COVID-19 and China: lessons and the way forward

China has largely controlled COVID-19. A country of 1·4 billion people and a size similar to Europe or the USA now reports only clusters of cases rather than widespread community transmission. China has been widely criticised for its role and responsibilities during the pandemic because of censorship, transparency, and human rights concerns. But the rest of the world can still learn from China’s successes in bringing its outbreak under control.China’s response shows the importance of domestic research and public health capacity. Huge investments have left China much better prepared for COVID-19 than for severe acute respiratory syndrome (SARS). When SARS broke out in 2002, China was unprepared initially, especially as the pathogen was unknown. When COVID-19 emerged in December, 2019, Chinese scientists were quickly able to identify the virus and shared genomic sequencing data internationally on Jan 11, 2020. By the end of January, doctors from mainland China and Hong Kong had characterised the clinical features of patients with COVID-19, person-to-person transmission, genomic characteristics, and epidemiology, warning the world about the threat of COVID-19 with research papers published in The Lancet. China has also been at the forefront of vaccine research, with promising results of early trials of a recombinant adenovirus type-5-vectored COVID-19 vaccine developed in China published in The Lancet in May and July. Such research was done incredibly fast and rigorously through close cooperation within China at a time of national emergency. For other countries, particularly low-income and middle-income countries, China’s experience shows the importance of investing in national health and research systems to enhance laboratory capacity as well as workforce. They are fundamental to a quick and effective national response to health emergencies and to global health security.

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