China has efficient systems in place to tackle infectious disease outbreaks

The mainland now has efficient monitoring and response systems in place to sound the alarm and tackle any outbreak of an infectious disease

PUBLISHED : Friday, 22 February, 2013, 12:00am
UPDATED : Friday, 22 February, 2013, 4:34am

There is a traditional Chinese saying that a setback may turn out to be a blessing in disguise. That's certainly the case for the mainland's public health system, which has developed in leaps and bounds since a big wake-up call over its weak response to the Sars outbreak in 2003.

The severe acute respiratory syndrome epidemic exposed the mainland's lack of emergency planning for major public health crises and the absence of a central command system. Health officials blamed a poor disease reporting system for a lack of timely information and a weak disease prevention and control system.

Feng Zijian , associate director general of the Chinese Centre for Disease Control and Prevention (CDC), said establishing a stronger public health system had been on the agenda before Sars. The CDC was founded in 2001 but the "epidemic two years later accelerated the process in a big way and boosted its development".

In the wake of Sars, billions of yuan were spent in building emergency centres and hospitals for infectious diseases in central and western provinces. Another 14.3 billion yuan (HK$17.76 billion) was spent on an information network and on prevention and control of serious illnesses.

By 2006 the Ministry of Health had declared that the mainland had basically established a disease prevention and control system and a public health emergency response system.

"The hardware, such as buildings and facilities, were renovated and maintained and then the equipment for the laboratories and offices was installed," Feng said. "A national, almost real-time, internet-based, direct reporting system for communicable diseases and public health incidents was established, which now covers 98 per cent of CDCs and medical institutions at county level or above and 88 per cent of township hospitals."

Before the CDC system, there was a network of anti-epidemic stations in counties and at prefecture and provincial levels. There was no comprehensive central agency for public health at the time.

Back then, doctors reported communicable diseases by sending report cards to local stations, which then sent their aggregate figures of each notifiable disease to upper level stations every 10 days. The provincial station reported to the Ministry of Health once a month.

Mao Qunan , director of the China Health Education Centre, said those reports were just numbers and had no significance in the prevention and control of communicable diseases.

The new system allows doctors with internet access to file reports on a communicable disease - including a patient's details, symptoms and diagnosis - and makes that information almost immediately available to the local CDC and the central CDC, reducing the chances of figures being manipulated.

"The data from the previous day is locked in every morning for the system to run an analysis and a report is generated every morning," Feng said. "A brief is drafted every day for health authorities."

He said the CDC had also set up an automatic warning system and an alert would be sent to on-call staff when an outbreak of a communicable disease was detected, or when unusual cluster outbreaks reached a threshold.

The post-Sars focus on the public health system also changed the use of Beijing's Ditan Hospital. It had specialised in the treatment of communicable diseases but was set to be integrated with another such hospital, Beijing's Youan Hospital, in May 2003 because they had a lot of empty beds most of the time.

Ditan Hospital treated 329 patients during the Sars epidemic, half of them in critical condition, and its treatment routine was videotaped and sent to other hospitals as a standard. The integration plan was aborted after Sars and one billion yuan was spent building a new Ditan Hospital in northern Beijing.

The Sars crisis left some formerly prominent people in disgrace.

Hong Tao, principal research fellow at the CDC's Institute of Virology and a Chinese Academy of Engineering academic, said at the time that a chlamydia-like agent was suspected of causing the Sars outbreak. That claim was immediately rejected by Dr Zhong Nanshan , director of the Guangzhou Respiratory Research Centre. Two months later, Zhong's team declared that Sars was caused by a coronavirus, a finding affirmed days later by the World Health Organisation.

Meng Xuenong , a protégé of President Hu Jintao , was sacked as Beijing mayor in April 2003.