What China Law Says About Prevention and Control of Epidemic Outbreak
As many reports have used the death of Doctor Li Wenliang to further confusion of the epidemic outbreak in China. I feel there should be a clarification what China law says in controlling epidemic situation like the current 2019-nCoV outbreak we are facing now. By understanding it, we can fairly evaluate the situation in China.
To make this article short, first, I will discuss the general picture of China law in epidemic control, then I will talk about Doctor Li Wenliang and what is the best we should do.
1. Classification of contagious diseases
In China, all contagious diseases are classified into three categories (A, B, C) according to the nature and medical definitions of the diseases. Category A is the highest class among all, which includes diseases like pestis and cholera. Coronavirus is classified in Category B. For highly contagious diseases such as contagious untypical pneumonia, SARS, Pulmonary Anthrax in Category B, preventive and controlling measures follows standards as defined by Category A, which means for some diseases listed in Category B, the preventive and controlling measures could be upgraded to the highest level according to nature of the diseases and contagious level.
From the language of the law, it seems all categories deal with KNOWN diseases in enumerated manner. The list does not include UNKNOWN diseases.
For UNKNOWN contagions, the preventive and controlling measures MUST be approved through reporting mechanism by the State Council before its publication and implementation.
On Jan. 20, 2020, China confirmed that 2019-nCoV had been classified to Category B contagious diseases and preventive and controlling measures for Category A diseases were to apply to 2019-nCoV.
2. Prevention of contagious diseases
To contain the contagious diseases, the best way is to take preventive measures before its outbreak. China has systematic policies to prevent contagious disease from outbreak and spreading, including measures in public health education, pathogen host control, planned vaccination, contagion monitoring and warning system.
China does not allow the discrimination on contagion patients, suspected contagion patients and pathogen carriers. However, to contain the spreading of contagious disease, these people, before complete cure or exclusion of suspicion, are not allowed to continue their work if their work might potentially help to spread the disease.
3. Report, publication for epidemic outbreak
For any epidemic outbreak, medical organizations must follow certain procedures to report epidemic situations. Epidemic reporting follows the principle of territory jurisdiction, which means the report must be made to the nearest disease preventive and controlling authority from the place of outbreak so the relevant authority can make quickest analysis to verify the situation.
For any epidemic outbreak situation, report made within 12 hours (for urban areas) or 24 hours (for rural areas) is within the parameter according to the law. However, the law requires immediate and fastest communication to report epidemic outbreak or situation to the local health administrative authorities and then to the higher authorities till to the central government.
4. Epidemic control
After confirmation of epidemic outbreak for diseases listed in Category A or Category B (those applying preventive and controlling measures based on Category A standards), the medical entities must timely adopt preventive measures to isolate the patients and pathogen carriers. For susceptive patients, they must be isolated to designated location for further diagnosis.
Public security authority may get involved to assist the medical entities to contain those who refuse to get isolated or who escaped from the isolation.
In addition, other measures could be used to contain the epidemic situation, for example, epidemiology investigation, defining epidemic zones, isolation medical staff, closing public activities, controlling public transportation system, temporary requisition of private facilities or properties, etc.
5. Accountability for responsible persons
As epidemic outbreak is a matter with serious public concern, China has very strict rules to make responsible person accountable for mistakes made, negligently or intentionally in reporting, controlling epidemic situation, disease control, medical treatment, medical research, manufacturing drugs, medical devices and supplies, malfeasance in discharging public duties, etc. For better understanding of this, please check the scenario chargeable criminally in the next section.
6. Criminal charges relating to epidemic outbreak
To make this article short, here is a list of criminal charges relating to epidemic control:
Intentional spreading contagious pathogen; Refusal to get isolated for quarantine so as to negligently cause the spreading of contagions; Manufacturing or selling fake drugs, preventive medical supplies, medical devices or materials that do not comply with national or industrial standards; Abuse of power by SOE staff; Falsified advertisement; Inflation of price during the epidemic outbreak or natural disasters; Fraud in name of epidemic prevention or control; Obstruction of justice or public services by violence or intimidation; Looting, ventilation, robbing during epidemic outbreak; Fabricating and spreading terror related to epidemic outbreak; Fabricating and spreading rumors for purpose of subverting or separation of the nation; Disturbing public orders; Medical malpractice; Environmental contamination by violation law in handling wastes;Embezzlement, encroachment, abuse of power, negligence in discharging public duties.
7. Doctor Li Wenliang v. Wuhan police
From many resources, it seems clear that the information about suspected SARS was leaked out from Doctor Li and other 7 people on or before Dec. 30. The police were involved to investigate the case for rumors. Here the question whether the police could treat what Doctor Li said to others as “rumors”. As explained in Section 1, unknown contagion must be reported to the central government to decide what measures to be taken to prevent and control the epidemic situation. It was not Doctor Li’s duty to release unconfirmed disease, although what he said might be significant to contain the situation.
According to Article 25 of the Public Security Administration Law of the PRC, the police has the power to investigate rumors for fabricating epidemic situation. Whether later the rumor was confirmed to be true, the police did not abuse their power for the investigation.
As released officially by Wuhan police, those 8 persons had never been put in the jail – arresting must follow procedures. Doctor Li had never said he was arrested.
8. Chinese government silenced and arrested Doctor Li?
This is another colorful episode in many media. It was reported that Doctor Li was arrested and after signing the paper with the police, he was silenced not to speak anything. True or not, the Chinese government had controlled the situation. On Dec. 31, Chinese government reported the unknown virus to WHO; On Jan. 1, seafood market in Wuhan was shut down…(see the timeline posted in my LinkedIn). What Doctor Li should have done more?
Doctor Li was contracted by the new virus and hospitalized for treatment. In my sense, the glory of Doctor Li after his death was not because of his “warning”, but his sacrifice of his life to service patients even though he had known the virus was novel one and very dangerous. He personally did not know what this virus was and how to prevent and protect himself. He left the question to other medical teams to make the discovery.
Silence or not silence, we can make an easy judgment. Arrestment? You judge.
9. Rumor or virus?
Epidemic situation is not like political affairs. The former needs serious scientific data to support what a government needs to take and to control the situation. There is no excuse Chinese government needs to make up to the public. For an unknown disease, there might be more inexperience in handling the situation. Chinese government has shut down the whole city and has done everything a country could do to contain the disease.
Let’s support China with a sense of humanity, not difference in ideology, not racism, discrimination or others. Do not let the rumor become the virus.
Some articles on media:
1. Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases (2013 Amendment)
2. Implementation Rules on Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases
3. Interpretation of the Supreme People's Court and the Supreme People's Procuratorate on Several Issues concerning the Specific Application of Law in the Handling of Criminal Cases of Obstructing the Prevention or Control of Unexpected Epidemics of Infectious Diseases and Other Disasters
4. Public Security Administrative Law of the People’s Republic of China
5. The Circular to Incorporate Pneumonia caused by Novel Coronavirus into Administration of Regulated Contagious Diseases –Publication No. 1 of 2020, National Health Commission of the People’s Republic of China
This article does not intend to be a legal advice, so please do not use it as your legal advice. If you have further question, please contact me at firstname.lastname@example.org. Thanks for reading.