 Hello and welcome to Newsclick. Today we are going to discuss what did China really do in Wuhan and not what people think they did. A lot of the misconception is about that this was really locked down, putting people at homes, not letting them move about and something of an authoritarian state controlling its people. This is a misconception and Dr. Ailward, who was a part of the WHO and China's joint commission on the COVID-19 effects in China, and there is an extensive reporting on that which is available at the WHO site, said that there were various stages that China went through in trying to control the epidemic. And this is something that we are going to see that how the Chinese people behave, what did the government do and how quickly they calibrated their policies in order to adopt or adapt to what was really happening. So let's go to what the scenario was in Wuhan and I will take from one of the papers which is widely available. This shows what the Chinese researchers retrospectively found in Wuhan. Some of the major findings that we all need to know about that even after extensive testing which they did, they believe 60% of the cases were not really identified and these are the real figures, not figures which we see on the various sites. Even what the Chinese have said, these are the figures they have found of people who are infected. They think that those who are not identified also were roughly in terms of numbers, 60% of the total infected, which means that when you are thinking you are tested and you have found the people, if you do not do extensive testing retrospectively you will really not know how many were infected. In fact, this is one of the reasons that the infection that we see in Italy still continues to spread because a lot of people who have not been identified and who are still actually infecting others will come to more details about it. But before we do that, let's look at the big picture that this is an epidemic which starts somewhere in December in the Wuhan and there are about maybe 50 to 100 cases that take place in December. Now this, if you see the screen, then you will see that there are about 50 to 100 cases that takes place in this period and only in the last week of December, the Chinese doctors in one of the hospitals finds that a family of four have pneumonia which doesn't seem to be typical. It's not a typical flu pneumonia and because they already have an experience from SARS earlier, so they know what atypical pneumonia and what SARS kind of infections may be coming and therefore he notifies in end of December somewhere in the 26th, 25th of December, he notifies the Chinese Disease Control Authority, CDC China and there by end of December they have identified this is something which is new and they notify WHO at the end of this period in December end itself and also for instance the United States in January 3rd. Now this is the first phase of the disease that the fact that you have identified that there is a new disease that has come into Wuhan. By 1st of January, they have actually closed the Wuhan market, the seafood market which has been talked about as possibly the center of the epidemic initially. Yes, there are a number of people who were infected from there, but retrospectively now we know that there were a lot of people who were tested, who had no connection to Wuhan. So, this was in the population not only in the seafood market, but also in other places in Wuhan. So obviously, this is a cluster center around the Wuhan seafood market, but the infection really did not seem to originate from there. At the moment we have no clear idea where the origination of the virus is or where did it actually jump from the animals into the human beings. So, at that point of time it is also important to understand that there are various respiratory viruses for instance the Mars virus which causes a very severe infection which does not actually do human to human transmission. So, there were really two issues that the Chinese had to contend with. What is the nature of this virus and is there a human to human transmission? Because if the human to human transmission takes place, obviously there is a much more serious case that they had to handle. If we look at the period that is there in January, then you will see how quickly they moved in after that. One is they were able to identify the genome sequence about two weeks. Now that's a very, very fast really typing, genotyping of the sequence and they were able to upload it on international database around about January 12th or 13th. So, you have this first genomic sequence of the Wuhan virus as Mr. Trump would like to call it. What the world is call it is the SARS-CoV-2 virus was able to identify it within two weeks and within another week they had already developed test kits. Because please remember without test kits you can't test, you only have clinical symptoms. Clinical symptoms are not very dissimilar from the standard flu that you see around you. So, the first test kits were available only around June, January 21st, 22nd or so by which they are able to dispatch these kits into Wuhan. Now this again in three weeks developing both the genome sequence and the test kits is a major achievement which we must credit the Chinese scientific community for having made. Now by that time that there are central authorities have moved into Wuhan, epidemiological experts have come in over there, they've taken over the administration. They've also been very critical of the Wuhan administration in the initial phase of handling this whole epidemic as well as the Hubei authorities. They sort of take over both the Hubei provincial administration as well as Wuhan administration. And by 23rd of January, 23rd, 24th of January they announced a full lockdown of Wuhan because they realize that a lot more cases are going on in the community than they are getting to know. This is also because a lot of the cases are what are called asymptomatic. That means you don't really show symptoms but you're infecting others. The second and this is something we now know that the period of incubation in which you can start infecting others is actually about anything from 10 to 27 days. You can show it after 5 days, you can show symptoms after 10 days. Average is about 10 to 14 but there are cases where the symptoms have been shown much later, developing much later. So this is also the problem. There are a lot of asymptomatic cases which who are infecting others but they don't know themselves that they are infected. So this is the period where you see that though there is a lockdown, the actual numbers seem to be going up because now you are testing much more widely and you are finding people who show symptoms are now infected. And so what you are catching is not new infections but what you really catching is your ability to identify those who are infected. So though the apparent numbers are continuously going up but the actual numbers as you can see by the blue lines as the blue columns, you can see that these numbers are actually decreasing. The blue bars show the actual numbers and you will see that after the lockdown of January 23rd, there is a continuous fall of these numbers but the apparent numbers are going up. Now this is a study done by the Chinese experts, Chinese researchers. It's available publicly. They have made it available which I have given on the slide footnotes below. So this is now publicly known. This is the nature of what was happening. Now is it true that the Chinese did not take immediate action? From January 1st to January 14th, 15th, there are criticisms that can be made of the Wuhan authorities but if you look at the sequence, two weeks identifying the genomic sequence, putting up the test kits, distributing them, locking them, this is all done in a matter of virtually three weeks. Now after this, the world should have known what to expect unfortunately and this includes countries like India as well. We do not seem to have made the preparation which the WHO had said right in the beginning that testing, testing and testing is the only way we can beat back the virus. Now I would like to take you through the other part of the Wuhan story which is did the lockdown by itself reduce the spread? Did it actually help to control it or something else had to be done? And for this we need to look at the chart that I am showing you on the screen which is essentially what is called the effective reproduction number chart. What does an effective reproductive number mean? It simply means that one person is infected on the average. How many persons do it does he or she infect? Now that is a relatively simple number. Now if you take the first phase of Wuhan and this is really the phase in which you are also seeing people who are infected being identified. So these numbers are not the real numbers but the numbers of people who are actually identified to be infected. We find the numbers are 3.88. That means on an average one person was infecting roughly about four persons. Now once you get what is called effectively the lockdown then also you are infecting others in your households. You are infecting people you come into contact with casually but the numbers have gone down from 3.88 to 1.25. Now that is not a bad figure because instead of infecting about roughly four persons you are infecting little more than one person. But the key issue is even if you do that your numbers would still go up. So lockdown is not going to bring down the numbers. The numbers come down only when you are able to come down below one. So Chinese between 23rd to February 2nd they made a quick calculation that they are still seeing expanding numbers. This was not going to be enough. So they did what is called centralized quarantine and what does centralized quarantine mean? It effectively meant separating the people who are either suspected to be infected or who have contacts with people who have been infected and putting them up in different places. Now lot of them were put up for instance in places where hotels, gymnasiums, in other places. They were not people who were sick but they were going to be observed and their samples were being taken for testing but they were isolated from the general population. And if the sample proved positive then they were shifted to what would be called mobile hospitals. They are not really mobile hospitals. I will say that temporary hospitals and these were really again stadiums, gymnasium, warehouses, two temporary hospitals which were created. These were when the mild cases were separated too. What it meant is those who were infected did not create fresh clusters by staying at homes and infecting their families. The second thing they did and that's a very important issue as well is they took out those who are health workers and put them in again in hotels, separated them from their families because they needed support themselves and of course they didn't really need to go back, travel long distances, prepare food, find no food in the supermarkets and so on. So they needed to be supported which is what they did. But it also meant if any of them showed any symptoms they were quickly transferred out of the population, the health worker population into again the people who are infected. Now this helped in providing the support to the health workers themselves and the second thing for the health workers were the kind of protective equipment that they were able to give. In the first lot of the Wuhan infections there were a large number of doctors, health workers, support people, nursing staff were also infected. In the second phase when they got complete protective gear and were supported like this and remember the number who came in from outside Wuhan in terms of medical staff of more than 42,000. Not a single one of them got infected. It's also important to realize why we did full body protective gear because even infections takes place from the hair and from your eyebrows, eyelashes, from your eyes. So you need goggles, you need to cover your hair, in fact you did full protection of the whole body. Now this is something they also did to really make sure that the health staff attending to people were not going to be infected. And if we see this then the important issue that we get is from 1.25 which is the second phase of the infections which we set from 3.88. The effective reproductive rate becomes 1.25. We see the numbers come down to 0.32. Now you didn't really need to bring down the number to 0.32. Probably 0.6, 0.7 might be enough so there are possibilities. We can retune some of these policies in different countries. What it meant was that this allowed from the quarantine phase, the centralized quarantine phase, this allowed the numbers to come down below 1. And that is how the Wuhan coronavirus epidemic was really controlled. I think the important part to realize is that just lockdowns are not going to be enough. As Dr. Elward said in his interview to New Scientist that if you want to do what the Italians have done, they have done the hard part. What you really need to do is the harder part which is isolate the people who are infected from others. If you don't do that then you are not going to be able to successfully bring down the number below 1. And it means extensive testing and separating people providing them with facilities. The last part and I think that's a very, very important part as well is the kind of support the government and Chinese people did. This lockdown would have not worked unless there were community committees which came up, which sprung up. They made sure that the sections who were really old could not go to places. If we look at what the Chinese people and his government did, then we realize this would not have succeeded if the people did not support the government and its measures by organizing themselves. They had committees which sprung up in every community, every group, in every housing society and they took care of the fact that the older people, those who are living alone, those who might have small children, that they would not be able to go out and shop. They provided food for them, the delivery services they do one even provided by the People's Liberation Army. So they provided all the support required for the people who are going to be housebound. They instituted Rota system by which one person in one family could go to shop once in four days and they did it not only in Wuhan, they did it in all provinces of China. So the whole attempt of society to support the government as WHO, Dr. Elward says, it was all in society, all in government effort that really stopped the coronavirus epidemic in China. And I think this is the lesson we have to learn from Wuhan, that it is not simply just lockdowns and administrative action that works. It is telling your people what the science is, what is the basis of your action, rationally explaining to them and providing the support people need in the lockdown period. And don't forget for any of these things, it's the poorest sections of society which suffered the most, their daily wages. How do they get food? And just surrounding them with police cordons as we seem to do in certain areas and isolating them does not solve the problem. If they are not able to get food, if they don't get any money in their accounts, they are obviously not going to be able to observe the lockdown or there will be upheavals. So I think instead of a coercive lockdown, what you need is a lockdown which is cooperative, which allows the people to organize and allows the people also access to basic needs, food, water, supplies of different kinds. And unless we are organized as society, as government to provide that, this kind of lockdowns alone is not going to help. And let's not forget, the crucial issue is the older people who are going to fall sick will need hospitals. And what kind of hospital support we have, are we ready to expand the capacity of the hospitals way above what we now have. It's a very, very small number of hospital beds and particularly intensive care units. Do we have ventilators? Do we have oxygen equipment? This is all going to be key to defeating the pandemic that we have, the COVID-19 pandemic. And China has shown the way, but does the rest of the world understand what has happened and does it have the will to follow it? These are the key questions I'll leave you with.