China beat the coronavirus with science and strong public health measures,
not just with authoritarianism
THE CONVERSATION
11/24/2020
By Elanah Uretsky | -
I live in a democracy. But as Thanksgiving approaches, I find myself longing
for the type of freedom I am seeing in China.
People in China are able to move around freely right now. Many Americans may
believe that the Chinese are able to enjoy this freedom because of China's
authoritarian regime. As a scholar of public health in China, I think the
answers go beyond that.
My research suggests that the control of the virus in China is not the
result of authoritarian policy, but of a national prioritization of health.
China learned a tough lesson with SARS, the first coronavirus pandemic of
the 21st century.
How China flattened its curve
Barely less than a year ago, a novel coronavirus emerged in Wuhan, China,
with 80,000 cases identified within three months, killing 3,000 people.
In late January 2020, the Chinese government decided to lock down this city
of 11 million people. All transportation to and from the city was stopped.
Officials further locked down several other cities in Hubei Province,
eventually quarantining over 50 million people.
By the beginning of April, the Chinese government limited the spread of the
virus to the point where they felt comfortable opening up Wuhan once again.
Seven months later, China has confirmed 9,100 additional cases and recorded
1,407 more deaths due to the coronavirus. People in China travel, eat in
restaurants and go into theaters, and kids go to school without much concern
for their health. Juxtapose that to what we are experiencing in the U.S. To
date, we have confirmed over 11 million cases, with the last 1 million
recorded in just the last one week alone.
In September and October, friends from China sent me pictures of food from
all over the country as they traveled around to visit friends and family for
the mid-autumn festival and then the seven-day National Day vacation week. I
envied them then and envy them even more now as Americans prepare and wonder
how we will celebrate Thanksgiving this year.
Mainland China and Hong Kong were both taken off guard by SARS.
What China learned from SARS
We Americans are told that the freedoms Chinese now enjoy come at the
expense of being subject to a set of draconian public health policies that
can be instituted only by an authoritarian government. But they also have
the experience of living through a similar epidemic.
SARS broke out in November of 2002 and ended in May of 2003, and China was
anything but prepared for its emergence. It didn't have the public health
infrastructure in place to detect or control such a disease, and initially
decided to prioritize politics and economy over health by covering up the
epidemic. This didn't work with such a virulent disease that started
spreading around the world.
After being forced to come to terms with SARS, China's leaders eventually
did enforce quarantine in Beijing and canceled the week-long May Day holiday
of 2003. This helped to end the pandemic within a few short months, with
minimal impact. SARS infected approximately 8,000 worldwide and killed about
800, 65% of which occurred in China and Hong Kong.
The Chinese government learned from SARS the important role public health
plays in protecting the nation. Following SARS, the government improved
training of public health professionals and developed one of the most
sophisticated disease surveillance systems in the world. While caught off
guard for this next big coronavirus outbreak in December 2019, the country
quickly mobilized its resources to bring the epidemic almost to a halt
inside its borders within three months.
What can the US learn from China?
Knowing that there were no safe or proven treatments or an effective
vaccine, China relied on proven nonpharmaceutical interventions to conquer
the epidemic. First and foremost was containing the virus through
controlling the sources of infection and blocking transmission. This was
accomplished through early detection (testing), isolation, treatment and
tracing the close contacts of any infected individual.
This strategy was aided by the three field hospitals (fancang) the
government built to isolate patients with mild to moderate symptoms from
their families. Strict quarantine measures were also central to preventing
the spread of this epidemic, as it was with the SARS epidemic in 2003. This
was paired with compulsory mask-wearing, promotion of personal hygiene
(hand-washing, home disinfection, ventilation), self-monitoring of body
temperature, universal compulsory stay-at-home orders for all residents, and
universal symptom surveys conducted by community workers and volunteers.
What else could the US have done to be prepared?
SARS exposed serious weaknesses in China's public health system and prompted
its government to reinvent its public health system. COVID-19 has exposed
similar shortcomings in the U.S. public health system. To date, however, the
current administration has taken the exact opposite approach, devastating
our public health system.
The Trump administration made major cuts to the budgets of the National
Institutes of Health and Centers for Disease Control and Prevention. The
last budget submitted by the Trump administration in February 2020, as the
pandemic was beginning, called for an additional reduction of US$693 million
to the CDC budget.
This affected our ability to prepare for a pandemic outbreak. In the past,
this preparation included international partnerships to help detect disease
before it reached our shores. For example, the CDC built up partnerships
with China following the SARS epidemic, to help contain the emergence of
infectious disease coming from the region. At one point the CDC had 10
American experts working on the ground in China and 40 local Chinese staff,
who mostly concentrated on infectious disease. Trump started slashing these
positions shortly after taking office, and by the time COVID-19 broke out,
those programs were whittled down to a skeleton staff of one or two.
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The Declaration of Alma Ata guaranteed health for all, and not just health
for people governed under a specific type of bureaucratic system. The U.S.
has been, and can be, just as dedicated to protecting the health of its
people as China under its authoritarian government. We demonstrated this
during the Ebola epidemic, with the launch of a whole government effort
coordinated by Ron Klain, who has been appointed White House chief of staff
under President-elect Biden.
This effort, which included a coordinated response with both African nations
and China, improved preparedness within the U.S. and ultimately helped to
save hundreds of thousands of lives around the world. A reduction in funding
for our public health infrastructure, under the Trump administration, was a
divestment in the health of the American people and should not have
happened. A new administration that places public health at the helm, once
again, will I hope prove to us that health is not just something that can be
protected under an authoritarian government, but is in fact a right for
all.The Conversation
Elanah Uretsky, Associate Professor of International and Global Studies,
Brandeis University
This article is republished from The Conversation under a Creative Commons
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