Last week, China officially began relaxing the suppression measures that have been in place across the country—and particularly in Hubei province—since early January. After passing an official peak of over 80,000 confirmed cases, the number of identified, still active, and tracked cases within China was down to fewer than 1,200. Compared to the hugely premature “reopening” talk going on in the United States, France, and Spain, the move to ease restrictions in China seemed appropriately cautious, and the images of weary doctors and nurses embracing in the streets of Wuhan seemed very well earned.
But a week after reporting its first day since January in which there were zero deaths across the nation attributed to COVID-19, China is already reporting an increase in cases. A nation that’s been held up as one of the examples in the fight against the novel coronavirus may actually be an example of another sort: how there is no real victory short of effective treatment or vaccine.
If there were a vaccine for COVID-19 with widespread availability, it would be possible to generate a level of herd immunity in just a few weeks that would drastically reduce the transmission rate of the virus. If there were a treatment demonstrated to be effective for those hospitalized by the disease, the toll of deaths and long-term damage could be so drastically reduced that it might be possible for nations to maintain a level of business-as-usual even in advance of the vaccine.
Neither of those things is true right now. There is no vaccine. There is no treatment. And there is certainly no existing widespread immunity.
That means that the only way to control the spread of COVID-19 is to restrict the opportunity for the virus to spread from person to person. It’s frustrating. It’s economically devastating. It’s absolutely necessary.
But there is a viable alternative to the suppression measures currently underway in the United States and elsewhere. That alternative is isolation of those who are infected and quarantine of those known to have come into contact with the infected. In theory, such a program allows a nation to not suffer the pain of a broad economic lockdown, while also not being overrun by a massive surge in cases that topples the health care system and brings the rate of COVID-19 deaths up to something very like the number of cases requiring medical care.
On April 11, China reported 99 new cases of COVID-19. On April 12, it was over 100. Both of those numbers seem almost minuscule compared to the number of new cases being turned up in the United States on those same days. They are. But they are also the first time China has reported numbers above 100 in almost six weeks.
Many of these new cases don’t seem to be focused in Wuhan—they’re in regions that were relatively lightly affected during the initial outbreak. In particular, there has been a local cluster near the city of Suifenhe on the border between China and Russia. France24 notes that even though the border between China and Russia is officially closed to all but Chinese nationals trying to return home, officials in Heilongjiang province blamed almost all of the new cases on travelers who had crossed into Russia, where COVID-19 is growing rapidly. China has responded with some of the moves seen early in the Hubei outbreak: addition of testing facilities, makeshift hospitals, and the introduction of additional sanitation squads working to disinfect public areas.
Near Wuhan, concern about a possible “second wave” remains high. The local government has provided green QR codes to those who have tested negative for the active virus. This code must be displayed to access public transport, and can be scanned by phone apps and surveillance cameras. As in Singapore and South Korea, officials are using phone programs not just in case tracking—as has been proposed by Apple and Google—but as a means of enforcing isolation. Hong Kong has backed this up with 200,000 people wearing ankle bracelets.
The sudden blip of new cases shortly after China began lowering some suppression measures may be coincidental. However, the rapid response to the numbers and the continued emphasis on using technology as a means to track and isolate those who are infected shows that China—along with other Asian countries viewed as the “success stories” of the COVID-19 pandemic—don’t believe this is over. In fact, Singapore last week tightened its social distancing rules, banning all social gatherings until the first week of May. This follows two weeks in which Singapore has seen new cases at a rate higher than the previous month.
Hong Kong is also tightening controls just weeks after it became the first in the region to loosen restrictions. Though officials there had successfully kept the incidence of COVID-19 in the city low throughout the rise and fall of the first wave in Hubei, relaxing measures in Hong Kong appears to have doubled active cases there in just over a week. And that’s in spite of a program of testing and isolation that’s significantly more intense than that of the United States.
China, Singapore, and Hong Kong are all looked on as nations that tackled the novel coronavirus, sometimes by using policies that were brutal or draconian. And in the case of China, that “success” was probably much less neat than it seemed, particularly when it comes to the number of deaths. But all of these nations are also clearly aware that their apparent victory isn’t merely hard-won, but tenuous. Until a vaccine arrives, any victory is temporary, and the war is far from won.
