Central quarantining, ‘Covid hotels’ and temperature guns – how China has shown a path out of coronavirus lockdown
BLAMED for spreading the coronavirus through its horrific wet markets and accused of covering up the ensuing crisis, China is an unlikely inspiration for beating the pandemic.
However, the targeted measures it has taken since January's outbreak in Wuhan appear to have worked wonders in allowing the nation to get back on its feet — with reported cases and deaths plummeting while other countries' tolls continue to rise.
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Favouring a system of 'central quarantining' that shields any infected individuals from the wider population - including even their families - China's success has now prompted calls for the UK to consider a similar approach.
While this would appear to mean greater restrictions on the public in the short-term, experts say it could provide the quickest route out of lockdown.
"The UK government had an assumption in the back of their minds that, in order to get out of this, a proportion of people will need to be infected — but it’s just absolutely wrong," says Daniel Falush, a professor of statistical genetics at the Institut Pasteur of Shanghai.
"It’s a very unsuccessful idea and they’ve abandoned it in a formal sense, but they simply haven’t been active in doing the type of things that are actually needed to get transmission under control."
Here, Prof Falush, who has witnessed China's bounceback first hand, explains the pioneering strategies it has used to fight Covid-19 - from central quarantining to 'corona hotels'.
Ruthless isolation even for mild symptoms
When the virus spread across Wuhan at the start of the year, the city scrambled to convert sports halls, gyms, and other large public spaces into makeshift 'central quarantine' facilities.
The idea was to take people with mild symptoms out of the general population altogether.
Research published in the Journal of the American Medical Association shows that the virus spread constantly in Wuhan in the first week of the outbreak, but dropped off dramatically when central quarantining was introduced on February 2nd.
The day before, the city had over 2,100 cases — by February 9th, it had under 500, and the number kept falling until it was virtually zero by April.
The barracks-like centres differ from hospitals in that they're just for mild cases — their main function is to keep potentially infectious people separate from the public rather than provide acute treatment.
The NHS Nightingale emergency hospitals set up across England, on the other hand, are for people who need active medical treatment.
Once at the centres in Wuhan, people stay for a short period of isolation before testing confirms they're safe to leave.
Prof Falush believes such central quarantining, in addition to quarantining at home, could be an effective strategy for slashing the spread in other countries too.
"People who are sick and infectious and are out in the world - however good their intentions are, they are a danger to their neighbours," he says.
People who are infectious and out in the world - however good their intentions are, they are a danger to their neighbours and families
Professor Daniel Falush
"In particular, they’re a danger to any uninfected family members."
He adds that a large proportion of transmissions in the Wuhan outbreak were between family members, but those infections fell dramatically when central quarantining was introduced.
"What was shown in Wuhan very effectively was that, when they introduced it (in the second week of the lockdown) it really cut down the overall rate of transmission very substantially."
Thermometer guns to check fever
Armed with infrared thermometer guns, Chinese health workers are still regularly taking people's temperatures to check for fevers.
Such checks, which are being used all over the world, help medics identify where infections are and isolate coronavirus patients before they spread the bug to anyone else.
The NHS says a typical adult temperature is around 37C, depending on factors including age and time of day, with anything over 38C considered high.
“The key thing is to get transmissions down to a very low level," Prof Falush says.
While the British Government aims to carry out 100,000 tests per day by the end of April, last week just 21,000 tests a day were being done on 14,000 people.
These tests tell medics if someone currently has coronavirus — we do not yet have a reliable test to determine if someone has already had the virus.
But regular temperature testing and reporting could help officials keep track of where outbreaks are taking place.
“Essentially, everyone can do their temperature morning and evening every day," Prof Faulsh says.
"By doing that, you get a pretty good idea of where infections are and you can spot them quickly."
Short lockdown & app rollout
Shanghai was only put into lockdown for three weeks and even then people were still free to leave their homes — though most chose to stay in anyway.
Instead, authorities in China identified people who had symptomatic cases and quickly put them in quarantine for 14 days.
Prof Falush says scientists then went house to house looking for others with symptoms.
All these measures together helped slash the rate of transmission near to zero.
Since the outbreak, China has had over 82,788 cases, of which 4,632 died and some 77,151 have recovered.
By contrast, the US has had 10 times as many cases at a staggering 820,273, of which 45,430 have died and just 83,068 have recovered.
A system of apps is also being used in China to track cases of the coronavirus.
These ask users about their health background and body temperature which is used to give the person a colour-coded status.
Users with green codes are determined to be symptom-free and are allowed to pass through checkpoints in restaurants, residential buildings and train stations.
Whereas people with red and yellow codes — those who either have symptoms or have been in contact with others who have them— are restricted.
'Quarantine hotels' better for mental health
Parties in luxury hotel rooms with young people dancing and laughing together might sound like the opposite of life in lockdown.
But that's exactly what's happening in some countries, where high-end resorts have been turned into central quarantining facilities for those with mild symptoms or returning from abroad.
Prof Falush thinks central quarantining might actually be more fun than having to isolate at home, even likening it to staying in a youth hostel.
“On Chinese social media, there are all these people dancing in their central quarantine," he says.
But the policy isn't just contained to China.
In Israel, ten hotels have been converted into quarantining facilities across the country for people with mild symptoms and those returning from abroad who are required to isolate.
While there are no doctors at the sites, ambulances are on standby to rush "guests" to hospital if their condition deteriorates.
But during their stay, guests are free to socialise and have a good time together.
Amit Katzav, a 21-year-old hair stylist, was sent to the converted Dan Panorama hotel in Israel after contracting a mild case of Covid-19 while flying back to Israel from the US, the reports.
She raised other guests' morale by giving them free haircuts using styling equipment she took in with her.
“In the evening, all the young people get together and put music on to pass the time,” she said.
“We have movie nights and a karaoke machine upstairs.”
British lockdown 'is much more draconian'
For the moment, there's no plan for how the lockdown will end in the UK.
Britain's policy reportedly began with a "herd immunity" strategy, in which it was hoped enough people would develop immunity to the coronavirus for life to continue as normal.
But that policy was abandoned in favour of ever-tightening restrictions on people's movements as the number of cases continues to spiral.
Prof Falush believes the time has come to have a frank conversation about introducing new measures such as those in China — which could be perceived as less stringent than the lockdown.
The lockdown is much more draconian than central quarantining. It's the only measure that affects you if you’re infected or not
Prof Falush
“The lockdown is much more draconian than central quarantining," he says.
"It's the only measure that affects you if you’re infected or not.
"Central quarantining is for a small proportion of the population at any one time, and it’s for two weeks.”
Whitehall was reportedly considering a top secret "traffic light" system of incrementally easing lockdown restrictions, but ministers have denied it.
Fundamentally, Prof Falush thinks central quarantining needs to be introduced to give a sense of how the coronavirus gridlock will be broken - with centres with extra capacity such as the new Nightingale hospital potentially opened up for further use.
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"A blanket lockdown is the most idiotic way of doing it possible," he says.
"I’m still absolutely in favour of it, but if you look at what happened in Britain, the point is you go into lockdown as hard and as fast as you can.
"Then you open up as you put the type of things in place that mean you have viral transmissions under control.
"The Government in England just hasn’t followed that playbook at all - and the results have been bad."