Control and Management of Virus

Novel coronavirus pneumonia has been the most serious worldwide public health emergency since being identified in December 2019. The rapid spread of the pandemic and the strong human to human infection rate of COVID-19 poses a great prevention challenge. There has been an explosion in the number of confirmed cases in several cities near Wuhan, including the highest in Honghu, Jinzhou. Owing to the limited admission capacity and medical resources, increasing numbers of suspected cases of COVID-19 infection were difficult to confirm or treat.

Following the arrival of the Guangdong medical aid team on 11 February, 2020, COVID-19 care in Honghu saw changes after a series of solutions were implemented based on the 'Four-Early' and 'Four-centralization' management measures. The 'Four-Early' measures are: early detection, early reporting, early quarantine, and early treatment for meeting an urgent need like the COVID-19 pandemic. 'Four-centralization' refers to the way in which recruited medical teams can make full use of medical resources to give patients the best treatment. These solutions successfully increased the recovery rate and reduced mortality among patients with COVID-19 in Honghu.

This management strategy is called the 'Honghu Model' which can be generalized to enable the prevention and management of COVID-19 worldwide.

Before the medical team was deployed (12 February, 2020), 262 cases of COVID-19 were diagnosed in Honghu, among which many were in a severe condition, with the case fatality rate in Honghu being higher (1.94% [Honghu] vs. 1.23% [outside Wuhan]), while the recovery rate being lower (0% [Honghu] vs. 14.90% [outside Wuhan]). Prior to the medical team's arrival, all the COVID-19 cases in Honghu were under treatment and none of them had fully recovered. Moreover, because of a severe lack of nucleic acid testing platforms in Honghu, large numbers of potentially infected patients were difficult to identify.

Therefore, the COVID-19 nucleic acid test samples of suspected cases had to be sent to Wuhan or Jingzhou as soon as possible, which took a minimum of three hours' physical transit before testing. Moreover, only two hospitals in Honghu were equipped with CT scanning equipment. The lack of CT scanning equipment greatly delayed the confirmation of suspected cases.

Patients diagnosed with COVID-19 were admitted and spread out among seven medical institutions and 21 township health centres in Honghu during the early COVID-19 outbreak. Of these, only Honghu People's Hospital was capable of treating patients with infectious diseases, and the patients at other hospitals could not receive standardized treatment for infectious diseases due to a lack of experience. Therefore, there was a higher proportion of severely-ill patients in Honghu than the average for the rest of Hubei. Compared with other counties in Jingzhou city, Honghu had the most serious pandemic area, accounting for approximately 25% of patients with severe symptoms in Jinzhou city.

Since the Guangdong medical aid team was deployed, with the support of the government, a series of administrative measures were performed forming a new model called the 'Honghu Model' that effectively contained the transmission of COVID-19 and increased the recovery rate from infections in Honghu.