Transmission control

Restricted traffic and cities: On January 14, 2020, the local government of Wuhan implemented the control of personnel departure, and set up temperature detection points and investigation points at airports, railway stations, coach stations and passenger terminals [4]. On January 22, Hubei province launched a secondary public health emergency alert. Wuhan closed the city on January 23 [5], and from January 23 to January 29, 31 provinces in China successively initiated first-level responses to major public health emergencies [6]. Many regions practiced closed-off management then. From March 4, 21 provinces, autonomous regions, and municipalities nationwide lowered their emergency response levels [7].

Closed zone management: Closed management was implemented in urban communities or rural villages. Non-community or non-village residents or vehicles were not allowed to enter the communities or villages; even the local residents needed to have their temperature measured when they were allowed in and out of the area. In the community or village areas, the epidemic prevention and control groups were established. These could be divided into many subgroups with different functions, such as: propaganda group, environment group, key personnel prevention and control group, personal in and out control group, material support group others, in order to complete the epidemic prevention and control work in an all-encompassing manner [8].

Personal management: From February 16, citizens in Wuhan were required to scan and enter identifying information when they assessed any open public places [9]. On March 5, 2020, “the reference architecture and technical guide of epidemic prevention access code” was issued. According to this regulation, Chinese citizens had to report their health status online and had their general health status captured by two-dimensional codes. The code could also work as an electronic voucher for citizens to go in and out of the local places. The health assessment based on two-dimensional codes was universal in the whole city, even the whole country [10].

Policy support

Staff support: On January 23, Shanghai and Guangdong sent the first medical teams to Wuhan [11]. On January 28, 6097 people across 52 medical teams nationwide went to support Hubei [12]. As of March 8, a total of 346 medical teams and 42 600 medical staff arrived in Hubei, fighting the virus alongside with local medical staff [13].

Funding support: On January 26, National Development and Reform Commission urgently issued 300 million Yuan (RMB) to support Hubei from the central budget, and 11.21 billion Yuan was issued from national finances at all levels in subsidies for disease prevention and control [14]. As of March 4, 110.48 billion Yuan had been arranged from the government’s finances at all levels for prevention and control [15].

Facility construction: Wuhan was the city with the worst epidemic situation, and it has become the key area for the epidemic prevention and control. In order to fight COVID-19, Wuhan set up “Vulcan Mountain” and “Thor Mountain” Hospitals, which only took about 10 days to finish, to treat severe patients [16]. In addition, 11 Cabin Hospitals were built for mild patients, and a dozen of hotels and schools were recruited to isolate mild patients and close contacts [17 ]. The policy for the patients, as well as the close contacts, was changed from self-isolation at home at the beginning to all-isolation at hospital or hotel at the end.

Scientific research

Recognition of novel coronavirus: The understanding of novel coronavirus was a gradually developing process. On December 8, 2019, Wuhan Municipal Health Commission notified the first confirmed case that showed symptoms on that same day. On January 2, 2020, the whole genome sequence of novel coronavirus was obtained by the Wuhan Institute of Virology, Chinese Academy of Sciences [18]. At a press conference of the National Health Commission of the People’s Republic of China on January 20, Professor Zhong Nanshan confirmed that the novel coronavirus was transmitted from person to person [19].

Detection reagents and treatment plan: In terms of detection reagents, on January 4, China’s Centre for Disease Control developed a specific PCR detection reagent. On January 11, China’s Centre for Disease Control provided PCR detection reagents to Wuhan hospitals. On January 26, the National Medical Products Administration approved 4 novel coronavirus detection products from 4 Chinese companies [20]. Regarding the diagnosis and treatment plan, on January 15, the National Health Commission of China issued the first Trail Edition of Diagnosis and Treatment Plan for COVID-19. By February 19, the versions were constantly updated. The seventh versions of the diagnosis and treatment plan had been issued [21]. The diagnostic criteria changed from the diagnosis based on the results of the novel coronavirus PCR test to the diagnosis based on clinical CT results.

Drug research and development: On January 28, the research and development of novel coronavirus mRNA vaccine was officially initiated [22]. On February 5, the clinical trials of Remdesivir began [23]. On February 21, the Ministry of Science and Technology stated that the vaccine should be submitted for clinical trials as soon as late April [24]. On March 6, Chloroquine Phosphate became a clinical treatment medication [25]. In addition, some Chinese traditional medicines have been demonstrated to be effective [26].

Many medical workers were infected in hospitals

According to investigations, more than 3000 medical staffs in Wuhan have been infected since the outbreak [28]. It is a warning to the world that the infection rate of the novel coronavirus is very high. More attention must be paid to the infection of medical staff and nosocomial infection.

Home isolation leads to increased household cluster infections

When China adopted the “home quarantine” policy at beginning, there was a large number of household cluster infections, and even tragedies where there would be deaths of entire families [29]. This proved again the high infection rate of the novel coronavirus and that “home quarantine” policy may be not a good choice. Once infected by COVID-19, patients are better isolated and separated from their families.

Young people can also be victims

Although it is generally believed that the elderly and patients with underlying diseases have higher mortality rates [30], it has been proven that healthy young people also can develop severe illness. The severity of the disease may be related to cytokine storm^[ 31^]. In addition, there were still a few cases of infant or children infection.

The results of molecular diagnosis may be both false negative and false positive

At beginning, the clinical diagnosis was based on detecting method of molecular biology – PCR (polymerase chain reaction). When throat swabs or nose swabs were taken as sampling, there were some patients whose test results showed negative. One of the patients was false negative 5 times [32]. Meanwhile there were also “asymptomatic carriers” with positive molecular diagnosis results, but no symptoms [33]. Because of false positive and false-negative results, molecular diagnosis, being the unique diagnostic criteria, is challenged. Later, combining PCR with clinical CT results was recommended as the basis for the diagnosis of COVID-19.

The patient’s condition might suddenly rapid worsen even during the recovery period

During treatment, there were some clinical cases in which convalescent patients had significantly improved symptoms. However, the patiens’ condition would suddenly deteriorate and they would pass away within only a few hours. The mechanism of death cause remains unknown.

COVID-19 causes serious shortage of medical supplies

On the one hand, COVID-19 outbreaks can cause serious medical supplies shortage. On the other hand, the public’s panic can make it much worse. The shortage of medical materials, staff and supplies should all be expected. This phenomenon deserves attention in other regions of the world. The storage of medical materials is particularly important, especially in the early stage of the outbreak.

Secondary disasters were caused by COVID-19

Due to the large amount of medical resources invested in the treatment of the novel coronavirus disease, other clinic treatments, such as surgery, emergency medical treatment, tumor radiotherapy and chemotherapy were not available [34]. This lead to increased mortality in patients with other diseases in the hospital.

There is no specific and effective treatment for COVID-19

The clinical treatment for COVID-19 is mainly oxygen inhalation and symptomatic treatment. There is no specific and effective drugs for saving life of severe patients at present [35].

Multi participation and unified action are the guarantee of epidemic control

Since COVID-19 first occurred in Wuhan, both the central government and the local government in China had paid great attention to it. Besides, more than 40 000 medical staff from other provinces were sent to Wuhan. Other participants from transportation, traffic and military industries actively took part in preparing medical material and food supplies. It took a national-level unified action to effectively control the COVID-19.

Isolation is the most effective way to reduce the risk of COVID-19

Strict closure of cities and quarantine measures have demonstrated that Chinese isolation counter-measures have achieved good results. The achievement is that Wuhan will be released from closure in April 8. Isolation measures can effectively reduce the COVID-19 incidence rate and save many people’s lives. Therefore, the isolation counter-measure is worth being recommended to other countries’ policy makers.

Results of high frequency word analysis

Keywords are used to generalize the literature’s content. Keyword frequency may reflect the main content of a group of the documents. Table 2 shows the top 30 keywords with their frequency and weight value. Integrating them with the high frequency terms, we found that experts’ advice for preventing and controlling COVID-19 included these specific keywords: material, prevention and control, pathogeny, propaganda, education, hygiene, technology, medical care, overall planning, policy and panic. These keywords reflect some main concerns that Chinese experts had about COVID-19.

Results of content analysis

Content analysis was used to summarize experts’ advice for preventing and controlling COVID-19. The main advices were sorted and analyzed from four aspects: publicity and education, various subjects, medical materials and law construction. Chinese experts’ advice is listed in Table 3 .