The COVID-19 pandemic has laid bare the shortfalls in China’s public health system, and “mending the weak parts” is now an urgent priority for the country, the Chinese government said in a policy document released Wednesday.

Improving the country’s testing capacity for infectious pathogens is a major focus of the plan. Authorities’ efforts to respond to the initial COVID-19 outbreak in the central city of Wuhan were hampered by an inability to conduct tests quickly, according to multiple media reports.

China will ensure there is at least one biosafety level three — or P3 — research laboratory in every province and one P2 laboratory in every city, according to the document jointly released by the National Development and Reform Commission and two other ministries.

Laboratories are assigned biosafety levels from one to four depending on the containment measures they employ to prevent the spread of dangerous pathogens, with four indicating the highest level of protection.

SARS-CoV-2 tests in China have to be conducted in P2 labs or above, but many primary hospitals don’t meet the requirements. The lack of eligible testing facilities was a key issue at the start of the epidemic, according to Chen Xi, associate professor of health policy and economics at the Yale School of Public Health.

“Many people have been discussing the malfunction of the early warning system, which actually has a lot to do with the limited testing capacity at the local level,” Chen told Sixth Tone. “When you’re unclear about the nature of the virus — such as the genome sequencing of the pathogen — there’s no way to develop a testing kit. And without a testing kit, you don’t know who’s been infected.”

The document also lays out measures to ensure that China has the health resources to cope with future public health  emergencies. It says public venues should be able to quickly convert into treatment and quarantine facilities like fangcang shelter hospitals during a crisis. It also states that China should strengthen its frontline public health facilities, including primary care facilities at the county, township, and residential community level.

Cities have been given targets for increasing the number of hospital beds capable of accommodating patients with infectious diseases and making them available for immediate use in the event of a future outbreak. Cities with over 5 million residents, for example, must have at least 600 such beds available, according to the document.

Many Chinese cities expanded their infectious disease hospitals in the aftermath of the 2003 SARS epidemic. During the COVID-19 outbreak, however, there was still a significant shortage of beds capable of admitting infected patients, Cai Weiping, a doctor and National People’s Congress delegate, told Chinese media outlet Caixin.

While the plan focuses mostly on improving China’s public health facilities, the section regarding potential reforms to the China CDC lacks specific details, according to Chen. Experts have called for the organization to be given a greater role in decision making during responses to future outbreaks.

Environmental changes are increasing the risk of virus spread, making it essential for all governments to take action to prepare for future pandemics, Chen added.

“Public health precautions can effectively reduce the risks of a pandemic,” said Chen. “Climate change is global. This time it (the outbreak) happened in Wuhan, but we don’t know where one might emerge next time.”

Editor: Dominic Morgan.

(Header image: People receive nucleic acid testing in Guangzhou, Guangdong province, April 19, 2020. People Visual)