China reports zero cases on three days, is it just a blip?

Bats coronavirus

China had zero cases on March 18-20, but one local transmission on March 21. The turnaround in China comes at a time when the virus is galloping in Europe and is quickly spreading in the U.S.

In a remarkable turnaround, China had zero cases of novel coronavirus (SARS-CoV-2) on March 18-20, including in Wuhan, the epicentre of the epidemic. This comes three months after the first case of the novel virus emerged in Wuhan. But on March 21, Guangdong province had one instance of local transmission from an imported case. As on March 22, China reported 314 imported cases.

As the instance on Saturday shows, more number of fresh cases from local transmission can show up, turning the zero cases reported on three consecutive days into nothing but a blip.

After peaking

At the peak of the epidemic, mainland China reported thousands of fresh cases and hundreds of deaths each day before the total number reached 81,054, which is nearly 26% of the global case load of 3,16,659 as on March 22. The total mortality from coronavirus disease (COVID-19) in mainland China stands at 3,237, which is less than the deaths reported from Italy (4,825).

The initial signs of the epidemic beginning to wane were visible when the first makeshift hospital in Wuhan was closed in early March after all patients had recovered and there were no new admissions.

The turnaround in China comes at a time when the virus is galloping in Europe and is quickly spreading in the U.S. Shutting down Wuhan and a few other cities on January 23 and many more in the following days placed nearly 60 million people in China in lockdown.

Opportunity squandered

In retrospect, the drastic measure sharply reduced the chances of a rapid spread of the virus within China and onward to the rest of the world. It gave Europe and the U.S. the much needed time to take appropriate measures in preventing the virus from gaining a foothold. Unfortunately, both Europe and the U.S. seem to have squandered that opportunity.

What was once considered undoable outside China is now being played out in Italy  — the entire country is locked down. Putting the rights of the community ahead of the individual, many countries have been adopting tough measures akin to China’s — restricting travel, banning mass gatherings, cancelling important events and shutting down educational institutions and entertainment in a bid to cut the transmission chain.

A stain hard to erase

Even as China’s success in containing the epidemic is in the spotlight, its cover-up of the outbreak until mid-January, nearly a month after the first few cases showed up, will remain a stain hard to erase. Worse, its refusal to inform its people even after notifying a cluster of cases to the World Health Organization on December 31, 2019 and gagging doctors for raising an alarm shows that not much has changed since the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002.

The only solace

The only solace is that China did not unduly delay informing WHO about the novel virus unlike in the case of the 2002 SARS outbreak. Also, it quickly sequenced the whole genome of the virus and made the data public just days after informing WHO; it has since shared 126 sequence data. Scientific papers published by Chinese researchers have given their peers across the world a head start in understanding the virus and the disease.

Published in The Hindu on March 23, 2020