Mainland China during the 2019–20 Wuhan coronavirus outbreak

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COVID-19 cases in mainland China ()
 deaths;  recoveries;  tested confirmed cases;  clinically diagnosed (C.D.) cases
Date
# of cases (excluding C.D.) # of cases (including C.D.)
2020-01-16
45 (n.a.)
2020-01-17
62 (+38%)
2020-01-18
121 (+95%)
2020-01-19
198 (+64%)
2020-01-20
291 (+47%)
2020-01-21
440 (+51%)
2020-01-22
571 (+30%)
2020-01-23
830 (+45%)
2020-01-24
1,287 (+55%)
2020-01-25
1,975 (+53%)
2020-01-26
2,744 (+39%)
2020-01-27
4,515 (+64%)
2020-01-28
5,974 (+32%)
2020-01-29
7,711 (+29%)
2020-01-30
9,692 (+26%)
2020-01-31
11,791 (+22%)
2020-02-01
14,380 (+22%)
2020-02-02
17,205 (+20%)
2020-02-03
20,438 (+19%)
2020-02-04
24,324 (+19%)
2020-02-05
28,018 (+15%)
2020-02-06
31,161 (+11%)
2020-02-07
34,546 (+11%)
2020-02-08
37,198 (+7.7%)
2020-02-09
40,171 (+8.0%)
2020-02-10
42,638 (+6.1%)
2020-02-11
44,653 (+4.7%)
2020-02-12
46,472 (+4.1%) 58,761 (n.a.)
2020-02-13
48,467 (+4.3%) 63,851 (+8.7%)
2020-02-14
49,970 (+3.1%) 66,492 (+4.1%)
2020-02-15
51,091 (+2.2%) 68,500 (+3.0%)
2020-02-16
70,548 (+3.0%)
2020-02-17
72,436 (+2.7%)
The bars for C.D. cases from 12–15 February 2020 represent the cases in Hubei that were not tested for the virus but clinically diagnosed based on symptoms and medical imaging showing signs of pneumonia.[1]
Data of tested cases is sourced from Chinese National Health Commission daily reports. Data of C.D. cases from 2020-02-12 to 2020-02-15 is sourced from Health Commission of Hubei daily reports.
2019-nCoV cases in mainland China broken down by provinces[2]

The outbreak of 2019-nCoV was first manifested by a cluster of mysterious pneumonia in Wuhan, the capital of Hubei Province in Mainland China. After a Wuhan hospital notified local center for disease control and prevention (CDC) and health commissions on 27 On 31 December, Wuhan CDC admitted there was a cluster of unknown pneumonia regarding Huanan Seafood Market, as unverified documents appeared on the Internet. The potential disease outbreak soon drew nationwide attention, including that of the National Health Commission (NHC) in Beijing, who sent experts to Wuhan on the following day. On 8 January, a new coronavirus was identified as the cause of the pneumonia.[3] The sequence of the virus was soon published on an open-access database.[4] Measures taken by China were widely praised by many including the World Health Organization (WHO).[5][6][7] China's response appeared to be much more transparent, especially when compared to how the country responded to SARS in 2003.[6][8]

However, delayed and controversial response by the Wuhan and Hubei authorities failed to contain the outbreak in the early stage, which has led to criticism from the public and the media.[9] By 29 January, the virus had been spread to all provinces of Mainland China.[10][11][12] By 8 February, over 724 had died of the coronavirus infection-associated pneumonia and 34,878 were confirmed to be infected. In Hubei alone, there were 24,953 cases of infections and 699 related deaths.[13] All provinces of Mainland China had initiated the highest response level to public health emergency.[14] WHO declared the outbreak a "public health emergency of international concern" on 31 January,[12] for fear that the virus spread beyond China to where there is no robust healthcare system, despite its confidence in China's efforts.[15]

Chinese Communist Party general secretary Xi Jinping warned a 'grave situation' facing China.[16][17] The Party Politburo formed a special leading group for epidemic control led by Premier Li Keqiang. Chinese New Year celebrations were cancelled. Passengers were checked for their temperatures.[18] Commands for epidemic control (CEC) have been formed in different regions including Wuhan and Hubei. Many inter-province bus services[19] and railway services have been suspended.[20] By 29th, all Hubei cities had been quarantined.[21] Curfew laws are in practice in Huanggang, Wenzhou[22] and other Mainland cities.[23] The region also sees a huge shortage of face masks and other protective gears, despite itself being the world's manufacturing hub for these products.[24]

With the increasing reported cases of infections, fear upgraded along with regional discrimination in China and racial discrimination beyond China, despite calls for stopping the discrimination by many governments.[25][26] Some rumors circulated across Chinese social media, along with counter-rumor efforts by media and governments.[27][28]

Contents

Context[edit]

Fear of another SARS outbreak[edit]

New infectious diseases impose a serious threat to the health of the general public. Their origins are often mysterious despite intensive research efforts.[29] Although human coronaviruses (CoVs) had been known as major pathogens to cause the common cold,[30][31] a new species of coronavirus, namely SARS-CoV, caused an epidemic involving 29 countries during 2002-03, which infected 8098 and killed 774 of them.[31]Evidence shows that the virus might have originated from an animal coronavirus but somehow entered human population.[31][32][33] Its outbreak also implies that animal coronaviruses could be a potential danger to humans.[31]

Since 2003 Sars outbreak, the general public and the science community in China have been worried about the potential return of the deadly virus, which motivated the Chinese government to reform its public health system in order to handle next public health crisis.[34][35][36] As part of the reform, China expanded the laboratory networks to handle pathogens of infectious diseases, which include a newly-built BSL-4 laboratory in Wuhan and a national key laboratory to investigate into pneumonia with unclear causes.[37] Zeng Guang, Chief Scientist at China CDC, believes a quicker publication of epidemic information was a lesson China learnt from the SARS outbreak, as lack of information release worsened the outbreak.[37]

With the improved public health system, China managed to handle several public health emergencies. In coping with 2009 H1N1 flu outbreak starting from Mexico, China developed and distributed vaccines to 100 million people within months as an active prevention.[36] During the 2013 H7N9 outbreak in East China, the country's health system identified the pathogen 5 days after the outbreak. Test kits for diagnosis were designed and distributed to all Mainland provinces 3 days after the identification. Within months, effective vaccines were developed. Besides, Chinese academic Li Lanjuan's group was the first to reveal the virus' transmission methods, molecular mechanisms and effective treatment.[38]

However, as Southern Metropolis Daily pointed out, although people pay more attention to public health, the government's funding to the health system was far from enough, as CDCs in smaller municipalities had to reduce their staff. 10 years after the Sars outbreak, few people wore a face mask when they had respiratory symptoms and hospitals were cutting off fever clinics.[39] Despite confidence in winning next battle against Sars, Zhong Nanshan, who earned a fame in fighting the Sars outbreak in 2003, still held a conservative attitude to whether Chinese officials would lie to the people about a disease outbreak.[36]

Animated Map of 2019-nCoV Confirmed Cases in Greater China
Mainland China refers to the part of Greater China excluding Hong Kong, Macao and Taiwan.

New coronavirus outbreak[edit]

On 1 December 2019, a viral pneumonia patient with an unknown cause was hospitalized at Jinyintan Hospital, a specialized hospital for infectious diseases in Wuhan, China. This patient was the earliest known case of 2019-nCoV infections. Although the patient had not had any exposure to Huanan Seafood Market, a wholesale market selling seafood and living animals, an outbreak of the virus began to happen among people who had been exposed to the market since 10 December.[40][41] The outbreak was not noticed until a Wuhan doctor found a cluster of unknown pneumonia and notified her hospital on 27 December.[42] Another Wuhan hospital had already sent a sample with the virus had already been sent to Shanghai Public Health Clinical Center (Shanghai PHC) on 26 December. The sample was later confirmed to contain a new virus.[40]

The outbreak was made public on 31 December, after rumor about it circulated on the Internet.[40] Since then, the virus has spread to all provinces of Mainland China and overseas.[40] By 2 February, in Mainland China, over 490 had died of the coronavirus infection-associated pneumonia and 24,313 were confirmed to be infected. In Hubei alone, there were 16,678 cases of infections and 479 related deaths.[43] WHO declared the outbreak a “public health emergency of international concern” on 31 January,[12] for fear that the virus spread beyond China to where there is no robust healthcare system, despite its confidence in China's efforts.[15]

Early cases surrounding the animal market suggests potential animal-to-human transmission, while later the virus is found to be able to transmit from ill people to others.[44] There have been cases where asymptomatic patients transmit the virus to others.[45][46] According to China NHC, the virus transmits by droplets or close contact,[47] while some proposed that feces could also be where the virus hides and transmit from.[48][49] Typical symptoms of the viral infection include fever, dry cough, dyspnea, headache, and pneumonia,[50] which are usually developed after an incubation time lasting as long as 2 weeks.[51] But there exist mild but infectious cases, which complicates the epidemic control efforts.[52] It is also noticed that patients might be able to transmit the virus even during the incubation period.[53]

Early response by Wuhan[edit]

One of the earliest Wuhan MHC notices about the pneumonia epidemic. It was first posted on Weibo on 30 December 2019 and was confirmed by Wuhan CDC the next day (31 December).

Mysterious pneumonia outbreak[edit]

Jinyintan Hospital is a specialised facility for highly infectious diseases in Wuhan.

Discovery[edit]

On 1 December 2019, a viral pneumonia patient with an unknown cause was hospitalised at Jinyintan Hospital, a specialised hospital for infectious diseases in Wuhan, China. This patient was the earliest known case of 2019-nCoV infections. Although the patient had not had any exposure to Huanan Seafood Market, a wholesale market selling seafood and living animals, an outbreak of the virus began to happen among people who had been exposed to the market since 10 December.[40][41] On 26 December, Shanghai PHC received a sample of a patient with unknown pneumonia from Wuhan CDC and Wuhan Central Hospital and started an investigation to the sample, which was later confirmed to contain a new coronavirus.[40]

However, the outbreak went unnoticed until a cluster of unknown pneumonia was observed by a Wuhan doctor called Zhang Jixian.[42] Zhang was an ICU doctor at Hubei Hospital of Integrated Traditional Chinese and Western Medicine. Her experience of fight Sars in 2003 kept her alerted about public health emergency. On 26 December 2019, a senior couple, who lived near Zhang's hospital, came to her for their fever and cough. The CT scan results of the couple's thorax showed unusual changes in the lungs, which were different from those in any known viral pneumonia. Dr. Zhang then advised the couple's son to see her, and found similar conditions. On the same day, a patient from Huanan Seafood Market that Dr. Zhang saw also had the unusual conditions.[54]

On 27 December, the doctor reported her discovery to her hospital and the hospital soon informed Jianghan CDC, thinking this might be an infectious disease as indicated by the familial cluster. As a precaution, she told her colleagues to wear protective gears and prepared a specialised area in the hospital to receive patients with similar conditions.[54]

On 28 and 29 December, three more patients came to the clinic of the hospital, all of whom were related to Huanan Seafood Market. The hospital then notified the provincial and municipal health commissions. The health commissions appointed Wuhan and Jianghan CDC and Jinyintan Hospital to undertake epidemiological research for the seven patients on 29 December. Six of them were then transferred to Jinyintan, a specialised facility for infectious diseases. Only one patient refused the transfer.[42][54] Dr. Zhang Jixian's discovery was later widely praised.[55] Hubei government later honoured her and Zhang Dingyu, president of Jinyintan, for their contribution to control the viral outbreak.[56]

Disclosure[edit]

On the evening of 30 December, two emergent notice letters from the Municipal Health Commission of Wuhan began to circulate on the Internet, which were soon confirmed by Wuhan CDC, who admitted there were 27 cases of pneumonia of unknown cause on 31 December. The letters required all hospitals in Wuhan to report any pneumonia patient with unknown causes and related to Huanan Seafood Market. They also asked the hospitals to give proper treatment to these patients. Wuhan CDC told The Beijing News the investigation was still underway and that experts from NHC were on the way to help the investigation,[57] after rumour about it circulated on the Internet.[40]

On 1 January 2020, the seafood market was closed down by Jianghan District's Health Agency and Administration for Market Regulation due to an "environment improvement." According to China Business, workers in hazmat suits were inspecting all around the market and collecting samples. Storekeepers at the market said they were not told what the people were collecting and detecting. Urban management officers and police officers were on the spot to ask the storekeepers to finish up and leave the market.[58]

Several doctors were warned by Wuhan police for "spreading misinformation" and eight "rumourmongers," who were all doctors at Wuhan hospitals according to Wang Gaofei, Weibo's CEO,[59] were summoned by police on 3 January.[60][61] Li Wenliang, one of the whistleblowers, died of the virus on 7 February,[62] which was the same day when the discoverers of the outbreak, Zhang Jixian and Zhang Dingyu were honoured by Hubei government.[63] The death of Dr. Li led to a widespread grief and criticism towards the government.[64]

Human-to-human transmission[edit]

Frozen case number[edit]

Although the early cases surrounding an animal market may suggest animal-to-human transmission, more evidence surface to support human-to-human transmission of the virus.[44] However, despite the expert-led investigation and early signs of human-to-human transmission, including a hospital-acquired infection (nosocomial) case confirmed on 10 January according to Caixin,[65] the local government of Wuhan denied any case of nosocomial infection and kept claiming that "there was no clear sign of human-to-human transmission" until 15 January when Wuhan's Municipal Health Commission (MHC) said on its website that "the result of present investigation shows no clear evidence of human-to-human transmission, but this does not rule out the possibility of such transmission. The risk of continuous human-to-human transmission is low."[66]

The reported case number froze at 41 during the Hubei Lianghui and Wuhan Lianghui, the local parliament sessions between 6–17 January, which the local authorities of Hubei and Wuhan claimed to be due to lack of PCR test kits for the new virus. But Caixin said other sequencing techniques can used for diagnosis, which take usually two days without any need of PCR kits.[67] Meanwhile, an Imperial College group[68][69] and a Hong Kong University group[70] both estimated over 1,000 cases in Wuhan as cases were being exported and confirmed overseas. Perceived discrepancies in the official Chinese data for the number of cases had left many netizens doubtful,[71] with some mockingly labeling the virus "patriotic" for its appearance of mainly infecting Chinese after they had left the country.[72][73][74]

"Manageable and preventable"[edit]

On 20 January, the number of reported new cases soared to 136, as major Mainland cities including Beijing and Shenzhen reported their first cases.[75][76] Only then did the Wuhan authorities stop claiming that the virus had a limited ability to transmit between humans.[77] On the same day, the city formed specialized command for epidemic control (CEC) to upgrade measures to cope with the epidemic, including enhanced protection over medical workers[78] and free treatment for all patients at fever clinics.[79] On the evening of that day, Zhong Nanshan, one of the NHC experts sent to Wuhan, who was well-known for fighting against SARS in 2003, exemplified human-to-human transmission of the new virus with a cluster of 14 hospital-acquired infections in Wuhan and two familial clusters in Guangdong.[80]

However, NHC still insisted that the epidemic be "manageable and preventable." At that time, BBC said that not much public attention was drawn to the virus outbreak.[65] On 19 January, despite the virus outbreak, over 40,000 Wuhan families joined an annual potluck banquet,[81] which was a community tradition observed for over two decades, to celebrate the Kitchen God Festival. A community leader told The Beijing News that "everything is normal now," when asked about the virus outbreak.[82] According to the community committee of Baibuting, where the banquet was held, as of 4 February a block of the community had at least 10 confirmed cases of the coronavirus infection, plus over 30 highly suspicious case but the community hospital also said the incidence of coronavirus was lower than that in other communities.[83]

Zhou Xianwang, the mayor of Wuhan, who was widely criticised by the public and media due to slow responses,[84] said to state media CCTV that the banquet was organised by the local community which had a long history of self-governance. He said that the government was not precautious enough to stop it because it was believed that the virus only had a limited ability to transmit between people.[85]

Controversial commentary[edit]

On 20th, Guan Yi, an expert in SARS epidemiology, told Caixin that the local government should not play on words about the transmissibility and that he hoped we could learn from 2003 SARS outbreak. He continued, "transmissibility, adaptability, incidence and virulence of the virus highly resembles those of SARS at the early stage [of 2003 outbreak]".[86] Guan's team came to Wuhan on 21 January and returned to Hong Kong the next day. He said to media that "epidemiology experts and scientists do not seem to be welcomed in the city."[87] On 22 January, Wuhan was still "an open city" to the virus outbreak, where most people did not wear a mask, although NHC had announced the coronavirus-associated pneumonia as a notifiable disease. He believed that a pandemic was unavoidable as the virus had spread with the migration flow of Chunyun.[88][89]

The statements of Guan, which were apparently different from that in most Chinese media, became highly controversial as journalists of state media reposted his statement on 15 January where he said he believed the disease was manageable and the news that his lab was fined by Chinese authorities in 2005. Wang Duan, the Caixin journalist who made the interview, described such behavior as "personal attacks" and complained that no expert had so far come forward to refute what Guan said.[90]

Hubei lockdowns[edit]

Health screening[edit]

Confirmed cases in Mainland China and Taiwan as of 22 January 2020, a day before Wuhan's lockdown. By the end of 22 January, there were 571 confirmed cases across Mainland China,[91] among which there were 444 confirmed cases in Hubei.[92]
Growth of confirmed cases in Mainland China during 10-23 January.

On 19 January, according to Wuhan Radio Television, the city authorities said it would monitor anyone leaving the city as a measure to contain the epidemic. Staff of Hankou Railway Station told The Beijing News on 20th that they would check the temperature of every passengers moving into and out of the station. If the temperature was above 38℃, further examinations would be made and they would notify the hospital if necessary.[93] Although the local government claimed that such measures were taken at the airport, railway stations, coach stations and piers in Wuhan since 14 January,[93][94] reports by Hong Kong-based Now News and Mainland-based Caixin indicated such measures were not taken at that time.[93][95] Caixin believed this to be a cause of the surge of confirmed cases.[93]

A temperature check at Wuhan Railway Station

On 22 January, Wuhan MHC said the city would have a random check on any private cars in and out of the city to see whether they carried any kinds of living poultry or wildlife.[96] The city authority began to require all citizens to wear a mask in public places.[97]

Travel advice[edit]

On 20 January, in a NHC press conference in Wuhan, Zhong Nanshan advised the public to avoid visiting Wuhan unless extremely urgent and to wear face masks. He also advised the city to perform a temperature check for anyone to leave the city and take compulsory measures to stop fever patients from leaving.[98] On the following day, Zhou Xianwang, Mayor of Wuhan, urged Wuhan citizens not to leave the city and non-Wuhan citizens to avoid coming in an interview by state media.[96] NHC also warned that a coronavirus outbreak had happened in Wuhan.[99]

On the same day, China Railway and Civil Aviation Administration announced that passengers were allowed to cancel stays or change dates for free if they had booked a ticket from/to Wuhan.[96][100] Wuhan-bound railway tickets purchased via Hong Kong's MTR could also be refunded.[101] Wuhan announced to postpone its tourism promotion activities for the Chinese New Year.[96]

Lockdown of Wuhan[edit]

On 22 January, Li Lanjuan, one of the NHC experts sent to Wuhan, flew to Beijing and advised the quarantine of Wuhan, which was soon adopted.[102][103] On the early morning of 23 January, the government of Wuhan announced a sudden lockdown at around 2 o'clock, which said, "Since 10:00 AM on 23 January 2020, the city's bus, metro, ferry, coach services will be suspended. Without a special reason, citizens should not leave Wuhan. Departure from the airport and railway stations will be temporarily prohibited. Recovery time of the services will be announced in a further notice."[104] Thus, Wuhan became a locked down area of a Class A Infectious Disease according to The law on Prevention and Treatment of Infections Diseases.[105]

Last train leaving Dazhi Road Metro station at 10:00AM when the lockdown officially began on 23 January.

Railway[edit]

China Railway announced later on the day of lockdown (23 January) that departure from railway stations in Wuhan would be stopped in order to assist the epidemic control, but transferring trains at Wuchang Station, Wuhan Station, and Hankou Station would be still allowed.[106][107] It also extended free refund and changing policy that originally applied to Wuhan to all parts of Mainland China, so as to reduce population movement.[108] On 24th, China Railway Wuhan (CRW) announced suspension of all its own train services. The company further announced suspension of most corporate train services it provided, except 6.5 pairs of trains that only runs within Henan Province. Only Jiangan Motive Power Depot, Jiangan Rail Yard, and Wuhanbei Station would be fully in service, while only a small number of people are reserved for other CRW facilities, and all the other employees would be on vacation.[109]

Flight[edit]

Tianhe International Airport, Wuhan's only civil airport, stopped anyone from leaving from 13:00 on 23 January. Cathay Dragon, Spring Airlines, Juneyao Airlines, China Southern Airlines, China Eastern Airlines and ANA changed or cancelled their scheduled Wuhan-bound flights. On 24 January, the airport was only open to international flights inbound which were required to leave without any passengers. Two cargo planes of SF Express, which carried supplies for epidemic control, were also allowed to land at the airport.[110]

Road and waterway[edit]

Downtown Wuhan after the private car ban.

Shanghai, Sichuan, and Jiangsu had cancelled all waterway and road passenger transport services to Wuhan and stopped approval of any chartered coaches to Wuhan,[111] before the Ministry of Transport called off all passenger transport services for Wuhan and asked the transport sectors to refund the affected tickets for free on 23 January.[112][113][114]

Although the announcement of lockdown did not mention whether citizens were allowed to leave Wuhan in their own cars, 30 entries to highways were cut by 14:00.[115] Roadblocks were said to be used in some areas according to BBC.[116] At 23:00, Wuhan CEC decided to stop P2P ridesharing services by 12:00 on 24th and to halve the number of street taxis.[117] Since 26th, private cars were prohibited from driving in downtown Wuhan.[118][119]

Fleeing Wuhan[edit]

On the morning of Wuhan's lockdown (23 January), hashtag #逃离武汉#, which literally means "fleeing Wuhan", hit the top of Weibo topics.[120][121] Wuhan citizens had rushed to railway stations to leave the city before lockdown, leading to long queues,[122] and many later posted of their success.[123] Some of them were then criticised for their lack of responsibility after they talked of managing to bypass the temperature check by taking antipyretics.[124] Almost 300 thousand had left the city by train before the lockdown, according to China Railway Wuhan.[120][123]

Zhou Xianwang, Mayor of Wuhan, said that by 23 January, 5 million Wuhan citizens had left the city for the Chinese New Year vacation, while 9 million remained in the city.[125] Data analysis by China Business Network showed that each year, only around half of the residents celebrate the Chinese New Year in the city, while 2/3 of those who leave the city go to other parts of Hubei. The rest leaves for other Chinese provinces and overseas. Henan, Hunan, Anhui are top 3 domestic destinations for them, while Bangkok, Singapore and Tokyo are the top 3 overseas destinations.[126]

Further lockdowns[edit]

Regions of Hubei quarantine are colored red. Mountainous and forest-covered Shennongjia[127] is the only area that is not quarantined.[128]

Soon after Wuhan's lockdown, Huanggang and Ezhou, two Hubei cities bordering Wuhan, followed suit, suspending their public transport systems.[129] By 24th, Huangshi, Chibi, Jingzhou, Yichang, Xiaogan, Jingmen, Zhijiang, Qianjiang, Xiantao, Xianning, Dangyang and Enshi had restricted the inbound and outbound traffic sequently, affecting over 40 million residents.[130] As Xiangyang became the last Hubei city to declare lockdown of city, all Hubei cities had been quarantined by 27th, with local access to road and railway networks temporarily shut down.[21] Forest-covered Shennongjia is the only part of Hubei that has not been locked down.[128]

At least 56 million Hubei residents were isolated. All public places, except hospitals, supermarkets, farmers' market, gas stations and drug stores, were closed, according to Hubei Daily.[131] Starting from 1 February, Hubei city of Huanggang introduced a curfew, which allows only one member of a local family to shop on the streets for every two days, making the city the first to restrict people from going outdoors.[22]

Hubei after lockdown[edit]

After lockdown, Wuhan's streets became silent, excepts those around hospitals.[132][133] Witness described that a "once-bustling city became a ghost town overnight". Although grocery stores and shops remained open, most people stayed at home. Food supply is steady despite a shortage in the early stage and the local government promised to provide enough vegetables, rice, and meat.[133] Similar scenes were observed in other Hubei cities after lockdown, including Enshi[134] and Shiyan[135].

Overcrowded hospitals[edit]

On the first day of lockdown, masses of fever patients were queuing outside hospitals, waiting for examinations,[124] while medical workers and hospitals were struggling with the surge of patients.[136] Wuhan MHC admitted they had a shortage of beds and long outpatient queues.[137] Multiple major Hubei hospitals began to request medical supplies, including surgical masks and other protective equipment, via social media almost at the same time when Wang Xiaodong, Governor of Hubei, promised to the people that there would be no shortage of supplies in a press conference after lockdown.[65]

Makeshift hospitals and laboratories[edit]

On 23 January, the day of Wuhan's lockdown, to relieve the shortage, the municipal government invited China Construction Third Engineering Bureau to build a makeshift hospital that resembled Xiaotangshan Hospital in Beijing during the 2003 SARS outbreak in Caidian, Wuhan. The hospital was later named Huoshenshan Hospital,[138][139] and was expected to be finished by 3 February.[140] On the afternoon of 25th, Wuhan CEC anounced the building of another makeshift hospital with at least 1,300 beds called Leishenshan Hospital.[141]

On 2 February, the construction of Huoshenshan Hospital was completed and the hospital was transferred to the military. [142][143] 1,400 military doctors started to work in the hospital since 3 February.[144][145]

Since Wuhan's healthcare system was overrun, which could tremendously underdiagnosed the patients, new laboratories were being built.[146] On 5 February, a new makeshift laboratory named Fire Eye (Chinese: 火眼),[146][147] which can process over 10,000 samples a day, came into operation on a trial basis.[148][147]

Protective gear shortage[edit]

On 22 January, Hubei Provincial Government said that as of 31 January, Hubei Province could only produce 8 million medical masks, 2 million protective clothing and 1,200 infrared thermometers, which could not meet the need of the province's epidemic prevention. Hubei Province plans to request support from the Central Government, including 40 million medical masks, 5 million protective clothing, and 5,000 sets of infrared thermometers.[149] On 23 January, Wuhan CEC set up a 24-hour telephone service to receive donation from all sectors of the society.[150]

On January 26, the Ministry of Industry and Information Technology (MIIT) said at a press conference that Hubei Province needed an estimated 3 million protective clothing a month. The ministry admitted that national production capacity was not meeting demand, and promised that in addition to the central reserve, the state was also seeking to purchase overseas equipment such as protective clothing and face masks.[151][152]

On 2 February, Cao Xuejun, MIIT's deputy director general, said that around 60% of the mask factories had restarted production. They could produce 10 million masks per day. But the director also acknowledged a gap between production capacity and demand of the key medical and protective products, and promised to prioritize Wuhan and Hubei's needs.[153]

Medical team from Army Medical University was boarding a military Il-76 to leave for Wuhan on 24 January.

Medical teams sent to Hubei[edit]

On 24 January, 135 medical workers from Shanghai, 128 from Guangdong were sent to Wuhan to assist local hospitals[154][155] On the evening of that day, 450 medical workers from three military medical universities were deployed to Wuhan on military planes.[156] On 25 January, medical workers from different provinces were sent to Wuhan, including 138 from Sichuan, 135 from Zhejiang, 138 from Shandong, and 147 from Jiangsu.[157][158] NHC also sent experts in intensive medicine to the epidemic areas, and formed 6 medical team with a total of 1,230 members to assist Wuhan, and another 6 teams waiting for request.[159]

Free lodging for medical workers[edit]

Wuhan hotels offered to help, as many medical workers had difficulty arriving at their hospitals due to public transport suspension.[160] On 24 January, 85 hotels in Wuhan formed a working group to provide rooms without central air conditioning for medical workers for free.[161] By the noon of 25 January, there had been 120 hotels in the group.[162] Major hoteliers, such as Tujia,[163] Home Inn,[164] Ziroom,[165] Danke,[166] offered free lodging for medical workers in Wuhan. There were also people offering free rides to medical workers.[161]

Encouragement of reporting in Hubei[edit]

In Fang county, the government issued a notice stating that anyone having a fever would be award RMB¥1000 for voluntarily going to a hospital, and anyone (including doctors and the public) reporting someone with fever would be awarded RMB¥500.[167]

Daily life[edit]

Food supplies[edit]

After lockdown, Wuhan citizens were buying vegetables at a market.

Wuhan's local markets saw spikes in food prices shortly after lockdown. Despite call for price control, Wuhan CEC stated that commodities, food, medical protection equipment were well-stocked and in smooth supply and appeal to the public not to hoard the goods or buy them at exorbitant prices.[168] According to Wuhan CEC, there were 5 million kilograms of finished rice, 4,000 tons of edible oil, 5,500 tons of pork, 2,000 tons of halal beef, 1,500 tons of sugar in Wuhan's market, while the Government also prepared 16.3 million kilograms of finished rice, 8,000 tons of edible oil, arranged 1.55 million kilograms of eggs, 5 million kilograms of vegetables, 1 million kilograms of fresh fish, 200 tons of halal beef and 6,000 head of pork, which would be released orderly through 300 plus supply outlets across the city.[169] After interviewed by the local market regulation administrators, the supermarkets that was reported to have raised food prices normalized the prices.[170]

China Railway Nanchang has been delivering key materials to Wuhan daily since 25 January. The first batch of 160 tons of turnips has been transported to Wuhan through the private compartments of T147 and T168 trains.[171] China Railway Hohhot also said first batch of 30 tons of potatoes were also sent to Wuhan by K598 and K1278 trains on 26 January to support Wuhan Epidemic Prevention and control.[172]

Community services[edit]

Since the outbreak, community managers were drafted to front lines, to help local residents with their treatment and diagnosis. With the increasing confirmed case number, their work loads became tremendous.[173]6,000 taxis were allocated to downtown communities. Since noon of 25 January, they will provide free service for residents under the command of community committees. Each community are expected to have 3-5 taxis under command. The committees are responsible for offering food and medicine for those with inconvenience in the community.[174]

Although the authority insisted on the role of community services in the epidemic control, the help they have acquired from the government has been so limited that all they can do is to "file forms and repeatedly report about patients’ conditions," according to a community manager. They have no access to medical resources and no enough manpower but have to face angry patients who fail to get help from them. Most community clinics do not have enough equipment, such as protective gears and diagnosis tools, to deal with the tasks assigned by the government to preliminary screen the patients for hospitals. Between 22 January and 1 February, many patients had to go home without enough medical assistance and proper quarantine, for they cannot be diagnosed.[173]

Impact beyond Hubei[edit]

2019-nCoV cases in Mainland China and Taiwan by prefectures
  Confirmed 1~9
  Confirmed 10~99
  Confirmed 100~499
  Confirmed 500~999
  Confirmed 1000~9999
  Confirmed ≥10000

Chinese Communist Party general secretary Xi Jinping warned a 'grave situation' facing China [16][17] and held a Party Politburo meeting which guaranteed resources and experts for treatment and supplies to Hubei,[175] as more and more cases of the viral infection, mostly exported from Wuhan, became confirmed in other cities in Hubei[10] and multiple parts in Mainland China.[176] On 29 January, Tibet announced its first confirmed case, a male who travelled from Wuhan to Lhasa by rail on 22–24 January,[177] which marked that the virus had been spread to all parts of Mainland China.[10][11][12]

Chinese New Year celebrations were cancelled in many cities. Passengers were checked for their temperatures to see whether they had a fever.[18] Henan, Wuxi, Hefei, Shanghai, Inner Mongolia suspended trade of living poultry on 21 January.[178]

Early responses by Henan[edit]

At the end of December 2019, Henan Province announced suspension of passenger trains to and from Wuhan. In early January 2020, the local government of Henan Province, with its complete disinfection measures, effective and intensive publicity, strong awareness of epidemic prevention and quarantine among the people, the setting up of return spots at the village entrance, and even the use of garbage trucks, the digging of trenches to block roads connecting Hubei, and the hanging of slogans such as "return home with sickness is to dishonor your parents." #抄河南的作业 (literally: 'copy Henan's homework') had become a trending Weibo topic hashtag.[179][180][181]

However, cutting off roads without authorization is illegal in Mainland China, as Xinhua and Public Security Ministry have pointed out.[182][183] The Ministry of Transport asked local governments to take the principle of "one to block and three not to block (Chinese: 一断三不断)", that is, to block the virus from spreading but not to block roads, traffic and Internet access, not to block the transport of emergency supplies, not to block the transport of life necessities.[184]

Staffs were examining cars for epidemic control at Qujiang entry to Xi'an Bypass
Body temperature screening at Jishuitan subway station, Beijing

Public Health Emergency declarations[edit]

Doctor father and son encouraged each other for fighting the virus in Chenzhou, Hunan

On 22 January, Hubei launched Class 2 Response to Public Health Emergency.[185] Ahead of the Hubei authorities, Class 1 Response to Public Health Emergency, the highest response level, were announced by the Mainland province of Zhejiang on 23th.[186][187] Guangdong and Hunan followed suit later on the day. On the following day, Hubei[176] and other 13 Mainland provinces[188][189][190][191] launched Class 1 Response. By 29th, all parts of Mainland had initiated Class 1 Response, after Tibet upgraded its response level on the day.[14]

The highest response level authorizes a provincial government to requisition resources under the administration in order to control the epidemic. The government is then allowed to organize and coordinate treatment for patients, to make investigations into the epidemic area, to announce certain area in the province to be an epidemic control area, to issues compulsory orders, to manage human movement, to publish information and reports, to sustain social stability and to do other work related to epidemic control.[192]

Cancellations, delays and shutdowns[edit]

Holiday extension[edit]

On 26 January, the State Council extended the 2020 Spring Festival holiday to 2 February (Sunday, the ninth day of the first lunar month), 3 February (Monday) starting normal work, colleges and universities, primary and secondary schools, kindergartens postponed the start of school.[193] Different provinces then made their own policies about holiday extension. [194]

Sporting events[edit]

For the 2020 Tokyo Olympic Games Qualifier, the third round of the Group B qualification match for the Asian division of the women's soccer team was planned to be held in Wuhan, and later Nanjing[195][196] but the match was finally held in Sydney, Australia as China gave up holding the game.[197] The Boxing Qualifier[198][199] has also been rescheduled to March and the venue has been moved to Amman, Jordan.[200] Group B of the women's basketball qualifiers for the Tokyo Olympic Games, originally scheduled to be held in Foshan, Guangdong, was also moved to Belgrade, Serbia.[201]

As for other major sports events, 2019-20 FIS Alpine Ski World Cup, scheduled for 15-16 February 2020, was canceled due to the outbreak, the event was originally the 2022 Winter Olympics's first test. The 2020 IAAF World Indoor Championships in Athletics, originally scheduled to take place in Nanjing from 13 to 15 March, has been postponed to March at the same venue in 2021.[202] The Confederations Cup Asia Pacific Group I, scheduled to be held in Dongguan, Guangdong, was moved to Nur-Sultan, Kazakhstan.[203]

The State General Administration of Sports announced a suspension of all sporting events until April. Mudanjiang Sports Culture Winter Camp,[204] China Rally Championship Changbai Mountains[205] are suspended. The 2020 Chinese FA Super Cup, to be held in Suzhou, Jiangsu Province on 5 February 2020, has been postponed.[206] AFC Champions League's additional match between Shanghai SIPG and Buriram United were played behind closed door.[207] China's 14th Winter Games, originally scheduled for 16-26 February, have also been postponed.[208] The Chinese Football Association has announced that the 2020 season will be postponed from 30 January.[209] China women's national football team is also quarantined at a hotel in Brisbane, Australia. After postponement of national women's basketball games, the Chinese Volleyball Association suspended all volleyball matches and activities.[210]

The 2020 Sanya ePrix, due to take place on March 21 as the third round of the 2019–20 Formula E season has been postponed to a to-be-announced date.[211] On February 12, the 2020 Chinese Grand Prix, due to take place on April 19 as the fourth round of the 2020 Formula One World Championship was announced to be postponed as well.[212]

Tourist attractions[edit]

Passengers were significantly reduced at May 4th Square Station of Qingdao Metro Line 3 during the epidemic.

On 21 January, the Wuhan Culture and Tourism Bureau postponed a tourism promotion activity to the city's citizens. All qualified citizens will be able to continue the qualification in the Bureau's next activity.[213] On 23 January, the Bureau announced temporarily shutting down museums, memorials, public libraries and cultural centers in Wuhan, which will be closed from 23 January to 8 February.[214] All tour groups to and from Wuhan will be cancelled.[215][216]

On 23 January, the City Administration of Dongcheng, Beijing cancelled temple fairs in Longtan and Temple of Earth, originally scheduled for January 25.[217] The Beijing Culture and Tourism Bureau later announced cancellations of all major events including temple fairs.[218] Tourist attractions in Beijing[219] and Tianjin[220], including the Forbidden City and the National Maritime Museum, closed their doors to the public from 24 January. On the evening of 23 January, the Palace Museum decided to shut down from 25 January,[221] and the West Lake in Hangzhou announced shutting down all paid attractions and the Music Fountain and suspended the services of all large-scale cruise ships since the next day.[222] Since 24 January, many major attractions have been shut down nationwide, including Sun Yat-sen Mausoleum in Nanjing,[223] Shanghai Disneyland, Pingyao Ancient City in Shanxi, Canton Tower in Guangdong, the Old Town of Lijiang, Yunnan and Mount Emei in Sichuan.[224]

Education[edit]

On 21 January 2020, the Ministry of Education (MoE) requested the education system to do a good job in the prevention and control of pneumonia caused by novel coronavirus infection. After that, private education providers including New Oriental, NewChannel and TAL Education[225], education departments in Hubei,[226] Zhejiang,[227] Shenzhen,[228] and Shanghai University[229] cancelled all ongoing courses and postponed the new semester. MoE announced on 27 that all higher education institutions should postpone the new spring semester, while all local education departments should determine the starting time of the new semester for K-12 education and local colleges according to the decision of local governments.[230] The Ministry of Human Resources and Social Security also decided to put off new semester for all vocational education facilities.[231]

The National Education Examinations Authority cancelled all IELTS, TOEFL, and GRE exams scheduled for February. The decision was first made for tests to be held in Wuhan, and then extended to those in all part of Mainland China.[232][233][234] MoE also urged Chinese students studying abroad to delay their travels. For those who need to go abroad, MoE advised them to arrive earlier in case of any kind of health check and to stop traveling if they have a sign of coughing and fever.[235]

On 28 January, the National Civil Service Bureau said that it would postpone the 2020 civil service recruitment examination, public selection and public selection interview time.[236]

Marriage registration[edit]

Civil Affairs authorities in Shanghai, Hangzhou, Guangzhou, Jinan, Ningbo and Gansu announced on January 25 that they would cancel the special arrangement of marriage registration scheduled for 2 February 2020, to avoid the spread of the epidemic and cross-infection caused by the gathering of people. [237][238][239][240] Later, on 30 January, the Ministry of Civil Affairs ordered to cancel marriage registration on 2 February.[241]

Parliament sessions[edit]

The outbreak has made an impact on the National People's Congress (NPC), China's national parliament, and many local parliaments. On 27 January, the Provincial People's Congress Standing Committee (PPCSC) of Yunnan announced to postpone local Lianghui sessions scheduled for early February, which was followed by the PPCSC of Sichuan on 28 January. Local parliament sessions of cities including Hohhot, Chengdu, Jinan, Qingdao, Binzhou, Zhengzhou, Pingdingshan, Anyang, Hefei, Changzhou, Ningbo, Wenzhou, Zhoushan, Ganzhou, Shangluo, Jiangjin, were also put off.[242]

NPC's Standing Committee will discuss on 24 February to decide whether or not to delay its March session.[243] The 10-day session in March is an annual gathering of about 3,000 delegates from all parts of China, where major laws are passed and key economic targets are unveiled. The potential delay will be the first time since 1995 when NPC first adopted the schedule for the March session.[244] Willy Lam, a political analyst at the Chinese University of Hong Kong, believed that the sessions may not only increase the risk of infections but also "post hostile and embarrassing questions to the top officials about the outbreak." He also believed cancelling the meetings would be possible although this never happened after the Cultural Revolution.[245]

Economic impact[edit]

China's economic growth is expected to slow by up to 1.1 percentage in the first half of 2020 as economic activity is negatively affected by the new coronavirus outbreak, according to a Morgan Stanley study cited by Reuters.[246] But on 1 February 2020, the People's Bank of China said that the impact of the epidemic on China's economy was temporary and that the fundamentals of China's long-term positive and high-quality growth remained unchanged.[247]

Due to the outbreak, the Shanghai Stock Exchange and the Shenzhen Stock Exchange announced that with the approval of the China Securities Regulatory Commission, the closing time for the Spring Festival will be extended to 2 February, and trading will resume on 3 February.[248][249] Before that, on 23 January, the last trading day of a shares before the Spring Festival, all three major stock indexes opened lower, creating a drop of about 3% , and the Shanghai index fell below 3000.[250] On 2 February, the first trading day after the holiday, the three major indexes even set a record low opening of about 8% [251]. By the end of the day, the decline narrowed slightly to about 7% , the Shenzhen index fell below 10,000 points, a total of 3,177 stocks in the two markets fell.[252]

The People's Bank of China and the State Administration of Foreign Exchange have announced that the inter-bank RMB foreign exchange market, the foreign currency-to-market and the foreign currency market will extend their holiday closed until 2 February 2020.[253] When the market opened on 3 February, the Renminbi was now depreciating against major foreign currencies. The central parity rate of the Renminbi against the US dollar opened at 6.9249, a drop of 373 basis points from the previous trading day.[254] It fell below the 7.00 than an hour after the opening,[255] and closed at 7.0257.[256]

Face mask shortage[edit]

People in Wuhan lining up in front of a drug store to buy surgical masks.
A notice at a supermarket in Beijing, which says each person can only buy a pack of surgical masks and a bottle of 84 disinfectant liquid a day.

As the epidemic accelerated, the mainland market saw a shortage of face masks due to the increased need from the public.[257] It was reported that Shanghai customers had to queue for nearly an hour to buy a pack of face masks which was sold out in another half an hour.[258] Some stores are hoarding, driving up prices and other acts, so the market regulator said it will crack down on such acts.[259][260] The shortage will not be relieved until late February when most workers return from the New Year vacation according to Lei Limin, an expert in the industry.[261]

On 22 January 2020, Taobao, China's largest e-commerce platform owned by Alibaba Group, said that all face masks on Taobao and Tmall would not be allowed to increase in price. Special subsidies would be provided to the retailers. Also, Alibaba Health's "urgent drug delivery" service would not be closed during the Spring Festival.[262] JD, another leading Chinese e-commerce platform, said, "We are actively working to ensure supply and price stability from sources, storage and distribution, platform control and so on" and "while fully ensuring price stability for JD's own commodities, JD.com has also exercised strict control over the commodities on JD's platform. Third-party vendors selling face masks are prohibited from raising prices. Once it is confirmed that the prices of third-party vendors have increased abnormally, JD will immediately remove the offending commodities from shelves and deal with the offending vendors accordingly."[263] Other major e-commerce platforms including Sunning.com and Pinduoduo also promised to keep the prices of health products stable.[264][265]

Lockdown and curfew[edit]

Government-issued permit for Jintan residents. Jintan announced that each family should only have one member to be outdoor for shopping life necessities for every 2 days.

Ever since Hubei's lockdown, areas bordering Hubei, including Yueyang, Hunan and Xinyang, Henan set up checkpoints at roads connecting to Hubei to urge cars and people from Hubei.[266][267] Between 24-25 January, local governments of Shanghai, Jiangsu, Hainan and other areas announced to quarantine passengers from "key areas" of Hubei for 14 days.[268][269] Chongqing also announced to screen every person who arrived from Wuhan since 1 January and set up 3 centers for treatment.[270]

Since 1 February, a curfew law that resembles that of Huanggang, Hubei, began to be in practice by Zhejiang city of Wenzhou, which is second largest center after Hubei. Each local family can only appoint one family member to go out for purchasing life necessities for every two days.[271] Since 4 February, Zhejiang's capital Hangzhou announced closure of all its villages, residential communities and work units to guests. People who come in and out of the places must show valid identification papers. Non-residents and cars will be checked strictly.[272][273] On the same day, Yueqing, Ningbo, Zhengzhou, Linyi, Harbin, Nanjing, Xuzhou, and Fuzhou began to take the same approach.[274] Zhumadian, Henan announced that each family should only have one member to be outdoor for shopping life necessities for every 5 days.[275]

Response by the Central Government[edit]

Pictographic world map comparing the largest periodic human migration events [276]

Safeguarding 2020 Chunyun[edit]

China's Chunyun is the largest human migration in the world. It is a 40-day period when people return home to spend the Chinese New Year with their families.[277] In 2020, it started on 10 January and ends on 18 February. Before the coronavirus outbreak, the government estimated 3 billion trips to be made during the period.[278]

On 9 January, a cross-ministry press conference regarding 2020 Chunyun was held. Wan Xiangdong, Chief Pilot of the Civil Aviation Administration, said the agency would keep a close watch on the outbreak and strengthen ties with the health authorities. Li Wenxin, Deputy General Manager of China Railway, said the railway authorities were paying attention to the situation and making sure to prevent the spread of the epidemic through railway stations and trains and to safeguard the health and safety of passengers. Wang Yang, Chief Engineer of the Ministry of Transport, said the ministry would carry out disinfection monitoring and protection measures in areas with heavy passenger traffic, including transport hubs, passenger stations and cargo terminal factory stations.[279]

However, on 22 January, as the coronavirus outbreak escalated, Li Bin, deputy president of NHC, warned in a press conference that Chunyun might speed up the transmission of the new virus. Li repeated the government's previous advice to the people, that is, stay away from Wuhan. George F. Gao, Director of China CDC, also admitted on the conference that the virus can transmit between humans and that there were also cases of community-acquired infections. The Chinese health officials also promised to take strict measures to stop the virus from spreading and to release information as soon as possible.[280]

Communist Party Politburo's leadership[edit]

Meetings on coronavirus outbreak[edit]

On 20 January, the Communist Party general secretary Xi Jinping ordered that great attention be paid to prevention and control of the epidemic. The Party also vowed to "guide" people's opinion, with intensive publicity strategies and interpretations of current policies, in order to ensure social stability. Premier Li Keqiang urged relevant ministries and localities to take a highly responsible attitude towards the People's health and to resolutely prevent the spread of the epidemic.[281][282] Premier Li Keqiang also called a meeting of the State Council's Executive Meeting and deployed the work of epidemic prevention and control.[283]

On 21 January, Premier Li visited a local hospital during a visit to Xining, Qinghai, where he urged protection and encouraged health care workers. The National Healthcare Security Administration has decided to adopt a special reimbursement policy for confirmed patients and temporarily bring relevant drugs and medical services into the reimbursement scope of medical insurance.[284] On 22 January, Vice Premier Sun Chunlan went to Wuhan to inspect the prevention and control of the epidemic.[285]

On 26 January, Li Keqiang chaired the first meeting of the Central Leading Group for the Response to the Epidemic of Pneumonia Caused by 2019-nCoV infection. The meeting prioritised the provision of urgently needed medical and health forces, protective clothing and face masks for prevention and control in Hubei Province and Wuhan, and attached importance to the transport of daily necessities for residents and relief supplies to Hubei. It urged local governments to enhance epidemic control, including cancelling meetings and events, strictly quarantining confirmed and suspected infection cases, extending the Chinese New Year holiday and supporting online office and teaching. The Central Government promised to crack down on hoarding and profiteering in materials for disease prevention and control. Public Finance at all levels should fully guarantee such funds as prevention and control of epidemic situations and treatment of patients.[286]

Xi Jinping's absence[edit]

On 27 January, Premier Li Keqiang, entrusted by Party general secretary Xi Jinping according to Xinhua,[287] arrived in Wuhan to inspect and guide the epidemic prevention and control work.[288][289] According to The Wall Street Journal, the appointment of Li who is considered a technocrat surprised some observers, given that he had been sidelined in recent years as Xi concentrated power and cultivated a populist ideological image, however some suggest that Xi was "more at risk to the political fallout of the coronavirus" while Li could be a convenient "political scapegoat".[290] Li's visit to Wuhan has earned high popularity on Chinese social media.[291] Xi Jinping claimed that he "personally commanded" the fight against coronavirus outbreak when meeting with WHO director general in Beijing on 28 January, but according to a report by The Guardian, he has not made any public presence since then; social media posts mocking Xi's absence were prompted deleted by censors.[292][293]

But Xi finally made an appearance at a residential community in Chaoyang, Beijing, on 10 February.[294] Xinhua posted photos of Xi wearing a mask and said the aim of Xi's visit was "to learn about the situation of epidemic prevision and control at the grassroots level."[295] It was his first time to interact with the people since the outbreak, after he paid a short visit to Yunnan during 19-21 January, as a tradition that China's leaders observed to visit smaller towns and villages before the Spring Festival. He was said to chair a meeting on 3 February by state media, but no picture or video were released.[295] Xi also met Cambodian Prime Minister Hun Sen, the first foreign leader to visit China since the coronavirus outbreak, on 5 February.[296]

Epidemic control efforts[edit]

NHC, with the approval of the State Council, announced 2019-nCoV-associated pneumonia as Category B Infectious Diseases with control measures of Class A infectious diseases as stipulated in The Law on the Prevention and Control of Infectious Diseases.[297] From 20 January, NHC will publish daily data on confirmed and suspected cases in all provinces of the country (including during the Spring Festival) until no longer necessary.[298]On 20 January, NHC set up a working group to deal with pneumonia caused by novel coronavirus infection.[282] On 28 January NHC sent seven supervision teams to seven provinces and cities in Beijing, Hebei, Shanghai, Henan, Hunan, Guangdong and Sichuan to supervise the epidemic control measures in the areas.[299]

Financial supports and tax reduction[edit]

On 1 February, the People's Bank of China and other five departments jointly issued the notice on further strengthening financial support for the prevention and control of the epidemic of pneumonia caused by novel coronavirus infection, stating that relevant financial services will be further strengthened during the period affected by the epidemic. For those who are temporarily affected by the epidemic and facing difficulties, the document requires financial institutions to tilt their credit policies appropriately, flexibly adjust their loan repayment arrangements and reasonably postpone the repayment period. Those overdue due to inconvenient repayment during the epidemic period shall not be included in the record of credit investigation and breach of trust.[300]

On 30 January, the Ministry of Finance and NHC issued a notice on the financial guarantee policy for the prevention and control of the new type of pneumonia. The Central Government shall grant a subsidy of 300 yuan per person per day to those who are in direct contact with the cases to be investigated or confirmed, who are involved in the diagnosis, treatment, nursing, hospital infection control, case specimen collection and pathogen detection For other medical personnel and epidemic prevention workers who take part in epidemic prevention and control, the Central Financial Department shall subsidize them at a rate of 200 yuan per person per day.[301]

The Ministry of Finance, the General Administration of Customs and the General Administration of Taxation issued a joint announcement that from 1 January to 31 March 2020, more preferential import tax policies will be implemented for imported materials used for epidemic prevention and control.[302]

Administrative supervision[edit]

Since the outbreak of the epidemic, a number of government officials have been publicly held accountable for their dereliction of duty in the epidemic prevention in 6 provinces.[303]

On 29 January, Director of Huanggang MHC Tang Zhihong failed to tell the capacity of local hospitals, including how many patients they could handle, how many could be hospitalized and how many patients could be tested each day, when asked about these questions despite being an administrator of the local hospitals.[304] A day later, the Party Committee of Huanggang proposed a removal of Tang from the post. On 1 February, according to Mayor of Huanggang Qui Lixin, the city authority had disciplined 337 of its officials and removed 6 cadres who "caused disadvantages to the epidemic prevention".[305][306]

On 2 February, Zhang Cong, Party Secretary of Xuanhua, Hebei, was admonished. Zhang Guoqing, Deputy Party Secretary of Xuanhua, and Guo Xiaoyi, the political commissar of local police, were given disciplinary actions by the Party.[307][308] On the same day, February, Xiangshui, Jiangsu reported three cases of misconduct. The cases were associated with illegal disclosure of personal data and dereliction of duty. Party secretary Zhang Changyue and deputy director Gu Bing of the Zhangji Health Center, and the director of the Xiangshui CDC were removed or disciplined.[309]

Tang Hu, director of the Health Bureau of the Nanhu New District in Yueyang, Hunan Province, was suspended; Cai Junfeng, deputy director of the Lengshuijiang Municipal Committee, and Yang Wen, deputy director of the municipal government office, were suspended; He Yong, deputy secretary of the Gutang Party Committee and township chief, was suspended.[310]

On 4 February, Zhang Qin, the vice president of the Hubei Red Cross, was removed from his post, and Gao Qin and Chen Bo of the Hubei Red Cross were given a warning.[311] The deputy director of the Wuhan Municipal Bureau of Statistics, Xia Guohua, was also removed from his post. The Secretary and Director of the Leading Party Group of the Wuhan Municipal Development and Reform Commission, the Secretary and Director of the Leading Party Group of the Wuhan Municipal Bureau of Statistics, Meng Wukang, and the deputy director of the General Office of the Wuhan Municipal Government, Huang Zhitong, were admonished.[312]

On 15 February , Qiushi magazine documented a January 7 order by Xi Jinping, General Secretary of the Communist Party at the time, regarding the Covid-19 outbreak at a Politburo Standing Committee meeting.[313]

International and regional relations[edit]

Wuhan is a transport hub connected to many international cities.[314] The figure shows top 20 flight international routes from Wuhan.

Information sharing[edit]

Foreign ministry spokesman Geng Shuang said on 21 January that Chinese authorities would share information of the epidemic "with the WHO, relevant nations and China's Hong Kong, Macao and Taiwan regions in a timely manner, including the genome sequence of the new coronavirus."[315]

During the sidelines of the World Economic Forum, Germany’s health minister Jens Spahn praised China for its improved transparency since 2003.[7] US officials and WHO also praised China for sharing data about the epidemic and keeping transparent. US experts had been invited by China's NHC.[6]

On 23 January, WHO director-general Tedros Adhanom and WHO regional director for the Western Pacific, Takeshi Kasai, arrived in Beijing to discuss the new coronavirus outbreak with Chinese authorities and health experts.[316] China agreed on 28 January that WHO send international experts to China.[317]

However, John Mackenzie, a member of the World Health Organization’s emergency committee, criticised China for being too slow to share all the infected cases, especially during major political meetings in Wuhan, after Tedros Adhanom praised China for helping "prevent the spread of coronavirus to other countries."[318]

Evacuations[edit]

Multiple countries have evacuated or are trying to evacuate their citizens from Wuhan, including South Korea, Japan, the US, the UK, Kazakhstan, Germany, Spain, Canada, Russia, the Netherlands, Australia, New Zealand, Indonesia, France, Switzerland, and Thailand.[319] Korean media Channel A said that China asked the evacuation flights to arrive in the evening and leave Wuhan in the next morning so that the evacuation would not be seen by the public.[320] According to BBC, any Chinese national, even with a UK citizenship, is not allowed to be evacuated by the UK.[321]

Taiwan[edit]

Despite controversy over One-China policy,[322] China allowed Taiwan to evacuate its citizens from Wuhan, with the assistance of the local Taiwan Affairs Office.[323] There were around 500 Taiwanese trapped in Wuhan. The first flight to help them leave left Wuhan on 3 February.[324] All of them would be quarantined for two weeks after they enter Taiwan.[323]

However, the evacuation halted after the first flight was found to carry an infected case. Taiwan claimed that the person was not in the evacuation list and that the most vulnerable were not included in the first flight. It also said that it was not prepared to take these people with high risk of viral infections home.[325] Taiwan's President Tsai Ing-wen criticised China's attempt to rule out Taiwan in WHO and said, "The information obtained by the WHO was obviously inaccurate ... and could cause the WHO to make mistakes in dealing with the global epidemic."[326] Premier Su Tseng-chang called for a government-to-government negotiation for the following arrangement of chapter flights,[327] despite the fact that the cross-strait communication mechanism between governments had been suspended since 2016 when Tsai was elected president.[328]

China mainland's State Council Taiwan Affair urged Taiwan authority to stop impeding the evacuation.[329] The office said that before the flight all the passengers had signed a personal declaration claiming that they have no contact with any confirmed or suspected cases and promising to comply with quarantine measures after returning to the island. All the passengers had been checked for their temperature three times before the flight and showed no abnormality. The office criticised that Taiwan authority first expressed appreciation before the flight but changed its attitude after the flight.[330] Wuhan's Taiwan Affairs Office asked Taiwan for more details about the infected case, as the basic descriptions of the patient, including age and gender, were not given as previously 17 cases in Taiwan. The office also said that the patient's close relatives were not at all informed of the viral infection.[331]

Immigration control[edit]

Since 25 January 2020, all passengers entering or exiting Mainland China in Beijing, Shanghai, and Guangdong must write a health declaration, where the individual must answer whether they have been to Hubei Province. This declaration form can also be filled using WeChat.[332]

Exit and entry of Mainland China[edit]

The State Administration of Immigration promised that the border inspection agencies at all ports of entry and exit in China would continue to provide necessary facilities and services for Chinese citizens returning home.[333] On 25 January, the General Administration of Customs decided to reactivate the health declaration system, where people entering or exiting Mainland China should write a health declaration. Border control staff shall also cooperate in health and quarantine work such as body temperature monitoring, medical inspection and medical check-up.[334]On 31 January, the Ministry of Foreign Affairs said it was arranging charter flights to take Chinese citizens from Hubei and Wuhan back to Wuhan 124, given the practical difficulties they face overseas.[335]

Hubei has suspended the processing of applications from mainland Chinese residents for entry and exit of Mainland China. For those with a valid visa to enter Hong Kong, Macao and Taiwan but fail to enter the areas due to the coronavirus outbreak, the Immigration Administration will issue a new visa for free on request of the visa holder after the outbreak is lifted. Some of automated border clearance systems will be shut down according to the needs of the epidemic prevention. After Wuhan declared lockdown on January 23, the Tianhe Airport and Hankou River ports have been without passengers for several days.[333]

Entry from Mainland China[edit]

Since 25 January[336], Taiwan has already banned anyone from Mainland China entering the island;[324] the ban extended to Mainland Chinese overseas.[337] Although global health officials' advised not to perform travel restrictions on China, the US and Australia restricted all Chinese citizens from China from entering their borders.[338] Travel restrictions were announced by Russia, Japan, Pakistan and Italy and other countries, despite China's criticism of border control.[339][340]

Since 28 February, Hong Kong government began to cut down traffic connecting Mainland China[317][341]. On the same day, China's National Immigration Administration announced that with immediate effect, the application of mainland residents' visa to Hong Kong and Macau would be suspended.[342] On 3 February, Hong Kong closed most of its border to Mainland China.[343][344] However, Hong Kong nurses still held a strike, demanding a complete closure.[345]

Discrimination[edit]

Hubei residents[edit]

Although there has been support from Chinese online towards those in virus-stricken areas,[346] instances of regional discrimination have also arisen.[25] According to World Journal, there have been instances of Wuhan natives in other provinces being turned away from hotels, having their ID numbers, home addresses, and telephone numbers deliberately leaked online, or dealing with harassing phone calls from strangers. Some places also reportedly had signs saying "people from Wuhan and cars from Hubei are not welcomed here." [347] Multiple hotels purportedly refused a Wuhan tour guide to check in after she returned to Hangzhou from Singapore, with one of them calling the police to give her a health check and asking the police to quarantine her. Amidst these incidents, various cities and prefectures outside of Hubei have adopted resettlement measures for Hubei people in their region, such as designated hotel accommodation for visitors from the province.[348] In Zhengding, Jingxing and Luquan of Shijiazhuang City, the local governments rewarded anyone who reported those who had been to Wuhan but not recorded in official documents at least 1,000 yuan RMB. In Meizhou, residents reporting people entering from Hunan were awarded with 30 face masks.[349]

It was reported that on a scheduled January 27 China Southern Airlines flight from Nagoya to Shanghai, some Shanghainese travellers refused to board with 16 others from Wuhan. Two of the Wuhan travellers were unable to board due to a fever, while the Shanghainese on the spot alleged that the others had taken medicine to bypass the temperature check.[347] One of the Wuhan tourists protested on Weibo, "are they really my countrymen?" to which a Shanghai tourist who was purportedly at the scene replied that they did it to protect Shanghai from the virus.[348] Many netizens criticised the Wuhan tourists for travelling with a fever, although some also called for understanding and for Shanghainese not to regionally discriminate.[350][351]

Overseas Chinese[edit]

Mainland Chinese overseas are being discriminated against during the coronavirus outbreak.[352] In Hong Kong, a Japanese noodle restaurant said on Facebook, "We want to live longer. We want to safeguard local customers. Please excuse us." It claimed to refuse mainland Chinese customers.[353] In Japan, a sweet shop in Hakone and a ramen restaurant in Sapporo posted "no Chinese" signs outside.[354] Similar things happen in South Korea.[352] French newspaper Courrier Picard published two articles headlined "Yellow alert" and "New yellow peril?" which may reflect the historical racist tropes about the Chinese. [354] Asians in general are also affected by the anti-China sentiment. Disinformation about Asian food and Asian communities are circulating. Videos showing Asian people eating bats go viral, along with dehumanizing comments and implication of the cause of the virus outbreak.[355]

Criticism[edit]

Hubei and Wuhan governments[edit]

Zhang Ouya's criticism[edit]

On 24th, Zhang Ouya, Chief Journalist of Hubei Daily, called for removal of the current leaders of Hubei and Wuhan on Weibo. But he was asked to remove his post, and the newspaper he worked for apologized to the Wuhan authorities.[9] Mayor Zhou of Wuhan said to state media on 27th, "As a local government, I can not disclose information until I get information and authorization, which was not understood at the time."[356] His argument, which hinted at the Central Government's responsibility[356], was refuted by China CDC. Chief Scientist Zeng Guang said to Chinese tabloid The Global Times that what scientists said was "often only part of their decision-making" and praised the eight whistleblowers who were warned by the Wuhan authorities before the epidemic.[357]

26 January press meeting[edit]

Hubei Government's press meeting on 26 January was described as a "scene of a massive car crash" by BBC, which led to widespread dissatisfaction. Despite the compulsory face mask law, Governor Wang Xiaodong did not wear a mask, while the other two official hosts, including Wuhan Mayor Zhou Xianwang and Provincial Party Secretary Bie Bixiong, wore masks incorrectly. The Governor said Xiantao, a Hubei city, was capable to produce 10.8 billion masks annually, after he made two corrections for the number hinted by someone else' notes. The Governor admitted a severe shortage of medical supplies in Hubei, while Mayor Zhou of Wuhan claimed that the shortage had been fully alleviated.[358]

Response to whistleblowers[edit]

In the early stage of the coronavirus outbreak, 8 people were summoned by Wuhan police for their claim there were SARS cases in Wuhan.[9] According to Wang Gaofei, Weibo's CEO, the eight people are all doctors at Wuhan hospitals who "are still fighting at the frontline".[59] The Supreme Court defended these doctors, and pointed out in a WeChat article on 28 January,[59] delay and opacity in public information are the root of fake news and the information that is mostly factual and not subjectively malicious, and causes no objectively severe consequences should be tolerated.[359] On 29 January, the 8 doctors were also praised by Zeng Guang, Chief Scientist at China CDC.[357][360]

Hu Xijin, the editor of nationalist tabloid Global Times, complained about local governments' low tolerance of different online voices and believed this weakened checks-and-balances of government powers through news media.[9]

Death of Li Wenliang[edit]

Li Wenliang, a Wuhan ophthalmologist who is believed to be one of the whistleblower of the coronavirus outbreak. He was warned by Wuhan police after he said that there were Sars cases at Huanan Seafood Market on WeChat. The doctor was later diagnosed of the virus infection and died of it on 7 February. He was said to be dead on the evening of 6 February, before the hospital said he was still under emergency treatment, yet people speculated that Dr Li was actually kept alive, while the authorities were trying to censor the news. After his death, people mourned his death and criticized the government.[361] "We want freedom of speech" and "Wuhan government owes Dr. Li Wenliang an apology" once became a trending topic on Weibo, before the posts about them were deleted by censor.[362] Financial Times believed Li's story fitted the historical archetypes in China, where incorruptible Confucian scholar who speaks truth to the emperor but is persecuted, and ultimately dies for his honesty.[363]

Central Government[edit]

Financial Times described the outbreak as China's Chernobyl moment, which made its leader Xi Jinping under pressure, as a trade war with the US, Hong Kong protests, African swine fever outbreak that led to pork shortage, had already been ominous signs for the current government.[363][364]

Science community[edit]

Alleged academic misconduct[edit]

On 29 January, the Ministry of Science and Technology issued a notice, urging scientists "to write their papers on the land of the motherland, to use the results to fight the epidemic" and that scientists should not focus on publishing their papers, until the epidemic prevention and control task is completed.[365] DuoWei News believed this was aimed to respond to the academic conflict between Zhang Yongzhen's group from Fudan University, which published the first genomic sequence of 2019-nCoV, and the Gao Shan group from Nankai University, which published an analysis[366] on the sequence without authorization from Zhang. Before the notice, Nankai and Fudan, two China's top universities had a fight over the alleged academic misconduct related to the analysis published by the Gao Shan group.[367]

Unpublished data[edit]

On 30 January, Wang Liming, a neuroscientist from Zhejiang University, showed anger on a Weibo post at George F. Gao's latest NEJM article[368]. Wang believed that the article indicated that China CDC already knew clear evidence of human-to-human transmission in early January and kept it secret until three weeks later. Although the post had soon been deleted, China CDC became under the spotlight. China CDC had to respond the next day that the research was a retrospective analysis of the 425 cases reported to CDC on 23 January.[369] Jennifer Zeis of NEJM's media Relations department told Chinese media The Paper that it only took two days to publish the article, but refused to give further details.[370]

Nature said at least 54 papers about the new coronavirus in China were published during the 20-day period between 10-30 January, which did not include any Chinese language articles.[371] Yet, Zuofeng Zhang, a public health expert from UCLA, questioned why the published data were not used in epidemic control before being published, when interviewed by Mainland China-based magazine Intellectual.[372] Zheng Yongnian, an oversea Chinese political scientist, believed that China needs a movement to promote science and to integrate science into policy making, where Chinese intellectuals should spread more scientific knowledge instead of more political knowledge.[373]

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