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In China, the largest number of reported COVID-19 infections was in Hubei province.

Other countries are experiencing exponential increase in reported infections, while the remainder of China is reporting relatively small numbers of casessource_1

What protects Chinese provinces other than Hubei from COVID-19 outbreak?

  • What is different about the remainder of China compared to the rest of the world?
  • Is there anything we can learn from the provinces in China that so far were less affected by the virus than Hubei?
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    How much do you trust the Chinese government's data collection and reporting? – Carey Gregory Mar 1 at 5:30
  • @CareyGregory - Reporting might be off by a lot, but I don't think they could hide it if all provinces were hit as hard as Hubai. So probably there is under-reporting of cases (for political reasons and also because it is not feasible to test everyone without symptoms for the presence of virus), but that would skew numbers across the board. – Karsten Theis Mar 1 at 20:22
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+50

I live in Guangdong, and this is what I've been seeing & reading about.

Wuhan (city in Hubei) is where the outbreak supposedly began. And it went unnoticed for a while, which mean it was spreading locally more-so than it was spreading nationally/internationally. Near at the start of the Chinese New Year holiday, the government decided to quarantine all of Hubei province. So while other provinces already had infected people, they spread hadn't grown as significantly as it had in Hubei yet.

The Chinese government then decided to take specific measures to control the epidemic. For starters, they required mask-wearing and encouraged staying indoors. They also began to set up body temperature checks all over the place (apartments, neighborhoods, roads leading into cities, and places of work once the holiday ended. Fever seems to be the first symptom, so this is why).

If anyone in an apartment building was confirmed to have the virus, then the entire building and all residents were/are quarantined for 14 days (happened to a 30+ story apartment building next to mine). Elevators, doors, and other public spaces are often disinfected, particularly if a suspected case had been in the area. Again, I saw this at a temperature checkpoint, someone must've had a fever and a little bit later some folks came and sprayed down the area.

Schools are also closed in all provinces across the country, and students are doing online schooling. Some companies are also allowing employees to work from home, or 'staggering' their work days (half come in into the office on Mon, Wed, Fri, the other half come in Tuesday and Thursday). This decreases the number of people a possible infected person can pass the virus to.

On top of this, companies needed to 'apply' to be able to resume work. Here in Shenzhen, nobody could return to work within 14 days of returning from the city, assuming they left during the holiday. We also need to record down our body temp when coming to and leaving from work. According to an SMS I received from the local government, if 2 employees have a body temperature >= 37.3C, then it needs to be reported immediately, as it indicates a possible spread in that workplace.

In short, the virus was able to take a foothold in Hubei, and it was noticed before it took a significant foothold in other provinces. Therefore other provinces had time to implement proactive and preventative measures, before the situation grew to Hubei-level of significance.

The best way to prevent it from spreading is simple steps, such as not going outside unless its necessary, avoid close contact with others (defined as within 6 feet for an extended period of time), washing your hands, and disinfecting often-touched surfaces like door knobs, keyboards, cell phones, etc. It remains to be seen whether other countries will take the same rather drastic measures that are being taken in China, I suppose it all depends on how bad things get in other countries.

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    This is such an honor to receive an answer from you, right from the source. Thank you for sharing, and for all the steps you have had to take to protect others from getting sick! – Karsten Theis Mar 2 at 13:41
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“The biggest conclusion is that China has demonstrated that the course of the outbreak can be altered. Normally, an outbreak of this nature would have exponential growth, would reach a high peak, and would then decline naturally once all susceptible people have been infected, or developed the disease. This has not happened in China in a number of ways,” he said.

“One: the shape of the course of the events - the graph, the epidemic curve, as we call it, of the numbers of cases over time - appears very unnatural. It is an epidemic that has been nipped as it was growing and stopped in its tracks. This is very clear from the data that we have, as well as the observations that we can see in society in general.

"So, that's a big lesson that the natural course of the outbreak does not need to be a very high peak that overrwhelms health services. This lesson in containment, therefore, is a lesson that other countries can learn from and adapt for their own circumstances".

China acheived this feat in Hubei through the ruthless application of science and knowledge of infection control. In the absence of a known treatment, the standard measure from centuries of history is containment and isolation in the containment regions.

They totally shut the borders to Wuhan, a city of 8 million people as well as other cities in the province of Hubei. This type of action has never been done in the history of mankind before. The border controls were put in place even before there was any stress on the health systems in Hubei Province. The onset of the pandemic was at the start of the Lunar Holidays which is the world's largest single yearly migration and this was shut down to stop the spread of virus.

All the cities in China were basically shut down so that even in Urumqi in the far western border, people were not allowed on the streets without good cause. Any threat to the confined Muslim population was also eliminated in this way.

This allowed medical staff all over China sufficient time to contact trace all infections, as well as gave them time to do case discovery as well as unprecedented actions ( random temperature checks, daily reporting of your temperature, tracing the movement of every citizen, separating every restaurant user from each other by barriers etc ) to stop the spread of the virus. There was mass movement of medical staff from Beijing and other centres to Wuhan to help control/treat the sick, and 1000 bed hospitals were built over the course of a week or so.

This is how China protected the other provinces from the infection. The Chinese govt has called the citizens of Wuhan heroes for enduring such harsh measures which have protected the other billion citizens.

Of course there is another story to all of this .. people left to die at home unable to access hospital care, a child with cerebral palsy who died at home as both parents had died and there was no one to care for him and other stories of immense human tragedy. And we must not forget our companions, the 10s of 1000s of pets left to starve as people were moved from apartments to isolation camps, and the efforts made to save them.

https://news.un.org/en/story/2020/03/1059502

https://www.nationalreview.com/news/coronavirus-wuhan-official-called-for-gratitude-education-to-teach-citizens-to-thank-xi-jinping-for-response/

https://www.hongkongfp.com/2020/03/17/hero-coronavirus-crisis-china-according-state-propaganda/

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