SitRep: Mainland China

The question on many people’s minds lately concerns what the reality of the situation is in China right now. As I’ve said for about a month, “the numbers are probably wrong but the trend is real.” This is to say there’s reasons to be suspicious of the numbers coming out of China both during the peak of the outbreak and today, but the overall pattern seems correct:

  • There was an undetected (or covered-up) outbreak in Wuhan from later December until roughly January 20th with an R0 of 3.7
  • Roughly five million people left Wuhan during this period for Chinese New Year travel, spreading COVID-19 to every province and city in the Mainland.
  • Wuhan went on lockdown on January 23th, quickly followed by several other cities in Hubei, then most of China. Inter-city travel between most cities was suspended.
  • The outbreak peaked in early February
  • the R0 dropped to .32 in Wuhan in February as centralized quarantine emerged, testing capacity scaled up dramatically, and contact tracing ramped up.
  • Cities like Beijing quarantined domestic arrivals by February 16th
  • Lockdowns across the country began easing up at the beginning of March
  • Beijing began quarantining all international arrivals on March 12th, which quickly became nation-wide policy
  • Hubei started reporting no new cases this week and even Wuhan is coming out of lockdown.

In short, China was on course to look like the United States with undetected outbreaks raging across the country undetected for a month. The timing of Chinese New Year, the travel associated with it, and January coverup couldn’t have been worse for public health. The dramatic – often draconian – responses in the last week of January and first week of February really did seem to stop community outbreaks outside of Hubei. 

Most of the country spent 6-8 weeks on lockdown, authorities vigorously tested and isolated everyone that might have it, then started quarantining all possible imports to trip the outbreak circuit. All of these measures should have worked, and by all appearances they did (even if the real number of new infections almost certainly isn’t zero). I am most skeptical of the numbers outside of Wuhan, especially deaths, and think there were likely wider community outbreaks than were recorded. I am far, far less skeptical that those outbreaks haven’t been contained.

Counterbalancing distrust of official Chinese numbers is the political logic of the CCP. They do NOT want a repeat of the last three months. As much as they desperately want to restart the economy and sell both the world and their own citizens about “China’s Success Story,” I have some degree of confidence that they understand how fragile their situation is and will do whatever is needed to suppress this virus again… even if the outside world never hears about it.

One of the ongoing criticisms about the official numbers coming out of China is that we knew they weren’t tallying asymptomatics in their reported numbers. There would be serious reason to worry internal numbers reflected that too, such that asymptomatics weren’t being isolated and contact traced. That they released the number of asymptomatics yesterday proves they were keeping track and do understand the threat they pose.

In my view, it is now safe to allow Chinese to travel internationally without quarantine. As I’ve written elsewhere, the real story of the travel bans early in the outbreak is that Chinese authorities were preventing their own citizens – especially potential imports – in isolation (i.e., off of airplanes and HSR trains to Hong Kong) before most governments put up redundant travel restrictions. That assessment would change if we see any new Chinese imports. The last import I’m aware of was two weeks ago.

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