Introduction
Methods
Result
National response to the COVID-19 pandemic
Containment strategy of China
Stage | Measures |
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Stage 1: Initial stage of COVID-19 | 1 Classification of infectious diseases: the COVID-19 included in category B infectious diseases, and adopted prevention and control measures for Category A infectious diseases. 2 Established COVID-19 Command System: (1) The National Health Commission made arrangements to send expert teams to Wuhan to conduct on-site investigations. (2) The central government set up a leading group on the disease response. |
Stage 2: spreading stage of COVID-19 | 1 Lockdown Wuhan city: (1) Activated public health emergency II level responses of Hubei province. (2) On Jan 23, 2020: temporarily closed Wuhan outbound routes of airports and railway stations at 10 a.m.; Suspended city's passenger transport operations; People were told to cannot leave Wuhan and home quarantine; Lockdown Wuhan city lasted 76 days. 2 Community and social control measures: (1) All provinces activated Level 1 public health emergency response. (2) Adopt measures to put “four categories of people” under classified management and conducted mass screenings to search for them; All those in need are tested, isolated, hospitalized, or treated was implemented. (3) Strictly observed the principle of early detection, reporting, quarantine, and treatment. (4) Extended the Chinese New Year holiday of 2020 and postponed the opening of schools. (5) Required residents to implement home quarantine, 14-day isolation after trans-regional travel, and protective measures including wearing masks, maintaining social distance and reducing gatherings. 3 Medical treatment policy: (1) Medical expenses incurred by COVID-19 patients will be covered by basic medical insurance, critical illness insurance and medical assistance, and the individual portion will be subsidized by the government. Medical insurance has also reduced the cost of treatment for suspected patients. (2) Established a mechanism to organize pairing assistance from other provinces to Hubei’s cities for treatment; Nationwide resources were mobilized to assist Hubei province; Rapidly constructed 16 mobile cabin hospitals by mobilizing nationwide medical equipment. (3) Produced and released Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia, which adding methods of traditional Chinese medicine. |
Stage 3: normalize prevention and control stage | 1 Guard against imported cases: (1) Tighten up border management, implemented "the first point of entry management" and nucleic acid testing of inbound personnel. (2) Implemented the declaration of health information for inbound personnel, and suspended the entry of foreigners holding Chinese visas and residence permits. 2 Prevent a rebound in indigenous cases: (1) Adopted precise and differentiated epidemic control strategies: Low-risk regions should focus on imported cases and restore production and life at an appropriate time; Medium-risk regions should prevent both imported cases and indigenous spread; High-risk regions should strictly commit epidemic prevention and control. (2) Using health color code as identification and the evidence of daily life and access to public places. (3) For sporadic cases: Strengthen screening of close contacts; Trace source of confirmed cases; Strengthen early-warning research and risk grading; Strengthen quarantine control of key personnel. 3 Expedited vaccines and medicines research and application: (1) COVID-19 therapeutic drugs were included in new scope of medical insurance list. (2) In Dec, launched a key population vaccination campaign. |
Intermediate strategy of India and South Africa
Country | India | South Africa |
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Stage | ||
Stage 1: Prevention and control of import cases | 1 Immigration Control Measures: (1) On Jan 25, 2020, issued a travel warning that avoiding unessential travel to China. (2) On Feb 2, stopped the electronic visa service for Chinese; On 13 Mar, all travel visas for foreigners became temporarily invalid except special visa categories. (3) Closed the border and banned international flights. (4) Passengers from severely affected countries would be under quarantine for 14 days. 2 Guaranteeing epidemic prevention materials: (1) Since Jan 31, the export of personal protective equipment including masks and protective clothing was banned during the epidemic. (2) Banned the export of 26 active pharmaceutical ingredients (APIs) and their medicines. | 1 Border control measures: (1) Closed country borders; Cross-provincial travel is prohibited. (2) Closed 35 land ports and 2 waterways; Strengthened airport monitoring measures. (3) Suspended visa issuance to visitors from high-risk countries such as China and Italy and foreigners who have visited these countries in the past 20 days. (4) Installed temperature monitoring equipment at all ports; designated 13 public hospitals across the country to treat COVID-19 patients and provided free treatment. 2 On Mar 15, 2020, South Africa entered into a state of national disaster and started a crisis management mechanism. |
Stage 2: spreading stage of COVID-19 | 1 Implement a five-stage blockade: Lockdown-1 imposed a nationwide strict lockdown and isolation for 21 days; closed all shops, factories, and so on; Suspended all unessential activities. Lockdown-2 divided hotpots and non-hotpots region, which relaxed restrictions, allowed some necessary activities, and gradually resumed work and production. Lockdown-3 divided three zones: red zones were under strict control, orange zones implemented strict residence rules and green zones allowed more free travel. Lockdown-4 imposed curfews and banned going outside except for necessary needs. Lockdown-5 shortened curfews and continued lockdown-4 policy is strictly policed areas, while non-strictly policed areas allowed free movement within the areas, and opened commercial centers. 2 Community prevention and control measures: (1) On Mar 22, imposed a curfew calling on all Indians to stay indoors between 7 and 21. (2) Several states, including New Delhi and Mumbai, made it mandatory to wear masks or be arrested and jailed for at least six months. (3) The government advised Work From Home Policy and pay wages as usual. 3 Guaranteed isolation and treatment sites, and strengthened testing: (1) Retrofitted about 20,000 train carriages for COVID-19 patients’ isolation; Set up nearly 60,000 isolation beds. (2) On Jun 27, built a square cabin hospital in the Bangalore International Exhibition Centre and closed on Sep 4. (3) Enhanced nucleic acid testing in New Delhi. | 1 Strictly enforce the blockade order: (1) At midnight on Mar 26, South Africa began a 21-day “lockdown”, and the lockdown level was set as Level 5, the strictest, closed all government offices, businesses, restaurants, and shops, except for public services such as hospitals and pharmacies. (2) Banned all social activities; only allowed people to go out to buy food, medicine, and take medical treatment. (3) Banned sales of alcohol and tobacco; Imposed daily curfew. 2 Implement single room policy: 5,571 isolation sites were set up to provide temporary shelters for the homeless and free self-isolation places for those who cannot self-isolate in their homes. 3 Fighting corruption in COVID-19: The President set up a special commission of inquiry to investigate corruption in the procurement of supplies for the COVID-19 epidemic. 4 Enhance virus detection capability: (1) Public laboratories were working with private laboratories to test for coronavirus. (2) Promoted community detection: Organized medical workers and mobile surveillance vehicles into communities to conduct coronavirus test census, and collected samples of suspected patients. (3) Established community contact tracing teams to track and monitor confirmed patients and close contacts. |
Stage 3: Restarting economic and social activities | 1 Removing restrictions in stages: In Jun, Unlock-1 opened places of worship, hotels, restaurants, shopping centers all across India and changed curfew time from 21 to 5, while freed cross-border traffic between states. In Jul, Unlock-2 reduced daily curfew by one hour reopened some routes and later resumed some international air travel. In Aug, Unlock-3 opened more activities outside the quarantine zone, while lifting the personal curfew. In Sep, to restore economy Unlock-4 allowed a limited opening of some public facilities, such as subways, shopping malls, and entertainment venues. In Oct, cinema, theatre, and so on were reopened, except the controlled areas, but the number of customers was limited to 50 percent of the authorized capacity; Schools, parks and other places were opened to the public. 2 Economic stimulus policies: (1) Introduced the slogan “India self-made” and launched an economic stimulus package about 20 trillion rupees. (2) Three rounds of economic stimulus: The first round of 20.97 lakh crore, focusing on basic livelihood assistance; The second round focused on stimulating consumption; The third round focused on supporting industries hardest hit by the epidemic, such as tourism and catering. | 1 Lower blockade level: (1) From Apr 23, gradually relaxed the level of lockdown order and allowed enterprises to resume work. 2 Relaxed community prevention and control measures: (1) Gradually opened Borders, resumed international travel, relaxed restrictions on public outings and social activities, and allowed most businesses to operate. (2) Relaxed restrictions on the sale of alcohol and tobacco; shortened curfews. 2 Launched economic support policies to restore the economy and stabilize employment: (1) Building a new economy: mobilized public and private resources and undertook massive infrastructure development and maintenance to drive economic recovery. (2) Launched a 500 billion Rand economic support and social relief program. 3 Adjusted the priorities of government work: implement "risk adjustment strategy", enhanced dynamic early warning and epidemic containment measures; Went deep into communities to ensure basic living conditions of residents; Provided support to affected businesses and workers. |
Stage 4: COVID-19 second outbreak | 1 Public health measures: (1) Mumbai decreed that if there are five or more confirmed cases in a residential building, the entire building and residents will be sealed off. (2) Mass celebrations were banned during the traditional holiday of Holi. (3) New Delhi imposed a daily curfew from 22 to 5. During the curfew, only allowed shops providing essential services and vehicles used for emergency matters. 2 Vaccination measures: (1) On Jan 3, 2021, the emergency use of vaccines was officially approved; Launched vaccination campaign, giving priority to nurses, doctors and other frontline workers. (2) On Mar 25, delayed in Mar and Apr delivery of COVAX, and restricted vaccine exports. | 1 Resumed strict community prevention and control measures: (1) Closed borders with neighboring countries such as Zimbabwe, Lesotho and Mozambique. (2) Extended curfews; Asked People to wear masks outside or risk prosecution; Postponed the start of school. (3) Banned on the sale of all alcoholic beverages. 2 Vaccination measures: (1) Implemented a phased vaccine promotion policy: the first phase target medical workers; The second phase is for workers in basic jobs to keep society running, people over 60, with basic medical conditions or in nursing homes; The remaining adults are the target for Phase 3. (2) In the second phase of vaccination, nationwide the number of vaccination sites increased from 53 to 2,000 by collaborating with private medical institutions. |
Mitigation strategy of Brazil and Russia
Country | Brazil | Russia |
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Stage | ||
Stage 1: Prevention and control of import cases | 1 Public health emergency: (1) On Jan 22, 2020, initiated a public health emergency and joint multi-sectoral epidemic prevention team against COVID-19. (2) On Jan 28, the first suspected case was reported and the health risk level was raised to level 2 (imminent danger) and raised to Level 3 (national public health emergency) in advance. (3) An emergency quarantine law was produced and implemented, and 34 Brazilian nationals were withdrawn from Wuhan and quarantined for 18 days. 2 Early warning: (1) Published a COVID-19 epidemic prevention manual and guidelines. (2) The Brazilian ministry of health and media released real-time information on the epidemic. | 1 Established COVID-19 Command System: On Jan 27, 2020, the government meeting on the prevention and control of the spread of the epidemic was held, and an epidemic prevention headquarters was set up. 2 Border prevention and control measures: (1) After the outbreak of the epidemic in China, on Jan 31, Russia closed its far eastern border with China, suspended visa services for Chinese citizens and temporarily banned Chinese citizens from entering the country for private purposes. (2) After the outbreak of the epidemic in Europe, on Mar 18, Russia banned foreign citizens entering the country, stopped issuing tourist visas and required entry quarantine for 14 days. (3) On Mar 27, Russia suspended all international flights. |
Stage 2: spreading stage of COVID-19 | 1 National and local social prevention and control measures: (1) The federal government issued a decree authorizing states to create their quarantine measures. (2) National measures: closed elementary and middle schools; Encouraged people to wear masks of any type and make by themselves. Brazil's health minister ordered a population-wide home quarantine, but the president only supported home isolation for the elderly to protect employment. (3) Local measures: closed schools in cities such as Sao Paulo, Rio and Brasilia; Indefinitely canceled major events; Required to wear masks or be fined; Implemented comprehensive ground lockdown city measures. 2 Border prevention and control measures: on Mar 30, Brazil completely closed its borders. 3 State of public disaster: (1) From Mar 20 to Dec 3, Brazil entered into a state of public disaster. (2) A package of emergency measures: launched R $147.3 billion to deal with the impact of COVID-19 outbreak on economy, and R $4.5 billion to fight COVID-19 directly. 4 Construction of square cabin hospitals: built and operated the Anhembi Square and the Convention Center Square cabin hospital, with a total capacity of 2,000 patients. | 1 Set up an epidemic prevention command operation agency and an inter-agency coordination agency. 2 Strengthened surveillance and vaccines: (1) Organized the troop and scientists to strengthen the research on virus surveillance, detection, and prevention, and developed many coronavirus detection systems. (2) Detected herd immune markers and initiated a free coronavirus antibody assay. 3 Set up medical centers: (1) Designated 32 military hospitals to receive COVID-19 patients, established 7 temporary mobile hospitals and allocated and renovated beds in local hospitals and clinics. (2) Allocated 8.8 billion rubles for constructing 16 multi-purpose infectious disease medical centers; Expanding and renovating the hospital ship “Irtysh” to treat other patients in the Far East. 4 Community epidemic prevention measures: (1) Paid vacation was extended from Mar 28 to May 11, and states of emergency were authorized. (2) Quasi-lockdown city: People were allowed to leave homes on limited occasions; Recreational places remained closed; Supermarkets, pharmacies and other places posted signs that queue 1.5 meters apart. (3) Banned on gatherings of more than 5,000 people; Introduced masks wearing and a passport system. |
Stage 3: Restarting economic and social activities | 1 Relaxed Quarantine measures and resumed economic activities: Since Jun, several states have begun to relax quarantine measures and gradually resumed commercial activities. Sao Paulo state gradually opened shopping malls, restaurants, bars, and other public places in 5 stages. 2 Medical measures: (1) Zero tariff on 34 drugs used for COVID-19 treatment. (2) A nucleic acid testing without getting out of cars was offered 200 tests a day in a shopping mall parking lot in Sao Paulo. (3) Closed the Anhembi square cabin hospital. (4) Conducted clinical trials of 9 coronavirus vaccines, developed in China, Russia, and other countries. 3 Brazil's Ministry of Health suspended the release of key data on the COVID-19 outbreak. | 1 Removed of restrictive measures by grading and stages: (1) On June 12, Russian nationwide holiday covering all sectors ended, and gradually lifted restrictions. In stage 1, lifted restrictions on sports, small-scale trade and service entities while maintaining social distance; In stage 2, people were allowed to walk outside, large businesses, physical service industries and educational institutions were allowed to limited open; In stage 3, opened public places at social distance, fully opened trade, physical services and all educational institutions and catering businesses. (2) According to epidemic prevention situations, each federal government managed by different levels. (3) On Jun 9, Moscow lifted policy of self-isolation, electronic pass system and walking requirement. (4) On Sep 1, opened universities and schools, and organized the opening examination. 2 Implemented a national economic recovery plan which forces on achieving economic growth and reducing unemployment. 3 Relaxation of entry and exit prevention and control: Resumed outboard flights; Allowed Russian to go abroad for medical treatment, take care, work, and study, and allowed foreign citizens inboard. |
Stage 4: COVID-19 second outbreak | 1 Some states upgraded prevention and control measures: The Rio Grande do Sul state government banned beach stays, suspended celebrations and restricted on catering hours; A curfew was imposed across Parana state; The state of Santa Catarina reopened empty intensive-care beds, tightened monitoring of masks and banned crowds; Sao Paulo state entered the most stringent epidemic prevention red phase, restricted time to open supermarkets, pharmacies, gas stations and other essential places; Para state canceled Carnival celebrations, banned public gatherings of more than 10 people, closed bars; The Federal District of Brasilia imposed restrictive measures on non-essential business. 2 Vaccination measures: (1) A four-stage priority vaccination strategy. The first is health workers, older people aged over 75 or over 60 and living in nursing homes, and indigenous people; then, people aged 60 to 74; the third Stage three is people with comorbidities; The fourth stage is for teachers, soldiers, police, rescue workers, prison officials and prisoners. (2) On Jan 18, 2021, all of Brazil's 26 states and the Federal District began vaccination. | 1 Strict prevention and control measures: (1) Since Oct 28, Russia from 23 to 6 to ban recreational activities and provide public catering services; Strengthened disinfection measures; Required masks in public places; Enhanced detection of coronavirus. (2) Tightened immigration rules: illegal immigrants had to leave Russia on their own or risk deportation. 2 Restarted medical centers: (1) Resumed the temporary mobile hospitals in Patriot Park and Leningrad Exhibition Hall operation. (2) Two new multi-purpose medical centers were built in Astrakhan Prefecture and Narimanov. 3 Vaccination measures: (1) Registered the world's first COVID-19 vaccine (Sputnik-V). (2) Since Oct 28, Russia from 23 to 6 to ban recreational activities and provide public catering services, and the formulation of the "Vaccine Passport" and international certification were promoted. |
Epidemic cooperation in BRICS
Measures | Key elements |
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Health cooperation | 1 Sent medical experts: (1) On Feb 5, 2020, seven Russian epidemiologists arrived in Beijing to help China contain the spread of the virus and develop a vaccine. (2) On April 11, China sent a 10-member expert team to Russia to exchange experience and provide guidance and training on prevention and control, diagnosis, and treatment. 2 Provided medical supplies: (1) In Feb 2020, Russia, India and South Africa donated masks and other medical supplies to China. The Brazil-China Association for the Promotion of Peaceful Reunification donated to China. (2) Since March, China has donated personal protective equipment, nucleic acid extraction reagents and other materials in batches to Russia, India, Brazil and South Africa. (3) On April 17, India committed to delivering nearly 100 million Hydroxychloroquine tablets to Russia for the treatment of COVID-19. (4) On May 23, Russia delivered the Coronavirus diagnostic test system to South Africa. 3 Established an early warning mechanism for infectious diseases: (1) On April 28, 2020, heads of BRICS Foreign Ministries held a special meeting on COVID-19 to support the joint establishment of an early warning mechanism for infectious diseases. (2) On Sep 9, 2021, the New Delhi Declaration of the 13th BRICS Summit endorsed the progress made in establishing an early warning system for the prevention of large-scale infectious diseases in BRICS countries to identify and predict future pandemics through institutional cooperation. 4 Shared experiences in fighting COVID-19: (1) China, South Africa, Russia, and Brazil held video conferences for COVID-19 prevention and control. (2) Experts in the design of Leishenshan Hospital in China, shared construction experience and helped South Africa improve the construction plan of anti-epidemic hospitals. (3) From March to April 2021, the National School of Governance of China offered courses on national governance and emergency management for middle and senior leaders of South African public organizations. |
Vaccine cooperation | (1) China and Russia are working together to develop and produce COVID-19 vaccines; Russia and Brazil carry vaccine cooperation in three aspects: clinical testing, vaccine production, supply to Brazil and the whole Latin American market; The Russian vaccine “Sputnik V” manufactured in India, Brazil, and China. (2) On July 24, 2020, Brazil launched a clinical trial of a coronavirus vaccine from China, which vaccinated 9,000 volunteers within 90 days. (3) On Nov 17, 2020, according to the Moscow Declaration of the 12th BRICS Summit, we will work to ensure that vaccines, once available, are distributed in a fair, equitable, and affordable manner; We also encourage the BRICS Vaccine Research and Development Center to become operational as soon as possible. (4) The contribution made by BRICS countries in providing over a billion COVID-19 vaccine doses, including grants and donations, bilaterally, to international organizations and the COVID-19 Vaccines Global Access (COVAX) facility. |
Economic cooperation | (1) In April 2020, New Development Bank established an emergency assistance facility, including US $5 billion for health and social security expenditures and US $5 billion to support economic recovery of member countries. (2) New Development Bank has issued three COVID-19 preparedness bonds and $1 billion in emergency loans to five member countries to purchase hospital beds, ventilators, and protective equipment for frontline medical workers, as well as to mitigate the economic downturn caused by the pandemic and lockdown. |