Our Nation's War Against the Epidemic
Dr. Zhong rapidly judged the situation and provided accurate recommendations, advising that the virus could be transmitted from person to person since medical workers were being infected, that it was crucial to identify and isolate persons showing symptoms as early as possible, and that it was necessary to launch the highest level emergency response in order to reduce opportunities for cross contamination. From Wuhan to Beijing to Guangdong, Dr. Zhong traveled extensively with his team, working on both advancing clinical treatment and promoting scientific and technological breakthroughs.
In a brief but powerful statement, Dr. Zhong said, "As long as we keep our heads up, we can get through this."
Also part of the National Health Commission's team of high-level experts is Li Lanjuan, another academician of the Chinese Academy of Engineering who made important contributions during the SARS and H7N9 outbreaks. A photo was taken recently of Dr. Li hard at work on the front lines of the fight against the coronavirus, with the weathered expression on her face crisscrossed by creases left by her mask.
"When the country is in crisis, we are duty-bound to act!" After earlier traveling to Wuhan to investigate and determine the nature of the epidemic, Dr. Li again led a team to provide aid to the city in the early hours of February 2. Before departing, she added, "We won't retreat until the battle is won!"
With every additional piece of understanding we have about the epidemic, we gain the confidence we need to defeat it.
Stressing the need to bolster our determination, work together, practice sound prevention and control measures, and take precise action, the CPC Central Committee has assessed the crisis from a holistic perspective, and promptly introduced overall requirements for winning the fight against the epidemic.
At the beginning of February, medical resources were constantly stressed past the limit with tens of thousands of people infected and more getting sick each day. With the epidemic posing such immense pressure, a strategy was needed to get patients in need admitted and treated as quickly as possible.
On February 3, Wang Chen, a pulmonologist and critical care expert currently serving as president of the Chinese Academy of Medical Sciences and vice president of the Chinese Academy of Engineering who headed the Beijing medical experts group during the SARS outbreak, made the following proposal: "All patients with mild symptoms should be brought together and put into isolation in order to prevent spread on a broader scale—this is one of the critical issues for prevention and control efforts in the decisive battleground of Wuhan. Setting up large temporary hospitals with lots of beds should be the absolute priority."
Dr. Wang did not waste a second in his work, warning, "If sources of transmission are not effectively controlled, the consequences will be even more grave." After arriving in Wuhan two days earlier, he immediately began conducting investigations through which he astutely recognized the urgent need to isolate patients in temporary hospitals. This was a key move made by China during the crisis, since temporary hospitals allowed for large numbers of patients with mild symptoms to be admitted for treatment within a short time frame and at a low cost.
Within just about 10 days, numerous temporary hospitals regarded as lifesaving refuges were built and put into operation all over Wuhan, substantially expanding the existing capacity to admit and treat patients.
At 3 PM on February 18, another 24 mild COVID-19 patients were released from the temporary hospital at Hongshan Stadium. As they departed, they expressed their sincere thanks to the medical workers that cared for them, and cheered, "Wuhan will prevail!" No longer wracked with illness, they walked with a new lightness in their step, their faces filled with relief and gratitude.
Xi Jinping's instructions were clear and firm: "We must adopt more vigorous measures to increase the number of beds at medical treatment facilities as quickly as possible. We must make good use of temporary hospitals, and increase the number of beds available for keeping people in isolation by requisitioning venues such as hotels and training centers, putting forth the greatest possible effort to see that those who are ill get treatment."
With the central steering group urging that a bed should be available for every patient who needed one, Wuhan had 16 temporary hospitals in operation by February 22 with an additional 19 under construction, offering a maximum of 30,000 beds.
On February 4, after 48 hours of frantic modifications, an intensive care unit for novel coronavirus patients set up under the leadership of Peking Union Medical College Hospital in coordination with Beijing Hospital, Wuhan's Tongji Hospital, and the Jiangsu Province medical team came into operation. Taking charge as temporary head of the department was Du Bin, a member of the National Health Commission's team of high-level experts and director of the Medical ICU at Peking Union Medical College Hospital.
At five o'clock in the evening that same day, the ICU's first patient was transferred in. "The patient is having extreme difficulty breathing, oxygen saturation is at just 50%!" With alarms blaring, Dr. Du decided he needed to perform an emergency intubation. Taking a look around, however, he discovered that the ward was not yet equipped with the level- three protective equipment that provides full spectrum protection.
"I've got this." Seeing that a life was in danger, Dr. Du performed the intubation at the risk of being infected, and successfully stabilized the patient.
When epidemic prevention and control efforts reached a critical phase, many of the country's top medical researchers converged on Hubei. With their sights set squarely on the coronavirus, they dramatically increased the pace of scientific and technological innovation. To generate core momentum for driving epidemic prevention and control efforts, we needed researchers to produce solid breakthroughs and proposals that could be put into action. Research on the coronavirus started immediately after the outbreak began, with teams established, special projects activated, and virus strain samples isolated. Working against the clock, researchers spared no effort to get studies underway.
On January 7, Chinese researchers isolated the novel coronavirus from a sample and sequenced its genome. China quickly shared this data with the world in order to kick-start the development of treatments and vaccines, earning high praise from the World Health Organization (WHO).
How could we go about rapidly identifying the virus? On January 26, Chen Wei of the Academy of Military Medical Sciences led a team that was urgently dispatched to Wuhan. For nearly two weeks, she and her team worked constantly with very little rest. Thanks to their efforts, the time needed for nucleic acid virus detection tests was significantly reduced, and cases of novel coronavirus were identified much more quickly.
Was it possible to develop effective medicines to treat the virus? From a library of more than 70,000 drugs and chemical compounds, 5,000 were selected as candidates that could potentially be effective. After repeated testing, roughly 100 drugs were chosen for live trials using subjects carrying the coronavirus. Ultimately, the pool of candidates was narrowed down to a few drugs including chloroquine phosphate, remdesivir, and favipiravir.
Behind the shrinking of this pool from tens of thousands, to thousands, to hundreds, and finally to a handful of candidates was a nationwide effort by scientists who worked together day and night to conduct systematic and extensive screening of drugs that were either already on the market or in clinical trials, and to push forward animal and human trials of potential treatments.
Updating the public on the latest progress in the scientific field, deputy head of the China National Center for Biotechnology Development Sun Yanrong said, "A number of drugs have shown preliminary results in the clinical setting."
Meanwhile, researchers began simultaneously working on a vaccine through a number of technical approaches, including using deactivated virus particles, genetic engineering, nucleic acid, and live attenuated influenza virus. These efforts have proceeded according to a coordinated roadmap, with the timeline for each segment planned down to the day.
Vaccine development teams composed of a wide range of domestic participants have worked day and night in an attempt to shorten the research and development process as much as possible while still ensuring safety and scientific integrity. Thanks to the efforts of these teams, our progress toward developing a vaccine through various technical approaches has matched that of other countries.
Science has proven to be a powerful weapon in the fight against the epidemic.
Through comprehensive assessments, more than 40 scientific experts, including Hou Yunde, Zhong Nanshan, Li Lanjuan, Zhang Boli, Xu Jianguo, have shaped our prevention and control tactics and made numerous important recommendations on issues such as diagnosing and treating the disease. Thanks to science-based methods used to boost preventative controls, combine Chinese and Western medical practices, and identify, report, isolate, and treat cases early on, more patients have been able to make a full recovery. Meanwhile, universities, research institutes, and enterprises have participated in scientific research related to epidemic prevention and control, contributing to efforts to trace the source of the virus and produce testing kits, aiding the development of drugs and vaccines, and leveraging their knowledge of big data and artificial intelligence.
Xu Nanping, vice minister of science and technology, commented, "Researchers now more than ever understand the importance of science. As they race against time to fight the virus, they find themselves writing their papers on the front lines, and directly applying their findings to combat the epidemic."
On January 24, 2020, which was Chinese New Year's Eve, a medical team from the Air Force Medical University received orders to immediately travel to Wuhan to provide assistance. A family member is seen here adjusting the backpack of one of the team members before she departs. XINHUA / PHOTO BY ZHANG HAOPENG
Aid from every direction:
bringing together a mighty force to vanquish the virus
Four months short of his 60th birthday, Li Desheng was getting ready to retire. Then the epidemic appeared out of nowhere and upended his life.
As a police officer in Jianghan District in Wuhan serving the Datong residential community, Mr. Li was keenly aware of the difficulty of fighting disease in aging neighborhoods. With this in mind, the graying Mr. Li took it upon himself to do delivery work, using his own vehicle to transport goods on multiple occasions. He put in extra hours with workers from the community office, taking 14 confirmed patients to hospitals for treatment and 30 suspected cases to designated facilities for isolation.
Some people asked him, "Do you really need to put in all this effort?" His rousing answer was, "I've been a police officer for 20 years. At this critical moment, I can't let up until the epidemic lets up."
Behind Mr. Li's efforts, the Wuhan Public Security Bureau was implementing a program through which police officers were engaging with residential communities to provide assistance. From February 6 to 20, police were dispatched 63,000 times to help in the important task of transporting 22,000 vulnerable people, i.e., confirmed cases, suspected cases, febrile patients who may be carriers of the virus and close contacts.
In epidemic prevention and control, a coordinated national response is essential. At critical moments, the CPC Central Committee conducted emergency planning. Giving full consideration to issues including the current status of the epidemic, the availability of manpower, and the lack of certain medical resources, it arranged for 19 provinces to pair off with and provide assistance to 15 cities and 1 prefecture in Hubei Province other than Wuhan.
Called to action by the epidemic, local authorities and government departments throughout the country immediately stepped up to provide assistance, and supplies and personnel began pouring in from every direction.
This was an unprecedented mobilization.
When the situation became critical, 19 provinces rallied together and divided up responsibilities for providing aid. Late at night on February 10, a 108-member medical team from Guangdong Province departed to provide assistance to Jingzhou, Hubei Province. At 2 PM on February 11, a 158-member medical team from Chongqing assembled and rushed to the front lines in Xiaogan. Also on the afternoon of February 11, the ninth medical team sent from Shandong Province to support Hubei set out from Jinan, with 107 medical workers bound for Huanggang.
Epidemic prevention and control in Wuhan and Hubei was the highest priority. In accordance with the requirements put forward by the CPC Central Committee to curb the spread of the virus within the province and prevent it from spreading beyond, more than 330 medical teams with more than 40,000 workers from 29 provincial-level units, the military, and the Xinjiang Production and Construction Corps were assigned to the task.
The response advanced at an incredible pace.
Huoshenshan Hospital, a field hospital made up of nearly 2,000 modular units complete with a reception area, an inpatient building, and ICU wards and occupying an area of over 30,000 square meters, about half the size of the Beijing National Aquatics Center, was finished in just ten days from the start of design to the completion of construction. At the same time, similar hospitals were being built in other key areas for epidemic prevention and control so as to ensure that dedicated facilities were available to admit and treat novel coronavirus patients.
The production and distribution of urgently needed masks was stepped up dramatically.
Since the middle of February, China's mask production capacity utilization rate has remained at 100% or more, reaching 110% on February 17. On February 19 alone, Hubei was provided with 336,000 N95 masks and 133,000 protective suits through various domestic channels. These numbers double the former national production capacity for masks and protective suits.
Supplies were delivered by air in a race against the clock.
Eight large transport aircraft, namely four Y-20s, one IL-76, and three Y-9s, left military airbases in the early hours of February 17, arriving in cities including Shenyang in Liaoning Province and Zhanjiang in Guangdong Province. After being loaded with medical teams and supplies, the eight planes took off again, and started landing at Tianhe International Airport in Wuhan at 9 AM.
That morning, the air force transported a shipment of medical supplies and 676 members of military medical teams to Wuhan under orders from the Central Military Commission. Since the start of the epidemic, the air force has carried out transportation tasks on a large scale, dispatching four flights delivering 30 planeloads of personnel and supplies.
Support systems have kept running smoothly overall.
In China and around the world, major epidemics and disasters throughout history have frequently brought about social disorder, which compounds the terrible effects of these events.
As more and more people have returned to work, demand for daily necessities in large and medium-sized cities has shot up. This demonstrates the fact that maintaining support services is an integral part of our fight to curb the epidemic.
According to a survey of 11,000 road and waterway transportation companies conducted by the Ministry of Transport, 3,550 had resumed normal operations by February 22, with close to 50% of their employees at work on average. China Post and SF Express had essentially resumed full operations, while 66.7% of the other main delivery companies had restarted their services.
Companies that produce medical supplies urgently needed for epidemic prevention and control rapidly restarted production and expanded their capacity. Important supplies were put under unified national management, and express transport corridors were set up to ensure that they were delivered quickly. A whole series of measures were implemented to keep the market stable and maintain social stability.
Using compassion to fuel the fight against the epidemic
At 10 AM on February 18, a special donor arrived at Jinyintan Hospital in Wuhan to give blood plasma. This donor was Cheng Lin, the wife of the hospital's director Zhang Dingyu and a nurse at Wuhan No. 4 Hospital. She had come to her husband's hospital 20 days after recovering from COVID-19 in the hopes that her plasma could help doctors save the lives of other patients.
According to the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 6) recently issued by the National Health Commission, convalescent plasma therapy is suitable for severe and critical patients whose condition is progressing relatively quickly. At a press conference for the Joint Prevention and Control Mechanism of the State Council, experts called for a plasma donation drive, hoping that more people who had recovered would donate and save lives through their compassion.
Back at Jinyintan Hospital, Cheng Lin underwent a physical examination under the guidance of a staff member. The results of the checkup showed that she met the requirements to donate. About half an hour later, she had successfully donated 400 ml of plasma.
Cheng Lin said, "I told my husband that I wanted to donate plasma, partly to support his work, but mostly to save more patients' lives. Giving a little bit of blood is the least I could do."
Hundreds of kilometers away in Qinglin Village, Tanluo Town, Nanning City, Guangxi Zhuang Autonomous Region at 2 AM on January 30, Lu Yueying and over 60 other villagers braved the cold as they worked through the night harvesting thousands and thousands of pounds of cabbage to send to markets in Wuhan.
Meanwhile, after receiving emergency orders, staff at the Hanzhong Train Operation Depot got to work to ensure that an urgently needed 3.5-ton shipment of tarpaulin was sent out. The workers ignored the cold and stripped off their jackets so that they could move more quickly, and ultimately got the train out more than an hour faster than normal.
Each one of these people worked together in a fight to save lives. The entire nation stepped up and sounded the charge, channeling wave after wave of reinforcements, supplies, and support from every corner of the country to the front lines.
Wuhan, a city that has endured countless trials throughout history, from the violence of the Revolution of 1911 and the devastation of Japanese invasion in the 1930s to the destruction of several massive floods, is once again at a critical moment, locked in an extraordinary battle against the COVID-19 epidemic.
China has formed a strategic setup for combating the epidemic featuring all-out mobilization and fully reinforced prevention and control measures. On the basis of regional characteristics and the state of the epidemic, we have instituted adaptive measures, focusing on Wuhan and the rest of Hubei as the main battlegrounds while strengthening guidance tailored to the needs of different provinces. Under this framework, we have fortified the "four lines of defense," namely medical diagnosis and treatment, public health, community management, and social support, and gradually made deeper progress through a step-by-step approach.
As the whole country has activated stronger measures in response to the virus, and particularly as Hubei has built internal momentum and medical resources from across China have arrived on the scene, we have seen significant progress in treatment work, and the number of active cases has started decreasing rapidly.
A small amount of effort, multiplied by 1.4 billion people, is enough to build a boundless pool of energy for fighting the epidemic. Meanwhile, when shared on the shoulders of 1.4 billion people, even a monumental challenge such as this can be faced down without fear.
The courage and tenacity that the Chinese people have demonstrated in responding to the epidemic has been admired the world over. Speaking at a press conference in Geneva on January 31, WHO Director-General Dr. Tedros praised China, saying "I have never seen, in my life, this kind of mobilization." He added that the hospital that was garnering significant international attention since it was built in just ten days was just one part of the many measures being taken by China, and he expressed his confidence that these measures would turn the tide of the epidemic.
The winter is over, and the heroic city of Wuhan has emerged from a long and vicious storm. Let us hope that a brighter spring is on the horizon.
The writers are reporters with Xinhua News Agency.
(Originally appeared in Qiushi Journal, Chinese edition, No. 5, 2020)