How Shanghai showed China how to deal with coronavirus

Shanghai was once considered a Chinese city especially vulnerable to the new coronavirus, due to its status as a transportation hub and its close economic ties with central China's Hubei Province, epicenter of the deadly outbreak.To get more news about coronoavirus in Shanghai, you can visit shine news official website.

However, the megacity of 30 million people has done better than most at managing the outbreak. As of Feb. 27, it reported 337 infections and three deaths, without a single case of unknown origin.

"Without early preparedness, an outbreak could have been disastrous," said Zhang Wenhong, head of the Shanghai Medical Treatment Expert Team and director of the Infectious Disease Department at prestigious Huashan Hospital, in an online article.

The city's success in preventing new cases from rising exponentially was also attributed to "multipronged measures taken by the government and strong discipline shown by the people," Zhang said in the article.

Nonetheless, Shanghai still faces challenges as migrant workers return and businesses reopen. "According to epidemiological theory, the second peak in an epidemic is often higher than the first," said Hu Bijie, deputy director of the Shanghai Institute of Respiratory Disease Research. "We are hoping for a lower peak but are prepared for a higher one."

Alerted early

On Jan. 3, Zhang Yongzhen, adjunct professor at the Fudan University-affiliated Shanghai Public Health and Clinical Center, a designated center for treating all diagnosed adult COVID-19 patients in Shanghai, received a sample from a patient with a fever of unknown origin and past exposure to a seafood market in Wuhan. It was one of many samples Zhang's team received from Wuhan Central Hospital under a joint program over the past few years.

"It was just routine work. However, we were shocked by the results," a member of Zhang's team told Caixin.

After more than 40 hours of viral genome sequencing, the team found that the sample was 89.11% similar to the virus that causes SARS, or severe acute respiratory syndrome, which is caused by another coronavirus. SARS emerged in late 2002, ravaging China and spreading to dozens of other countries in early 2003.

The virus in the sample had never been seen in humans, the team concluded. Zhang's team immediately shared the findings with doctors in Wuhan. After some discussion, Zhang identified the virus as the pathogen that caused the patient's symptoms and determined it was highly likely to infect humans through the respiratory system.

On Jan. 5, the center reported its findings to Shanghai authorities and China's National Health Commission, the government agency that oversees China's Center for Disease Control and Prevention. In the internal report, they strongly recommended precautions in public places and anti-viral treatment. The report was most likely the first to lay out the entire genome sequence of the virus.

In late December, doctors in Shanghai had heard a "rumor" about a new SARS-like outbreak in Hubei's capital, Wuhan. Instead of dismissing it, doctors in Shanghai closely followed developments in Wuhan and sounded an alarm within Shanghai's hospital system.

"As early as Jan. 5, we believed the disease was contagious," Lu Hongzhou, the center's party secretary, said in an interview with Caixin. By then, Wuhan had already reported 59 confirmed cases but still denied the existence of human-to-human transmission and any infections among medical workers.

In early January, Shanghai started training doctors to ensure they were armed with the right knowledge before the first patient with COVID-19 -- the disease caused by the new coronavirus -- appeared.

"Prior to official recognition of person-to-person transmission [on Jan. 20], we had studied the features of virus-related CT images and advised medical staff to pay extra attention to such cases," Lu said.

On Jan. 12, a woman from Wuhan arrived in Shanghai with symptoms of fever and fatigue. On Jan. 15, she visited a fever clinic in the Changning district. She was isolated immediately and transferred to a negative pressure room at the center. After she tested positive for the coronavirus, Shanghai authorities reported the first confirmed case to the CDC. On Jan. 24, she recovered and was discharged from the hospital.