What China did to control the coronavirus


As talk increases of states relaxing the restrictions on physical distancing, on a recent episode of the radio show Fresh Air, Donald G. McNeil Jr., science and health reporter for the New York Times, says that the US is nowhere near ready to do that. He says that the remarkable success of the Chinese government in shutting down the spread of the virus was due to its willingness to put in place highly restrictive measures for as long as was necessary and only after the number of new cases were tiny enough to ensure that contact tracing could be done effectively did they begin to loosen the restrictions.

He says that compared to what China did, the US seems like it is having a garden party even at the height of its restrictions.

“I hear anecdotally that people [in the U.S.] are holding … barbecues and people are still going out on Internet dates and having play dates with kids,” he says. “Unfortunately, that’s the reason that we have about 30,000 new infections a day in this country. … China didn’t reopen until they had zero new infections a day.”

He describes what measures China put in place. He also says that the criticisms of the Chinese government for its slow initial response is likely misplaced. He said that it looked like the local authorities in Wuhan including the mayor who were the ones who initially tried to hide the emergence of the virus in their area, suppress news about it, and lied about it to the central government. But after the central government sent in a team that realized that there was a new virus that had human-to-human transmission capability, the head of the country’s infectious diseases unit (their equivalent of Anthony Fauci) went on national TV on January 22 to describe what was happening and the government put Wuhan into lockdown and instituted all the other containment measures. (I described the resulting daily life in one Chinese city in an earlier post.)

It is quite extraordinary the amount of resources and the logistical organization that were made available to the Chinese public health authorities, when compared to the chaotic system here where health care providers have to scramble to find even basic necessities.

“The model in China was, when it was time to be tested, you were taken to a fever clinic. You were screened in several ways: Your temperature was taken. You were given a quick flu test and a quick white blood cell count to make sure you didn’t have a flu or bacterial pneumonia. And then you’d be given a quick CT scan. They could run as many as 200 CT scans a day on some of these portable machines so that they could check your lungs — because their tests had some time before the results came back too. And only after you cleared all those hurdles and you were definitely still a COVID case, then you got the test, because their tests were imperfect like ours are. And then you didn’t go home to wait for the results of your test. You stayed there in the fever clinic, in the center. You were told to sit far apart from other people — 6 feet away from other people. And people sat there sort of scared with their envelopes with their CT scan results in their hands, waiting to hear if they were yes or no.

And then, if you were positive, you went straight into isolation — not back with your family but in one of these gymnasiums or armories, someplace like that, where you were in bed. There might be 100 people in a room.”

Were the measures too coercive? He says that while there were some heavy-handed actions especially in the early days, a lot of effort was put into creating awareness that people would be treated well and that this was all for the public good, and this enabled the government to get a great deal of voluntary compliance.

“Chinese people love their families just as much as Americans love their families. They were initially reluctant to go into these quarantine shelters too. But when it became clear that it was saving the lives of their families. I mean, yes, some of them were forced in. Some of them were chucked into the back of ambulances by policemen. But that was not the norm. The norm was you were told, “Please come with us to the shelter. You will have food. You will have medical care. We will keep an eye out for you. And in three weeks, if you’re good to go back home, we’re going to test you, make sure you’re OK, and then you can go back home.” It’s portrayed as brutal. But there are a lot of brutal things that the government in Beijing does. … In this case, it was not brutal to its own citizens. It saved probably 10 million lives. That’s how many I estimated would have died in China if this had just gone unchecked.”

He says that there is a great danger in opening up too soon before adequate levels of testing are available and the number of cases are low enough that contact tracing can be done.

He says that China may be the nation that has the ability to devote the necessary resources to research a vaccine for the virus and develop and manufacture a vaccine in the large numbers of doses necessary, and that the US might be dependent on that nation to get the vaccines. He says the Trump’s continuous insulting of China may come back to haunt the US if they get fed up with him and the US. He also says that, contrary to the criticisms that Trump has made of the WHO, he thinks that this has been the WHO’s finest hour in terms of its efforts to warn about pandemics and what needed to be done.

That the Chinese government is getting sick of the US’s attitude can be seen in how the official state Chinese news agency Xinhua tweeted a short video mocking the incoherence of US and Trump’s response to this crisis and heir flailing efforts to distract attention by blaming others. It is not clear if they are the ones who created the meme or used one that they found on the internet.

McNeil hopes that like after previous major crises, the country emerges with a better vision of what structural changes should be instituted.

“This is like going through a war. And if we went through World War I and World War II, and after each of those wars, we tried to create the League of Nations, and we did create the United Nations. People saw that we were all in this together, and the attitudes changed after those wars. Unions were strengthened. Incomes became more level. People had had it with war profiteers, and taxes on the rich went up.

It led to the GI Bill and the Veterans Administration mortgages. In Europe, the widows’ and orphans’ pension funds led to the creation of the famous European social safety net. [They were] a very equalizing kind of events. And I’m hoping that something like that will happen in this country too, that we’ll have kind of a rosy outcome from this and that people will value life more.”

I hope he is right but in those past times did the country have such a dangerous mix of a stupidly ignorant president and a major political party that quaked in fear of him and enabled his vicious petty actions?

It is an interesting interview. You can listen to it here.

Interestingly, Sweden is an outlier in Europe, taking such a casual attitude to dealing with the pandemic that it shocked a Swede who recently returned to his country.

Just as the U.S. and most of Europe were tightening restrictions, Swedish bar owners were allowed to open their outside patios earlier than usual. With some minor exceptions, Swedish bars, cafés, restaurants, clubs, and stores remain open to this day. Sweden’s per capita death rate is now among the highest in the world, above the United States and nearly six times as high as some of our Scandinavian neighbors. Total deaths from COVID-19 in Sweden are nearing 2,500, more than all but four American states’.

Swedes have done the least in Europe to change their movements according to social distancing, anonymized mobility data from Google has shown. When I flew into Sweden earlier this month from Los Angeles (a necessary trip—taken while dressed in mask, gloves, and a Beastie Boys’ “Intergalactic”–type faux hazmat suit), it was like arriving in an alternate universe. No screening of any kind took place. There were no pamphlets about COVID-19 precautions. It was like COVID-19 had never left Wuhan, China.

What I quickly noticed during the ride to my Stockholm apartment was how things seemed exactly normal for this time of year. Spring, when the Swede wakes up from his winter depression and goes outside to manically face the sun with closed eyes, was the same as it ever was. No one I could see was minding social distance. Cafés were full to the brim, and people were picnicking in parks, on the same blanket. And within the first few hours back in Stockholm, I saw more handshakes and hugs in public than I had seen in two months in Los Angeles, where I had seen none.

Sweden is going to provide a natural experiment by serving as a control group to see the effectiveness of the countermeasures taken by other countries.

Comments

  1. Mano Singham says

    hyphenman,

    I think Taibbi was focusing more on the censorship issue more than the measures taken to clamp down on the spread of the virus.

  2. jrkrideau says

    @ 2 xohjoh2n
    If we ignore the New York Post editorializing and listen to what Dr Ryan is saying, he is saying that Sweden has taken strong measures just not the same as some other countries. Japan seems to have done the same type of thing.

    I do not see this as a criticism of a “lock-down” model, just a recognition of a different approach. Taiwan has not gone to a lock-down either but has focused on lots of testing and very aggressive contact tracing.

  3. says

    @Mano, No. 3,

    Yes. I should have been more clear.

    My takeaway from Taibbi’s piece was that government officials are overreaching by suggesting that if China’s policies work so well to tamp down the virus, then those tactics could also be applied to the censorship policies to also tamp down questionable and counter-to-policy messages like those from the two doctors (Drs. Dan Erickson and Artin Massahi) that he mentions were censored by YouTube because:

    They’d held a presentation in which they argued that widespread lockdowns were perhaps not necessary, according to data they were collecting and analyzing.

    “Millions of cases, small amounts of deaths,” said Erickson, a vigorous, cheery-looking Norwegian-American who argued the numbers showed Covid-19 was similar to flu in mortality rate. “Does [that] necessitate shutdown, loss of jobs, destruction of oil companies, furloughing doctors…? I think the answer is going to be increasingly clear.”

    Yes, later in the piece, Taibbi writes:

    From everything I’ve heard, talking to doctors and reading the background material, the Bakersfield doctors are probably not the best sources. But the functional impact of removing their videos (in addition to giving them press they wouldn’t otherwise have had) is to stamp out discussion of things that do actually need to be discussed, like when the damage to the economy and the effects of other crisis-related problems – domestic abuse, substance abuse, suicide, stroke, abuse of children, etc. – become as significant a threat to the public as the pandemic. We do actually have to talk about this. We can’t not talk about it out of fear of being censored, or because we’re confusing real harm with political harm.

    And I completely agree with that last sentence. The response to objectionable speech must never be censorship. The only proper response is more speech. But that requires people get off their butts and take action.
    .

  4. lorn says

    …”crisis-related problems – domestic abuse, substance abuse, suicide, stroke, abuse of children, etc. – become as significant a threat to the public as the pandemic.”

    Seems to that all of those issues were present before the lock down. The restrictions have made them worse, and perhaps made them visible where they were hidden before but these issues didn’t just materialize out of nothing. It seems like a sure thing that when the restrictions are lifted these problems will still be present. Where they disappear it can be assumed they have not so much gone away as been swept under the rug.

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