On 2nd June 2020, the municipal government of Wuhan in China, the city that was the starting point of the COVID-19 outbreak, held a press conference announcing the results of the “10 days of battle”. “10 days of battle” was a health campaign in Wuhan that aimed at testing the entire population of the city of 10 million people (aged 6 and above) for the coronavirus in a matter of two weeks. The health campaign began on 14th May after Wuhan had reported six new cases on 9th May, following 35 days without any new infection. During the press conference, the city’s government officials confirmed that among the 9.9mn people tested, no new positive case was found, while 300 non-infectious asymptomatic carriers were identified.
To test 10 million people in two weeks is no small achievement. How was it done? Our portfolio manager Sabrina Ren, who is originally from Wuhan, interviewed some friends and relatives to find out.
The process?
First, you receive a text message on your mobile phone from the government announcing the start of the campaign. The health commission of the government would post a FAQ section explaining how the tests would be done (within your local community), what you need to know (why are the tests needed? who is eligible? what is the cost? what is the data privacy policy? how am I going to get the results? etc.) and measures taken to ensure the process being smooth and safe (one-meter social distancing, scheduling system to avoid crowding, etc.).
Then you would register your name and ID number on the government’s system via Wechat or Alipay to generate your own unique barcode. Your residential community office would then inform you of the dates of the tests, and you could make your own appointment. When it is time for your appointment, you would go to the nearest makeshift tents that have been set up in each residential compound across the city (see pictures) and show your barcode to the local health centre or hospital workers and ask them to conduct the test. The test takes one minute, and the results were made available on a centralized government data system within a week.
Who conducts the tests?
The government’s website designated 53 institutions eligible to do the tests. They are local hospitals, research institutions, government labs and private labs, some of them being listed companies.
The testing methods?
Different methods were used, ranging from antibody/antigen test to DNA sequencing to check the biomarkers in the saliva or blood. It would involve swabs in the throat, in the nose or some blood testing.
The laboratory capacity?
Wuhan adopted a batch testing method that enabled health workers to assess as many as ten samples simultaneously. Samples from up to ten persons living in the same community were pooled together and tested. Pooling samples enables more tests to be done with existing kits while still providing sufficient diagnostic accuracy as the infection rate remains below 1%, according to local healthcare experts. If a batch turns out to be positive, authorities would then follow up with an assessment of each person within the batch.
Can you say no?
The test is theoretically voluntary. However, the pressure from the government and from society helped boost the number of people who responded.
Since February, major Chinese cities have rolled out a health code system, which we discussed in previous newsletters. A green code on your smartphone means that you are allowed to move around the city and travel freely (see pictures below). People who received a yellow or red code need to immediately quarantine themselves at home or undergo supervised quarantine, in the case of a red code. In the present situation in Wuhan, anyone who has not been tested within the scheduled timeframe faces the prospect of having his/her health status downgraded to yellow or red, which will greatly affect his/her daily life, such as the ability to work, travel, go shopping, visit restaurants, use public transportation, and even get access to his/her own residential building. Anyone in all major cities of China is having his/her health code status on his/her smartphone checked numerous times every day.
Cost and benefits?
Some asked whether the massive efforts were necessary or excessive since the results didn’t pinpoint any new COVID-19 case. During its press conference, the municipal government indicated that total cost that had been covered by the district and municipal authorities, was around RMB 900m or USD 120m (USD13 per person). The centralized purchase of test kits helped keep the costs down (a test done in a private clinic in Wuhan typically costs RMB 260). As to the benefits, the aim of the campaign was to restore public confidence after months of fear and panic. In that sense, it served its purpose very well. People felt secure having obtained a green code and reassured about their environment. Restaurants and shopping malls saw traffic rising as a result. This campaign was perceived as having been a major milestone towards going back to normality.
What do we think?
We were impressed by the city’s ability to mobilize the necessary human resources and equipment to implement such a large scale initiative. The success of that initiative was the combination of advanced technology, political will and a disciplined population that was traumatized by the recent events, eager to bring back normality to day-to-day life. We wish the city and its citizens a speedy recovery from the COVID-19 outbreak.