Comprehensive Community Epidemic Prevention and Control Models to Repel COVID-19 Pandemic-Grid-based management and digital response Experience from Four Provinces of China
Nianshi Wang1, Ye Li1, Zhixin Fan1, Meiyan Ma1, Baoguo Shi1, Wanxin Tian1, Qi Xia1, Xiyu Zhang1, Qunhong Wu1, Tao Sun2, Mingli Jiao1 & Linghan Shan1
1 Harbin Medical University 1 Hang Zhou Normal University Correspondence to:
(Submitted: 3 April 2020 – Published online: 6 April 2020)
DISCLAIMER
This paper was submitted to the Bulletin of the World Health Organization and was posted to the COVID-19 open site, according to the protocol for public health emergencies for international concern as described in Vasee Moorthy et al. (http://dx.doi.org/10.2471/BLT.20.251561).
The information herein is available for unrestricted use, distribution and reproduction in any medium, provided that the original work is properly cited as indicated by the Creative Commons Attribution 3.0 Intergovernmental Organizations licence (CC BY IGO 3.0).
RECOMMENDED CITATION
Wang N, Li Y, Fan Z, Ma M, Shi B, Tian W, Xia Q, Zhang X, Wu Q, Sun T, Jiao M & Shan L. Comprehensive Community Epidemic Prevention and Control Models to Repel COVID-19 Pandemic-Grid-based management and digital response Experience from Four Provinces of China. [Preprint]. Bull World Health Organ. E-pub: 6 April 2020. doi: http://dx.doi.org/10.2471/BLT.20.258053
Introduction
The re-emergency of infectious disease are making a comeback in worldwide, bringing unprecedented threats to human survival and development. At the end of
2019, an unknown infectious disease epidemic quietly broke out in Wuhan, China, knocking on the door of the Chinese Gengzi Year and covering a heavy white fear for the whole country.[1]
As the number increase of patients with unexplained pneumonia due to high fever by unknown virus, a survey by the National Health Commission of the People’s
Republic of China had been urgently conducted and found that most of the pneumonia cases were from operators in Huanan Wholesale Seafood Market. On January 8 of
2020, the mysterious veil of this virus was lifted and Chinese expert group locked it to be a new coronavirus.[2]With the timely supplementation of virus detection technology and resources, the number of confirmed cases in China continues to increase rapidly. On January 25, Chinese government required the implementation of comprehensive measures focusing on community prevention and control, including community grid management, carpet-type investigators, health promotion and other work, which aimed to lay a solid foundation for subsequent epidemic control work.[3]
In the next day, the National Health Commission of the People’s Republic of China announced 30 provinces, municipalities and autonomous regions quickly launched a first-level response to major public health emergencies and launched an outbreak prevention and control campaign.[4] By February 28, the confirmed cases dramatically increased to 66,337 in Hubei Province.[5] As of March 15, 2020, China has accumulated a total of 80844 confirmed cases and 3199 deaths.[6]However, the cumulative number of cured cases has reached 66911, and new confirmed cases have been reported in some regions. As of March 19, there were no new indigenous cases reported in mainland China for the first time, which indicates that the trend of outbreaks in mainland China is improving. [7]The World Health Organization praises this as an amazing achievement.
With the novel corona virus epidemic causing shock waves and panic across the world, the World Health Organization (WHO) officially named it COVID-19 and announced it as a Public Health Emergency of International Concern(PHEIC) on
January 31.[8]The WHO has only declared such emergency incidents 6 times.
Immediately after, in just 40 days, the WHO announced that the COVID-19 has entered a global pandemic state. [9]As March 27, 2020, there are 145,047 confirmed cases in Asia beyond China. A total of 290,066 confirmed cases have been diagnosed in Europe and 92,337 cases have been diagnosed in North America,7,728 people in
South America,3508 people in South America,3405 people in Oceania.[10]The number of confirmed cases worldwide has exceeded 542,803, with the exception of
China, the number of deaths worldwide has reached 20,663, and the epidemic has spread to 206 Countries, areas or territories.[11]Statistics from WHO indicated that it took 67 days from the first report case to reach the 100,000 cases, 11 days for the second 100,000 cases, and just 4 days for the third 100,000 cases, [12]which indicating that the pandemic is extremely accelerating and the prevention and control situation is not optimistic.
Defensive measures such as physical distancing measures are taken as a useful way to slow down the spread of COVID-19. Moreover, aggressive and targeted tactics such as tracing and quarantining close contact also should be adopted to attack the
COVID-19. It obviously demonstrated that effective epidemic prevention and control has become the first task. The community is the foundation for implementing grid-based emergency management and the first defense lines for infectious disease prevention and control. Risk communication and community engagement (RCCE) is particularly important for public health. This sudden and deadly new acute infectious disease epidemic has plunged countries around the world into the predicament of emergency response, who are struggling with the capacity to carry out offensive measures for fighting the epidemic.
The Chinese society has shown unprecedented efforts in this epidemic, and has been appreciated by the World Health Organization, who said that China curbed the spread of the epidemic from the source. [13]Although China itself has paid a huge price, it has gained time for the world and slowed the spread of the virus to the world.
However, after unremitting efforts, China's epidemic situation has improved, and even in Hubei, 14 places have achieved zero new cases for 14 consecutive days. [14]More than 15 provinces (autonomous regions) nationwide achieved 0 existing confirmed cases.[10] Community prevention and control in China has contributed a lot for this progress. This study summarizes the model of community epidemic prevention and control in typical provinces of China in order to provide experience for other countries in the world. With a view to helping the rest of the world win the
COVID-19 at an early date .
Methods
Sample selection
This study selected four provinces in China as samples including Zhejiang Province.
Guangdong Province. Sichuan Province, and Hubei Province. The first three provinces show good experiences with their excellent epidemic prevention and control measures. As the earliest and most severe area of COVID-19 in China, Hubei
Province has achieved no new confirmed cases and no new suspected cases on March
18 .Therefore, the summary of experience in community prevention and control in these four provinces is selected to provide reference for other countries or regions.
Information capture and summary
From the official website and report of China’s epidemic prevention and control, the
World Health Organization’s epidemic information and documents, the study extracted the basic information of community organization, the epidemic situation and community response measures. The quantitative analysis was used to make a comparative analysis of epidemic situation of COVID-19 in the four provinces. The qualitative methods were adopted to summarize the community epidemic response models and characteristics of the four provinces. After searching for the official news, documents and literatures on the epidemic response in the four provinces, we made a further systematic summary and integration as follows: extracting the key fragmented information on community prevention and control; classifying all the selected information into different response functions and measures; by focus group discussion, further screening and integrating the functions and measures of prevention and control; finally forming a complete model of community epidemic prevention and control in four provinces.
Basic Information
1. Basic Information of Community in four povinces
Zhejiang Guangdong Sichuan Hubei
Community Health Service Centers 5312 2602 980 1161
village clinic 11483 25996 56019 24411
Residents committee 4680 6794 7482 4528
Village committee 24711 19792 45524 233922
Sub-district office 467 467 353 310
Table 1 Basic community information
Table 1 summarizes the situation of grass-roots community organizations in various provinces. Community Health Service Centers, it is a place where residents are provided with prevention, medical treatment, rehabilitation and health promotion.
There are 5,312 community service centers in Zhejiang Province, 2602 in Guangdong
Province, 980 in Sichuan Province, and 1161 in Hubei. The village clinic is a medical institution at the village level. Compared to Si Chuang Province (56019), there are only 11,483 in Zhejiang. Residents 'Committee is a grassroots mass autonomous organization for residents' self-management, self-education and self-service, with the largest number of 7482 in Sichuan Province. Villagers' committees are mass self-government organizations elected by villagers under the jurisdiction of townships (towns) in mainland China which all have exceeded 10,000 in four provinces. The
sub-district office is the management organization of sub-districts in China's
township-level administrative regions, with the similar numbers in four provinces.
2020/3/15 2020/3/10 2020/3/5 2020/2/29 2020/2/24 2020/2/19 2020/2/14 2020/2/9 2020/2/4 2020/1/30 2020/1/25 2020/1/20 2020/1/15 123456
Zhejiang Guangdong Sichuan Hubei
Figure 1 Time of epidemic prevention measures by province
Note: 1: Start time of first-level plan 2: Earliest time for health promotion 3: Time for passenger control 4: Start time of health code for epidemic control 5: Time for Community online psychological consultation 6:Time for Online teaching
Among the four provinces, Guangdong took the lead in launching the first-level
response to public health emergencies (2020/1/23), and the next day, Zhejiang, Hubei,
and Sichuan also started accordingly. Hubei is the first province to conduct health
promotion for epidemic on January 21, 2020, with the following Guangdong Province
on January 27. Guangdong and Hubei provinces launched passenger transport control
as early as January 21, 2020, and Zhejiang and Sichuan also started on the subsequent
22th and 23th, separately. The earliest using application of health code for epidemic control is Zhejiang Province on February 11, in the following February 14th, 22th, and
24th Sichuan, Hubei, Guangdong provinces started to use one after another.
Community online psychological counseling can both channel community residents' mental health and reduce offline contact. Hubei Province began online community counseling on February 1, 2020. And Sichuan Province also started online community counseling 7 days later. Guangdong Province started on February 14th, Zhejiang
Province started on February 15.ZhejiangProvince started online teaching on February
6, 2020, and Hubei Province followed closely after four days. On March 2 and March
9, Guangdong Province and Sichuan Province also started online teaching.
2.Epidemic situation in four provinces
Figure 2 Change of cases in the three provinces
The epidemiological curve of cumulative confirmed cases and cumulative discharged cases in the three provinces shows a trend of increasing with time; it peaked on March
11, cumulative confirmed cases reaching to 1215 and 539 and 1353 separately, cumulative discharge cases reaching to 1205, 484, and 1282 separately .The epidemiological curve of medical observers in each province showed a trend of first increase and then decrease. On February 10, Zhejiang and Sichuan Province received the most medical observations. During the period from February 10 to March 11, the number has been declined from 13293 to 926,and 6912 to 298.Guangdong Province was even earlier, peaking on February 5 .Zhejiang Province has the highest discharge rate of 99.2%.Among the three provinces, the number of people receiving medical observations in Guangdong has fallen the most with the number of medical observations falling from a peak of 3247 on February 5 to 297 on March 11th .
Figure 3 Change of cases in Hubei Province
From January 26 to March 11, 2020, the cumulative number of confirmed cases in
Hubei Province increased by 47 times. However, the discharge rates reached 72.4%, which was an increase of 1114 times compared with the original rate. From January 26 to February 20, 2020, the number of people receiving medical observations in Hubei
Province continued to increase, 7 times than before. However, it has shown a significant downward trend since February 25.Compared with the 20th, the number of medical observations on the 25th decreased by 12,051.As of March 11, compared with the peak, the number of people receiving medical observations has decreased by 8.5 times.
Summary of Community Epidemic Prevention Models in China
1.Zhejiang ----- Community smart epidemic prevention coverage based on City
Brain
Hangzhou is the most populous region and capital cities in Zhejiang Province, but its cumulative number of confirmed cases is not the highest, and so far it has achieved zero deaths.[10]Therefore, the epidemic prevention and control in Zhejiang
Province were introduced with Hangzhou. The epidemic prevention and control model in Zhejiang can be summarized as "one picture", "one code", and "one index".
[15]Among them, "One picture" is to use five colors to represent different levels of epidemic situation, and use these five colors to identify the province. "One code" refers to the health code, which is divided into three colors and represents three different groups of people, which is convenient for the management of the crowd during the epidemic period. The "one index" is an intelligent control index, which consists of seven indicators referring the degree of epidemic control. As an emerging science and technology city in Zhejiang Province, Hangzhou's epidemic-prevention community also has scientific and technological characteristics. Firstly, relying on
City Brain, Hangzhou has formed a smart prevention and control model covering the entire community in all directions, which integrates five functions into a response network, including command and coordination system, community personnel inspection system, community patrol management and control system, big data information transmission system, and logistics support system. As the core of the response network, the Command and Coordination System is responsible for receiving information, processing it and then assigning response tasks, with multi-party participation including community party committee and community
medical organizations. Community personnel inspection is the most critical step in the interruption of transmission. A fuzzy community personnel inspection is equivalent to planting a bomb in community response work. A comprehensive set of personnel inspections, including precise contact identification, restrict community access control system, local and foreigner tracking and monitoring programs, and isolation management have been implemented to interrupt the transmission. The health codes contribute a lot for the convenience and timeliness of inspections. By the information connection of City Brain, the community could identify the high-risk and suspected groups (with yellow and red codes) and adopt supervision measures at the first time.
Moreover, community patrol is significant for the effective emergency response, which is responsible for personnel isolation management, traffic restriction and health promotion. Based on the existing big data storage and information sharing of City
Brain, a series of APP are developed for patrol management for the epidemic prevention, such as the Zheli Office.[16]Community residents can implement epidemic self-inspection and epidemic reporting through mobile phones. Timely interaction of information between residents and communities could be achieved by the APP. The logistical support department provides daily household goods procurement for community isolated families, provides medical supplies for community inspectors, and keeps the community clean and disinfected.
The second characteristic is the digital epidemic response involving the City
Brain. The most representative business card of Hangzhou industry is the digital economy. This feature was vividly demonstrated in this epidemic response. Hangzhou City Brain is the center of artificial intelligence in Hangzhou. Its functions involve
police, transportation, urban management, cultural tourism, health, housing
management, and emergency. Comprehensive coverage of Hangzhou's politics,
economy, culture, society, and ecology. The first time the epidemic occurred in
Hangzhou, the Hangzhou Municipal Health Commission and other related
departments established a COVID-19 prevention and control system based on the
City Brain. Government departments can learn the number of people who arrive in
Hangzhou from Wuhan every day, and send short messages to this cell phone to remind them to observe in isolation. Secondly, some communities link the access control system with the City Brain and set different conditions according to the development stage of the epidemic. Once the people who meet certain conditions use the access card to return to the community, the City Brain immediately issues an early warning prompt, and this personnel information will be pushed to the community staff for community control.[17]The City Brain provides technical support for community grid investigation and improves the prevention and control efficiency of Community.
Relying on the smart module of the City Brain digital cockpit to stop and control the abnormal situation of vehicles, personnel and other personnel in the jurisdiction in real time. At the same time, the city's brain can detect the situation of personnel and vehicles in the area under its jurisdiction. Once vehicles in key areas of the epidemic occur, they will be pushed to nearby staff for inspection as soon as possible. In addition to the above functions, the City Brain also participated in the publicity of community epidemic prevention and control knowledge, pushing the latest epidemic announcements, prevention and control knowledge, and home disinfection measures through big data platforms. The Hangzhou City Brain has also traced close contacts of confirmed cases. To prevent the phenomenon of person-to-person transmission, an infrared temperature detector is also installed in the community to use big data to sense body temperature. In addition, community residents can understand the traffic trajectory of diagnosed patients and achieve self-examination of health status. You can also learn about the prices of vegetables near the community on the platform to achieve contactless shopping. The system collects information through government departments to achieve community prevention and control functions and linkages between functions. All-round assistance was provided to Hangzhou community epidemic prevention and control.
five functions into a response network
digital epidemic response involving the City Brain
Figure 4 Zhejiang community prevention and control model
2.Guangdong Internet + Battle COVID-19
Guangdong Province has two super-first-tier cities. In the China Statistical
Yearbook 2019, Guangdong Province ranks first in the country with a permanent
population of 113.46 million. [18]As the most densely populated and economically
prosperous province in the country, the number of cases cured in Guangdong is
second only to Hubei, and relatively few deaths.[10]Guangdong Province has taken
advantage of its developed Internet economy. The Internet + epidemic prevention and
control features have helped communities to prevent and control epidemics.
Community epidemic prevention and control in Guangdong can be divided into
seven parts, namely community inspections, health promotion, volunteer services,
psychological support, online medical treatment, services for vulnerable people, and
supervision. Internet + is reflected in the above sections and enables various departments to connect closely and work together. Community inspections are generally the most important part of community work. The three major investigations carried out in Guangdong refer to a close inspection of all close contacts of confirmed cases in our province, personnel from key epidemic areas, and key populations in the province.[19]Guangdong Province has developed Internet technologies and Internet companies. Therefore, many WeChat mini programs and APP have been developed to apply and respond to epidemic situations, which has become a powerful help for community workers. On the one hand, it is self-examination and self-reporting of online health status of community residents, and appointment purchase of medical protective masks. Secondly, the government and other relevant departments can also use the Internet technology to report the relevant information of the epidemic situation as soon as possible through the residents' health report in order to assess the
community's danger level as soon as possible. The community's epidemic knowledge
promotion includes but is not limited to new media methods such as SMS, WeChat,
Weibo and TV. Guangdong Province has also produced a series of relevant animated
promotional videos, which are publicized in an easy-to-understand manner to make
more people understand the common sense, symptoms and prevention knowledge of
COVID-19.[20]
Facing the epidemic, more than 100,000 volunteers from Guangdong stepped
forward to participate in community epidemic prevention work.[21]Many volunteers
not only contributed to the promotion of the community's COVID-19, but also
provided convenience services for the vulnerable groups in the community. The
specific performance is to post poster banners in the community, to isolate the family's purchase of living materials, etc., and to provide great help for the normal operation of the community. In order to protect the mental health of community residents,
Guangdong Province not only opened a telephone to provide psychological counseling to community residents, but also used its convenient Internet technology to
conduct online psychological online counseling. [22]This not only protects the mental
health of residents, but also reduces cross-infection caused by offline meetings.
Guangdong's Internet technology is also used in the opening of online hospitals,
including online fever clinics and COVID-19 consultation services, which not only
provides community residents with medical convenience, reduces the pressure on
hospitals, and reduces the rate of offline infections.[23]For the elderly, the disabled
and other vulnerable groups, corresponding care plans have also been developed to provide chronic patients with stable health status with long-term prescriptions and home delivery services.[24]And strengthened the epidemic prevention education for this vulnerable group, to guide the elderly and patients with chronic diseases to understand and master the relevant information of COVID-19.
For community children, the management department requires community doctors to fully grasp the health status of children in the community.[25]Secondly, the primary medical institutions have rationally adjusted the child outpatient hours, and suspended preventive health services such as vaccination to reduce offline infections.
Community doctors can provide online guidance services through online services such as telephone, WeChat, and online video. In addition, a supervision and inspection team has been established to carry out supervision and inspection of various work in the community, including publicity of community epidemic prevention knowledge, distribution of materials, and community inspections. Relying on its developed Internet technology, Guangdong Province has made Internet technology infiltrate the community's epidemic prevention and control work. Weave a comprehensive epidemic prevention and control network for the community and escort the community residents. Guangdong Province maintains open and transparent information on the epidemic situation. This includes, but is not limited to cumulative confirmed cases in the region, daily new cases, and the number of medical observations. As early as January 21, 2020, Guangdong Province took the lead in holding the nation's first press conference on epidemic prevention and control, and held it every day after the 27th.In addition to the response to community joint prevention and control, medical assistance and personal protection, the activity track of confirmed cases is also publicly disclosed. This openness, transparency, accuracy, and timeliness of the epidemic information effectively controlled the spread of rumors, soothing the public.
Figure 5 Guangdong community prevention and control model
3.Sichuan smart community responds to COVID-19
Sichuan and Hubei provinces are closer, but the cumulative number of confirmed cases has been the smallest of the three provinces. Sichuan Province pursues epidemic prevention and control measures combining technology with traditional methods.
Facing the domestic main battlefield, Sichuan also contributed. Sichuan accounts for two of the five universities that develop COVID-19 detection reagents and has
obtained EU certification to provide detection reagents to the world. Secondly,
Sichuan Province has leveraged the advantages of the University of Traditional
Chinese Medicine in the province, exerted significant advantages in community
prevention and control, and used Chinese medicine for family and community units to
conduct early intervention.[26]In the community, comprehensive prevention and
control of the epidemic were carried out from the four aspects including health
promotion and education, community personnel management, prevention and control
of material management, and environmental health management.
First of all, in terms of health promotion, Sichuan Province reflects its localized
propaganda method and uses the advantages of the Internet to make information
dissemination close to the life of the community and convenient. The community
develops a new media platform so that residents can learn information about the
epidemic in their region by turning on their mobile phones. Meanwhile, the
community dissuades residents from gathering in a more localized and humorous
language and promotes relevant prevention and control knowledge. The daily active
volume of the community platform is now more than 100,000 people, which has
become the main means of publicity for prevention and control of grassroots
epidemics. At the same time, community workers also use WeChat, community
bulletin boards, radio, and other new media combined with traditional methods to
publicize the epidemic-related knowledge to community residents, and discourage
residents from staying at home, wearing masks when go out. [27]Although the community is closed, it must also meet the daily needs of community residents, such as food and medical supplies. Some communities have also realized community group purchases to meet the needs of residents with pre-sale + self-collection. The merchant will send the community group shopping funds to the designated location in the community, and then the residents of the community will pick it up at the right time.
This effectively prevents person-to-person transmission while satisfying the daily lives of residents, and also reduces the backlog of merchant goods caused by closed communities.
Secondly, in terms of community personnel survey, Sichuan Province also adopted carpet survey. In the early stage, manual inspection was conducted on a household-by-household basis, and information was collected and reported in a timely manner. In the later period, Sichuan Province adopted information technology to launch a smart community management platform. Residents can use mobile phones to report information and then report collectively to staff. According to reports, 39,941 villages (communities) across the province have launched epidemic prevention and control information platforms, with a coverage rate of 75.4%, which uses the system to push out epidemic prevention and control information to residents, screen key personnel, and achieve precise and intelligent epidemic prevention and control. At the same time, due to the closed management of the community, the community and other primary health institutions adopted online service methods to provide services to vulnerable groups such as the elderly, children, and patients with chronic diseases.
The services included online consultation, home delivery of medicines and long prescriptions for some patients with chronic diseases.[27]The community also released local fever clinic information for? residents, which is responsible for shunting the crowd. People with respiratory symptoms but no fever go to the community health service for medical treatment, fever patients go to the hot clinic, and COVID patients go to designated hospitals.[27]
Last but not least, the community also pays attention to psychological status of residents, and provides psychological counseling, psychological intervention and other psychological services to diagnosed patients and their families, families with deceased persons, and families of front-line workers.[28]The community organizes psychology majors, and social volunteers to capture psychological counseling for the above. On the one hand, it helps the healers to return to the normal life of the community, and also guides the residents of the community to treat it normally and avoid discrimination. It also provides online psychological consultation and telephone hotline to provide psychological care for community residents. Sichuan also attaches importance to community disinfection. On the one hand, some areas distribute disinfection supplies free of charge to communities in order to minimize the spread of virus in the community. And community staff carried out a comprehensive disinfection of the community, including residential buildings, garbage disposal centers and other places. Residents' masks are also placed in trash cans to prevent infections caused by secondary use of masks.[27] Figure 6 Sichuan community prevention and control model
4. Community Epidemic Response under Tradition with Technology Measures in Hubei Province
The outbreak in Hubei Province began in Wuhan, and Wuhan became the most severely affected area in Hubei Province. Therefore, Wuhan is used as a starting point for introduction. But so far, Hubei Province has no new confirmed cases.The community epidemic prevention work in Wuhan is divided into five parts: community investigation, care for vulnerable groups, health promotion, psychological support, and supervision, and each part consists of several small tasks.
Wuhan has implemented community closure measures, and all residents must not go out except for medical and epidemic prevention and security operations. All personnel in the district shall take temperature measurement and register. Without special reasons, outsiders were not allowed to enter the community.[29]The community
in Wuhan conducted a house-to-house health check, and a carpet-like check ensured
that no one was missed. Once the fever is detected, a dedicated car will be sent to the
fever clinic for nucleic acid test. Confirmed patients are immediately isolated for
treatment, and suspected patients will also undergo medical observation for 14 days to
ensure safety. [30]The local Centers for Disease Control and Prevention would also
investigate the epidemiological history of confirmed patients to find out their close
contacts and gave them test as soon as possible to prevent further spread of the
epidemic. The function of the community is to assist the CDC in community
disinfection services.[30]For community residents who need to go out due to special circumstances, such as medical services, the community uses a health code to mark their health status for registration management.[31] Face recognition systems are used in some communities, and outsiders will not be able to enter the community, blocking the source of the epidemic. In addition to community personnel investigation, the community must use traditional media such as speakers, banners, posters and new media such as WeChat, TV, and WeiBo to promote community-based residents to prevent COVID-19 prevention measures, household disinfection methods, and how to properly wear masks, and other related knowledge.[27]The mental health of community residents is also crucial. Wuhan has developed two types of psychological intervention services, online and offline.[32] The situation of Online One Psychological Medical
Team provides psychological assistance services for community residents, isolated families, medical personnel and close contacts. Offline services provides 24-hour psychological counseling to community residents on the phone. Due to the closed management of the community, the living security of the
residents of the community has become a problem. Therefore, Wuhan City recruits
specialized volunteers to provide community residents with procurement of living
materials. [33]In the community, grid members establish community group buying
channels, and there are online vegetable shopping platforms. Residents purchase
online and then deliver to the community through contactless distribution. Moreover, doctors provide long-term prescriptions for stable chronic elderly patients in the community, and volunteers deliver medicines to their homes to ensure the normal life of the community residents. Based on the grid-based community management, new
media methods such as WeChat and other APP are used to establish communication
channel with the elderly and patients with chronic diseases, to conduct follow-up
services, understand their health status and provide targeted guidance.[34]The
psychological condition of the elderly should not be ignored. In addition, a supervision and inspection team is indispensable. Wuhan has specially established a community inspection team for epidemic prevention work to carry out supervision and inspection of community personnel's entry and exit registration, health information survey and convenience services. At the same time, an epidemic monitoring and reporting channel has been established, and community residents can report areas of dissatisfaction with community work through this channel.
Figure 7 Hubei community prevention and control model
Conclusion
The World Health Organization says that mainland China ’s reporting of no new indigenous cases is a remarkable achievement, and China has proven to the world that the development trajectory of the epidemic can be changed. In this epidemic response, one of the most outstanding works is the comprehensive implementation of community prevention and control, with three main characteristics worth learning:
Firstly, a grid-based accurate community epidemic response network is established with extensive health inspection and accurate diagnosed and suspected case identification. Most communities have adopted carpet-type personnel inspection measures to grasp the health status of residents excluding infected people from healthy personnel. Different measures can be taken to prevent and control the epidemic. Secondly, The entire Chinese community conducts all-round detection of the community through a combination of carpet-type personnel search and smart means such as APP. Taking Hangzhou as an example, relying on the City Brain, the government can understand the movement of people in the region, including the movement of people in local and key epidemic areas. It can also grasp the number of cases in the community, track and investigate close contacts in time, and accurately lock close contacts .Communities such as communities, hospitals, and CDCs conduct a coordinated response between detection and epidemiological investigations to pinpoint the confirmed and suspected cases. that's it a series of digital tools and APPs have been used as aggressive measures to quick identify confirmed cases and further break the chains of transmission.
Thirdly, with extensive health education and promotion in community, the
Chinese residents have become knowledgeable and cooperative for the epidemic control, which makes the interruption of transmission by defensive measures. Most residents prefer to stay at home in cooperation with government work, which makes the quarantine work smoothly and avoids the outbreak of clustered cases caused by crowd gathering. This reduces the pressure on the health system and the workload of medical staff. The World Health Organization also recognizes the importance of delivering the right message.
In the face of the menacing COVID-19, China has taken the most active and flexible measures in history, and has already achieved world-renowned results. This study started with community epidemic prevention measures in four provinces, with a view to contributing to the world's reduction of COVID-19.
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