China’s Precision Pandemic Alleviation

Abstract

For several months I’ve witnessed firsthand, in both China and the U.S., how the two countries have tackled the deadly Covid-19, and the difference was astonishing. While the U.S. effort has been led by politicians who downplayed the peril and then blamed China for their inaction, China has battled the pandemic just as it has fought poverty and other problems—with experts who rapidly executed comprehensive, national strategies with scientific precision.

For several months I’ve witnessed firsthand, in both China and the U.S., how the two countries have tackled the deadly Covid-19, and the difference was astonishing. While the U.S. effort has been led by politicians who downplayed the peril for and then blamed China for their inaction, China has battled the pandemic just as it has fought poverty and other problems—with experts who rapidly executed comprehensive, national strategies with scientific precision.

Foreign media of course criticized China for its initial delay in announcing the virus, but even as you don’t shout “fire” in a crowded room, you don’t panic 1.4 billion people or the rest of the world, before you’re certain there is a problem. But once the threat was verified, China rapidly isolated the virus’ genome and shared it with the world.

Today, my wife and I can walk about our Chinese city without fear of the virus, but friends and family in the U.S. are huddled in their homes, and experts say there is no longer any hope of curtailing the threat until a cure is perfected 12 to 18 months from now.

China is relatively safe today because the country did not hesitate to sacrifice its economy to save lives. On January 23, China shut down Wuhan, a city of 11 million people (compared with 8 million in New York) even though the nation had only 500 cases and 17 deaths at that point.

Other nations immediately attacked China’s forced quarantines as violating the inalienable right of liberty, but those nations have now imposed their own quarantines, though too late to be effective.

Priority Is People, Not Economy

Foreign media also reported how Chinese suffered under draconian quarantine measures, but what they failed to mention was the Chinese’ astonishing sense of solidarity, commitment and confidence because, contrary to foreign reports, the Chinese trusted leaders who have proven over 40 years of reform and opening up that their ultimate priority is not the economy but people.

“We’re careful, but not afraid,” a college student said to me. “We Chinese have faced adversity before, and we can overcome this too.”

A single girl in her 30s said, “I get bored alone in quarantine, but it is for the best. At least I have lots of time to read and study, and I can use my phone to have food and necessities delivered to my doorstep.”

This stoic acceptance contrasts sharply with what I saw in the U.S. as shoppers literally fought each other to buy the last roll of toilet paper or hand cleanser—but I well understand their fear. Chinese are trusting in experts and scientists like Major General Chen Wei, a veteran of SARS and Ebola, to fight the virus; Americans’ hope, however, is in the hands of mayors, governors and a president who fight each other harder than they fight the virus.

Safest Place on the Planet?

It is no wonder that Dr. Bruce Aylward, who led the WHO-China Joint Mission on Covid-19 in February, said after his return from China, “You know, if I had Covid-19, I’d want to be treated in China… Folks, this is a rapidly escalating epidemic in different places that we’ve got to tackle superfast to prevent a pandemic.”¹

Aylward concluded in February that the rest of the world is “simply not ready”. The world was still not ready on April 1st when the USA Today headline read, “This is what China did to beat corona virus. Experts say America couldn’t handle it.”²

Early Warnings Ignored

But Americans, especially New York City, should have prepared long ago. In 2006, New York City’s 266-page Pandemic Plan warned that the city was “uniquely vulnerable to infectious disease threats”, and could be short of 9454 ventilators during a pandemic. The city responded by purchasing a small supply of face masks and 500 ventilators, and then sold the ventilators because of maintenance costs.³

In March, 2015, Bill Gates’ short TEDtalk warned that the world was unprepared for the next pandemic. He said we’d been lucky with Ebola because it did not spread through the air but:

Next time, we might not be so lucky. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market…. In fact, let’s look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here’s what would happen: It would spread throughout the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned.

The world ignored Gates—and Covid-19 turned out to be the pandemic that did spread through the air. And U.S. officials warned each other privately but told the public there was nothing to worry about.

On January 29, Trump adviser Navarro warned in a memo that the virus could infect 100 million Americans and kill 1–2 million people. In a February 23 memo, he warned the crisis could cost trillions and take millions of lives. Yet that very same day, he told the media there was “nothing to worry about for the American people” under Trump’s leadership.⁴ Also on that same day, he told Fox News, “The American economy is extremely strong and not particularly vulnerable to what happens in China.”

Don’t Wear Masks!

Leaders and experts not only downplayed the danger but even discouraged people, including healthcare workers, from taking such basic precautions as masks because, sadly, the country had no masks.

On January 30, the CDC said it did not recommend the general public wear masks because “the virus is not spreading in the general community.”

On February 29, the Surgeon General tweeted, “Seriously people: STOP BUYING MASKS! They are NOT effective.”

On April 2, New York City Mayor Blasio finally suggested that New Yorkers cover their nose and mouth in public to protect other people. New York Governor Cuomo responded by saying that masks just gave people a “false sense of security”, but less than two weeks later, on April 15, Cuomo himself ordered New Yorkers to wear face coverings in public. He said, “[It’s] your right to go out for a walk in the park… You don’t have a right to infect me.”

It took Cuomo three and a half months, 200,000 confirmed cases and over 11,000 deaths to finally require face coverings, yet even then Cuomo admitted he could not enforce his order but was relying upon New Yorkers to enforce it themselves by asking people without masks, “‘Where’s your mask, buddy?’ in a nice, New York kind of way.”

Doctors Fired for Wearing Masks

New Yorkers were also reminded to make their own masks so that real masks could be saved for healthcare workers—although doctors and nurses in both the U.S. and UK had been fired for wearing masks because they “frighten patients”.

On April 6, the Guardian reported that doctors in Britain are pressured to treat Covid-19 patients without protective gear and told to “hold their breath to avoid getting infected.”⁵

On April 17, headlines read that ten nurses had lost their jobs for refusing to treat Covid-19 patients without masks at Los Angeles’s Providence Saint John’s Health Center.

Dr. David L. Heymann, a WHO panel expert, was quoted by the New York Times on March 22 as saying, “The virus can be stopped, but only with harsh steps.… You need to identify and stop discrete outbreaks, and then do rigorous contact tracing.… But doing so takes intelligent, rapidly adaptive work by health officials, and near-total cooperation from the populace. Containment becomes realistic only when Americans realize that working together is the only way to protect themselves and their loved ones.”⁶

A Politicized Pandemic

But Americans have not worked together because their leaders have not worked together. Governors fight mayors, and all of them fight the president who has claimed his authority is absolute, prompting Governor Cuomo to remind him, “You are a President, not a King.”

These leaders are even now, with the virus at its peak, weighing the cost in lives from resuming business because they’ve already lost the virus war and don’t want to lose the economy as well.

Sadly, the greatest price for this political incompetence will be paid not by Americans but by the impoverished peoples in India, Latin America, Africa and Asia who have no way to practice social distance, who can barely afford clothes, much less masks, and who can’t wash their hands because they have no clean water. And these poor will suffer through the next pandemic if the world does not learn from China’s experience with Covid-19.

China’s Secret: Pandemics Are War

A USA Today article, “China’s Nationwide Response vs. America’s Patchwork”, quoted Huiyao Wang, a Chinese government senior adviser, as saying that “China’s response to the outbreak was truly a nationwide response: systematic, comprehensive and coordinated…. Lockdowns, bans on gatherings, basic quarantines, testing, hand-washing, this is not enough. You need to isolate people on an enormous scale, in stadiums, big exhibition halls, wherever you can. It seems extreme. It works. ‘No one left behind’ was the slogan in Wuhan. No one.⁷

Bill Gates said in 2015 that epidemics are war, and China has fought this Covid-19 War with experts like Major General Chen Wei, a 54-year-old virologist and China’s No. 1 expert in biological and chemical weapons defense. She said, “The epidemic is like a military situation. The epicenter equals to the battlefield.”⁸

General Chen spoke from experience. In 2003, General Chen led the team to isolate the SARS, and in 2004, her team in Africa created the first Ebola vaccine that entered clinical trial.⁹ Chen knows too well what is at stake, and told the China Science Daily, “Prevention and control of an epidemic can never wait until the disease has happened.”

China was able to implement many of its Covid-19 strategies precisely because it had learned from SARS, Swine Flu and other epidemics.

China’s Steps

Business Insider’s¹⁰ succinct overview of China’s steps in tackling the virus could very well form the basis of a simple manual for the next pandemic.

• 1. Free and easy testing. From the outset, China gave everyone from farmers to foreigners free virus tests, and to this day, our temperature is taken several times a day in stores, restaurants, buses or when we pass a street corner health station. Compare that to the experience of Ms. Danni Askini, an American who was billed USD 34,927.43 for testing and treatment. She said, “I was pretty sticker-shocked. I personally don’t know anybody who has that kind of money.”¹¹

• 2. Postponement of non-urgent medical care and elective surgeries. Western media criticized China for this, yet Italy and Spain faced the same choices when overwhelmed, and on March 24, the American College of Surgeons warned that:

  We continue to recommend that surgeons curtail the performance of “elective” surgical procedures (boldface theirs). The ACS is receiving reports that most surgeons are in the process of or have already stopped performing elective operations.

• 3. Trains quit stopping in Wuhan. This is not likely in America, where governors argue with mayors over who has the right to enforce quarantines, and everyone argues with the president, who by law can restrict foreign travel but cannot easily intervene in states.

• 4. China walled off entire hospital wards. China also built two hospitals built almost overnight, thanks to lessons learned in 2003 with SARS. In only 10 days, a crew of 7000 built a 645,000 sq. foot, 2-storey, 1000 patient hospital with several isolation wards and 30 ICUs. Another 323,000 sq. foot, 1300 bed hospital was finished two days later. The blueprints were modeled after Beijing’s Xiaotangshan hospital, which was built in one week during the 2003 SARS epidemic.

  The hospitals’ construction so enthralled the nation that they were live-streamed and the millions who would have normally been on Chinese New Year vacation but were now home on “staycations” called themselves “supervisors”, gave cranes nicknames such as “Little Red”, and cheered “Go!” and “Dig Faster!” Their sense of humor and resilience in this trying time was truly heartwarming.

• 5. China used technology to trace every case. The West has criticized China, Singapore, Israel and others for violating the right of privacy with this “Digital Authoritarianism”, but consider Typhoid Mary (1869–1938), who was tracked down and locked up twice, the second time for 23 years. She was denied her right to liberty because of her threat to public health. Covid-19, even treated, is 10 times deadlier than typhoid.

  Pandemics are possible precisely because of the technology that makes our world so interconnected, and we need to use technology to combat such threats, even as the U.S. White House and CDC helped create and distribute a Modular Wireless Patient Monitoring System to track Ebola patients in Africa. The WHO’s executive director, Dr. Michael Ryan, said that tracing cases is effective, inexpensive, and a “very basic public health intervention”.

• 6. Relatively easy for shut-ins to get food and supplies. While Americans are fighting over toilet paper, hand sanitizer and bottled water, Chinese in quarantine, virtually anywhere in China, can use their phones to have anything delivered to their door, including freshly prepared meals and hot tea or coffee.

• 7. Quickly shifted jobs to help. China sent 40,000 medical workers, many of them volunteers, to help Wuhan. People across the entire country enthusiastically accepted transfers to work in completely different fields to do their part in what is very much a “war effort”.

• 8. People worked together. Even the WHO’s Dr. Aylward was astounded by the Chinese sense of national solidarity. As the old Chinese saying goes, “When the nest crashes, no egg survives.” But for three decades I’ve witnessed this same solidarity and trust in the leadership because Chinese are confident in a government that has completely transformed the nation in only four decades of reform and opening up. In those nations led by self-serving politicians, however, there is no solidarity, only “every man for himself”.

As Dr. Aylward noted, “Hundreds of thousands of people in China did not get Covid-19 because of this aggressive response,” which he said continually evolved as the Chinese learned more about the enemy. Aylward also noted that China’s approach was simply the use of “old-fashioned public-health tools” applied “with a rigor and innovation of approach on a scale that we’ve never seen in history.”

“In 30 years of doing this business,” Aylward said, “I’ve not seen this before, nor was I sure it would work.”

It did work, but only because the government acted immediately, with courage and decisiveness, and the people had ample reason to trust their government. No wonder Chinese are optimistic—but does the rest of the world have hope?

Pan-Global Pandemic Response

In 1990, Kenichi Ohmae wrote in The Borderless World that trade was open and free for all nations, even though his own home of Japan had some of the most rigid cultural, political and economic barriers in the world. Trade is not borderless to this day, and probably never will be—but Covid-19 truly knows no borders. Rich and poor alike fall before it, though the elderly, the weak and the poor are hardest hit.

In our inescapably interconnected world, with 60% of the global GDP from trade, a borderless virus requires a truly borderless response, because even one nation’s failure endangers all others.

I was heartened, therefore, when several EU countries sent China medical equipment when it was most needed, and how China in turn helped the EU, the U.S. and many other countries. Those bright moments in otherwise dark months offered hope that we may yet learn to face a common enemy together.

For our children’s sake, I hope that the nations will cease bickering and blaming and learn from one another so we can respond to the next pandemic scientifically, not politically, and as a global community, not as isolated nations. Our enemy, after all, should be the virus, not each other, and the only way to defeat a borderless pandemic is with a borderless response.

And if the world can learn from China’s response to Covid-19, I hope it can also learn from China how to defeat that other ancient enemy, poverty, which throughout history has taken far more lives than any pandemic.

Fortunately, China’s BRI is already helping other nations lift themselves from poverty in the same way as China did—by building sound infrastructure that fosters innovation and self-sufficiency.