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dcyphr | Challenges of SARS-CoV-2 and lessons learnt from SARS in Guangdong Province, China

Abstract

This paper discusses the measures taken in Guangdong, China (most populated province in the country) to curb the spread of COVID-19. Many of the region's recent draconian measures are based on its experience from fighting the 2003 SARS outbreak. Strict regulations combined with extensive healthcare measures resulted in significant day-on-day infection ratio drop offs starting Feb 1st. 


Introduction

China’s early spike in COVID-19 cases makes it a valuable source of information for other nations who experienced peak infection numbers more recently. The densely populated Guangdong Province in China (population 113.46 million) received 94,000 travelers from Wuhan China in late January during the Spring Festival period. This holiday travel resulted in the rapid spread of COVID-19 through the region. In response to this spread, the government adopted a policy of  “‘early detection, early reporting, early isolation, and early treatment.’” 


Methods

On January 23rd, 2020, the government enacted protocols for its highest level of public emergency. Temperatures in public areas were monitored, public transport was limited or closed, and respirator use was enforced. Due to the 2-14 day incubation period, a main concern was transmission between individuals unaware of their condition. To avoid mass panic and misinformation, epidemic data, expert interviews, and general health information were shared on a large scale. 

Online medical services were developed to prevent nosocomial transmission. Holiday breaks were extended and residents were instructed to stay indoors and to avoid public spaces. Rules for respirator use were also established, with punishments enforced for those who did not obey them. Ventilation of public areas was also a priority, with strict disinfection (four times a day) standards being set for spaces such as elevators. Dining establishments were required to transition to take out meals instead of in-restaurant serving. 

Lastly, 17,000 medical professionals in 104 hospitals were mobilized to ensure patients were taken care of promptly and effectively. 


Results

All of these strict measures resulted in a significant drop off in day-on-day ratios in Guangdong Province. Data from Jan and Feb shows that the province experienced consistently lower ratios (number of people infected in a given day compared to cumulative number of all previous days) than mainland China (except Wuhan). By mid to late Feb, the region’s ratio of new cases to total cases leveled off to nearly zero. 


Discussion

Guangdong Province’s previous experience with the 2003 SARS outbreak enabled it to act quickly and decisively following the outbreak of COVID-19. The region's strict social and medical protocols resulted in a rapid reduction of new cases following a late Jan peak. While the outcome is encouraging, 435,000 people will be traveling back to Guangdong from Wuhan when traffic reopens. This migration opens up new risks, and strict monitoring in the region will continue.