China’s Experience in Confronting COVID-19: Factors of Success, Aspects of Weakness and Lessons Learned

Mohamed Fayez Farahat | 19 Mar 2020

Coronavirus, or COVID-19 as it has come to be known, first appeared in a Chinese city (Wuhan) in December 2019. Infections and deaths because of the virus grew at an increasing pace, which led the Chinese authorities to declare top-level emergency in many of the country’s provinces to counter the rapid spread of the disease. As a result of the tight method adopted by the Chinese government in managing the virus spread crisis, rates of infection and death began to fall remarkably starting from the third quarter of February 2020. So much so that no new infections of local origin were recorded on 19 March.

This paper sheds light on some aspects of the Chinese experience in countering the spread of coronavirus, how China succeeded in managing and containing the impacts of one of the most dangerous health crises which the country has faced in its contemporary history, the most salient vulnerabilities relevant to this process, and what the world can learn from all this.

The spread of coronavirus in China: indications of recovery

While the number of active infections (number of infections minus number of recoveries) increased from 554 cases on 22 January 2020 to 11,289 cases on 31 January, with the number continuing to increase to reach 58,016 cases on 17 February, that number showed a downward trend right the following day, decreasing to 57,805 cases on 18 February, 35,129 cases on 29 February, 10,733 cases on 14 March, 9,893 cases on 15 March, and 8,043 cases on 17 March (a reduction of 920 cases in one day). Figure 1 shows the development of the number of daily active infections between 22 January and 17 March 2020.

This rapid improvement in infection rates could be attributed to two main parallel factors: first, a reduction in the number of daily new infections; second, the increased number of recoveries. A shift has occurred in the number of new infections and recoveries on 18 February; the number of recoveries far exceeded the number of new infections as of 19 February (See figure 2). The number of new infections on 15 March was 16 cases only compared to 824 recoveries on that day, after the gap had peaked on 12 February when the number of infections on that day reached 14,108 cases compared to 1,162 recoveries only.

This improvement has been reflected in two other important indicators: first, the decrease in the number of daily deaths, starting from 18 February. While the number of daily deaths during the period before 18 February took an ascending trend, reaching 8 deaths on 23 January, and 46, 146, 143 and 142 deaths on 31 January, 12 February, 14 February and 15 February, respectively, this indicator was reversed starting from 18 February. With the exception of 23 February (when the number of deaths increased to 150 cases), the number of daily deaths took a descending trend to reach 14 cases only on 15 March, 13 cases on 16 March, and 11 cases only on 17 March (see figure 3).

The second indicator, which is the result of the earlier indicators, was the increase in the number of recoveries compared to the remarkable decrease in the number of deaths. This widened the gap clearly in favour of the rate of recovery which increased on 15 March to 95.47 percent while the death rate decreased to 4.53 percent, unlike the situation at the beginning of February when the recovery rate was 56.82 percent compared to a death rate of 43.18 percent (see figure 4).

Factors of Chinese success in managing the coronavirus crisis

Many factors can explain China’s success in managing the coronavirus crisis and limiting the spread of the disease in its territory. Some of these relate to the peculiarity of both political and sociocultural systems of the country, others relate to the nature of Chinese capital and large companies, while a third group relates to Chinese financial capabilities.

1. Peculiarity of the political and sociocultural systems

China implemented a strict system to prevent the spread of the virus, including a package of stringent measures aimed at curbing the spread of suspected cases and detecting them. This system would not have been successful in dealing with a huge population (around 1.4 billion) had it not been characterized by a significant degree of stringency and decisiveness. One of the explanations put forward of the effectiveness of the system is the nature of the political regime in China in terms of political centralism based on the domination of the Chinese Communist Party which in turn controls the political system, the print and visual media, electronic and non-electronic, in addition to domination of the social media. Important as this explanation may be, another factor should not be ignored, namely the nature of the Chinese Confucian culture that attaches great importance to obedience of public authority (the power of the state, community or family).

The nature of both the political and sociocultural systems has enabled the Chinese government to implement a package of special measures to curb the spread of the virus, detect infections, impose group mandatory isolations, etc., with high efficiency, which created a degree of understanding and close cooperation on the part of the society in the implementation of those measures.

2. Substantial financial and technical resources and the capability of deploying artificial intelligence techniques

 One of the basic factors of success of the Chinese experience in countering coronavirus is the availability of huge financial and technical resources that were promptly deployed, within a short time span, to counter the virus at different levels and concurrently (stop of the spread rate, detection of infections, treatment and reduction of deaths, investment in the development of the vaccine and suitable treatment within medical institutions, etc.). Such financial capabilities enabled the Chinese government to develop effective systems and measures to detect infections, regularly disinfect buildings and streets, build production lines of the necessary medical materials and supplies, promptly construct hospitals dedicated to receiving infections, etc.

Furthermore, this factor played a role in the shift of the Chinese government to another level of countering, namely working on mitigating the economic impact of the crisis on companies and the business sector, and the maintenance of the levels of local supply and demand, by the deployment of a package of financial measures, including cancellation of bank interest for companies affected by the crisis and the reduction of interest rates for loans offered to companies with the aim of reducing the costs of finance and production. This was not limited to companies operating within the city of Wuhan or the Hubei province which were most affected as it also included a large number of provinces. It also included seeking to reduce the cyclical financial burden of affected companies, such as the announcement issued on 18 February to exempt all companies operating in the Hubei province and small companies in the remaining provinces from paying pensions and unemployment and injury allowances until next June (2020), and the reduction of this burden by half until April for large companies outside the Hubei province. In addition, some provinces tended to develop the insurance system, as in Hainan province (south of China) which announced on 17 February the launch of the first insurance product especially designed to cover losses sustained by companies as a result of the spread of the virus.

The implementation of some of those measures required the injection of financial resources into the Chinese banking apparatus. While there are no accurate estimates yet of the overall cost of those measures, it is certainly not low.

On the other hand, the Chinese government and large companies demonstrated a high capability to promptly deploy artificial intelligence techniques available to a number of large Chinese companies in managing the crisis, in addition to the capability to establish and deploy huge databases in the countering operations at all their dimensions. Technology companies played an important role in this field, including what was done by Baidu company which developed a temperature screening system based on artificial intelligence software which could be used in highly-crowded public places to detect pedestrians with high temperature. The technique is capable of screening 200 people per minute without intercepting or detaining pedestrians, which contributed to screening a huge number of citizens in a record time compared to traditional screening methods by human medical teams.

The Chinese government also managed to cooperate with the same company in developing a group of smart robots to carry out a number of tasks, from screening suspected individuals (taking swabs of saliva) to delivering medicine to patients inside hospitals dedicated to the provision of medical care. Such techniques played a significant role in reducing rates of disease spread from infected people to medical teams and vice versa. Those robots were also relied upon in the performance of a huge number of calls with citizens to collect data about their health conditions and the history of their movements, subsequently analyze this data and link it to the health conditions of individuals and determine the possibilities of their infection with the disease. Thus, it was possible to reach advance estimates of the rates of infection and the map of spread of the disease.

Last but not least, reference could be made to another important mechanism that was used in managing operations to combat the spread of the disease, namely the autonomous mobile droids used to provide food and medical supplies and disinfect hospitals. These played a significant role in reducing contact and direct human interaction with infected patients and heavily infected places.

3. Awareness by Chinese capital of its social responsibility

In addition to the important role played by the Chinese state, capital, represented by large companies, particularly information technology and electronic commerce companies, also played an important role in the following three main fields:

First, what those companies did in terms of contributing to the provision of accurate and updated information on the nature of the virus and the map of its spread, the method of access to the necessary medical services, and the map of medical centres. This information was extremely important at the initial stages of the outbreak of the virus in view of the lack of specific information on how to deal with it. Some companies also added new services to their electronic applications, such as Baidu which added a map on its map application (Baidu Map App) that included updated information on the number of confirmed and suspected cases within the area where the user of the application is located in a manner that would help the user avoid heavily infected areas, in addition to the information included in the map with regard to the medical centres and closed roads.

The Qihoo 360 application also launched a platform through which passengers of trains and airplanes can learn whether there are any confirmed infections on their planned trips (once they enter trip data) so that they can take appropriate measures to protect themselves or visit the nearest hospital if symptoms appear on them.

Second, a number of companies contributed to providing alternative spaces to remotely manage and coordinate business and support remote learning activities after schools and universities were closed. In this context, the Ding Talk website, owned by Alibaba company, WeChat Work, owned by Tencent company, Feishu, owned by ByteDance company, and WeLink, owned by Huawei company, provided spaces to remotely coordinate and manage business. ByteDance company also permitted free use of the commercial version of the Feishu application for three years for all small and medium-sized companies, non-governmental organizations, hospitals and medical institutions. A number of companies increased the internet capacities dedicated to videoconferencing and phone calls, and the use of medical websites. In the field of facilitating remote learning, a number of learning platforms and websites, such as Liulishuo, Onion Academy and Zuoyebang, provided e-learning courses to school students. The application DingTalk, owned by Alibaba company, provided an electronic window for teachers and university professors for providing educational lessons and lectures from home.

Third, some of those companies played a role in supporting relevant research and development activities. For example, Alibaba company offered the free use of its artificial intelligence computing capabilities by state research institutions with a view to supporting research and development activities aimed at learning the genetic composition of the virus and the processes of developing the necessary vaccine. Baidu company also made available its LinearFold Algorithm for use by scientists and medical institutions working on combating the spread of the virus and the determination of the secondary RNA structure of the virus and analyzing changes in this structure of homologous composition (man and animal), which facilitates better learning how the virus spreads between different creatures.

The role played by large Chinese companies in these three fields had a significant impact on the effectiveness of managing the crisis, considering the huge financial capabilities available to those companies in general and their technological capabilities in particular. That role also reflected the deep-rooted social responsibility of those companies, something that the business sector lacks in many other countries. However, this social responsibility cannot also be understood apart from the nature of the sociocultural system in China.

Vulnerabilities exposed by the crisis

Despite the importance of the manifestations of Chinese success in containing the coronavirus, the crisis has also revealed some problems. Two main problems are worth noting: first, the centralism and slow reaction of the Chinese administrative apparatus and its hesitation in countering emergency developments and phenomena. Despite China’s earlier experience with the SARS virus in 2002 and 2003, the reaction towards the spread of coronavirus seemed relatively slow. At the initial stages of the emergence of the virus, local beaurocracy in Wuhan city tended to deal with it from a security perspective (monitoring chatrooms on the social media). The pace of functional dealing with the virus remained relatively slow until President Xi Jinping himself showed interest in the issue and dealt with it as a real crisis. This slowness is relatively attributable to the nature of the Chinese political and administrative system which is characterized by a high degree of centralism. This required the issuance of central decisions to shift the issue from the field of security and social discipline to treating it as an actual and dangerous health crisis.

The second problem was the demographic composition as a catalyst for the increase in the death rate at the initial stages of the crisis. Despite significant indicators of the success of the Chinese experience in limiting the spread of the coronavirus, the death rate seemed high during the period from the outbreak of the virus till 18 February. This high rate could be attributable to a number of factors, some of which relate to the demographic composition of the Chinese society, while others relate to the prevailing behavioural habits.

Here, two important features can be pointed out; first, the high percentage of elderly categories which led to an increase in the percentage of those vulnerable to the health complications of the virus (pneumonia). The demographic composition of the Chinese society has undergone a remarkable transformation over the last three decades towards an increase in the percentage of the elderly as a result of the accelerating rates of socio-economic development and the improvement of health care. This led to increased life expectancy at birth, in addition to the one-child policy implemented for decades before some adjustments were made to it over the last years which eventually led to an end in the population pyramid imbalance. The percentage of the younger age group (0-14 years) declined from 33.6 percent in 1982 to only 16.8 percent of the total population in 2017. In contrast, the percentage of the older age group (65 years and above) increased from 4.9 to 11.4 percent of the total population in the same years, according to the data of the National Bureau of Statistics of China. In other words, the percentage of the 0-14 years age group decreased by half what it was at the beginning of the 1980s, while the older age group (65 years and above) increased by more than double.

The increase in the percentage of the older age groups doubtlessly contributed to the increase in the percentage of deaths during the initial stages of the virus outbreak. This is because that category is more vulnerable to the health complications of the virus, something which was not given attention to by the Chinese authorities at the beginning of the virus spread crisis.

The second feature is the high rate of smoking in the Chinese society, especially among men (47.6 percent of adult men compared to 1.8 percent only of women). This factor contributed in turn to the increase in the potential of sustaining the health complications of the virus. This phenomenon may explain the high percentage of men among the total deaths because of the virus compared to women (64 percent of total deaths compared to 36 percent of women).

Overall, the high rate of deaths before the rate of virus spread was brought under control has revealed the problem of the imbalance of the population pyramid in China. This is a problem which the coronavirus crisis may contribute to shedding more light on during the recovery stage and beyond.

Conclusion

While China represented the area of the outbreak of coronavirus, and has sustained high rates of prevalence and death during the initial stages of the crisis, it soon managed to contain it as rates of prevalence and death gradually began to fall and develop in the opposite direction starting from 18 February. It could be said that China provided an important experience in dealing with one of the new and non-traditional threats which demonstrated over time the extent of danger of this kind of threats with their huge human and economic costs which soon turned into a global crisis because of globalization.

In managing the crisis, the Chinese experience relied on a package of financial tools to mitigate the economic effects on the companies and provinces affected by the crisis. Yet it generally revealed three basic conclusions: the first conclusion relates to the importance of the role of society in the countering process as a condition for the success of the measures implemented to contain the virus. The second conclusion refers to the important role played by capital, represented by large companies, in the success of managing the crisis. China’s success in dealing efficiently with the spread of the virus could not be perceived without the important role played by those companies, owned by both the state and the private sector, in supporting the countering process and supporting the efforts of the state and strengthening the society’s capability to resist the disease. That role was not limited to large technology companies as it also included commercial companies such as Alibaba. The third conclusion points out the importance of deploying artificial intelligence technology and big data in the process of countering the spread of contagious and rapidly transmitted diseases as in the case of the coronavirus.

The success of the Chinese experience is partly attributable to some aspects of national peculiarity, such as the nature of the political and administrative system, the substantial financial surpluses, and the nature of the sociocultural system. However, a large portion of this experience continues to be important for the world. This means that the next stage should witness a large-scale cooperation and coordination between China and the world to share this experience and the substantial amount of information now available to the Chinese government and medical institutions about, inter alia, this virus, its genetic characteristics, the possibilities of its future development, the different relation patterns between the infection and death rates on the one hand and the variables of the individual’s age, sex and health history on the other, within a comparative framework of these patterns in other societies. This is based on the fact that the epidemic is no longer a local but rather a global threat par excellence.

Success in sharing this experience requires important conditions; first, giving up by all parties of subjecting the coronavirus to a conspiracy theory and proceeding to exchange of accusations thereon, given that it is not the first time that such crises are subjected to this theory. The crisis of the SARS virus and bird flu has also been subjected to this theory which has proven futile and hindered efforts to enhance international cooperation in countering similar health crises. Subjecting the coronavirus crisis to this pattern of thinking will certainly inflict serious damage on the countering process in the future.

* Researcher on Sino-Asian affairs.   

 

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