China CDC is a governmental and national-level technical organization specialized in disease control and prevention. Under the leadership of the National Health Commission (NHC), China CDC exerts its function by providing technical guidance and support of public health. Unlike the US CDC which is part of a governmental agency, China CDC does not have executive authority to implement a wide range of measures in case of an emergency. Its role only allows the organization to report an epidemic and/or emergency to the government and participate in the preparation and response of public health emergencies as technical and scientific resources.
Following the SARS outbreak in 2003, China enacted two laws: The Regulation on Public Health Emergency and The Measures for the Administration of Information Reporting on Monitoring Public Health Emergencies and Epidemic Situation of Infectious Diseases (5–6). The government established a management system for public health emergencies and detailed the principal rules for the prevention and control of infectious disease (i.e., infection source control, interruption of route of transmission, and susceptible person’s protection). Both central and local governments are in place to provide public health emergency responses (e.g., techniques, personnel, materials, and management preparedness), and an emergency information dissemination system that provides quick (within 2 hours), accurate, and comprehensive release of information. The public health management system reform led to better handling of an epidemic of infectious diseases. For example, the Chinese Ministry of Health (CMH, the precursor to the NHC) issued a swine flu prevention guide on April 29, 2009, 12 days before the first reported H1N1 case in China (7). On April 3, 2013, 4 days after the first H7N9 confirmed case, the CMH also issued a nosocomial H7N9-infection prevention guide (8).
It is worth noting that China’s public health response and management system contributed significantly to handling the COVID-19 crisis after the outbreak. For example, the rapid publication of COVID-19 genetic sequence information allowed scientists across the globe to immediately start developing vaccines; peer-reviewed publications of epidemiological and clinical case analysis provided first-hand information for healthcare workers on how to detect, isolate, and treat the disease caused by COVID-19; and multiple guideline publications and case tracking information on COVID-19 greatly promoted public awareness of this disease. The COVID-19 epidemic in China showed a clear picture of what would happen if a potential human-to-human transmissible infectious source was left unattended in the community. However, other parts of China appeared to effectively mitigate the spread of the disease and many have shown significant improvements recently. Therefore, there is a need for the continuous improvement of the current public health management system. Specific strategies include the following:
To have more involvement of multidisciplinary experts (epidemiology, infectious disease, microbiology, clinical medicine, etc.) from CDCs, hospitals, and universities in the local and central government decision-making process.
To improve the emergency medical supply management system and plans to ensure clear pathways to follow in case of an epidemic emergency.
To establish a big data platform for disease control and prevention. On the premise of ensuring information security, colleges and universities cooperate with CDC to integrate basic population information, population movement information, patient information, medical insurance information, medical treatment information, and CDC data to establish a big data platform. This platform can realize the real-time, automatic, and quantitative reporting of new infectious diseases, and establish a system for prediction, early warning, and emergency response mechanisms to prevent the delayed detection and response to public health emergencies.