No 'one-size fits all' model suited for lockdowns, experts say

No 'one-size fits all' model suited for lockdowns, experts say

Thailand is struggling with soaring Covid-19 infections with more than 14,000 new cases a day. The Public Health Ministry has flagged a tougher lockdown like the one imposed by the Chinese government in Wuhan last year as it mulls how to tackle the fast-spreading Delta variant.

Known in Thailand as the "Wuhan model", some sectors are sceptical whether imposing such measures would work here.

The Bangkok Post talked to acting Chinese Ambassador Yang Xin, Chargé d'Affaires of the Chinese embassy in Thailand, and Assoc Prof Piti Srisangnam, director of academic affairs of the Asean Studies Centre at Chulalongkorn University, about lessons learned from the so-called Wuhan model.

Public support needed

China has received mixed messages from the Wuhan lockdown, according to Mr Yang.

In the early days of the outbreak, infected people were urged to treat themselves at home to save hospital beds for patients with severe symptoms, only to learn that it resulted in family and community transmission, he said.

The local government and Beijing made a U-turn, setting up field hospitals and conducting mass testing to flush out infected people, he said. Mild cases were treated at field hospitals while those needing full intensive care were sent to hospitals.

Lockdown was the most-talked about when the Wuhan-style measures were imposed to handle the outbreak, according to the acting ambassador.

It was a tough call for the Chinese government and a huge quarantine effort with over 10 million people locked in, he said.

The decision made by Beijing and President Xi Jinping to put the city under lockdown came ahead of the travel rush during the Lunar New Year holiday when many feared the virus would spread further.

For lockdown measures to work, first the public must understand what the restrictions are and why they need to cooperate, he said. "People stayed home for almost 100 days. It was not only medical workers who fought the virus, but also the people of Wuhan," he said.

Next, authorities must see to it that people have what they need during lockdown, said Mr Yang. The local government went into action, mobilising resources to deliver supplies to people and arrange transport to ferry patients to hospitals.

When resources were running low, the Chinese government sent in medical supplies and medical workers from other parts of the country. At least 340 teams of 42,600 personnel were sent from other provinces to Hubei.

As the Covid-19 outbreak wreaked havoc on the economy, financial assistance was extended to all sectors affected by the virus curbs, he said.

The financial relief included a debt moratorium and soft loans, offered especially to SMEs and factories which were forced to close. An economic recovery was kickstarted as soon as possible.

Tracing and testing a must-do

According to Mr Yang, the Guangzhou-style measures are more relevant to the current Covid-19 situation and demand a closer look for countries seeking to contain transmission.

China has seen flare-ups of Covid-19 in other parts of the country after the Wuhan outbreak. What it learned from Wuhan is that a timely response is needed when cases emerge, meaning the infected must be isolated and tracing and testing in community implemented speedily.

He said authorities have adopted an approach refined from Wuhan and Guangzhou responses to contain outbreaks when a cluster transmission emerged recently in Nanjing.

Knowing that people can contract the virus not only other people, but also contaminated items or rooms, proactive screening was conducted and seven cleaning staff at Nanjing airport found to be infected. This prompted a halt to flights at the airport and a lockdown of communities where the staff were living. Mass swab testing was conducted at night.

Mr Yang said 17 people have been found infected and the city has ordered city-wide mass testing, meaning that more than 10 million people will be tested.

"From our experience, if we can quickly identify the patients, we can use a localised lockdown and limit impacts on the economy. In Guangzhou, we don't use a sweeping lockdown. We start from one community and move to two and so on to avoid strangling the economy," he said.

'Guangzhou' model more relevant

Pointing out he has yet to hear the details of the Wuhan model from the government, Mr Piti said if Thailand is to find a virus response it should study the measures adopted in Guangzhou where an outbreak was brought under control in three weeks.

The Wuhan outbreak caught everyone off guard with zero information about the virus; at that time the Covid-19 testing technology was not good enough, the Covid-19 vaccines had not come into play and the virus had not yet mutated, he said.

"We should look at the lockdown measures in Guangzhou during May 21-June 15 this year. The outbreak took place after the arrival of the Delta variant, the vaccine rollout and Covid-19 screening technology in China," he said.

In Guangzhou of Guangdong province, only communities with infections were sealed off followed by mass testing around-the-clock for seven consecutive days. Fully vaccinated volunteers made door-to-door visits advising people to get tested for the virus.

Technology like artificial intelligence also played a significant role in the fight against the virus outbreak and enhanced the city's screening capability, according to Mr Piti.

The areas were classified as high, medium or low risk allowing people to know the status of their community and those in the red zone were not allowed to travel except to hospital and had to be tested three to five times a week.

Applications were developed to help people buy products they wanted and the goods were delivered via special channels to keep infection risks at zero. The supply chains remained intact.

Laws were also strictly enforced against those defying the disease containment measures. He said China has succeeded in containing the Wuhan outbreak and other flare-ups due to seven key factors including a timely lockdown, stepped-up vaccination drive and preparedness.

The lockdown measures worked because the move was timely and airtight; the economy has been affected but the virus transmission also curbed. "In Wuhan the lockdown was announced at 2 am and went into action at 10 am. The infections were 571 and 17 deaths. When you want to catch birds or fish, you won't warn them you're coming," he said.

No 'one size fits all' model

China also intensified vaccinations in Guangzhou with targeted lockdowns following the outbreak, according to Mr Piti. Only 30% of the public were vaccinated and the people had lowered their guard as the virus was subdued for almost a year. After the campaign, the percentage of people getting shots against Covid-19 had risen to 60% in three weeks.

"We've heard people saying the Chinese vaccine isn't effective against the variants. But China has long stressed that no matter how many people are inoculated, social distancing must be observed. "The restrictions will be eased only when areas are cleared of infections. That's why the Delta outbreak was brought under control in three weeks. You have to know how to behave," he said.

China has an action plan detailing steps to be taken if the situation worsens, and also a contingency plan to cope with unforeseen circumstances. The public is assured that lockdowns will break the chain and embraces it. "But with all that said, you can't still use the Wuhan or Guangzhou model as a whole in Thailand. Neither you can use the Singapore model or the UK model. The situations vary," he said.

Mr Piti said that if the government wants to apply the Covid-19 restriction measures adopted in China, it needs strong leadership to make it work, an action plan and strong state capacity to sustain the people's livelihood.

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