Introducing Zhong Nanshan: The hero of SARS and COVID-19

Zhong Nanshan is already a household name in China, known as the ‘hero of SARS’ from 2002-2003 when he spoke plainly on the basis of ‘seeking truth from facts’ – the Chinese spirit. He is increasingly becoming an international name, as his advice is sought around the world concerning China’s experience with COVID-19.

When COVID-19 was first identified in Wuhan, the 84 year old was called up by the National Health Commission (NHC) to head up the top-level team to oversee the massive containment, testing and hospitalisation project, while undertaking research into the virus itself.

Below is an interview with Zhong, where he elaborates on his background and motivation, but it is preceded by a longer interview and then a few shorter videos. Note the one where he points out clearly that the virus may not have originated in China, and the one where he mourns the death of Li Wenliang’s death, who was granted posthumously the award of ‘martyr’, the highest state honour in the People’s Republic. He makes such statements based strictly on seeking truth from facts.

And the interview on People’s Daily (here):

“Doctors care about patients, not diseases. The question we should often think about is what are the medical problems that haven’t been solved yet and how can we solve them,” renowned Chinese respiratory expert Zhong Nanshan said on April 4 during an exclusive interview, Zhongguo Jijian Jiancha Bao (China Discipline Inspection and Supervision Daily) reported Tuesday.

Zhong, who is also an academician with the Chinese Academy of Engineering (CAE), is the head of the high-level expert team put together and sent to Wuhan by China’s National Health Commission (NHC) to guide epidemic response work and conduct on-site investigations.

Zhong was born in in 1936 in Nanjing, capital of east China’s Jiangsu province. He graduated from Peking University Health Science Center (then the state-run Beijing Medical School) in 1960, and was one of the first batch of students sponsored by the Chinese government to study abroad after the implementation of the reform and opening-up policy.

In 2013, Zhong took part in the country’s fight against the Severe Acute Respiratory Syndrome (SARS) epidemic. This year, when the novel coronavirus outbreak hit China, the 84-year-old expert once again went to the front line of the battle like an iron warrior.

During the recent three-day Qingming Festival national holiday from April 4 to 6, Zhong continued to work tirelessly in his office in the Yuexiu campus of Guangzhou Medical University in Guangzhou, capital of south China’s Guangdong province.

His recent interview with Zhongguo Jijian Jiancha Bao gave a great deal of insight into his work, ideas, beliefs, and some of the reasons why the man is so highly respected in China.

Going to the front: “I went to Wuhan with an urgent desire to learn more about the disease.”

On Jan. 18, Zhong went to Wuhan, capital of central China’s Hubei province and also the previous epicenter of the novel coronavirus disease (COVID-19), on short notice.

“On the afternoon of Jan. 18, I got the notice about going to Wuhan and joined the NHC’s high-level expert team that same night. I was made head of the team and was told to take part in discussions the next day. I realized then that the situation was probably serious. I went to Wuhan with an urgent desire to learn more about the disease,” Zhong said.

Zhong reported the epidemic situation on behalf of the expert team on the morning of Jan. 20, when he confirmed human-to-human transmission of the novel coronavirus and cases of medical workers becoming infected. These were two very important signs, as they signified that the disease would spread quickly, Zhong pointed out.

“In the face of a new infectious disease, the first priority is to think about how to prevent it,” Zhong said, stressing that for all public health incidents, the first priority is to keep the situation within the upper stream of those incidents, and that efforts must be made to prevent it from spreading out.

Fighting COVID-19: “We need to prevent more infections and reduce deaths. What can be more important for a doctor than this?”

Under the leadership of the Central Committee of the Communist Party of China (CPC), China has formulated the correct epidemic prevention and control strategies, Zhong said.

During the initial stage of the outbreak, China locked down Wuhan in order to cut off the spread of the virus and launched mass prevention and treatment measures across the country, Zhong said, noting that those measures were later upgraded to joint prevention and control efforts.

The joint prevention and control efforts highlight four key points: early discovery, early reporting, early isolation, and early treatment, Zhong explained, adding that these efforts have proven effective in China.

China has been making efforts to summarize the ways the disease works while paying close attention to medical treatment, Zhong pointed out, adding that the clinical manifestations and effective drugs China discovered during its fight against COVID-19 serve as a good reference for the world to follow.

After painstaking efforts, China has made important phased achievements in prevention and control of the epidemic, and these results were hard-won, according to Zhong.

However, the disease is spreading rapidly overseas and the country is coming under mounting pressure from imported COVID-19 cases, Zhong noted, pointing out that by April 3, China had reported more than 700 imported cases of COVID-19, and the figure continues to rise.

China should promptly adjust and improve its epidemic prevention and control measures and focus its efforts on preventing imported cases and a recurrence of the outbreak in the country, Zhong said.

When asked about the greatest pressure he faced during the fight against the epidemic, Zhong said throughout his career as a doctor, the greatest pressure has always come from a patient’s death.

“Since I started my career as a doctor, the greatest pressure for me has always come from whether I am successful in saving patients’ lives. If I manage to save and cure a patient, then everything else is easier to deal with. But if I fail to save the life, it’s the most stressful moment for me,” Zhong revealed.

“The same is true with the present fight against COVID-19. We need to prevent more infections and reduce deaths. What can be more important for a doctor than this?”

Making progress: “Historical experience has told us that a vaccine is the final answer to prevention and control of an epidemic.”

“We have carried out clinical tests for chloroquine and the Lianhua Qingwen Capsule, which have so far both proven to have positive effects. Chloroquine can shorten the course of the disease and reduce viral load, while Lianhua Qingwen Capsule can significantly reduce the time needed for alleviation of symptoms,” Zhong disclosed.

“It’s essential to develop vaccines for the COVID-19,” Zhong said, noting that COVID-19 is more contagious than SARS, which is why some countries are now reporting more than 10,000 confirmed cases a day.

“Historical experience has told us that the vaccine is the final answer to prevention and control of an epidemic,” Zhong said, adding that vaccines for COVID-19 are urgently needed.

Scientific research: “Basic scientific research should serve clinical practice.”

“Clinical treatment must always have an extremely important position in anti-epidemic efforts, and basic scientific research should serve clinical practice,” said Zhong.

Zhong disclosed that his research team collected the clinical characteristics of 1,099 COVID-19 cases and published its findings in the New England Journal of Medicine soon after the outbreak of the epidemic.

“It was the first time that data on more than 1,000 COVID-19 patients across the country was gathered. The paper is also by far the most cited research on the epidemic in the world,” Zhong added.

“We found in the research that about half of the COVID-19 patients didn’t have fever when they were admitted to hospital, and some patients who had high laboratory indexes quickly became severe cases. Such basic research findings have played a very good guiding role in curing and treating the disease around the world,” Zhong said.

Family tradition: “My father didn’t talk much. He said one should make sure what he says is based on evidence.”

Zhong says his career choice can be largely attributed to his family environment.

Zhong’s father was a paediatrician. His mother graduated in advanced nursing from Peking Union Medical College (then China Union Medical University) and served as vice president of Sun Yat-sen University Cancer Center (then tumor hospital in south China).

“In the 1940s and 1950s, many neighbors often brought their children to my home for medical diagnosis and treatment. After they were cured, the neighbors were very happy and my father felt a sense of achievement,” Zhong said.

“My parents talked a lot about medicine at home, which had quite a big influence on me. It helped develop my interest in the subject,” Zhong added.

The greatest influence his father had on him was the idea that one should always seek truth from facts, according to Zhong. “My father didn’t talk much. He said that one should make sure what he says is based on evidence.”

According to Zhong, his family members understand his work and have always supported his career.

“I’ve made some achievements in my work. The support from my family is very important,” Zhong said.

Life: “How the Steel Was Tempered had a very big influence on me. The patriotism in the book has influenced a whole generation.”

During his time in the University of Edinburgh, some of Zhong’s studies won widespread recognition from his teachers and research fellows. One of his teachers tried to persuade him to stay, but Zhong decided to return to his motherland when his studies had ended.

“Our country gave us the opportunity to study abroad when it was in a very difficult situation financially, so I never thought about not returning home. I thought I had to come back to help with our country’s scientific research after finishing my studies abroad,” Zhong said.

“I haven’t had much time to read novels since I began to work, but I read a lot of novels when I was in primary and secondary school. How the Steel Was Tempered had a very big influence on me. The patriotism and the idea of ‘one for all and all for one’ in the book has influenced a whole generation,” Zhong said.

“Just like my father said, you can feel your life has been worthwhile if you leave something valuable in the world,” Zhong said.

Medicine is a practical discipline, said Zhong, revealing that many of his ideas, inspiration in work, and research questions came from clinical practice.

“I’m not used to finding research questions from literature,” Zhong said.

 

How China Learned About SARS-CoV-2 in the Weeks Before the Global Pandemic

This article is copied from part 2 of an article on Independent Media (here). It also appeared on Counterpunch (here), to which I was directed by NT at Trades Hall Sydney. It also reinforces in more detail what I have been saying in various posts on this blog (here, here and here).

The World Health Organization (WHO) declared a global pandemic on March 11, 2020. Dr. Tedros Adhanom Ghebreyesus, the director-general of the WHO, said at the press conference on that day that this was “the first pandemic caused by a coronavirus.” He said, “In the past two weeks, the number of cases of COVID-19 outside China has increased 13-fold, and the number of affected countries has tripled.” From March 11 onward, it became clear that this virus was deadly and that it had the capacity to tear through human society with ease. But this was not always so clear.

On March 17, Kristian Andersen of the Scripps Research Institute in California and his team showed that the new coronavirus strain, SARS-CoV-2, had a mutation in its genes known as a polybasic cleavage site that was unseen in any coronaviruses found in bats or pangolins and that there is a likelihood that the virus came to humans many years ago, and indeed not necessarily in Wuhan. Dr. Chen Jinping of the Guangdong Institute of Applied Biological Resources, along with colleagues, had earlier published a paper on February 20 noting that their data did not support the claim that the new coronavirus in humans evolved directly from a pangolin coronavirus strain. Zhong Nanshan, a noted epidemiologist, said that “although the COVID-19 first appeared in China, that does not necessarily mean it originated here.”

Scientific studies will continue and will eventually give us a conclusive understanding of this virus. For now, there is no clarity that it emerged directly from the Wuhan market.

The Western media have consistently made scientifically unfounded claims about the source of the virus, even when Western scientists were urging caution. They were certainly not listening to the doctors in Wuhan or to public health experts in China.

When doctors in Wuhan first saw patients in their hospitals in December, they believed that the patients had pneumonia, although CT scans showed severe lung damage; the patients were not responding to the typical medical treatment. Doctors were alarmed by the situation, but there was no cause to imagine that this was going to escalate into a regional epidemic and then a global pandemic.

The doctors and hospitals in Wuhan eventually came to grips with the evidence before them, and as soon as it became clear that this was an unfamiliar virus and that it spread rapidly, they contacted China’s national Center for Disease Control (CDC) and then the WHO.

You would not know this if you only read Western newspapers, notably the New York Times, which suggested in a widely circulated reportthat the Chinese government had suppressed information about the epidemic and that the Chinese warning system did not work.

Our investigation finds neither of these arguments to be true. There is no evidence that the Chinese government systematically suppressed information; there is only evidence that a few doctors were reprimanded by their hospitals or the local police station for divulging information to the public and not using the established protocols. There is also no evidence that the Chinese direct reporting system was faulty; instead, there is only evidence that the system, like any system, could not easily adjust to unknown or unclassified outbreaks.

The Chinese medical system, like other systems, has a rigorous procedure to report such things as health care emergencies. Medical personnel report to their hospital administration, which then reports to the various levels of CDC and the Health Commissions; they can also use the internet-based direct reporting system. It did not take long for the medical personnel to report the problem, and even less time for a high-level investigation team to arrive in Wuhan. This is what our investigation found.

Did the Chinese Government Suppress Information?

Dr. Zhang Jixian, director of Respiratory and Critical Medicine at the Hubei Provincial Hospital of Integrated Traditional Chinese & Western Medicine, saw an elderly couple on December 26. Their ailment bothered her. She arranged CT scans of the lung of the couple’s son who otherwise appeared healthy; the result, however, “showed ground glass opacity.” Uncertain about the causes, Dr. Zhang reported the situation to Xia Wenguang, the vice president of the hospital, as well as other departments of the hospital; the hospital promptly told Jianghan District Center for Disease Control and Prevention. This took place within 24 hours.

More patients arrived at the Hubei Provincial Hospital on December 28 and 29. The doctors still did not know more than that these patients presented symptoms of pneumonia, and that they had significant lung damage. It became clear to them that the immediate location for the spread of the virus was the South China Seafood Market. On December 29, as the cases increased, the hospital’s vice president Xia Wenguang reported directly to the disease control department of the provincial and municipal Health Commissions. That day, the disease control department of the municipal and provincial Health Commissions instructed Wuhan CDC, Jinyintan Hospital and Jianghan District CDC to visit the Hubei Provincial Hospital for an epidemiological investigation. On December 31, an expert group of the National Health Commission arrived in Wuhan from Beijing. In other words, officials from Beijing arrived in Wuhan within five days of the first sign of a problem.

The day before the expert group arrived from Beijing, one doctor—Dr. Ai Fen—expressed her frustration at the mysterious virus with some medical school classmates. Dr. Ai Fen saw a test report of unidentified pneumonia. She circled the words “SARS coronavirus” in red, photographed it, and passed it on to a medical school classmate. The report spread among doctors in Wuhan, including Dr. Li Wenliang (a Communist Party member) and seven other doctors who were later reprimanded by the police. On January 2, the head of Wuhan Central Hospital Supervision Department warned Dr. Ai Fen not to release information outside the channels of the hospital.

The reprimands received by these doctors are offered as evidence of suppression of information about the virus. This is not logical. The reprimands took place in early January. By December 31, a high-level team arrived from Beijing, and on that day, the WHO had been informed; China’s CDC and the WHO had been informed before these two doctors were reprimanded.

On February 7, 2020, the National Supervision Commission decided to send an investigation team to Wuhan to investigate the situation. On March 19, 2020, the team published the results of their investigation and held a press conference to share their findings. As a result of the investigation, the Wuhan Public Security Bureau issued a circular to revoke the letter of reprimand issued to Dr. Li Wenliang. On April 2, Dr. Li Wenliang and 13 others who died in the fight against the virus were honored by the government as martyrs (this is the highest honor given by the Communist Party and the People’s Republic of China to its citizens).

There is no evidence that local officials were afraid to report the epidemic to Beijing. There is no evidence that it took “whistleblowers,” as the New York Times put it, to shine a light on the issue. Dr. Zhang was not a whistleblower; she followed the established protocol, which led to information being passed on to the WHO within days.

China’s Early Warning System

In mid-November 2002, a SARS outbreak broke out in Foshan, Guangdong Province, China. Doctors could not easily understand what was going on. Eventually, in mid-February China’s Ministry of Health wrote an email to the WHO Beijing office “describing ‘a strange contagious disease’ that has ‘already left more than 100 people dead’” in one week. Also mentioned in the message was “a ‘panic’ attitude, currently, where people are emptying pharmaceutical stocks of any medicine they think may protect them.” It took eight months to contain this SARS outbreak.

In its aftermath, the Chinese government set up a direct reporting system to catch any health emergencies before they go out of control. The system works very well for clearly defined infectious diseases. Dr. Hu Shanlian, a professor of health economics at Fudan University, describes two such incidents. As part of the polio eradication expert group, his team found two cases of polio in Qinghai. The local government reported the cases to the central government, and it began emergency immunization as well as gave children a sugar cube vaccine to effectively control the imported poliomyelitis. As well, he reports about the two cases of plague in Beijing that came from the Inner Mongolia Autonomous Region. “Diseases like these,” he wrote, “can be quickly absorbed from the direct reporting system.”

Well-known ailments such as polio and plague can easily be entered into an early warning system. But if the doctors are confounded by the virus, the system cannot easily work. Dr. Ai Fen, who forwarded some clinical records to her colleagues, said that the direct reporting system is very effective if the ailment is commonplace, such as hepatitis and tuberculosis. “But this time it was unknown,” she said. Dr. Zhang Wenhong of Shanghai said that the direct reporting system “is more powerful than those in most countries in the world for known pathogens [such as MERS, H1N1] or pathogens that do not spread quickly and have limited human transmission [such as H7N9].” If confronted with a new virus, the medical personnel and the direct reporting system are bewildered.

The most effective way to proceed when there is no clarity about the infection is to inform the disease control department in the hospital. This is exactly what Dr. Zhang Jixian did, and her superior, the head of the hospital, contacted the local CDC, who contacted China’s national CDC and the National Health Commission of China. Within five days of Dr. Zhang’s alarm, the WHO was informed about a mysterious virus in Wuhan.

Since January 21, the WHO has released a daily situation report. The first report highlights the events from December 31 to January 20. The first bullet point of that report says that on December 31, the WHO China Country Office was informed that there were “cases of pneumonia unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China.” The Chinese authorities isolated a new type of coronavirus on January 7, and then on January 12 they shared the genetic sequence of the novel coronavirus for use in developing diagnostic kits. Precise information about the virus’s form of transmission would not come until later.

The direct reporting system was updated on January 24, 2020, with the information about the novel coronavirus. It has now learned from experience.

Facts and Ideology

Florida Senator Marco Rubio accused the WHO of “servility to the Chinese Communist Party.” He wrote that the United States will open “investigations into the WHO’s unacceptably slow decision-making on whether to declare a global pandemic and into how China has compromised the integrity of the WHO.” U.S. funds for the WHO are in the balance. Characteristically, Rubio offered no facts.

Was the WHO slow in declaring a global pandemic? In 2009, the first known case of H1N1 was detected in California on April 15; the WHO declared a global pandemic on June 11, two months later. In the case of SARS-CoV-2, the first known cases were detected in January 2020; the WHO declared a global pandemic on March 11—one and a half months later. In the interim, the WHO sent in investigation teams to Wuhan (January 20-21) and to Beijing, Guangdong, Sichuan, and Wuhan (February 16-24); their investigation, before the declaration, was thorough. The timeframe for the WHO declaration is similar, even faster in 2020 than it was in 2009.

Whether it is the New York Times or Marco Rubio, there is an urgency to conclude that China’s government and Chinese society are to blame for the global pandemic, and that their failures not only compromised the WHO but caused the pandemic. Facts become irrelevant. What we have shown in this report is that there was neither willful suppression of the facts nor was there a fear from local officials to report to Beijing; nor indeed was the system broken. The coronavirus epidemic was mysterious and complex, and the Chinese doctors and authorities hastily learned what was going on and then made—based on the facts available—rational decisions.

Written by Vijay Prashad, Weiyan Zhu, and Du Xiaojun.

A post-COVID-19 world: China, India and Russia to set the agenda

If the 2008 financial crisis signalled a seismic shift to Asia and away from the North Atlantic as the world’s economic powerhouse and centre of geopolitical strength, 2020 may well be its concluding phase.

It was this article by Shishir Upadhyaya (here) that set me thinking. His basic proposition is that in light of significant recent moves, both China and India will be working together much more closely in a post-COVID-19 world. The signals are already clear, despite their rocky relationship in the past: two meetings between Xi Jinping and Narendra Modi in 2018 and 2019; the explicit reminder at recent celebrations that India was the first non-socialist country to recognise the People’s Republic of China 70 years ago; and the fact that India was one of the first of 120 countries to receive from China crucial medical supplies, especially protective gears, masks and ventilators.

There are a few problems with the article, especially the suggestion that China has few friends in the world and needs India. Of course, we can expect such a perspective from such a writer, but the reality is that China actually has many friends, especially in the developing world, but also in Eastern Europe and Eurasia. The zero-sum lagards in the world, which number only a few countries, may not like this, but that is their problem. Thus, a more realistic perspective is that despite their differences, China – as the world’s largest economy – and India would do better to work together. This is not least because they may well be the only countries not to see a recession in 2020 – a short-term decline in growth, yes, but not a recession.

The missing country in the article is Russia. Not only has Russia clearly established itself as an independent global player, but it also has historically close ties with India and has developed ties with China that are arguably the closest they have been for a very long time, guaranteeing global stability (see here). Russia has also determined – correctly – that the Western liberal order has come an end and that a multipolar world is in many respects a reality.

Given that the ‘last stand of the West’ is sinking in delusions and economic disaster (see here), it is perfectly feasible for China, Russia and India that increasingly will set the agenda for a different world order. I for one find this an exciting prospect.

 

 

Chinese economic resilience during an epidemic: how citizens are supported

The systemic dimension of Chinese economic resilience may be known by many, but there are also many features at the local and household level that make a distinct difference during the time of an epidemic, or indeed any other disaster.

This article by Liang Xiaomin in the China Daily (here) explains in more detail:

Most Chinese people are staying at home and avoiding contact with others to prevent the spread of the novel coronavirus amid the outbreak. Economic activities are suspended nationwide. However, the negative impacts on people’s daily life are relatively limited. Here are the reasons.

First, the timing of outbreak overlaps with the Spring Festival, reducing the negative impact on income. The Spring Festival is a 7-day national holiday in China and most companies are temporarily closed except for those in tertiary sectors like retail, accommodation and catering. Most of the employees get their payments before the holiday, while those in informal sectors have prepared cash flow in advance. For example, migrant workers who are paid on daily basis usually return home to gather with their family two weeks before the Spring Festival and get back to cities two weeks after the holiday. The overlapping period between self-quarantining and family gathering during the holiday alleviates the impact of the epidemic on their incomes.

Second, the characteristics of rural communities where most Chinese live during the outbreak alleviate their financial pressure. As of 2018, the proportion of rural population was 42.1 percent in China, much higher than that in the US (18.0 percent), South Korea (17.3 percent) and Japan (5.7 percent). The percentage remains quite high even excluding migrant workers. In China, an acquaintance society is a feature of rural communities, where rural residents benefit from interpersonal trust and intra-family transfers. Rural communities are also geographically and economically independent and can support residents’ daily life even during a lockdown for weeks. For those who plant most food by themselves, the damage of the temporary isolation is also limited.

Third, the high saving rate in China cushions the economic blow from the virus outbreak. According to OECD data, the household saving rate in China was 36.1 percent in 2016, much higher than the average level in OECD countries. These savings provide a buffer for Chinese residents against the income cut-off.

Household Saving Rate in 2016  Source: OECD

Fourth, the vulnerable are supported by the social security system. At the end of 2018, fiscal expenditure on minimum living allowances reached 146.25 billion yuan with a coverage of 45.28 million people. During the epidemic period, most vulnerable people within the system could subsist on the allowance. In the meantime, facing the temporary hardships suffered by some low-income people, the government adopted a flexible process and raised allowances with an extended coverage immediately.

Fifth, a sound internet infrastructure allows employees to work from home. As of April 2018, 95 percent of villages and 99 percent of the population have access to 4G. The fiber broadband network covers more than 95 percent villages in China. Major telecom operators in China have been cutting down internet costs in recent years. With accessible, affordable and high-speed internet, employees can work from home and get paid amid the outbreak.

Last, with the government’s strong actions to counteract the downward pressure on growth, the expectations concerning economic and employment factors remains stable. Attention is now paid on maintaining the normal economic and social order as the COVID-19 outbreak is being contained. Fiscal policies and monetary policies are adopted in a timely manner. Actions to lower the operating cost are taken in order to support enterprises. An array of aid policies stabilize expectations in regard to economic development.

Home quarantine during the Spring Festival has not led to severe blows to residents’ incomes in China. However, it should be admitted that the lockdown of Wuhan and Hubei has brought about some problems and the suspension of economic and social activities will lead to declining growth rate and increasing unemployment rate. This is also the reason why the Chinese government has adopted differentiated measures to resume production right after the outbreak is contained.

Efficiency, transparency and collectivism: long reads

A series of long reads for the day.

First, a piece in China Daily called ‘Efficient measures key to containment’ (here).

Second, a detailed timeline has been published by the State Council Information Office, called ‘Timeline of China releasing information on COVID-19 and advancing international cooperation on epidemic response’. The full text is available on multiple platforms, but I am using one on Xinhua News (here).

Since many of you probably have long hours at home, it is well worth taking your time with these texts. But here are some of the key points:

Efficiency of the socialist system

Alongside the most noticeable features – Wuhan lockdown, massive testing, strict quarantine regulations and timely treatment-there are some other crucial features: swift national mobilization, especially assistance to Wuhan on a huge scale; cooperation from the public, which made various isolation and social distancing policies a reality; and the country’s strong command system with President Xi Jinping as the core, which ensured efficient and synchronized policies in various regions.

A careful read of the ‘Efficient Measures’ piece will show how dire the situation in Wuhan was at the beginning of the outbreak, with shortages of medical staff, equipment, and hospital beds. This experience is now being seen in other countries.

The massive difference was the way the whole of the country and whole of society responded in a highly coordinated manner. Manufacturers rapidly set up supply chains for medical equipment, the system of governance meant that teams of medical workers from each province in China were despatched to Wuhan, hundreds of locations were converted for quarantine and treatment, and two specific-purpose hospitals – Huoshenshan and Leishenshan – were built for severe cases at typical ‘Chinese Speed’. There were many, many more examples.

International Transparency

The key text is the timeline, but let me quote from an article published in The Lancet (here), already on 7 March, 2020:

Health authorities there have been working tirelessly to respond to and control the COVID-19 outbreak within China, providing countries around the world precious time needed to prepare for the possible arrival of the virus inside their borders. Importantly, health authorities in China have paved the way for the international scientific community to join the fight.

China’s doctors laid the foundation for this mobilisation of scientific and research muscle by rapidly identifying the new coronavirus in the middle of the influenza season. Chinese scientists lifted obstacles to researching the virus by sharing its genome sequencing publicly. The fact that this information was shared with networks worldwide is accelerating the design of vaccines and drugs targeted at the new coronavirus.

Collectivism

Wang Zhen, from the Shanghai Mental Health Center, said … traditional Chinese culture emphasizes collectivism, rather than individualism. “For us, the nation is the biggest collective, and collectivism will be activated when the nation faces a major disaster, so that we can carry out various disease control measures better than people in some Western countries.”

But this is not some vague concept:

Liu Jinlong, a professor of agriculture and rural area development at Renmin University of China, said, “Communities are at the frontline of epidemic control this time, and our efforts to improve community management in recent years have paid off.

“In places where more progress has been made in community management, such as the Pearl River Delta and Yangtze River Delta, epidemic control measures appear to be more timely and effective.”

Post-epidemic containment: a universal health ‘app’

To conclude: what does the China Model indicate after the pandemic is contained and before a vaccine is available?

One notable feature is a universal health ‘app’, which enables someone with a ‘green’ clearance to move about. The app also includes a map that identifies where the most recent infections have been in your area, with colour coding for how long ago such infections occurred. It uses AI logorithms to ensure real-time updates. In China, it is often attached to Wechat or Alipay apps, but it is noticeable that South Korea quickly followed the Chinese model and also uses such an app.

I notice an increasing number of calls in other places for such an ‘app’ (see here), but this development is fascinating, since it indicates profound cultural differences in understandings of the state, science and technology.

In those states that derive from the ‘Western’ liberal tradition, there are deep-seated suspicions of the state, science and technology. The reasons are many, but a major one is that the regimes in question have a long history of surveillance of the population. Couple this reality with the primacy of the individual (who is, as Marx already pointed out, in a profound contradiction between being a private individual and citizen of a state) and you have situation that leads to resistance to any universal health app as an ‘invasion’ of privacy.

By contrast, as Domenico Losurdo pointed out, in the countries that have been colonised or semi-colonised in the past, the state is generally seen in a good light. To be sure, it has to be a competent, transparent and thus trustworthy state (see here). Why this trust? A strong and capable state is the guarantee of freedom from (neo-)colonial interference, but it is also necessary for ensuring improved education, healthcare, care for the elderly, a robust economy, and so on. A comparable sensibility applies to science and technology (already with Deng Xiaoping), which are seen as productive forces in their own right and must be developed to improve the wellbeing of all.

For these reasons, a universal health ‘app’ is widely approved in a country like China. Simply put, it is necessary for the common good.