2019年12月に中国の武漢から蔓延した新型コロナウイルス感染症 (COVID-19) により, 世界中の歯科医師はかつてない難局に直面した. COVID-19の感染拡大初期より, 歯科治療における院内感染リスクの高さが危惧されていたが, 感染予防手段について当初は暗中模索であった. 本稿では武漢が迎えた危機に関連する文献を展望しながら, 世界で初めてCOVID-19に遭遇した歯科医師たちが困難を克服するにいたるまでの経緯を紹介する.

 湖北省の省都,

 武漢大学歯学部の文献を中心に関連資料を総覧することにより, 武漢の歯科医師たちが苦労を重ねながらもCOVID-19の感染拡大を安全に乗り切ったことが明らかになった.

On 5th January 2020, World Health Organization notified all member states about the new outbreak of pneumonia of unknown cause in Wuhan City, Hubei Province of China. It was a beginning of pandemic of the novel transmissible disease, which was later named as COVID-19. The causative agent was soon searched using whole genome analysis and a new coronavirus that is very similar to the virus causing SARS was identified. The virus was named SARS-CoV-2. COVID-19 rapidly spread inside China and the Government of China decided to shut all public transportation at the end of January. In Japan, a man who travelled back from Wuhan city in early January was the first case. To rescue Japanese nationals trapped in Wuhan, the Japanese Government chartered five flights. All passengers were put under quarantine after arrival and were subjected to PCR testings. On 1^st February, a passenger on a cruise ship ‘Diamond Princess’ that had departed from Yokohama was confirmed to be infected with SARS-CoV-2 at Hong Kong. Therefore, all passengers and crews on the ship were put under quarantine offshore Yokohama, the final destination of the cruise. PCR testings were performed on symptomatic persons and persons that had close contact with cases. The number of cases increased day by day from the start of the quarantine. Epidemiological research was conducted worldwide from an early stage and demonstrate good indices to understand epidemiology of COVID-19. Case reports from China showed presence of many asymptomatic cases especially in younger generations. Mathematical modelling studies estimated the length of incubation period of COVID-19 and its serial interval and the possibility of transmission during asymptomatic period was also highlighted to give warning. Effectiveness of the quarantine measures on the Diamond Princess was evaluated in another study and drastic reduction of the predicted number of future cases was proven. At the end of February, a specialist advisory group was organized under the Ministry of Health, Labor and Welfare. Advised by this group, Japan started to tackle COVID-19 by applying a unique strategy in the world.

The Chinese government under the control of the Chinese Communist Party selected a lockdown to control COVID-19 in the first half of 2020. The main purpose of lockdown was to restrict the activities of ordinary people including their everyday life. The transfer from Wuhan/Hebei province to other cities/provinces was under severe restrictions. The Chinese government stopped the public transportations including railway, subway, bus, ships, and private car drive in Wuhan. The mobilization inside Wuhan was also under severe regulations, to buy everyday food was also under the mobilization permit. These kinds of severe and big-scale lockdown were the first case in the history of public health.

The lockdown was very effective to control COVID-19 in Wuhan, the pandemic was quite controlled in a few months. To control mobilization, the Chinese government prepared to supply much food, medical instruments for the ordinary people of Wuhan, and the central and local governments also paid much attention to support the people’s everyday life. The Chinese People’s Liberation Army was also mobilized to support the lockdown.

Why did the Chinese government succeed in anti-COVID-19? In Wuhan and other Chinese urban districts, “community” (社区 She-qu) played a key role in the lockdown. The severe inspections for health conditions were advanced at the health stations in the “community” by the staff who had a close tie with the local unit of the Chinese Communist Party. A severe curfew was also advanced based on “community” and sub-“community” (小区 Xiao-qu). The origin of this method was started at the anti-SARS movement in 2003, but the digitalization of community or personal control by the advanced ITC systems, for example, the “Health Code” was one of the new key methods at the control of COVID-19 pandemic in 2020.

The reality in China shows us that the “community” control is the reason why the Chinese government succeed in the control of COVID-19. The urban “community” was reorganized during the period of the privatization of the state-owned company, but only few studies discussed the role of public health. How to examine the role of “community” of China in the history of public health and the contemporary anti-epidemic measures is one of the important topics in Chinese studies and public health studies.

2019年12月，中国湖北省

2019年末，中国