The COVID-19 Epidemic in China. Lawrence J Lau

day before the Spring Festival holiday). At 10 am on 23 January, Wuhan was sealed off from the rest of China. By the end of the same day, another six cities in Hubei — Chibi, Ezhou, Huanggang, Qianjiang, Xiantao and Zhijiang^25,26 — were locked down. Their residents were not allowed to leave these cities and most of them were required to stay at home. All regular inbound and outbound flights and trains, both domestic and international, were cancelled. All highway and waterway traffic was blocked.²⁷

      With the alarmingly rapid spread of the epidemic, the cumulative number of newly confirmed cases in Hubei doubled in three days, from 270 on 20 January to 549 on 23 January, and then more than doubled again to 1,423 on 26 January.²⁸ Thus, on 27 January, all 12 prefecture-level cities, one autonomous prefecture and three county-level cities in Hubei, with the exception of Shennongjia Forest region, were locked down.²⁹

      Hubei launched a Level II emergency response to public health emergencies on 22 January.³⁰ It was followed by the entire Mainland (including Hubei itself) launching Level I (the highest) emergency response to public health emergencies within the same week.^31,32

      The time line of the events under “The Blockade and Lockdown” is presented in Table 2-2.

Table 2-2: The Blockade and Lockdown

Date	Events
22 January 2020	Hubei implemented a Level II emergency response to major public health emergencies.
23 January 2020	A blockade was imposed on Wuhan, suspending all air and rail services into and out of Wuhan. All highways, roads and waterways into and out of Wuhan were also blocked. A lockdown of the entire city was implemented at 10:00 am.
23 January 2020	An additional six cities in Hubei — Chibi, Ezhou, Huanggang, Qianjiang, Xiantao and Zhijiang — were also sealed off and locked down at 11:00 pm.
23 January 2020	Hunan, Guangdong and Zhejiang implemented Level I emergency responses to major public health emergencies.
24 January 2020	Hubei raised its emergency response from Level II to Level I. Anhui, Beijing, Chongqing, Fujian, Guangxi, Jiangxi, Shandong, Shanghai, Sichuan, Tianjin and Yunnan all launched Level I responses to major public health emergencies.
25 January 2020	Gansu, Guizhou, Hainan, Hebei, Heilongjiang, Henan, Jiangsu, Jilin, Liaoning, Neimenggu (Inner Mongolia), Ningxia, Qinghai, Shaanxi, Shanxi and Xinjiang launched Level I responses to major public health emergencies.
27 January 2020	Xiangyang, the second largest city of Hubei, was also locked down. Altogether, 12 prefecture-level cities, 1 autonomous prefecture and 3 county-level cities within Hubei, with the exception of Shennongjia Forest region, were also locked down.
29 January 2020	Tibet launched a Level I response to major public health emergencies.

       Combatting the COVID-19 Virus

      On 23 January, the cumulative total numbers of confirmed COVID-19 cases in Wuhan and Hubei, according to official data, stood at 495 and 549 respectively and had been doubling every three days. It was determined that at this rate of growth, the then existing healthcare infrastructure and personnel in Wuhan and Hubei would be totally overwhelmed and unable to handle the situation on their own. In order to alleviate the shortage of healthcare personnel, the central government coordinated the provinces, municipalities and autonomous regions to send medical teams to support Hubei. The first such team arrived in Wuhan on 23 January. Since then, a total of 344 medical teams from different parts of the country, consisting of 11,416 medical doctors and 28,679 nurses, had rushed to assist Hubei and Wuhan.³³

      In order to alleviate the shortage of medical facilities in Wuhan, in particular, the shortage of hospitals equipped with intensive care units and isolation wards, two new hospitals — Huoshenshan (Fire God Mountain) Hospital and Leishenshan (Thunder God Mountain) Hospital — were built and equipped at record speed in Wuhan, to treat the most critically and severely ill COVID-19 patients. The Huoshenshan Hospital began construction in the evening of 23 January and formally commenced operation, staffed by volunteer medical personnel of the People’s Liberation Army, on 2 February.³⁴ It took only ten days from the final design to the completion and delivery, which is known as the “Speed of China”.³⁵ Construction of the Leishenshan Hospital, with 1,600 beds, started on 28 January, and it was completed and put into service on 8 February,³⁶ also at record speed.

      Fangcang, in Chinese, literally means a cabin in Noah’s Ark. Fangcang hospitals were temporary hospitals specially set up to treat the patients of the COVID-19 epidemic in Wuhan. The two new hospitals (Huoshenshan Hospital and Leishenshan Hospital) were primarily used to treat the severely and critically ill patients, while the Fangcang hospitals were mainly used to treat patients with mild COVID-19 symptoms.

      In order to rapidly expand the capacity of its hospitals, Wuhan started to set up Fangcang hospitals on 3 February. The Fangcang hospital is a kind of field mobile medical system of the People’s Liberation Army, which can be built as a collection of mobile modules. The first batch of Fangcang hospitals requisitioned three large public facilities in Wuhan — the Hongshan Gymnasium, the Wuhan Living Room Exhibition Center and the Wuhan International Convention and Exhibition Center. Together they provided more than 4,000 beds.³⁷ On 5 February, the first Fangcang hospital was put into service.³⁸ As of 13 February, Wuhan had opened seven Fangcang hospitals, treating more than 5,600 patients. On 28 February, the National Health Commission announced that the Fangcang hospitals had more than 7,600 patients under treatment and also had 5,600 vacant beds.

      On 1 March, the first Fangcang hospital was closed. Between 7 and 9 March, another nine Fangcang hospitals were closed successively. On 10 March, the last two Fangcang hospitals were closed. During the epidemic, 16 Fangcang hospitals were established in Wuhan, treating a total of more than 12,000 patients, representing one quarter of the total number of COVID-19 patients in Wuhan.³⁹ Moreover, the Fangcang hospitals achieved zero infection, zero death and zero re-admission of previously cured patients.

      Since 8 March, the daily number of newly confirmed cases in Hubei has been almost zero. By 11 March, COVID-19 had spread across 105 countries around the world, infecting a total of 37,056 persons and causing 1,120 deaths outside of China. In view of its widespread geographical footprint and severity, WHO characterised the COVID-19 as a pandemic.

      As the epidemic in Hubei was brought under control, the medical teams from outside of Hubei began to return home after 54 days on 17 March.⁴⁰ On 15 April, the 186-member medical team from the Peking Union Medical College Hospital left Wuhan and returned to Beijing.⁴¹ It was the last outside medical team to leave Hubei. Also on 15 April, both Huoshenshan Hospital and Leishenshan Hospital were officially closed. The Huoshenshan Hospital treated a total of 3,059 COVID-19 patients and cured 2,961 of them. The Leishenshan Hospital treated a total of 2,011 patients and cured 1,965 of them.

      The time line of the events under “Combatting the COVID-19 Virus” is presented in Table 2-3.

Table 2-3: Combatting the COVID-19 Virus

Date	Events
23 January 2020	The first medical team from outside of Hubei arrived at Wuhan.
23 January 2020	Construction of the Huoshenshan Hospital in Wuhan began.
28 January 2020	Construction of the Leishenshan Hospital began.
2 February 2020	The Huoshenshan Hospital was completed.
3 February 2020	The Huoshenshan Hospital began operation.
3 February 2020	The first three Fangcang hospital were set up in Wuhan, providing 4,000 hospital beds.
4 February 2020	Another eight Fangcang hospitals began construction. A total of 16 Fangcang hospitals were built.
5 February 2020	The first Fangcang hospital was put into service.
8 February 2020	The Leishenshan Hospital was completed and put into service.
11 February 2020	WHO formally changed the name of 2019-nCoV to COVID-19.
12 February 2020	Hubei changed the definition of a COVID-19 confirmed case to conform to the practice in the rest of Mainland China.
1 March 2020	The first Fangcang hospital was closed, followed