The Comparison of Different COVID-19 Epidemic Control Measures

By Hailuan Zhu，Vice President of Sanofi（China）& Jingyi Yu，Senior Manager of Pfizer（China）

According to WHO，the number of confirmed COVID-19 cases reached 850，000 in 206 countries and regions worldwide（data source：WHO website https：//www.who.int/）as of March 31. It is time to analyze the advantages and disadvantages of the infectious disease prevention and epidemic control measures in different economy，cultural，and political systems，and it can serve as supportive evidence for the future public health emergency preparation.

1 Comparison of major pandemic control measures

During the breakout of COVID-19 in 2020，different epidemic control measures have been adopted across the countries and regions in response to the virus. Some worked well，and some are less efficient. Both China and Singapore have achieved positive results，which was recognized by the Director General of the WHO.[1] The United States has attracted considerable attention in its response to COVID-19，as it has the world’s most advanced technology.

Table COVID-19 Cases on April 30th 2020 by John Hopkins

In general，China strictly controlled mobilization by implementing large scale lock down right after the outbreak；Singapore and Japan focus on precisely tracking and containing epidemic at the early stage；whereas，the United States tried to balance the epidemic control and economic impact.

（1）China’s approach：people’s lives first

In a country with more than 1.3 billion population，central and provincial government took immediate response to COVID-19 under the unified decision-making and deployment of the Central Committee of the Communist Party of China. All levels government were clearly requested to make containing COVID-19 as their primary task. With order from central government，the epidemic control tasks were quickly expanded from Wuhan and surrounding arears in Hubei to all over China. China approach is a successful epidemic control case，which has quickly contained the spread of COVID-19 right after the outbreak in Wuhan. Given the controversy of the massive lock down，this approach has been adopted by multiple countries during the global outbreak.

The “China--World Health Organization New Coronavirus Pneumonia（COVID-19）Joint Investigation Report” elaborated described China’s anti-epidemic measures：set anti-epidemic strategies according to the spot of the COVID-19 cases，focusing on preventing export cases from key areas in Hubei Province，such as Wuhan，and tracking import cases in other areas of the country.[2] The purposed of the strategy is to control the source of infectious disease，block transmission，and prevent proliferation. On January 20，COVID-19 was classified as Class B infectious diseases in China，which requires mandatory report，and as national border quarantine infectious disease.[3] According to the regulation，traffic quarantine stations were set up to monitor passengers’ temperature and health declaration. On January 23，strict traffic restriction was imposed in Wuhan. To reduce the mobility of population，government decisively extended Chinese New Year holiday and cancel crowd gathering activities. Central government coordinated the supply and deployment of medical supplies，built new field hospitals，used reserve hospital beds，and expropriated lands and buildings to ensure all patients are hospitalized. In addition，the stability of grocery supplies and operation in the community are maintained well. China government considered thoroughly when making policies to contain virus. An example is the government promulgate the medical insurance policy--“medical insurance payment，off-site settlement and financial aids”--to expand coverage of COVID-19.[4]

What remarkable in China is that when the country is under crisis，the entire society quickly reach consensus and take unified actions. Each organization can effectively implement and even enhance epidemic control measures，such as continuously improving the speed of diagnosis，quarantine，and early treatment. The local government proactively adopted cutting-edge technology to promote innovation in COVID-19 containment，such as launching the online medical platform to provide consultation and using the 5G platform to support epidemic control in rural areas. Provincial and city government worked together to support vulnerable group in the communities during the crisis. Although the epidemic occurred in the places outside Hubei，other provinces and cities continuously dispatched tens of thousands of medical personnel to Hubei and Wuhan to treat COVID-19 patients. Tons of medical supplies were sent to Hubei when there were severe shortage of masks and preventive clothing. The Chinese people have demonstrated great courage and conviction in the face of the epidemic by complying with strictest containment measures--whether it was public gathering suspension，“stay at home” for more than a month，or a travel ban.

In the face of this previously unknown virus，China has taken the bravest and most proactive epidemic control measures in history. It surprised the world with the speed and scale of efficient pandemic containment. By far China’s epidemic control is quite outstanding. On March 10，all square cabin hospitals in Wuhan were closed.[5] That day in Hubei，the areas outside Wuhan reported zero new cases for 7 days.[6] This sharp decline of new cases contributed to health of the entire nation and earned time for the foreign government to prepare for the outbreak in their countries. During this period，COVID-19 has costed many lives and huge amount of resource in China，including the economy impact from the nation’s shutdown for almost one month and the supply shortages of medical supplies and protective materials.

Since mid-February，China government has begun to gradually transform “control” into “service”. It has introduced a number of measures to assist companies to resume business activities as soon as possible.

（2）Singapore approach：quick intervention in the early stage

On January 23，2020，Singapore confirmed the first case of imported COVID-19 case. Until March 21，Singapore had 432 cases diagnosed，with the first two deaths. Singapore has successfully controlled the epidemic without implementing large scale lock down. Until the end of March，the government didn’t recommend wearing masks in public，or closing the schools and offices. WHO Director General Tanker said Singapore is a good example of all government approach，which effectively identifies sick individuals，strictly tracks close contacts，and prevents disease transmission.[7] With the increasing imported COVID-19 cases，Singapore government required everyone to wear mask in public from April 15th.[8]

Singapore’s epidemic control approach is the characteristics of “fast，precise，and strict”：

1）Fast response and quick actions. Singapore implemented strict travel control to prevent imported cases. Although the first imported patient was diagnosed on January 23，2020，on January 2，the Singapore Ministry of Health issued “Precautionary measures in response to severe pneumonia cases in Wuhan，China” to alert all medical practices to pay attention to Suspected cases of new crowns in Wuhan.[9] Once patient with suspected COVID-19 is identified，the patient is quarantined immediately. From January 3，all passengers from Wuhan must take temperature at airport and are provided with detailed health guidance when entering Singapore，and the passengers with fever are sent to hospital for further evaluation. The first COVID-19 case was confirmed on January 23，the next day the Ministry of Health announced that it will take temperature of passengers at both waterway and land entry points.[10] With the increasing the number of cases，from January 28 to January 30，the government further implemented a series of policies including travel restrictions and quarantine when entering Singapore from overseas.[11]

2）“Precise” refers to evidence-based scientific decision-making measures，precisely adjusted the strategy during epidemic in accordance with the development of the situation

·First，emphasize on diagnosis and screening. Precisely screen patients and patients suspected with COVID-19. The government uses a Bluetooth app to locate patients and people who contact with the patients without infringing privacy. South Korea also used similar approach to track patients，paying attention to diagnose and track patients as early as possible to identify the spot where is highly contagious.[12]

·Hierarchical diagnosis and treatment guidance prevented infection transmission cross hospital and ensured the efficient medical resources utilization.（Source：Singapore MOH https：//www.moh.gov.sg/COVID-19）

·Detailed and easy-to-understand guidance includes personal protection schemes and responsibilities including whether it’s necessary to wear a mask and the correct way to wear it，how to make judgement whether to stay at home or take compulsory leave，etc.[13]

3）“Strict” refers to Singapore’s world-famous strict legal system，which benefits the government in response to COVID-19.[14]

Singapore’s streamlined epidemic control approach is coupled with timely and detailed public information，which has improved the transparency and，as a result，reduced the public panic. The epidemic control measures are widely accepted and strictly implemented，successfully controlled the epidemic at the first stage and avoiding community transmission. At the same time，it left limited the impact to daily life and economy.

（3）Japan’s approach：focusing on critical cases treatment.

In Japan pandemic information is fully disclosed，decisions are made based on scientific evidence，and precisely screen and track patients to prioritize resource allocation.

The diagnosis was only recommended to high risk populations（fever over 37.5 centigrade for 4 days，37.5 centigrade for 2 days in the elderly and with underlying diseases）.[15] Statistics show that from February 18 to March 29，there were 540，000 tested for COVID-19 nationwide，with an average of just over 1，000 tests per day.[16] The actual daily testing capacity increased to over 10，000 cases in March in the early days of the outbreak.[17]

In Japan，only critical cases are hospitalized，and the mild case are quarantined at home.[18] The government limited or canceled public gatherings. Business wasn’t shut down even when community infection happened，and emergency status was announced.

There were 56 deaths in Japan as of March 31（Data Source：WHO Website https：//www.who.int/）The New York Times mentioned that Japan hasn’t extremely restricted the mobilization of people，nor has it conducted a massive lock down which is harmful to the economy，and it has not even done extensive testing，but Japan hasn’t been as tragic as it is in Italy and New York.

（4）The United States approach：attempting to balance epidemic control and economy impact

In the United States，the first COVID-19 patient was diagnosed on January 21（There aremany arguements regarding this point，even the first COVID-19 patiet in the US starts in Nov. 2019）.[19] After WHO declared COVID-19 as an International Public Health Emergency（PHEIC）on January 20，[20] US States declared a national health emergency.[21] At the beginning，Americans were suggested to wash hands more often and carefully，avoid touching the face with hands，and keep social distance of 6 feet. The government didn’t suggest healthy individuals to wear masks，nor did it ban the large-scale gatherings. The New York Times，entitled “A Missed Month in the United States” on March 28，analyzed the United States’ lack of leadership in the White House due to low efficiency diagnostic technology and inadequate regulations.[22] The government’s bureaucracy has caused the United States to lose 30 days for epidemic control.

Jeffrey Levi，a professor at the Department of Health Policy and Management at George Washington University in the United States，said，“If the US government could carry out extensive virus detection earlier and improve the detection system，we wouldn’t have gone to such a situation today.” Besides diagnostic technology and regulations，federal government also has cost-effective considerations. Testing for low prevalence rate disease will bring unnecessary burdens to patients，doctors and even communities. Therefore，the previous guidelines provided to doctors by the CDC suggested them to provide COVID-19 diagnostic testing to high-risk patients suspected with COVID-19 only.[23] In addition，there wasn’t enough evidence to prove the portion asymptomatic carriers among the population and their ability to carry and spread disease. The US CDC considered tracking each COVID-19 asymptomatic carriers as a waste of public resource.

The differences in the epidemic control measures in the above countries reflect the different status in virus containment，which are determined based on the epidemics，politics，economy，infrastructures，and culture of each country. As one of the centers of COVID-19 breakout，China has taken the fully epidemic control as its primary goal，reflecting the country’s willingness to take global responsibility and respect lives. When facing a new pandemic situation of infectious diseases，it is not clear for the government to determine the outcome and risk of epidemic control measures，but the costs are clear. In the context of globalization，not only the virus can spread across countries，but also one country’s economy can affect that of one another’s.

COVID-19 isn’t over yet，and the virus is likely to continue to mutate. Regardless of the results of various epidemic control measures，it will provide data and reference for future plans.

2 Thoughts and suggestions

This global public public health incidence has brought profound experience and insights for everyone. 1.The epidemic is hard to defend from and is ever-changing，and plan in advance and the quality of the prevention is the key. 2.Resources are not unlimited；we must carefully analyze the evidence to make rational decisions，minimizing the impact with limited resources. 3.During the crisis，the power of trust has shown significant impact. It is important that each country has a public health emergency plan as part of the disaster preparedness plan. Enterprise need to establish business continuity plan to keep business continue operations and avoid unemployment. Humanity need to trust each other when facing the disasters.

I. Establish a national emergency plan for public health disasters. Public health disaster occurs accidentally with unknown nature and scope，which requires attempts to identify the epidemic and plan for the containment. Scientists can build and maintain the predictive models with various scenarios of disease occurrence and development and the corresponding impacts，especially time-sensitive scenario analysis. Based on data and evidence，high-quality analysis can help policy makers to make rational，focused，and flexible prevention and control measures. For example，an approach that can balance between controlling the epidemic and avoiding panics. The extreme measures will help prevent infected and deceased people，but it will also induce other losses due to the economy downturn and the lack of timely treatment for patients with other diseases. This requires the participation of multidisciplinary professional experts in addition to clinical and medical experts，such as public health and health economics experts. Finally，how to ensure people’s health without affecting economy is a science as well as an art，which has put forward higher requirements for the future decision-making and governance level of government.

II. Enterprise business continuity planning. For enterprises，many multinational companies have “Business Continuity Planning”（Business Continuity Planning，BCP）. BCP is the process of the prevention and recovery system established by enterprises in response to potential threats such as natural disasters or cyber-attacks. The purpose of enterprise continuous planning and design is to protect people and assets and ensure that they can work quickly when disaster strikes. BCP is usually pre-conceived，and the planning should be tested to ensure that there are no identifiable and correctable defects.

Enterprises are vulnerable disasters；the degree of impact varies from mild to catastrophic. The disruptions of business mean loss of revenue and higher costs，which will lead to a decline in profitability. BCPs are considered as important parts of companies’ business. Enterprise cannot only rely on insurance alone，since it covers part of the costs and customers will turn to competitors. BCPs are different from disaster recovery plans，which focus on restoring company business after a crisis. Of course，when a large number of people are affected by the outbreak of the disease，BCP may not be as effective，but it can reduce the impact as much as possible.

When creating a business continuity plan，enterprises need to follow the steps including business impact analysis，recovery，organization，and training.

·Business impact analysis：the business identifies time-sensitive functions and related resources.

·Recovery：the business identifies and implements steps to recover critical business functions.

·Organization：a continuity working team should be created continuously working on it. This team will develop a plan to deal with the damage.

·Training：the continuity team must be trained and tested. Team members should also complete the practice of reviewing plans and strategies.

·In addition，it is useful to make a list，including emergency contact information，a list of resources that the continuity team may need，storage or storage locations for backup data and other necessary information，and other key details such as important personnel.

In addition to testing the continuity team，the enterprise should test the BCP itself. It should be tested multiple times and regularly to ensure it can be applied to different risk scenarios by identifying the flaws in the plans and correcting them.

In order for the business continuity plan to succeed，all employees—even those who are not on the continuity team—must understand the plan.

Business continuity impact analysis is an important part of developing BCPs. It determines the impact of business function and process interruption. It also uses this information to determine the priority and strategy of recovery.

III. It is necessary to the establish of trust among the countries. Trust may expose a country to risks，but it will also greatly improve the efficiency of governance and reduce the cost of governance.

At this moment of crisis，people often suddenly find trust and kindness. The doctor-patient relationship during the epidemic is no longer a confrontation，but more trust and support. Facing an unknown situation，people are more likely to trust the authorities and proactively follow guidance when informed with scientific facts.

Lack of trust between individuals or between individuals and collectives can lead to overwhelming repetitive investments and increasing burden. The mistrust between countries will cause the nationalization of key industries and technologies reducing productivity and the efficiency of resource allocation.

Trust isn’t built or rebuilt overnight. However，the actions must be taken right away. During G20 on March 26，President Xi Jinping proposed to establish a COVID-19 knowledge center and open to all countries as part of the partnership among all countries in epidemic control. He also suggested all countries should support the role of international organizations. This is an attempt to establish trust and encourage partnership with other countries.[24]

Disaster usually arrives when we are not expecting one. We wouldn’t know when and how it comes，therefore，improving the capability to prevent disasters and partnership across countries have become fundamental to the stability of the global politics and economy.

Just as President Xi said，humanity is in a community of shared destiny，and we should watch for each other and work together to create a better tomorrow for everyone.[25]

References

1.Why Tedros Adhanom Praised China COVID-19 Containment Several Times [2020-02-24]，China News https：//m.chinanews.com/wap/detail/zw/gj/2020/02-24/9103169.shtml.

2.China--World Health Organization New Coronavirus Pneumonia（COVID-19）Joint Investigation Report [2020-2-29]，China MOH http：//www.nhc.gov.cn/jkj/s3578/202002/87fd92510d094e4b9bad597608f5cc2c.shtml.

3.All Wuhan Mobile Cabin Hospitals Are Clear On March 10th [2020-3-10]，China Government Net http：//www.gov.cn/xinwen/2020-03/10/content_5489713.htm#1.

4.44th COVID-19 Epidemic Control Press Release [2020-3-13]，Hubei Government Site，http：//wjw.hubei.gov.cn/fbjd/dtyw/202003/t20200313_2181090.shtml.

5.Tedros Adhanom Ghebrey Twitter [2020-2-18]，https：//twitter.com/drtedros/status/1229711415319179266？s=12.

6.What should I wear a mask？[2020-4-14]，Singapore MOH，https：//www.moh.gov.sg/article/when-should-i-wear-a-mask Gov.sg.

7.PRECAUTIONARY MEASURES IN RESPONSE TO SEVERE PNEUMONIA CASES IN WUHAN，CHINA [2020-1-2] Singapore MOH https：//www.moh.gov.sg/news-highlights/details/precautionary-measures-in-response-to-severe-pneumonia-cases-in-wuhan-china.

8.MOH STEPS UP PRECAUTIONARY MEASURES IN RESPONSE TO INCREASE IN CASES OF NOVEL CORONAVIRUS PNEUMONIA IN WUHAN [2020-1-20]| ADDITIONAL PRECAUTIONARY MEASURES IN RESPONSE TO NOVEL CORONAVIRUS PNEUMONIA IN CHINA [2020-1-21]| MOH ISSUES PUBLIC HEALTH TRAVEL ADVISORY IN RESPONSE TO CASES OF NOVEL CORONAVIRUS IN CHINA [2020-1-22]| Temperature Screening To Be Implemented At The Land Checkpoints From 24 January 2020 [2020-1-24] | Temperature Screening at Sea Checkpoints [2020-1-24] | Update on Additional Measures by the Ministry of Manpower to Minimise the Risk of Community Spread of the COVID-19 [2020-1-31] | EXTENSION OF PRECAUTIONARY MEASURES TO MINIMISE RISK OF COMMUNITY SPREAD IN SINGAPORE [2020-1-31] Singapore MOH https：//www.moh.gov.sg/COVID-19/past-updates.

9.[special report] fighting a new epidemic：success stories from South Korea and Singapore. [2020-5-1]，United Unions News，https：//news.un.org/zh/story/2020/05/1056402.

10.CONTENT YOU CAN USE，Singapore MOH，https：//www.moh.gov.sg/COVID-19/resources.

11.COVID-19（TEMPORARY MEASURES）（CONTROL ORDER）REGULATIONS，Singapore MOH，https：//www.moh.gov.sg/policies-and-legislation/COVID-19-（temporary-measures）-（control-order）-regulations.

12.Benchmark of Disease Prevention and Control，Japan Ministry of Health，Labor and Welfare，https：//www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_09534.html.

13.About National and International Pandemics，Japan Ministry of Health，Labor and Welfare，https：//www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_09534.html.

14.Ministry of Health，Labour and Welfare plans to expand the nucleic acid detection capacity，[2020-4-9]，NHK World Japan，https：//www3.nhk.or.jp/nhkworld/zh/news/231090/.

15.COVID-19 Basic Policy：（4）Health Provider，Japan Ministry of Health，Labor and Welfare，https：//www.mhlw.go.jp/content/10900000/000608655.pdf.

16.First Wuhan Coronavirus Patient Identified in the United States，Rabin，Roni Caryn. [2020-01-21]，The New York Times，https：//www.nytimes.com/2020/01/21/health/cdc-coronavirus.html.

17.Situation report-11 Novel Coronavirus（2019-nCoV），[2020-1-31]，WHO，https：//www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.

18.WHO declares coronavirus outbreak a global health emergency，[2020-01-20]，Statnews，https：//www.statnews.com/2020/01/30/who-declares-coronavirus-outbreak-a-global-health-emergency/.

19.The Lost Month：How a Failure to Test Blinded the U.S. to COVID-19，[2020-03-28]，https：//www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html.

20.Transcript for CDC Telebriefing：Update on COVID-19，[2020-02-21]，United States CDC，https：//www.cdc.gov/media/releases/2020/t0221-cdc-telebriefing-COVID-19.html.

21.Xi Jinping Gives Important Speech On G20，[2020-03-26]，Xinhua Net，http：//www.xinhuanet.com/politics/leaders/2020-03/26/c_1125773764.htm.

22.A Letter Replied by Xi Jinping To WHO Director-General Tedros Adhanom，[2020-03-26]，China Government Net，http：//www.gov.cn/xinwen/2020-03/26/content_5495902.htm.

[1] Why Tedros Adhanom Praised China COVID-19 Containment Several Times [2020-02-24]，China News https：//m.chinanews.com/wap/detail/zw/gj/2020/02-24/9103169.shtml.

[2] China--World Health Organization New Coronavirus Pneumonia（COVID-19）Joint Investigation Report [2020-2-29]，China MOH http：//www.nhc.gov.cn/jkj/s3578/202002/87fd92510d094e4b9bad597608f5cc2c.shtml.

[3] China--World Health Organization New Coronavirus Pneumonia（COVID-19）Joint Investigation Report [2020-2-29]，China MOH http：//www.nhc.gov.cn/jkj/s3578/202002/87fd92510d094e4b9bad597608f5cc2c.shtml.

[4] China--World Health Organization New Coronavirus Pneumonia（COVID-19）Joint Investigation Report [2020-2-29]，China MOH http：//www.nhc.gov.cn/jkj/s3578/202002/87fd92510d094e4b9bad597608f5cc2c.shtml.

[5] All Wuhan Mobile Cabin Hospitals Are Clear On March 10th [2020-3-10]，China Government Net http：//www.gov.cn/xinwen/2020-03/10/content_5489713.htm#1.

[6] 44th COVID-19 Epidemic Control Press Release [2020-3-13]，Hubei Government Site，http：//wjw.hubei.gov.cn/fbjd/dtyw/202003/t20200313_2181090.shtml.

[7] Tedros Adhanom Ghebrey Twitter [2020-2-18]，https：//twitter.com/drtedros/status/1229711415319179266？s=12.

[8] What should I wear a mask？[2020-4-14]，Singapore MOH，https：//www.moh.gov.sg/article/when-should-i-wear-a-mask Gov.sg.

[9] PRECAUTIONARY MEASURES IN RESPONSE TO SEVERE PNEUMONIA CASES IN WUHAN，CHINA [2020-1-2] Singapore MOH https：//www.moh.gov.sg/news-highlights/details/precautionary-measures-in-response-to-severe-pneumonia-cases-in-wuhan-china.

[10] MOH STEPS UP PRECAUTIONARY MEASURES IN RESPONSE TO INCREASE IN CASES OF NOVEL CORONAVIRUS PNEUMONIA IN WUHAN [2020-1-20]| ADDITIONAL PRECAUTIONARY MEASURES IN RESPONSE TO NOVEL CORONAVIRUS PNEUMONIA IN CHINA [2020-1-21]| MOH ISSUES PUBLIC HEALTH TRAVEL ADVISORY IN RESPONSE TO CASES OF NOVEL CORONAVIRUS IN CHINA [2020-1-22]| Temperature Screening To Be Implemented At The Land Checkpoints From 24 January 2020 [2020-1-24] | Temperature Screening at Sea Checkpoints [2020-1-24] | Update on Additional Measures by the Ministry of Manpower to Minimise the Risk of Community Spread of the COVID-19 [2020-1-31] | EXTENSION OF PRECAUTIONARY MEASURES TO MINIMISE RISK OF COMMUNITY SPREAD IN SINGAPORE [2020-1-31] Singapore MOH https：//www.moh.gov.sg/COVID-19/past-updates.

[11] MOH STEPS UP PRECAUTIONARY MEASURES IN RESPONSE TO INCREASE IN CASES OF NOVEL CORONAVIRUS PNEUMONIA IN WUHAN [2020-1-20]| ADDITIONAL PRECAUTIONARY MEASURES IN RESPONSE TO NOVEL CORONAVIRUS PNEUMONIA IN CHINA [2020-1-21]| MOH ISSUES PUBLIC HEALTH TRAVEL ADVISORY IN RESPONSE TO CASES OF NOVEL CORONAVIRUS IN CHINA [2020-1-22]| Temperature Screening To Be Implemented At The Land Checkpoints From 24 January 2020 [2020-1-24] | Temperature Screening at Sea Checkpoints [2020-1-24] | Update on Additional Measures by the Ministry of Manpower to Minimise the Risk of Community Spread of the COVID-19 [2020-1-31] | EXTENSION OF PRECAUTIONARY MEASURES TO MINIMISE RISK OF COMMUNITY SPREAD IN SINGAPORE [2020-1-31] Singapore MOH https：//www.moh.gov.sg/COVID-19/past-updates.

[12] [special report] fighting a new epidemic：success stories from South Korea and Singapore. [2020-5-1]，United Unions News，https：//news.un.org/zh/story/2020/05/1056402.

[13] CONTENT YOU CAN USE，Singapore MOH，https：//www.moh.gov.sg/COVID-19/resources.

[14] COVID-19（TEMPORARY MEASURES）（CONTROL ORDER）REGULATIONS，Singapore MOH，https：//www.moh.gov.sg/policies-and-legislation/COVID-19-（temporary-measures）-（control-order）-regulations.

[15] Benchmark of Disease Prevention and Control，Japan Ministry of Health，Labor and Welfare，https：//www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_09534.html.

[16] About National and International Pandemics，Japan Ministry of Health，Labor and Welfare，https：//www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_09534.html.

[17] Ministry of Health，Labour and Welfare plans to expand the nucleic acid detection capacity，[2020-4-9]，NHK World Japan，https：//www3.nhk.or.jp/nhkworld/zh/news/231090/.

[18] COVID-19 Basic Policy：（4）Health Provider，Japan Ministry of Health，Labor and Welfare，https：//www.mhlw.go.jp/content/10900000/000608655.pdf.

[19] First Wuhan Coronavirus Patient Identified in the United States，Rabin，Roni Caryn. [2020-01-21]，The New York Times，https：//www.nytimes.com/2020/01/21/health/cdc-coronavirus.html.

[20] Situation report-11 Novel Coronavirus（2019-nCoV），[2020-1-31]，WHO，https：//www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.

[21] WHO declares coronavirus outbreak a global health emergency，[2020-01-20]，Statnews，https：//www.statnews.com/2020/01/30/who-declares-coronavirus-outbreak-a-global-health-emergency/.

[22] The Lost Month：How a Failure to Test Blinded the U.S. to COVID-19，[2020-03-28]，https：//www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html.

[23] Transcript for CDC Telebriefing：Update on COVID-19，[2020-02-21]，United States CDC，https：//www.cdc.gov/media/releases/2020/t0221-cdc-telebriefing-COVID-19.html.

[24] Xi Jinping Gives Important Speech On G20，[2020-03-26]，Xinhua Net，http：//www.xinhuanet.com/politics/leaders/2020-03/26/c_1125773764.htm.

[25] A Letter Replied by Xi Jinping To WHO Director-General Tedros Adhanom，[2020-03-26]，China Government Net，http：//www.gov.cn/xinwen/2020-03/26/content_5495902.htm.

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