Health

China’s experience: What do cities have to consider when preparing for a lockdown?

It is important to note that the information provided in this Series is intended for your general knowledge only and is not a substitute for professional medical advice or treatment.

As COVID-19 continues to spread, national and city leaders in the world face the tough decision of whether to opt for a citywide lockdown. For world cities, such as London and New York, it is a particularly tough decision. To make the Wuhan experience easier to understand, we compare the conditions of Wuhan and a city of similar size, London, to illustrate some of the political and practical issues. Both cities have about 8.9 million residents, and the areas of the two cities are also quite similar: 8,382 km² for London and 8,494.41 km² for Wuhan.

Decision makers are unavoidably torn between human costs and economic costs associated with a lockdown. Both cities have many businesses, but London’s GDP and GDP per capita are much higher than those of Wuhan. London’s share of the national GDP is also much higher than that of Wuhan. London comprises 22% of the UK’s GDP, whereas Wuhan’s share of China’s GDP is only 1.6%. A comparable lockdown would have much greater impact on the UK’s national economy than the lockdown of Wuhan had on China’s economy. What is more, London is a world financial centre. The impact on the world’s economy should also be taken into account.

Leaving the economic considerations aside and instead prioritising the health security of the population on the very top of the government agenda, the city was locked down on 23rd January. There are a number of practical issues to enforce a lockdown.

For a total lockdown to work, it would require strong incentives for the central and local authorities to enforce the rules and a strong persuasive power to build up social consensus. Otherwise, if people can travel or lead a normal life as usual, the purpose of introducing a lockdown would be defeated.

Two levels of lockdown have been enforced in Wuhan over the past two months. The lockdown at the municipality level, or external lockdown, means cutting down all the unnecessary travels into and out of the city. Wuhan has 19 highway exits and 30 toll stations with physical barriers. When the travel ban started, the toll stations were shut down and the need for human enforcement was minimal. The highway system in the UK is toll free, so there are no existing highway barriers. Apart from highway, there are many ordinary roads that can be used to drive out of town. All would require enforcement staff.

The force available for policing the lockdown in the two cities is similar in number. Wuhan has about 20,000 people working as formal police officers and another 12,000 auxiliary police staff. The role of the auxiliary police in China is mainly traffic control in the street. These are often retired or previously unemployed people. During the lockdown, these people were able to man the roadblock. In London, the police force is much stronger with more than 30,000 police officers. However, it has fewer community support officers.

For the lockdown in Wuhan at community level, or the internal lockdown, the need for enforcement officers and service providers would be exponentially higher than a municipal level lockdown. In communities in Wuhan, to make sure of food supply, army force and street level bureaucrats were mobilised to arrange food rationing and delivery to the entrance of the communities. Government officials, volunteers and community security guards were placed at the entrance of all the communities and public spaces and shops to enforce the rules.

The lockdown policy has been enforced for almost two months. In fact, it was not so strictly implemented in the first 3-4 days particularly in the first 8 hours immediately after the announcement of the lockdown. In Wuhan the lockdown was announced at 2 am on 23rd January and the actual implementation was at 10 am with an eight-hour gap in between. Some interviews suggest that the eight-hour gap allowed 300 thousand people left the city before the lockdown. Some experts labelled this practice as compromised implementation.

These considerations are by no means all. We will continue to discuss other factors in the future Q&As. What Wuhan has done is unprecedented. Many lessons can be learnt from this experience. How to build a city and labour force that can protect the population from the most unexpected disasters is a topic not only for Chinese cities, but also for other cities around the world.

COURTESY: National Health Commission of the People’s Republic of China

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