Overcoming COVID-19 in China despite shortcomings of the public health system: what can we learn?

Abstract

Background and objective The COVID-19 pandemic started in Wuhan, China, in December 2019. Although there are some doubts about the reporting of cases and deaths in China, it seems that this country was able to control the epidemic more effectively than many other countries. In this paper, we would like to analyze the measures taken in China and compare them with other countries in order to find out what they can learn from China. Methods We develop a system dynamics model of the COVID-19 pandemic in Wuhan. Based on a number of simulations we analyze the impact of changing parameters, such as contact rates, on the development of a second wave. Results Although China’s health care system seems to be poorly financed and inefficient, the epidemic was brought under control in a comparably short period of time and no second wave was experienced in Wuhan until today. The measures to contain the epidemic do not differ from what was implemented in other countries, but China applied them very early and rigorously. For instance, the consequent implementation of health codes and contact-tracking technology contributed to contain the disease and effectively prevented the second and third waves. Conclusions China’s success in fighting COVID-19 is based on a very strict implementation of a set of measures, including digital management. While other countries discuss relaxing the lock-down at a rate of 50 per 100,000 inhabitants, China started local lock-downs at a rate of 3 per 100,000. We call for a public debate whether this policy would be feasible for more liberal countries as well.

The Lancet Commission on lessons for the future from the COVID-19 pandemic

“…Notably, China was intent to contain the pandemic from Jan 23, 2020, adopting a policy that became known in China as the zero-COVID strategy. 153,154 From early 2020 onwards, Australia, Cambodia, China, Hong Kong SAR, Lao PDR, New Zealand, Singapore, Viet Nam, and several small Pacific island states attempted to pursue a suppression strategy based on the Asia-Pacific Strategy for Emerging Diseases and Public Health Emergencies, which was adopted by the WHO Western Pacific region in the aftermath of the epidemic of severe acute respiratory syndrome in 2003. 155 Singapore was the only country of the Western Pacific region to have a substantial outbreak during the first half of 2020, which occurred when COVID-19 spread through the hostels of migrant workers.…”

“…Notably, China was intent to contain the pandemic from Jan 23, 2020, adopting a policy that became known in China as the zero-COVID strategy. 153 , 154 …”

The impact of inspection policies on reducing disease prevalence in public buildings: A systems dynamics approach

“…The system dynamics approach has also had applications in investigating the epidemic problem [ 42 , 43 ]. Wang and Flessa modeled the prevalence of the disease in the community with uncertainty using system dynamics [ 44 ].…”