concluded.