key: cord-0822852-xvnv5aam
authors: Zhang, Xiaoyan; Xiang, Chen
title: Turning rural villages into the home front for social stability—Examination of coronavirus disease 2019 control experiences in rural areas in China
date: 2020-07-16
journal: Int J Health Plann Manage
DOI: 10.1002/hpm.3007
sha: 6c468897764e4998cc30322f480ff5bfd956ea64
doc_id: 822852
cord_uid: xvnv5aam

Since the outbreak of COVID‐19, the disease has continued to spread and countries around the world have been plagued by its causal agent, the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). In the comprehensive fight against the SARS‐CoV‐2, China has taken a series of important measures, achieved major victories in safeguarding people's lives and health, and accumulated important experience. Rural epidemic prevention and control is a basic part of the entire prevention and control system, with certain particularities. This study summarizes China's experience in preventing and controlling COVID‐19 and the local measures taken to effectively prevent the spread of the disease in rural areas. All countries worldwide can learn from China's experience and take measures according to their own national and local conditions to effectively achieve the rural prevention and control of COVID‐19. Meanwhile, the crisis itself can be viewed as a new opportunity for rural development.

treatment or SARS-CoV-2 vaccine at present, which poses a great threat to the lives and health of people worldwide.

In China, the healthcare and hygiene conditions of rural areas are poorer than those of the urban areas, with rural residents possessing poor knowledge about protection from diseases. 1 Furthermore, this epidemic occurred during the Chinese New Year, a time when large numbers of rural residents return to their hometowns, thus leading to an increased risk of an epidemic. Notably, disease control in rural regions is one of the major areas in the prevention and control of an epidemic. Therefore, the Government of the People's Republic of China swiftly employed forceful, orderly, scientific, and thorough measures to effectively prevent the spread of the disease in rural areas. This ensured the health and safety of the public as a whole, healthy economic development, social stability in the rural communities, and enabled rural areas to become the home front for national stability.

There were five major areas in the COVID-19 prevention and control experience of China's rural areas, all of which involved different components and focus areas.

First, an organization-along with an effective operation mechanism-was established to lead and clearly define the responsibilities of COVID-19 prevention and control and to carry out the tasks involved. On the basis of existing regulations on the response to public health emergencies, the governments of the various provinces, autonomous regions, and municipalities directly under the central government set up local epidemic emergency response headquarters after the COVID-19 outbreak. The relevant departments of the local governments at or above the county level were responsible for handling the emergency response to the outbreak within the scope of their respective functions and duties. Once COVID-19 had become an epidemic, committees in villages and towns immediately organized forces to unite and cooperate on mass disease prevention and treatment measures, assisting the health administrative department and other relevant departments as well as medical and health institutions in the collection and reporting of information, the dispersion and isolation of personnel, the implementation of public health measures, and the conveyance of infectious disease prevention and control knowledge to the villagers.

During the epidemic period, the state council issued a notice on further improving the prevention and control of the pneumonia epidemic caused by the novel coronavirus in rural areas. Under the leading group for epidemic response and following the working mechanism for joint prevention and control, local party committees and governments set up special classes on epidemic prevention and control in rural areas to strengthen the unified command and dispatch measures, to adhere to the integrated deployment and promotion of prevention and control in rural and urban areas, and to effectively guarantee the needs of materials, funds, and personnel for epidemic prevention and control in rural areas. For example, in the Fuyang District of Hangzhou City (Zhejiang Province), the whole region implemented a four-level linkage mechanism of "organizing groups and joining villages" to carry out the epidemic prevention and control work. According to the overall planning requirements of the main leaders, which included all township cadres and village (Party member) representatives, a total of 276 epidemic prevention teams were set up in 276 administrative villages in 24 townships (subdistricts) of the region. More than 1600 township cadres were assigned to the teams to carry out COVID-19 epidemic prevention and control, thus achieving full coverage of the region. During the period of group association, members of the town and street leading group were responsible for contacting the villagers, grasping the whereabouts of the mobile personnel in the village, paying attention to the personnel trends, and regularly reporting to the main leaders of the town and street leading group.

In the event of any special situation, the town and street leading group would contact the emergency response team immediately and report to the district leading group. Township cadres clarified specific responsibility blocks through zoning; regularly collected and summarized changes in the epidemic situation in the area; and organized the promotion of epidemic prevention knowledge, the control of personnel entry and exit, and other investigations.

The village representatives (Party members) were divided according to their place of residence and were in close contact with the households, being responsible for understanding the situation of each household in real time (via telephone, WeChat, etc.), collecting information on the actual difficulties faced by each household, and reporting any emergencies. All the villages in the district had established a village-level defense network, with the town and village cadres and village (Party members) representatives acting as the main body, and the anti-epidemic work was thus carried out in an orderly manner. Third, the monitoring of migrant staff, returning staff, and rural residents was strengthened, and autonomous epidemic control based on local conditions was carried out. Epidemic prevention and control is a battle that requires the participation of everyone, and rural residents must also be guided and mobilized to participate as a joint prevention and control effort. As many staff and students returned to the rural areas before the Chinese New Year, the pressure of prevention and control in the rural areas was increased. Therefore, Chinese villages viewed the quaran- such as the following: refusing to cooperate with epidemic prevention, quarantine, compulsory quarantine, and isolation treatment by deliberate escape, malicious obstruction, violent resistance, and other means; disturbing the medical order of a hospital, injuring medical staff, or preventing state functionaries from performing their official duties according to law; knowingly entering a public place or coming into contact with others while concealing his or her status of being possibly or definitely infected with the novel coronavirus; fabricating and spreading false information related to the epidemic situation, knowingly spreading false information on the information network or other media, spreading rumors, making false reports of dangerous situations or the epidemic situation, or deliberately disturbing public order by other means; disturbing the work of epidemic prevention and control groups and disrupting public order by bidding up prices or hoarding supplies for profit; and refusing to carry out the commands issued by the various levels of the People's governments during the period of epidemic prevention and control.

In addition, it is insufficient to rely solely on top-down resource allocation and grassroots cadres for epidemic control. Therefore, the characteristics and situation of each village were used to actively mobilize the public. That is, existing rural administrative organizations and social organizations were utilized; and WeChat groups, public accounts, and mobilization books were all used to mobilize the masses to participate in grassroots epidemic prevention and control. Mobile investigation teams, village patrol teams, anti-gathering persuasion teams, and volunteer teams for assisting vulnerable people were established. A medical system that complies with various epidemic control regulations was set up to maintain social order and focus on reconstruction and prevention. During the epidemic, many rural organizations, retired soldiers, high school students, and ordinary villagers in the rural areas were frontline staff who carried out tasks ranging from cleaning, to the disinfection of public places, and guard duty. These people used professional knowledge for psychological counseling, assisted in promotion work, donated funds and materials, assisted in the collection and distribution of materials, and aided in the organization of epidemic-related data, updating, and verification work so as to truly achieve joint epidemic prevention and control based on society-wide efforts.

Fourth, the promotion of guidance for the epidemic prevention and control work, along with the promotion of epidemic-specific laws, was strengthened. Guidance promotion was strengthened via promotional banners, village 2. Guaranteeing the flow of capital: To ensure that farmers had access to capital, credit guarantee-related fees for the agricultural industry were reduced/waived, disaster relief funds for the agricultural industry were disbursed as soon as possible, Central Finance development funds for the agricultural industry were distributed to key epidemic regions, and the coordination of local fiscal funds was strengthened.

3. Optimizing administrative review and approval services: The Government of the People's Republic of China has requested various levels of agricultural departments to simplify review and approval procedures, shorten their duration and efficiency, and continuously innovate services through online work. All these measures will drive the resumption of work and production in the agricultural industry.

4. Driving the resumption of work by migrant workers: Migrant work concerns the livelihood of farmers. While resuming work and production in companies in China, epidemic prevention and control for the resumption of migrant work should be carried out to strengthen the effective linkage between import and export regions.

5. Ensuring the availability of the daily necessities for agricultural production: The guarantee that materials and tools are available for agricultural production necessitates smooth transportation to villages and the maintenance of access to exclusive roads. To completely restore normal agricultural production and vehicular access so that agricultural products are able to leave places of production and materials for agricultural production can in turn enter these places, the blockade of all disease transmission channels is a prerequisite.

Rural COVID-19 prevention and control work is an important component of this epidemic's prevention and control. However, in rural areas, there is a shortage of medical resources and the diagnostic and treatment levels are poor. Therefore, COVID-19 control work in rural areas should be adjusted according to local conditions, widespread promotion should be carried out to improve the disease control knowledge of the public, and the masses should be mobilized for participation in epidemic prevention and control work. In China, a strict COVID-19 control network was set up and responsibilities were strictly defined to ensure its efficient operation. In addition, existing medical resources were fully utilized so that the COVID-19 prevention and control work in rural areas could be carried out by rural grassroots medical institutions and rural physicians.

This COVID-19 epidemic has brought many new crises to rural areas. However, crises are also opportunities to develop rural regions. At the grassroots level, rural grassroots governance will be optimized to guide the healthy development of rural organizations. With regard to rural environmental governance, the rural toilet revolution was launched, and village cleaning activities were strengthened to comprehensively drive domestic garbage governance and domestic wastewater processing in rural areas. With regard to economic development in the agricultural industry, the collective economic activity of rural areas was strengthened and a modern and intelligent agricultural industry was developed.

Explaining urban-rural health disparities in China

The primary health-care system in China

Primary care practitioners' response to 2019 novel coronavirus outbreak in China. medRxiv

How to cite this article: Zhang X, Xiang C. Turning rural villages into the home front for social stability-Examination of coronavirus disease 2019 control experiences in rural areas in China

The authors have no competing interests.

Xiaoyan Zhang contributed to the conception of the study and helped perform the analysis with constructive discussions. Chen Xiang contributed significantly to analysis and manuscript preparation and performed the data analyses and wrote the manuscript.

This manuscript is a commentary and does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

ZHANG AND XIANG ORCID Xiaoyan Zhang https://orcid.org/0000-0002-1815-5188Chen Xiang https://orcid.org/0000-0002-5469-5739