OPINION

China’s approach to containing coronavirus cannot be replicated

China has gotten a grip on its coronavirus outbreak by deploying authoritarian methods of containment.

Medical workers celebrate the closu of Jianghan Fangcang temporary hospital for COVID-19 patients in Wuhan, Hubei province, China, March 9, 2020 [EPA-EFE/LI KE]
Medical workers celebrate the closu of Jianghan Fangcang temporary hospital for COVID-19 patients in Wuhan, Hubei province, China, March 9, 2020 [EPA-EFE/LI KE]

What a spatial and temporal shift. Just one month ago, we were preoccupied with the ballooning number of COVID-19 cases and the rising death toll in China.

Mainstream media outlets in the West, which had at first criticised China’s cover-up and inaction during the initial stages of the outbreak, next moved on to aggressively cover China’s draconian containment measures.

The number of new infections, however, began to drop in mid-February, and on March 19, China declared zero new cases for the first time.

A recent study carried out by mostly Chinese scientists, attributes China’s success in bringing down the number of new cases to effective intervention measures, such as suspending intra-city public transport, closing entertainment venues and banning public gatherings.

While the disease is under control in China, the virus is wreaking havoc in other parts of the world, however. 

As of March 20, three-quarters of the total confirmed COVID-19 cases had been reported in countries other than China.

With a population less than 5 percent the size of China’s, Italy has the largest number of total confirmed coronavirus deaths – 5,476.

Many Western countries now find themselves being criticised for not taking effective actions promptly.

This led Dr Bruce Aylward, a leading expert at the World Health Organization (WHO), in late February to suggest that other countries should replicate China’s approach to containing the spread of COVID-19.

But the Chinese approach is hardly replicable.

Even without considering the lack of policy autonomy in many democracies – because they do not have “despotic” power and must contend with the checks and balances of a democratic system – effective implementation of those draconian containment measures would require a strong state to penetrate society and enforce its decisions.

China can achieve that, thanks to the extensive array of vehicles installed in the Mao era to do just that – village party branches, street subdistrict offices and former barefoot doctors (those who received little training but were allowed to practise in the countryside in the Mao era; in the 1980s they were certified to become “village doctors”) who were mobilised to take temperatures, quarantine people and trace infections and their close contacts.

Differing from the former Soviet Union, which relied heavily on formal bureaucracy and police to enforce government policies, China also uses social forces to conduct “community policing”, for example by having residents monitor each other’s activities.

These traditional vehicles were made more efficient with the introduction of big data and information technology, such as QR codes, to track and stop the spread of the virus. Partly because the stringent quarantine measures were brought in during the spring festival holiday, Chinese people overall were cooperative with this seemingly Orwellian approach.

Furthermore, the rapid centralisation of political power in China since 2012 has generated strong incentives for government officials to rush to jump onto President Xi Jinping’s bandwagon to demonstrate their political loyalty.

Not surprisingly, when President Xi clearly signalled his policy priority in the COVID-19 crisis after January 20, inaction and foot-dragging soon gave way to zealous and heavy-handed policy actions.

Other countries may borrow some of China’s containment measures (for example, shutting down a city), but it would be challenging for them to halt economic production and strictly enforce social distancing measures to the same level as seen in China.

The Chinese government sealed off cities, apartment complexes and villages, placing security guards on patrol around the clock to monitor people’s movements. There have even been reports of residents being arrested for stepping outside their homes or not wearing masks while playing Mahjong at home.

Even in Italy, the first Western democracy to adopt expansive containment measures that appeared to mirror China’s lockdown of Wuhan, the government did not immediately stop essential businesses from operating as normal, nor did it bar foreigners and outsiders from coming in and out of the affected areas.

In New York, despite the implementation of mass social distancing measures, grocery stores, pharmacies and major retailers like Walmart are still allowed to open and public transportation remains operational.

Those who ask other countries to “copy and paste” the Chinese approach also fail to recognise that the draconian containment measures in China have taken a heavy toll on the economy and society.

As a result of the spread of the virus and strict government containment measures, China’s industrial output shrank at “the sharpest pace in 30 years” in January and February. Retail sales saw a 20.5 percent decline over the same period.

Moreover, in the absence of advance planning, the drastic lockdown of the city of Wuhan on January 23 caused public panic.

As residents showing flu-like symptoms flooded the hospitals seeking medical assistance, there was a serious shortage of testing kits and hospital beds.

As a result, a large number of COVID-19 patients who could not get a proper diagnosis and/or treatment died at home. Many deaths never showed up in government figures.

The already high fatality rate in Wuhan (5.8 percent as of February 24), therefore, probably underestimates the actual mortality level. There were also second-order problems caused by the shutdown, like the disruption or denial of access to healthcare or medicines for those who were suffering from other diseases (for example cancer or HIV).

According to China Newsweek, a hospital in Wuhan discharged at least 15 terminal cancer patients to free up beds for suspected coronavirus patients.

If measures aimed at maximising health protection at all costs represents one extreme on the spectrum of government response, a Pollyanna approach that downplays the risk in order to minimise the disruption to the economy and society, like the one the Trump administration and the UK government pursued until recently, can be placed at the other end of the spectrum.

But in addressing this pandemic, sound government response is not about choosing between the two. Instead, policymakers should carefully balance managing health risks and keeping economies and society afloat.

Factors to consider here include the nature of the virus, the trajectory of its spread, the vulnerable population, healthcare system capacity, government capacity to mobilise resources, and economic and social tolerance of drastic control measures.

By acting quickly and taking aggressive and innovative measures, including rigorous detection, strict quarantine, social distancing and effective communication, Singapore, Taiwan, Hong Kong and, to a lesser extent, South Korea, have managed to contain the virus spread.

In that sense, China’s harsh, restrictive containment measures are not only non-replicable in most places. They probably should not be replicated.



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