Measures to Contain Ebola in China
Expert talk of the growing threat of Ebola spreading to China has the international media abuzz and increasingly scrutinizing the country’s preparedness to contain the highly infectious disease. Noted Belgian microbiologist Peter Piot, co-discoverer of the virus in 1976, warned China is vulnerable given the number of Chinese now resident and working in West Africa. He also presaged that the experience of other viral outbreaks points to the basic ineffectiveness of screening at airports.
China’s National Health and Family Planning Commission (NHFPC) declared no Ebola cases in China at present and that health bureaus across the country are upping inspections at ports of entry, notably, in Beijing, Shanghai, and Guangzhou where emergency drills have been carried out to deal with potential cases. CNTV (Central Television) quoted Song Shuli, spokesman for the NHFPC as saying, “the country has set up a complete disease control and prevention mechanism following the SARS epidemic and experts believe there is no possibility of a large-scale Ebola outbreak in China.”
With viruses like Ebola, the issue of quarantine is a tricky one for many countries. An impromptu survey of online mainland and Hong Kong Chinese viewers of a debate program on Hong Kong’s Phoenix TV showed over 96% wanting restrictions on visas for West Africans to China. A recent CBS poll conducted in the US late last month indicated that 80% of Americans support mandatory quarantines for US citizens and legal residents arriving from West Africa. 27% even wanted travel bans on West Africans to the US until the virus is contained.
Two weeks ago, the states of New York and New Jersey brought in 21-day mandatory quarantines for all health workers returning from West Africa while US troops that have served in West Africa are also subject to quarantine. The Canadian government announced last Friday that no new travel visas will be issued for residents or citizens of Ebola-stricken countries along with a halt on processing of permanent residency visas for people from affected countries. Australia has also closed its borders to citizens from the three worst-hit countries.
Memories of the SARS outbreak in 2003 when over 5,000 people were infected resulting in 300 deaths partially as a result of initial policy bungling and measures taken since have much better prepared China for any possible outbreak. Interviewed by Bloomberg, Ben Cowling, an associate professor of infectious disease epidemiology at the University of Hong Kong’s School of Public Health remarked: “After SARS, China doesn’t want to be in the same situation again…In the last 10 years, they’ve built up massive capacity to respond to this kind of situation, to avoid damage to public health and prevent the socio-economic problems that arise with it.”
The limited spread of another bird flu strain, H7N9 in the spring of 2013 further firmed Beijing’s determination to fight pandemics by being transparent and cooperative with the World Health Organization (WHO) and other health authorities around the world. Learning from the SARS experience, NHFPC shared samples of the virus with laboratories worldwide to help develop vaccines in case the virus started spreading among humans.
The NHFPC introduced a Ebola control plan back in July, laying out procedures for screening, reporting, and controlling potential infections. In Guangdong, which receives as many as 190 flights from Africa every month, over a two-month period to October 21, local health authorities tracked about 8,700 visitors from Ebola-hit countries of which over 5,000 are longer being monitored. As well, 27 hospitals have been designated to handle possible Ebola cases.
Meanwhile, health checks are being stepped up across the country, especially in Guangzhou where a 100,000+ strong (mainly West African (?)) community resides. Moreover, returning medical personnel who had worked with Ebola patients in West Africa are subject to a battery of tests before entering a mandatory 21-day observation period supervised by local health workers although it is not clear whether they could spend their quarantines at home or at secure isolation units. Any staff developing symptoms would be dispatched to a designated hospital.
For ordinary Chinese returning from Ebola-affected regions, those whose temperatures checked over 37.3 degrees Celsius would be sent to hospitals for further tests. Those without a fever who have had contact with Ebola patients would have to have their temperatures checked twice a day for a period of 21 days. Those who haven’t had contact with Ebola patients are recommended to quarantine themselves at home for 21 days. In addition, the dispatching of virus screening experts to Ebola-affected areas has benefitted the work of public health authorities at home by focusing on pre-emption.
At the same time, however, a major crack remains in China’s wall to contain currently untreatable pathogens such as Ebola – China still has no level 4 biosafety laboratory to conduct scientific research on Ebola. Level 3 facilities can handle widely-known viruses, including HIV, SARS, rabies and yellow fever but not Ebola.
A senior official of the Chinese Center for Disease Control and Prevention (CCDCP), China’s equivalent of US’s CDC, recently told state media that the country is building a level 4 facility in Wuhan in collaboration with the French. The new lab is scheduled to open early next year and the CCDCP has further plans to build one on its own. But, health officials readily admit that two level 4 labs are far from enough to deal with varied pathogen risks that China will face going forward.