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China reaches an important milestone in the coronavirus pandemic with zero new domestic cases reported for the first time. Photo: Xinhua

China ‘still at risk of second wave of coronavirus cases’ despite first day with no domestic cases

  • Nationwide, the country recorded 34 new infections all of them from overseas
  • Public health experts warn it’s too soon to declare victory and imported cases risk triggering further outbreaks

Public health experts warned against premature celebrations after mainland China reported no new domestic Covid-19 infections, warning a second wave could break out any time.

The National Health Commission said on Thursday that all of the 34 new infections reported the previous day had been imported cases – the first time this has happened since the coronavirus that causes the disease emerged.

It is also the first time Hubei province – where the coronavirus was first spotted – recorded no new cases either domestically or from abroad.

The figures were in stark contrast to other places, particularly the United States and Europe, where new infections continue to surge, but epidemiologists said there was no reason to declare victory in China.

“I think it is too early to celebrate. It is likely that a second wave has already started in China, but it may be too early to detect it at the moment,” said Ben Cowling, professor of epidemiology at the University of Hong Kong School of Public Health.

Raina Maclntyre, head of the biosecurity research programme at the University of New South Wales's Kirby Institute, said the rising number of cases overseas meant China needed to manage the risk from imported cases.

“Even if you believe there were 100 times more cases in China than were detected, that’s still less than 1 per cent of the population – so most people remain susceptible to the virus. There is a risk of outbreaks occurring again, but if they have enhanced surveillance and can identify them early, they can contain them,” she said.

“Until we have a vaccine, all countries will be trying to flatten the curve and maintain health systems at a manageable level until that time. That could be 12 to 18 months, so will be very challenging for all of us”.

Jeffrey Shaman, a professor at Columbia University’s Mailman School of Public Health, said there may be undocumented infections and potentially an uptick.

“Once control measures are lifted, the virus will rebound. Even it is eliminated it will be reintroduced from another country. Most of China’s population remains susceptible, so it will spread efficiently”.

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The number of new deaths on mainland China was down to single digits, with just eight reported, bringing the total death toll to 3,245.

The National Health Commission said 23 new suspected cases had been reported, with the total number of infections now standing at 80,928. A total of 70,420 patients have recovered.

The commission has been releasing daily infection figures in Hubei since January 10 and nationwide data since January 20.

But critics have questioned the accuracy of the Chinese data, which has caused confusion in the past because of the frequent changes in diagnostic criteria.

Medical professionals in both China and abroad have also questioned whether Beijing covered up the epidemic – especially in its initial stage – after the first case in China was traced back to November, while Chinese doctors only realised they were dealing with a new disease in late December.

“The international community has strong reason to really hold scepticism about China’s data, because data manipulation is an issue that has been going on for decades...it’s not only about the disease – it’s about the GDP, public finance data, debt. There’s too many examples like this,” said Alfred Wu, associate professor in Lee Kuan Yew School of Public Policy at National University of Singapore.

As the number of new cases dropped, the authorities in Hubei started relaxing some of the lock down measures imposed since January 23 to contain the outbreak.

The government in the provincial capital Wuhan said people living in residential compounds with no new cases for seven days would be allowed to walk outdoors, even though gatherings are still not allowed.

The Hubei government on Thursday ordered local officials and quarantine enforcers to scan the QR codes used in other cities to check people’s state of health without demanding other proof.

Elsewhere, infections from what is now a global pandemic continue to rise. Spain reported 3,237 new cases, bringing total infections to 17,147 and total death at 767. Italy reported 3,526 new cases overnight, Germany 4,070 and Spain 4,719. The US also reported 1,875 new cases.

Mi Feng, a spokesman for National Health Commission, said imported cases represented almost 85 per cent of new infections on mainland China over the past seven days, adding that it was essential to step up border controls is essential.

For example, some flights to Beijing will be diverted to Tianjin and Inner Mongolia to avoid further outbreaks in the capital.

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Zhong Nanshan, a leading Chinese epidemiologist, said that without strong intervention the coronavirus would not be eliminated.

“I think many countries should take measures [based on] the intervention mechanism invented by China. Upstream control is an ancient way but effective,” Zhong said in a press conference on Wednesday.

“The core points are the ‘four earlys’: early prevention, early detection, early diagnosis, and early quarantine.”

Global deaths from the deadly disease are around 9,000, the largest number of which are from China. More than 217,000 people have now been infected by the virus around the world.

The World Health Organisation has said that the epicentre of the pandemic has now moved to Europe, where cases in Italy and other countries on the continent have soared.

“Now Europe is experiencing the first wave of outbreak. The number of confirmed cases will be still climbing. I suggest they take stronger measures to contain. They should test and quarantine the families and close contacts of infected people, don’t wait for the symptoms to show up,” Zhong said.

“I’m not saying [China’s] way is the only way or the best way. The situation varies from country to country. China has paid a high price on the economy, to preserve the health of people. Now the next task is resuming production.”

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This article appeared in the South China Morning Post print edition as: Mainland still at risk of second wave of infections
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