As the world grapples with the escalating coronavirus pandemic, China reopened the city of Wuhan on Wednesday, allowing its 11 million residents to leave for the first time in over two months, a milestone in its effort to combat the outbreak.
But while the operation to contain Wuhan’s coronavirus outbreak has been hailed as a success by China and many international health experts, it didn’t come easy.
Using virus case data, official reports and over a dozen interviews with officials, residents and scientists in Wuhan, Reuters has compiled a comprehensive account of how the military-style quarantine of the city unfolded.
Wuhan health authorities reported the first case of what turned out to be the new coronavirus in December, and the first known death linked to the virus in early January.
City officials insisted the situation was under control for the first two weeks of January, downplaying the possibility of human-to-human transmission as they focused on a seafood and wildlife market where the outbreak was believed to have started.
But troubling signs were emerging.
Hospital respiratory wards began reaching capacity by around Jan 12, and some people were being turned away, a half dozen Wuhan residents told Reuters.
But at least up to Jan. 16, Wuhan’s government said that no new cases of the disease had occurred for about two weeks, and the city continued as normal. Diners packed restaurants, shoppers flocked to commercial districts, and travellers headed to train stations and airports for their Lunar New Year holidays.
Minimal measures were put in place to take the temperatures of residents in public places, or encourage them to wear protective masks, residents said.
“We ordinary people did not know that we needed to take protective measures,” said Wang Wenjun, whose uncle died of the coronavirus on Jan 31.
But that changed after Jan 18, when a team of scientists sent by the central government in Beijing arrived in Wuhan.
Leading the group was 83-year-old Zhong Nanshan, an epidemiologist credited with raising the alarm in China about the spread of another coronavirus, SARS, in 2003. Over two days, the team investigated the source and scale of Wuhan’s outbreak, inspecting the seafood and wildlife market and other sites.
As the scientists toured Wuhan, their mood darkened as the scale of the crisis became clear, said a source familiar with the trip.
A day before the scientists arrived, four new cases were confirmed in Wuhan, none of which had apparent links to the market.
That cast doubt over local authorities’ previous assertions that there was no substantial evidence of human-to-human transmission, which would have required them to impose drastic containment measures on the city.
The scientists’ visit was the third by an expert group since the end of December as suspicion in Beijing grew that the virus was transmissible and local officials had concealed the challenges they faced containing the disease, according to an academic on the Jan 18 trip and a scientist who visited on Jan 2. Another trip took place on Jan 8.
During the Jan 18 visit, the team made several discoveries that had been previously undisclosed to the public by local officials.
Over a dozen healthcare workers had been infected, efforts to track close contacts with other confirmed cases had dwindled, and hospitals had not conducted a single test before Jan. 16, Zhong and other experts on the team announced a few days after their trip to Wuhan.
On Jan 19, the group of about a half dozen scientists returned to Beijing, where they reported their findings to the National Health Commission, which formulates China’s health policy.
The experts recommended that Wuhan be put under quarantine and that hospital capacity be rapidly expanded, according to two sources who were briefed on the discussions. Zhong himself had suggested the lockdown measures, they said. Zhong and the commission did not respond to requests for comment.
One of the sources said the proposal was initially rejected by Wuhan government officials because they feared the economic impact, but they were overruled by the central authorities.
On the evening of Jan 20, the central government set up a taskforce in Wuhan to spearhead the fight against the epidemic.
The lockdown of Wuhan had been put in motion.
Ye Qing, deputy chief of the statistics bureau in Hubei province, where Wuhan is located, said it was only when Zhong announced his findings that he began to realize the seriousness of this epidemic.
Wuhan officials, he said, reacted far too late. “If the government had sent out a notice, if they had asked everyone to wear masks, to do temperature checks, maybe a lot fewer people would have died.”
He added: “It’s a painful lesson with blood and tears.”
Later tracing of virus patients showed that people confirmed to have the virus travelled from Wuhan to at least 25 provinces, municipalities and administrative regions across China before the lockdown plan went into action.
The Wuhan government and the National Health Commission in Beijing did not respond to requests for comment.
The ripple effects of events in Beijing were soon felt in Wuhan.
On Jan 22, senior officials in Wuhan received a written government notice telling them not to leave the city, or report their whereabouts if they had, according to two local government sources.
The directive offered no further details, but at about 8 p.m. that night, some officials received notice by telephone that the city would be shut off the next morning, the sources said.
The lockdown was publicly announced at 2 a.m., sending thousands of Wuhan residents scrambling to find a way out.
But access into and out of the city was quickly closed off, with public transportation shut down and the use of private cars banned. Residents were soon after restricted to their homes.
Having seized control of the crisis, Beijing also removed a number of key officials from Wuhan and Hubei province.
Wuhan’s mayor, Zhou Xianwang, who kept his job, made a frank admission in an interview with state media a few days later that party-reporting mechanisms had stifled early action.
“Information should have been released more quickly,” he said. The process had been slowed by officials in Wuhan being “obliged to seek permission” before fully disclosing information to the public, he said.
Almost two months after the lockdown was imposed, China has started allowing residents to leave the city, as well as permitting domestic flights and inter-city trains. Wuhan has reported just one new case in the past week, and around 93% of all cases have recovered, according to official data.
As other countries consider Wuhan-style quarantines, those numbers have come under increased scrutiny, however. U.S. President Donald Trump said last week that China’s numbers were “on the light side,” drawing the ire of Beijing.
China has also only just begun reporting data on asymptomatic cases – those in which carriers can transmit the disease without feeling symptoms – in the past week. That followed a public backlash on social media in China that the key numbers had been omitted from the official tally, raising concerns that such cases could lead to a second wave of infections.
Xue Lan, a professor at Tsinghua University who is a member of a government coronavirus task force, said precautions put in place for the lockdown – like social distancing – would likely become a part of life in the future in China.
“From now on our social lives will enter a new normal,” Xue said.