China
Measures are beefed up to prevent COVID-19 in rural areas lagging in healthcare facilities and hygiene awareness
By Ji Jing  ·  2021-02-03  ·   Source: NO.5 FEBRUARY 4, 2021
A volunteer on duty at a checkpoint in a village in Wangkui County, Heilongjiang Province in northeast China, on January 15 (XINHUA)

In Heilongjiang, China's northeasternmost province bordering Russia, the New Year started on a dismal note. On January 10, a 30-year-old woman became the first reported novel coronavirus disease (COVID-19) patient in the province after months of no new infection.

More cases surfaced. The next day, 45 asymptomatic cases were reported, all from the village in Wangkui County where the woman's father lives. Soon there were several hundred confirmed and asymptomatic cases.

On examination, the father was also found to be asymptomatic. He had led an active social life in the past few days, including dining at a restaurant and taking part in two weddings, where he could have got the infection.

The trail of infections continued via the bus the man took to return home from a wedding. Among the passengers were a couple from Jilin Province in the northeast. They took a train back to their home city one week later and subsequently, were diagnosed as asymptomatic. By that time the virus had spread to other passengers who shared the same carriage with them on the train. By January 20, Jilin had reported 162 confirmed cases.

Speaking about why the cases popped up in rural areas, Liu Youning, a professor of respiratory medicine at the Chinese PLA General Hospital, told China News Service that people in rural areas have a weak awareness of COVID-19. Many people do not go to see a doctor if their symptoms are mild.

Besides, compared with cities, rural areas have weaker medical service capacities. In Hebei Province, north China, some doctors in villages couldn't identify COVID-19 cases, delaying treatment for some patients.

Besides, the sense of hygiene is weak in some rural areas, Liang Xiaofeng, Vice President and Secretary General of the Chinese Preventive Medicine Association, said. Some people still do not have good hygiene habits.

It was the same in Hebei where the new COVID-19 cases were mostly reported in rural areas, which raised the alarm for epidemic control in such areas.

The first confirmed case in Hebei this year was reported on January 2. A 61-year-old woman from a village visited her sister in another village and took part in a wedding feast in a restaurant. Soon Hebei reported several hundred cases within days while it had no new infections for months. Many of those infected had taken part in mass gatherings such as village fairs.

A villager called Li Jie in Wangkui told Xinhua News Agency that in winter since there is little farm work, people participate in mass gatherings, especially weddings. Some villagers had attended three to four weddings despite the warnings against mass gatherings.

According to a press conference on epidemic prevention and control held by Hebei's local authorities on January 12, most of the current outbreaks in the province were in rural areas. They accounted for 70 percent of the cases as of January 12.


A centralized quarantine facility is assembled at Huangzhuang, a village in Shijiazhuang, Hebei Province in north China, on January 18 (XINHUA)

Epidemic response

Once the new breeding ground of the disease was detected, the local authorities in Heilongjiang and Hebei swung into action to contain it.

City-wide mass nucleic acid testing started. In Shijiazhuang, capital of Hebei, over 5,000 people from three villages with the most serious epidemic situation were put under centralized quarantine and medical observation.

On January 13, a 4,156-room modular quarantine center for close contacts and secondary close contacts of infected persons started to be assembled in Hebei. China Construction First Group Corp. was one of the builders. Fourteen workers from the company arrived at the construction site on January 16 and finished putting up 68 rooms and a warehouse on January 18, four and a half hours ahead of schedule.

In addition to centralized quarantine, some villages in Shijiazhuang were locked down and public transport was suspended. Those who needed to go out to work had to register with the volunteers at the village entrance.

Local officials bought necessities such as vegetables for those asked to stay at home. Fan Liansu is a village official who did the shopping. She created a WeChat group where she posted the price of vegetables at the nearby supermarket. The group members would inform her what they wanted and every two to three days she bought the ordered vegetables. The villagers paid her via WeChat.

Shijiazhuang has also notified residents to postpone weddings and simplify funerals. Meeting to dine together or play cards has been forbidden.

Ren Xuemei, a doctor at a village clinic, said she and her peers have been given several rounds of training to improve their ability to diagnose the disease.

Winter, a season when people are prone to colds, flu and other respiratory diseases, is anticipated to be a time of some COVID-19 outbreaks. But once the weather gets warmer, the situation is expected to improve, Liu said.

A heartening factor is that more than 15 million doses of COVID-19 vaccine have been administered since December 2020, according to the National Health Commission (NHC) on January 20. The government has said all citizens will receive free vaccination. But it will be a long process as people have to be given two doses each at an interval.

With the Spring Festival, the Chinese New Year, coming up on February 12, and millions of people traditionally traveling during the holiday period, multiple provinces and municipalities have been urging their residents to celebrate the holiday wherever they are, without traveling back to their hometowns.

Around 1.7 billion passenger trips are anticipated during the Spring Festival travel rush, the Ministry of Transport said on January 20. Though 40 percent down from 2019, before the emergence of the virus, it is still a 10-percent increase on 2020.

The NHC said on January 20 that people intending to travel home to rural areas during the Spring Festival travel rush must provide negative COVID-19 test results. The tests have to be taken within seven days of departure as part of the measures to cope with the rising risks.

It's an unusual time now and we should do whatever is good for epidemic control, Jiang Qingwu, former head of the School of Public Health, Fudan University in Shanghai, told the media. Reducing the flow of people will help stop transmission of the virus. But the government should also balance epidemic control and people's desires for family reunion, he added.

(Print Edition Title: Strengthening the Weakest Link) 

Copyedited by Sudeshna Sarkar

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