Scientific Epidemic Prevention under the Constitutional Framework / Sheng Hong

It is said that after a high-speed train bound for Xi’an arrived, passengers from Beijing and Zhengzhou were forcibly taken to an underground parking lot and ordered to return along the same way the next day (Tencent, 2021). No one seemed to explain why. It is also said  two trains bound for Beijing to be stopped when two close contacts respectively were found, and “collectively isolate” all passengers. The results of nucleic acid tests were negative for all personnel, including the close contacts (Liu Jianrui et al., 2021). Ejina has isolated all tourists who are traveling there because a pair of returning tourists have been diagnosed. Shanghai Disneyland was closed and all field visitors were tested because a visitor the day before confirmed the case of COVID-19 (Urban Express, 2021). The community I live in (I hide its name because the problem is not caused by the community itself) is completely closed because two residents (a couple) are diagnosed. The residents of the building are not allowed to go out, and all the residents of the unit are required to be isolated in the hotel. And the isolation time has far exceeded 14 days, reaching 25 days. The travel code of some Chengdu residents, it is said that 80000 people, suddenly turned yellow one day, and their personal freedom was limited. The reason is that they are accidentally within 800 meters from a COVID-19 patient (Xiaohan New Vision, 2021).

These measures of epidemic over prevention seem to be necessary, because the goal of Chinese mainland’s epidemic prevention is to “clear to zero” at present. However, the goal has not been achieved. It has been nearly two years since the outbreak of the epidemic, and several waves of epidemic have still spread since this year. Since late October, confirmed cases have been found in Chinese mainland cities. From border towns to central cities, such as Beijing, Shanghai, Zhengzhou, Chengdu, Shijiazhuang, Harbin, Dalian. In Beijing, newly confirmed cases also occur one after another. From Changping, Haidian, Xicheng, Dongcheng to Chaoyang, Pinggu, Fengtai, Fangshan. For where the new cases are transmitted from, the early official saying was “imported from abroad”. However, it is increasingly recognized that there are “local cases”. Where did local cases come from? This shows that there are serious loopholes in the so-called current “clear to zero” measures that take extreme methods to restrict personal freedom, interfere with normal life and at the cost of the deterioration of other diseases. I have discussed this issue in several articles. This loophole is the administrative system itself on which this epidemic prevention model depends.

The administrative system seems to have many advantages. The biggest advantages are that it has a single goal, concentrated resources and rapid action, seemly easy to achieve the goal. However, its disadvantages are also obvious. The most important feature is that the administrative system depends on repeated contacts between people, and repeated contacts are an important form of virus transmission. Within the administrative system, people need to gather for meetings, arrange work and ask for instructions and reports; in the process of its operation, grass-roots administrators and their employees should deal with others repeatedly. In this way, the administrative system personnel themselves have a huge risk of infection, and they are required to perform nucleic acid detection, isolation and related tasks, which need to deal with the crowd repeatedly. This increases the transmission channels of the virus.

Under the institutional environment of Chinese mainland, the number of confirmed cases is greatly underestimated, and the number of confirmed cases of grassroots administrators may be hidden. This makes people confused about the channels of virus transmission. For example, in my community, a staff member of a neighborhood committee was detected as nucleic acid positive because he installed an epidemic prevention door magnet on the door of the diagnosed person’s house and did not wear protective clothing in a standardized manner. He came home and infected his brother. The rest of the neighborhood committee may have been infected by him. As a result, all members of the neighborhood committee were isolated as close contacts. A decorator in the same unit of the diagnosed person was also tested positive, but he sat with everyone in the van which pulled the residents of the unit out for isolation, and someone talked with him for about half an hour. Everyone was really nervous when they heard that he was positive. People didn’t rest assured until several nucleic acid tests were negative. A government worker in the town where the community belongs called me and said that she was isolated because she contacted an infected nucleic acid tester. It is also reported that four nucleic acid testers in Gansu were infected (Yilu Qianweizi, 2021).

The more serious problem is that this current clear-to-zero epidemic prevention model is costly. The biggest cost is to violate the Constitution and infringe on citizens’ rights without legal due process. Citizens’ constitutional rights are a kind of comprehensive basic rights and an institutional arrangement that condenses the success and failure of thousands of years, especially the experience and lessons of major disasters in modern China. If violated, it will not only damage other related derived rights, but also damage the interests of all aspects of citizens. These damaged aspects cannot be completely sorted out by reason.

First of all, human rights are necessary for people’s normal life. For example, personal freedom. After the residents of our unit were forced to be isolated in the hotel, they could only stay in a room of more than 20 square meters every day, even without “outdoor” time. People are not creatures that just eat and sleep. Normal life also includes outdoor sports, reading, writing, painting, listening to music and other activities at home. Although I strive to stay at home for isolation, my habit is to walk, run and ride in the park every day. Although I insist on indoor exercises during this isolation time, I still feel weak. According to the doctor, if you sit still for a long time (such as more than ten hours), it is easy to cause thrombosis. If people are kept indoors for a long time without sunshine, fresh air, pleasant scenery and happy mood, people’s body and mind will be damaged. Some studies have shown that the “mental health of isolated personnel has decreased significantly”. Because “the scope and degree of activities are limited, the sense of depression and bondage are increased, and the body and mind cannot be effectively adjusted, they are prone to somatic manifestations such as sleep disorders” and “the level of depression and stress is high” (Ma Kaixuan et al., 2020).

Second, human rights are necessary for people’s normal work, for obtaining income and supporting daily life. Isolation for 14 days, 21 days or even longer will force people to interrupt their normal work, so that people who rely on the market will immediately interrupt their daily income, people who rely on wage income may face the risk of unemployment, or make their institutions bear the financial burden, which may lead to loss or bankruptcy. Losing income, people face with financial difficulties, such as small business working capital, residential mortgage monthly payment, loan repayment, which will even lead to family financial bankruptcy. For example, Ruili has closed the city four times in a year, the tourism and emerald business has almost stagnated, and the business and service industry cannot operate for a long time. It is not simply that there is no cost of living at present, but that it has lost the means of making a living. Many people not only have no income in the past year, but also spent their previous accumulation (Li Pengliang, Zhou Shiling, 2021).

Third, human rights are the basic rights to deal with accidental injuries. For example, among the elderly tourists isolated in Ejina, there are many kinds of diseases, such as cancer, cardiovascular and cerebrovascular diseases, depression, etc. when they were isolated for a long time, they ate up the medicine they took with them. Cutting off the medicine would lead to the deterioration of their condition and even life-threatening. Due to the restriction of personal freedom, they couldn’t go home for a long time and couldn’t continue to take medicine. Even if someone responded after seeing the news and provided their own medicine, it was delayed for some time and the quantity was limited (Zhang Yali, he Xiangyi, Zhang Meng, 2021). Other diseases, as the same as COVID-19, may harm health of people. At the cost of worsening other diseases and their harm to health and even life, to reduce the infection of COVID-19 with small probability reduces the welfare of people in general.

Fourth, human rights are the basic rights of normal social life. When a considerable number of citizens are suddenly isolated at home, not only their income is damaged, but also many socio-economic, political and cultural activities are suddenly interrupted. If they are suddenly isolated, teachers will interrupt teaching, doctors will interrupt treatment, security guards will interrupt safety services, and cleaners will interrupt urban cleaning services. When the social activities that should have been carried out are interrupted, not only the suppliers will lose their income, but also the demanders will suffer losses because their needs are not met, and the whole society will lose corresponding value and wealth. For example, Ruili is a prosperous border port town. Now it has been closed for a long time due to excessive epidemic prevention. The whole region has lost the function of border trade and tourism and has become a place unsuitable for normal life and work. It is said that from January to May 2021, Ruili’s tourism revenue decreased by 69% year-on-year (Xi Xiaodan, 2021); a large number of permanent residents outflow, from 500000 to 200000 (Serious Aunt, 2021).

Finally, generally speaking, it is a violation of human dignity. The above restrictions and reductions on citizens’ rights without normal reasons are violations of citizens’ dignity; without effective protection of rights, citizens have no dignity. Moreover, formally, the means and language of the administration are often arrogant and insulting. Its coercive practices, such as treating citizens as prisoners; their rude language and threatening attitude are intuitively sacrilegious actions; in the eyes of government officials, these citizens are treated as potential carriers of the virus. More narrowly, they are treated as the cost of their official career by administrative officials. As Kant said, human dignity comes from the will of people as legislators who follow the universal moral law as they are regarded as an end rather than a means. When their rights are violated as a means, their dignity disappears.

Of course, it is also possible to limit people’s basic rights as shortest as possible time for the practical effect of preventing virus infection. However, after fully explaining the necessity, it should be approved by the legislature. And in the implementation, the administrative authorities should not show off their restrictions on rights. However, in Chinese mainland, the administrative authorities did not follow such procedures when carrying out excessive epidemic prevention. They may not even think about the word of the “Constitution”. Outside the constitutional framework, the administrative authorities have made the extremely restrictions on people’s basic rights when administrative power is not constrained.

The first is the range of people to be isolated. We note that the definition of “close contact” has quietly changed. The original definition was “from 2 days before the symptoms of suspected cases and confirmed cases appear, or 2 days before the sampling of asymptomatic infected persons, those have close contact with them within 1 meter without effective protection.” Zhong Nanshan changed the definition to, “In the same space, in the same unit, in the same building, in the same construction, in the four days before the onset of the disease, those who get along with these patients are all close contacts.” (Agricultural Television Network, 2021) Mr. Zhong, as a rigorous expert, if there is no external pressure, it is inconceivable to modify the definition in this way. The so-called “one building, one construction” It is an extremely vague concept, and its size and distribution are very different. A huge building, such as the Great Hall of the People and a residential building with multiple closed apartment units, is also “one building”. If one wants to change the definition wider, there should also be a reasonable expansion of quantity, such as changing one meter to two meters. Not to mention adding “secondary close connection” and “secondary secondary close connection”.

At the other end, beyond the boundaries of science, an increase in the scope of “close contacts” is a violation of civil rights. The definition of concept in law is an important part of law, and the modification of concept definition is the modification of law. Amending the law is a serious process, which needs to go through due procedures of law and finally approved by the legislature. On the other hand, the administration revised the definition of “close contact” based on the words of an expert, which is the act of violating the law. According to Article 39 of the The Infectious Disease Prevention and Control Law, when “patients, pathogen carriers and close contacts of suspected patients” refuse isolation, compulsory measures can be taken. However, at the time of the establishment of the law, “close contacts” were contacts “within one meter” according to the original definition, and individual experts or administrative authorities had no power to modify them. Therefore, according to the tampered definition, it is illegal to describe people over one meter away from the patient as “close contacts”. And it is illegal to apply the relevant provisions of The Infectious Disease Prevention and Control Law, which is tantamount to tampering with the law.

What’s more, someone has created and invented the concept of “space-time companion”. It is absurd that there are people who have been there for more than 10 minutes within a radius of 800 meters around the place where the diagnosed person has been, or who have stayed for more than 30 hours in the place where the diagnosed patient has been within 14 days. The aforementioned green code of 80000 people in Chengdu suddenly turned into yellow code, which is such a “space-time companion” event. They are all regarded as the “space-time companion” of the infected people, causing a lot of inconvenience. This approach is more absurd than expanding the definition of “close contact”. This is 800 times the distance of 1 meter defined by the original “close contact”. Is there any rational basis? There seems to be no evidence that the virus on a patient can spread to another person over a distance of 800 meters. Is the virus imagination of the Chengdu authorities too boundless?

The administration is also arbitrarily extending the time of isolation. For example, the WHO said that the reasonable isolation time is 14 days, which is the incubation time obtained according to the statistics of a large number of cases. Now it has increased to 21 days in some places, and it might not lift the lockdown when the time comes. For example, our community was closed for 25 days without any explanation. For those who come back from foreign countries where there has been an epidemic, even if they have been isolated abroad for 14 days, they will continue to be isolated for 14 days at home. What is more serious is that epidemic prevention and isolation also means mutual distrust and blockade among regions. If a tourist has been isolated for 21 days due to the epidemic in Ejina, he needs to be isolated for another 14 days when he returns to his place of residence. This is even more unreasonable. It is obviously the result of investigating local governments according to the number of cases in administrative divisions, and local governments do not trust each other. This has no scientific basis

Why do local administrative departments tend to expand the concept of “close contacts”, expand the scope of isolators and prolong the isolation time until being absurd without scientific basis? This is related to the institutional environment in Chinese mainland. For epidemic prevention, the main goal is to clear the virus at the moment to zero, which mainly depends on the top-down administrative system. What promotes the action of administrative officials at all levels is to investigate the number of cases in their areas, and then use the removal of officials as a means to drive officials at all levels to excessive epidemic prevention. There is a problem with the goal. Because a society involves many factors related to the well-being of citizens, COVID-19 epidemic prevention is only one of many goals. It has a reasonable weight in the comprehensive goal. If it exceeds this weight, it is inappropriate. If we ignore the comprehensive social goals and only emphasize a single goal, we may over amplify the importance of this goal, relatively reduce the importance of other goals, or even reduce the importance of the latter by suppressing public opinion, which will produce improper views and actions in the society and the government, and realize this single goal at the cost of damaging the comprehensive social goals.

For local administrative officials, since the goal set by his superior is the single goal of epidemic prevention, and his career depends on whether he can achieve this goal. If not, his superior has absolute power to remove him from his post, his career will end, or even worse. Therefore, just to keep his official position, he should also realize the current “clearing to zero” task. If a suspected case is found, he should try his best to put it out. Because the comprehensive social goals are not within the scope of the assessment by the superior, and because there is no cost for the violation of civil rights due to epidemic prevention in the institutional environment of unrestricted power, when the superior pays attention to epidemic prevention, a COVID-19 case is more likely to be punished than ten death of other diseases are, therefore, a local official’s rational calculation is that he would rather violate the Constitution and infringe upon the civil rights, and would rather cause the loss of life, work and health, and also do not want to have a COVID-19 case, risk losing his official position.

In reality, the system works like this. There have been many negative examples. For example, due to several epidemic fluctuations in Ruili City, two secretaries of the CPC Municipal Committee have been removed from office within half a year (Qiu Kaimao, 2021); when the epidemic broke out in Ejina in October, Chen Zhanyun, Secretary of the CPC Ejina Committee, was immediately dismissed. In August, Fang Zhongyou, Secretary of the Nanjing Health Committee of the CPC, was dismissed due to the epidemic accident at Nanjing airport; The Secretary of the CPC District Committee in Hanjiang and Guangling districts of Yangzhou was dismissed because of poor epidemic prevention. It is reported that 70 ~ 80 local officials have been “held accountable” since the fight against the epidemic. In fact, this evaluation of officials with a single administrative goal is unfair to these officials; perhaps on the whole, they have made achievements. Yunnan Province proposed to Ruili to “ensure that it clears to zero quickly, not spread out and not rebound”. It did not mention the local needs of Ruili at all, as if it were an abandoned piece, which seemed very unbalanced.

Under the institutional environment of Chinese mainland, the subordinate officials are completely passive. Although the Civil Servant Law stipulates that civil servants have the right to appeal and accuse of improper punishment, in reality, it is almost impossible for sanctioned officials to exercise such rights. Especially in this nearly two-year epidemic prevention, the epidemic prevention task has been politicized. We have not seen any officials dare to appeal or sue their dismissal for a single administrative goal on the basis of constitutional principles. In fact, even in this case, the general judgment is that there is no possibility of success. In this institutional environment, officials are likely to be eliminated in reverse. Hayek once pointed out that an organizer should make full use of the knowledge of his subordinates, so as to form complementary knowledge. The simple removal of officials under the single goal of “epidemic prevention” is to remove those officials who use their own knowledge advantages to avoid problems not considered by their superiors; those who replace them are those who learn their “lessons” and simply implement the orders of their superiors regardless of their negative results.

In the practice of epidemic prevention, there are some extreme examples occasionally. For example, someone returns to positive a few days after the nucleic acid test is negative, which makes these officials worry that even if people’s nucleic acid test is negative, there can be no guarantee that no one will return to positive and infect others in the future. To be on the safe side, they have to isolate the “close contacts”, “secondary close contacts”, others in the “one building” and even the surrounding communities for 14 to 21 days even if they are negative after observation. In fact, even if the example of returning positive appears, the probability is very low. From a social point of view, if this happens, the degree of infection is also very low, and it is not worth mobilizing the public. The reason why these officials did so was that they had no concept of probability and could not distinguish between 1 / 10 possibility and 1 / 100000 possibility; Secondly, even if they have the concept of probability, because the occurrence of a small epidemic with little probability will affect their official position, they should multiply the very low probability by a large safety factor; moreover, their excessive epidemic prevention measures are for the “upper” to see, which is a “statement” or even a “flattering” action; finally, because in Chinese mainland, power is not bound by the Constitution and laws. So these officials need not pay the cost of taking measures that harm civil rights and social interests, so they would rather harm others to protect themselves.

In the specific implementation, a lot of funds are needed to mobilize social resources. In theory, the funds come from government finance. Because the financial funds are public and used for epidemic prevention, they seem not to be criticized and restricted in this special period. Therefore, especially for rich areas, the problem of funds is not an obstacle to limiting the expansion of epidemic prevention scope of local governments, and they even spend a lot of money. For there is a minor epidemic in Shanghai Disneyland, all tourists in the park the next day not only were tested nucleic acid  exaggeratedly, but also stopped the subway and mobilized 210 buses to transport tourists back to the city, which is a waste. If you think these passengers would “infect” the subway, you could disinfect it later. In Beijing, taking our community as an example, because two cases were confirmed in one unit of a building, the residents of the whole North Community and the South Community (separated by a road) have been isolated for 25 days, which is far beyond the boundless definition of “close contact”, and two “big white” guards are sent at the door of each unit. When Beijing and other cities pull residents out of “centralized isolation”, the cost is paid by the government. Of course, citizens pay in the end. This is their tax money.

In less affluent areas, such as Ruili and Ejina, the government requires residents or tourists to pay out of their own pocket. For example, in Ruili, residents or outsiders who want to leave Ruili need to be isolated for 14 days at their own expense. For local residents and outsiders who have been impoverished due to the closure of the city, it is obviously worse to charge isolation fees. Even those who do not participate in nucleic acid testing will be forced to isolate at their own expense for 21 days (Ruili COVID-19 epidemic prevention and control command headquarters, 2021). This is amazing. Because if people are free to choose between nucleic acid detection and isolation at their own expense for 21 days, rational people will choose the former. In Ejina, tourists were forced to be isolated at their own expense, and the time was prolonged again and again. Later, they were still isolated for 14 days when they were transferred to other areas. What’s more, when Li Zhuang, a legal expert, made a professional criticism of “self-funded isolation” on the Internet, local police came to “admonish” him. Li Zhuang made it clear in his article “Answer netizens on ‘isolation fees'” (2021) that mandatory isolation fees cannot be charged. In addition, allowing residents or tourists to “isolate at their own expense” is transferring the financial burden. In addition to encroaching on the interests of isolated citizens, it also aims to reduce the financial burden of the local government, so as to make it easier for them to decide on compulsory isolation and expand its scope and time.

When these local governments take excessive epidemic prevention measures, due to their inappropriateness and coercion, they will inevitably lead to the disgust of some citizens. Because their power is not constrained, these local governments will further take measures to violate citizens’ rights and dignity and force citizens to submit. For example, in the incident that Xi’an high-speed railway station forced Beijing and Zhengzhou passengers to go to the underground parking lot and return the same way of their coming, the local government dispatched some “big whites” to enforce coercion on passengers; In Cangzhou rural areas, local governments force the elderly to be vaccinated. If they are unwilling to be vaccinated, they were threatened to stop pension insurance and seed fertilizer subsidies. In some local kindergartens, teachers put psychological pressure on unvaccinated children by treating them differently, forcing their parents to agree to vaccinate them. Most intuitively, the “epidemic prevention personnel” sent by the government have a rough and bad attitude. When residents refuse the mandatory measures they require, they take the means of harassment for many times, and even deliberately call at night to destroy residents’ sleep. Their more frequent mantra is “if you don’t…, I’ll call the police.” this is called “illegal threat”. As mentioned earlier, it is illegal to modify the definition of “close contact” without due process of law. Therefore, when the administrative authorities use the police against ordinary residents, they are violating residents’ rights.

The above problems are still under the assumption of the most goodwill to the local government. Not surprisingly, when local governments can restrict and invade civil rights in the name of “epidemic prevention”, some people with bad conduct among civil servants and their “epidemic prevention personnel” take the opportunity to infringe on citizens’ personal, residential and property, resulting in a lot of losses and social panic. For example, Shangrao City illegally pried open a resident’s house after the residents were “centrally isolated” and went in to “kill” the resident’s dog (Hertz, 2021). When some lawyers went to other places to carry out legal business, in order to prevent them from defending their clients, the local government took advantage of the convenience of manipulating the health code or travel code to turn their health code red or yellow. In fact, their own nucleic acid tests were negative, for  they had not been to medium and high-risk areas. Chen Hongguo, a legal scholar, returned to Xi’an from Yuncheng, a low-risk area. When he showed his travel code, he found that it turned yellow. It showed that he had been to the Philippines within 14 days, but he had never been there at all (Chen Hongguo, 2021). Wafangdian City in Dalian even stipulates that those who do not participate in nucleic acid testing twice will become yellow code and three times will become red code. On the whole, health codes and travel codes have been maliciously used by some local governments and have become tools for systematically violating citizens’ personal freedom rights; In turn, it disintegrated the authority and scientificity of the two codes and seriously damaged the epidemic prevention system.

When local governments infringe on citizens’ rights under the banner of “epidemic prevention”, resulting in a significant decline in citizens’ quality of life, interruption of medical treatment, serious impact on citizens’ health, or the occurrence of vicious accidents that infringe on citizens’ housing and property rights, resulting in victims’ complaints and public condemnation, these local governments further infringe on citizens’ right to freedom of expression, use violence to suppress the exposure of accidents and criticism of their practices. For example, in the above “admonition” to Li Zhuang; the owner of the dog “slaughtered” in Shangrao was threatened to delete the microblog after sending the message, and some articles criticizing the Shangrao government on the Internet were also deleted. Later, the local government declared that it “got the understanding of the dog owner” (Hertz, 2021). There are also articles that complain that the health code and travel code have been changed by malicious operation, which have also been deleted. Ruili’s residents who complained in the deteriorating living environment were illegally detained by the local government (serious aunt, 2021). This only shows that things are more serious than the information we have access to, and a large number of problems have been suppressed and not exposed.

In short, the existing Chinese mainland’s epidemic prevention model has serious defects, and the single goal of epidemic prevention is not yet achieved. Both the loss of civil rights and the cost of social interests are very huge. It must be corrected and adjusted. The most important way is to put epidemic prevention under the constitutional framework. Constitutional principles are a concise summary of the successes and failures of historical development, and a great wisdom; The single administrative goal is narrow and short-term, which often conflicts with the comprehensive social goals represented by the constitutional principles and citizens’ constitutional rights, and is far less than the constitutional principles. Adhering to the constitutional principles and putting epidemic prevention within the constitutional framework requires governments at all levels to take the Constitution as the highest principle, so that in epidemic prevention, they will not highlight a single goal and harm other rights and interests of citizens, give consideration to a single goal and comprehensive social goals, and will not do things that harm civil freedom, property, health and life.

To put epidemic prevention under the constitutional framework, we must correct those things that have violated the constitution. First of all, it is necessary to restrict the administrative departments from arbitrarily changing the quarantine and other epidemic prevention rules and standards. For example, the definition of “close contact” must be determined by a neutral expert group and voted by the legislature before it can be determined or modified; the time standard for isolation of “close contacts” or other epidemic prevention measures shall also be so determined or modified; the creation and use of the concept of “space-time companion” should also go through such due process of law, and cannot be arbitrarily established by officials of administrative departments. If it has been established or changed, it shall be revoked and implemented in accordance with the previous standards before there is no new standard. In fact, the concept of “close contact” should return to the original concept with scientific basis, and the concept of “space-time companion” should be abolished. Those who violate citizens’ rights, injure citizens’ personal freedom and damage citizens’ property in the name of “epidemic prevention” shall be punished in accordance with normal legal provisions.

For example, government administrative departments and their responsible persons who arbitrarily expand epidemic prevention measures to restrict citizens’ personal freedom beyond the provisions of the Infectious Disease Prevention Law shall be given administrative sanctions, and those involved in criminal crimes shall be prosecuted to the court. For the “epidemic prevention personnel” who broke into residents’ homes and killed their pet dogs in Shangrao, they should be prosecuted according to the crimes of violating houses and property, and the leaders behind them should also be punished accordingly. Those who abuse police power to suppress the normal reflection of excessive epidemic prevention mistakes and the difficulties they create should be stopped and punished. Administrative officials who use the opportunity of epidemic prevention to invade the epidemic database and tamper with data for other purposes shall be prosecuted and punished for the crime of undermining data security and disintegrating epidemic prevention data system.

Under the constitutional framework, epidemic prevention, of course, should limit the means space of the current government; However, while eliminating a large number of the consequences of the violations of the people’s rights, it did not greatly curb epidemic prevention. Moreover, the success of epidemic prevention depends not on brute force, but on wisdom. In order to better prevent epidemic disease within the framework of the constitution, we must know COVID-19 more scientifically. In addition to devotes to developing vaccines and medicine, it is more important to have a deep understanding of its infectious characteristics and provide a basis for social means of epidemic prevention. First, we should change Chinese mainland’s “current clearing to zero” mode to “gradually clearing up”. The goal of “epidemic prevention” will be set down to reduce the basic reproduction number to below one (Sheng Hong, 2020). This means that if the basic reproduction number is reduced to less than one, the number of infected people will gradually decline and finally return to zero. This is a very common truth. We are worried about endangered animals today. The main reason is that if the population size is smaller than a critical point, the success rate of male and female pairing will be reduced, and the reproductive rate will be reduced below one, that is, each adult animal cannot produce one offspring, so it will go to the extinction of the population. The reason for viruses is the same.

Figure 1 Assumes that the basic reproduction number of Wuhan City closure day starts to be 0.94

Note: the ordinate represents the number of infected people, and the abscissa represents the time. The time unit is a day. There are 365 days here.

Source: Sheng Hong, “The appropriate goal to fight against COVID-19 is to reduce the basic reproduction number below 1”, Professor Sheng Hong, April 23, 2020.

My rough research last year suggested that if we reduce unnecessary contacts, wear masks, maintain social distance, and virtual transactions and services, the basic reproduction number of in Chinese mainland can be reduced to below 1. It is estimated that regardless of whether vaccination prevents infection, only the original cautious definition is adopted to isolate the “close contacts” for 14 days, which can further significantly reduce the basic reproduction number, which means that the number of infected people decreases faster. The goal of gradually clearing zero can be achieved. As for the isolation without strict time limit under the definition of great expansion, it is obviously unnecessary and a huge waste. Strictly speaking, this waste shows that the social cost of epidemic prevention is much greater than the social benefit. How to judge the social cost and social benefit of epidemic prevention?

The COVID-19 would make people dead. Although human life is priceless, life is composed of time. Lu Xun’s saying that “Time is life, and wasting other people’s time for no reason is actually tantamount to murder for money” has literary color, but it also opens up the relationship between overall life and part of time. Therefore, we can learn from insurance, and we can make estimation reluctantly. We can learn from the method of life insurance, regard the total number and time of people whose personal freedom is restricted in one isolation as the social cost of isolation, and regard the death of COVID-19 reduced by this isolation as the social benefit of isolation, and compare the two. We can have the following formula, which specifies the upper limit of isolation:

Social cost: Number of people isolated × Days ≤

Social benefit: Reduce the number of infections due to isolation × Mortality × (reduced life expectancy of COVID-19 death) × 365 days

Here, according to a research team at the University of Glasgow, we assume that the “reduced life expectancy of COVID-19 death” is 11 years (Upstream News, 2020). The meaning of this formula is that, theoretically, isolation measures for close contacts should be based on the point that the upper limit of the cost (days) caused by isolation measures should be the benefit (days) of preventing infection and saving lives. If the former is greater than the latter, the cost of epidemic prevention is too high.

For example, according to an observation and study of 2593 close contacts in Guangzhou, 127 close contacts (within one meter) were infected, about 4.9%; 88.98% of them are family members who get along day and night. Assuming that these close contacts are not isolated, assuming that they infect family members or others with the same probability, assuming each family has 3 members, each close contact may infect 0.87 family members, all infected close contacts will infect 110 family members, and 14 people outside the family, a total of 124 people. The case fatality rate at that time was 4.5%, that is, about 6 people might be in danger; if they didn’t get COVID-19, they still have 11 years of life expectancy, 4015 days, which multiply by 6,  we get 24090 days; 2593 close contacts were isolated for 14 days, it is together 36302 days, higher than 24090 days, i.e.

36302 days > 24090 days

The social cost of isolation is slightly higher than the social benefit of isolation, which shows that the measure of isolating all close contacts for 14 days is somewhat excessive, but it is basically acceptable.

For another example, two confirmed cases (a couple) in our community infected two people. The administrative authorities isolated about 2000 people in the whole community as “close contacts” for 25 days. According to 2000 people, the probability of infection of “close contacts” is 0.01%. Assuming that the 2000 people are not isolated, the infected people will infect others according to the same infection probability, and then infect two more people. Multiplied by the case fatality rate of 4.5%, 0.09 people may die. Multiplied by the remaining life expectancy of 11 years, it is converted into days, about 361 days. And 2000 people multiplied by 25 days is 50000 days. Much more than 361 days. Namely:

50000 days > > > > 361 days

The cost of isolation (days) is much greater than the life loss reduced by isolation (days), which is about 139 times that of the latter. This is because the scope and time of isolation have been improperly expanded. Therefore, this isolation measure is very unworthy. If according to the original definition of “close contact” (within one meter) range (about 10 people) and the 14 day isolation period recognized by WHO, the isolation cost is 140 days, which is less than 361 days.

Changing the definition of “close contacts” from “within one meter” to “one building” or even a community, one person gets sick and 2000 people are isolated. The administrative authorities believe that each of the 2000 “close contacts” with the expanded definition may be infected with the virus and have no ability to identify the infected. However, there are many ideas, methods and technologies that can identify infected people without isolating 2000 people. For example, according to the previous study on close contacts in Guangzhou, the infection probability of close contacts (within one meter) is 4.9%, of which 89% are family members, so the infection probability of close contacts who are not family members is only 0.5%, and they are distributed in vehicles, workplaces, entertainment places and medical institutions, and then the close contacts in these places (within one meter) are detected (without isolation), Then we can find out the 0.5% infected people (isolation). Even if there are very few “missed” infected people, it is very small. Thus, the effect of this method is basically the same as that of isolating the whole community indiscriminately. Even if there is a difference, it will be too small to be significant; it may even be better, because it reduces the chance of mutual infection between administrative, medical personnel and quarantined people caused by the administrative department’s forcibly “organizing” isolation and repeated detection of nucleic acid.

Of course, the above two examples are only rough demonstrations. Careful research should be able to write an academic paper. The parameters cited above are not accurate enough, mostly small sample data. In order to make the research accurate and reliable, it is necessary to obtain more accurate parameters. Through the analysis of big data, we should obtain the basic reproduction number of virus, the length of incubation period, the maximum distance and probability of direct infection, the probability of direct contact infection, the maximum interval and probability of nucleic acid negative and re-positive, the efficiency of vaccine and the efficiency of medical treatment. In particular, we can also observe and study people’s epidemic prevention behavior, such as the effects of wearing masks, washing hands and social distance, so as to make more accurate judgment and find a better epidemic prevention behavior model. The administrative department can formulate an isolation policy that takes into account of the epidemic prevention and social comprehensive objectives, and with the change of parameters, such as the reduction of mortality.

The concept of probability is important if the above epidemic prevention measures and their adjustments are to be implemented. Anyone who has read a bachelor’s degree should have studied probability theory. For the basic reproduction number, infection probability, serious disease rate, case fatality rate, infection probability of close contacts, infection probability of secondary close contacts, return-positive probability of cured patients, etc., there should be statistical probability based on big data, and epidemic prevention measures should be taken according to the proportionality principle referred probability. The so-called “proportionality principle” is to take corresponding measures according to the severity of the nature of the disease and the probability of occurrence, rather than taking upper limit (or no upper limit) measures regardless of the severity and probability. With the concept of probability, the proportionality principle can be used accordingly. This is what a rational society should do, and it is also very common in our society. We will not ban flights because there have been plane crashes. Nor will the highway be closed down because of accidents on the high speed road. According to statistics, the number of Chinese mainland deaths due to road traffic accidents is around 60 thousand per year. People who live hundreds of meters around patients are often isolated for 25 days. This shows those who made decision do not understand the nature of probability and the proportionality principle.

Confucius said, “Propriety is the foundation of public governance.” here, “propriety” refers to the non-mandatory rules of society, which means that public governance should be based on non-mandatory rules. I explained this sentence as, “Although Confucianism knows that the government has the power to use coercive force, all the efforts of Confucianism are to minimize the use of coercive force in public governance.” In a society, non-coercive rules are superior to and prior to coercive rules. In Chinese mainland, the local government seems to think of coercive power first, which is particularly evident in this epidemic. The abuse of coercive force is not only “inhumane”, but also “unwise”. It is because in the fuzzy zone between compulsion and non-compulsion, it is necessary to use wisdom to explore wise measures that take into account the comprehensive objectives of epidemic prevention and society with a kind mind. Officials who frequently use coercive means are not only not loving the people, but also likely to be stupid, because they can think of it without thinking. Therefore, “Scientific epidemic prevention under the framework of the Constitution” is the due meaning of the issue.

Reference

Nongshi.com, “Zhong Nanshan: close contacts have been redefined”, August 2, 2021.

Upstream News, “research shows that the life span of dead patients infected with new crown is at least 10 years shorter than their natural life span”, Upstream News, May 12, 2020.

Tencent.com, “Xi’an high-speed railway station detains all people from Zhengzhou and Beijing in the underground parking lot and let them return by the original high-speed railway tomorrow” (video), November 12, 2021.

Chen Hongguo, “What’s the ‘space-time companion’? I was gone Philippine”, Wechat Public Account “Golden Bottle Joke”, November 19, 2021.

Chen Hongguo, “I was gone Philippine and my travel card turned yellow”, Wechat Public Account “Big Case Present”, November 12, 2021.

Gong Zuojiong, “Clinical analysis of 25 cases of COVID-19 pneumonia death: a retrospective study of a medical center in Wuhan, China”, “MedRxiv”, February 25, 2020.

Hertz, “Even if my blog is closed, I have to say something for this dog | Shangrao pet dog is tortured and killed”, Hertz laboratory, November 17, 2021.

Li pengliang, Zhou Shiling, “Yunnan Ruili’s workers: they stopped work for half a year and did nucleic acid 100 times, but they couldn’t go back even paid 10000 yuan”, Phoenix Star, October 29, 2021.

Li Zhuang, “Answer netizens on” isolation fee “, Wechat Public Account” East John “.

Liu Jianrui, Zeng Lingke, “two trips to Beijing high-speed railway were urgently stopped, 346 people were all negative in nucleic acid test, and the return date of centralized isolation is uncertain”, Xiaoxiang Morning Post, October 30, 2021.

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Ma Yu, Ma Meng, Luo Ye Fei, Liu Fanghua, Yang Yunou, Chen Siyu, Jing Qin long, Luo Lei, Zhang Zhou Bin, “Guangzhou city New Coronavirus pneumonia close contacts of infection risk factors analysis”, “China Public Health” April 2020 volume thirty-sixth fourth issue.

Qiu Kaimao, “The two voices about Ruili inadvertently contributed to the double reed effect”, wechat public account “One Hill and Ten Thousand Valleys”, October 29, 2021.

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Xiaohan’s New Vision, “Health code turns yellow when you haven’t been to the epidemic area. Chengdu has created a romantic epidemic prevention term ‘space-time companion'”, November 7, 2021.

Zhang Yali, He Xiangyi, Zhang Meng, “Elderly tourists in Ejina: they come out with double cancer and lose their medicine for a week due to isolation”, Sohu Polar Day, October 28, 2021.

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  November 27, 2021 at Fivewoods Study

Author: flourishflood

Economist, Confucianist

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