One story continues to dominate world news: the coronavirus outbreak. But in recent weeks, this story has entered a new chapter, with the infection spreading away from China to distant global hotspots including Italy and Iran. Numerous countries, including the United States and Britain, are now bracing for similar outbreaks. Governments, stock markets and citizens have reacted with shock and panic.
In stark contrast, China is edging ever closer to the end of its COVID-19 ordeal, officially past the peak of infection. Data this week has reported a sharp drop in new cases mostly limited to residents of Hubei province and travellers arriving from overseas. And while Chinese statistics must always be taken with a pinch of salt (as I wrote about here), its encouraging recent data is likely to be accurate in trend terms.
Indeed, China’s positive turn was all but confirmed this week as paramount leader Xi Jinping made a visit to the virus epicentre, Wuhan. This was as clear a signal as any that the Chinese government believes it has successfully dealt with the outbreak, and that it is now on the brink of total containment. From what I'm seeing on the streets of Beijing, it's very clear that life and work are returning to normal at an accelerating pace.
The contrast and timing of China’s turnaround could not be more acute given the worsening outbreaks in Europe and America. After weeks of watching and waiting while Beijing took unprecedented steps to prevent and control the epidemic, the rest of humanity appears now to be waking up to its own COVID-19 nightmare.
According to the WHO's assistant director general, this has prompted people to ask him, how did China do it? What lessons can be learnt? Beijing has thus gone from something of a pariah in the international community – the "sick man of Asia", as one Wall Street Journal commentator regrettably described it – to a wiser mentor figure, with valuable lessons to teach the rest of the world about this novel coronavirus threat.
China's propaganda organs have been quick to trumpet their achievements amid growing global turmoil, while its social media users have wasted no time in praising officials and citizens, especially the long-suffering people of Wuhan. Despite widespread anger and despair during the outbreak, Chinese people are now expressing pride in their government's actions, joking that other countries can't even "copy homework".
Xi Jinping delivers a speech during a visit to the coronavirus epicentre, Wuhan (CGTN).
What a dramatic reversal in fortunes. Rather than hurting China's ruling Communist Party leadership, as some China hawks predicted and probably hoped for (see for example this commentary by academic Minxin Pei), the crisis actually appears to have strengthened it. That is the verdict reached by several leading China specialists including Jude Blanchette.
I would go even further and suggest the following: that instead of damaging China's standing in the world, Beijing's response to the coronavirus may in fact be boosting the country's position internationally, even catalysing its rise to superpower status.
Now, this may seem a bit far-fetched, and there is certainly a possibility of China's global reputation declining on account of the outbreak starting there. Indeed, many voices around the world remain highly critical of China's actions, especially early attempts to silence whistleblower doctors in Wuhan. Some media figures have even called for Beijing to apologise for what they label a "Chinese virus", echoing the unfortunate characterisation consistently made by President Trump.
Nevertheless, the international community increasingly appears to be recognising the success of China's efforts. And in some cases, countries are even adopting Chinese practices wholesale. This is partly by virtue of China being the global epicentre of this novel coronavirus outbreak, unavoidably setting precedents for the entire world. But it is also because measures taken by China appear to have worked quite well.
If those precedents succeed in the rest of the world, too, then the effect for Beijing's image and influence globally could be a net positive one. Most reasonable people and politicians will not begrudge China for the fact the virus started there, but will be extremely thankful for the measures it took if they then inform containment efforts in their own countries. This, over the long term, could significantly elevate China's global standing.
It remains too early to tell whether or not that will indeed happen. For now, what we can do is look through the lens of the coronavirus situation, to see which of China's precedents have been successful and adopted more widely, viewing them as a metric for growing Chinese soft power. Here, I have identified and analysed four aspects of Beijing's approach – (1) mass quarantines, (2) widespread face mask usage, (3) free medical treatment, and (4) coherent strategy and messaging – that I feel best demonstrate this idea.
A deserted street in Wuhan during the height of its unprecedented lockdown (ABC).
1. Large-Scale Quarantines
By far the most striking aspect of China's containment strategy has been the use of quarantines. These have ranged from more moderate isolation policies encouraging people to stay at home and work remotely, to the quarantining of entire towns and cities. The lockdown of Hubei province, a region the size of England, is considered the largest lockdown in human history.
Many international observers were quick to dismiss this approach. "Quarantines won't work," said one NYU academic. Clearly, western experts baulked at the idea of using such a primitive, medieval remedy to tackle a disease in modern times. (The first formal quarantine is said to have happened in Venice during the 14th century amid an outbreak of the bubonic plague.)
Furthermore, while these extreme measures could be introduced in authoritarian China, it would never be possible in the liberal democracies of the Free World. Our ethical standards and human rights simply preclude us from locking up millions of people. Or so we thought.
Fast forward a few weeks and it is very hard to deny that those extreme measures have been effective in China, with new daily cases falling significantly after the imposition of quarantines. (See here how this can be demonstrated through data analysis.) Now faced with similar emergencies, other countries have sat up and taken notice quickly. The entire nation of Italy is currently on lockdown, something previously considered unthinkable in the West.
And it is not just the actions of Western countries that have shifted to align with China's. So too has the narrative. Rather than sowing doubt or focusing on how "oppressive" or "authoritarian" Italy's lockdown is, as was the case with China, Western observers now appear more concerned with the ability of such measures to solve an unfolding humanitarian crisis. Concurrently, the term "social distancing" has entered the lexicon to describe what are mostly very similar steps to those "draconian" ones taken in China.
A simple Google Trends search reveals this gradually shifting narrative:
From this graph we can see that while the outbreak was peaking in China, the term "draconian" was much more widely used online. But now that the epidemic is starting to peak in Western countries, use of the term "social distancing" has soared. Of course, these terms are not perfect substitutes, but they offer a decent like-for-like comparison. And their changing internet usage suggests that there are inherent biases shaping the way people across the world think and speak about this outbreak, and China's role in it.
It is still unclear how successful quarantines in Western countries will be. For now, Italy remains a test case for taking such drastic action in a liberal democratic context. Yet if such an approach is effective and adopted more widely, then it could be a sign that, to put it simply, China's way has won. And in turn, that would prove to be a boon for China's international reputation and perceived ability to handle major crises.
Other countries, including many Western ones, may soon have no choice but to admit the important precedent Beijing's policies have set. But if and when that happens, there will likely be less emphasis on how "oppressive" or "draconian" those measures were, and more emphasis on the fact that they simply got the job done.
2. Widespread Use of Face Masks
Another aspect of China's strategy that has proven controversial is the government's advice for people to wear face masks in public. As with quarantines, many Western medical professionals have been quick to dismiss this as an effective solution, saying repeatedly that face masks "don't work", except if you are already ill and trying to stop others getting infected. The US Surgeon General even sent a tweet instructing people to "STOP BUYING MASKS!"
The argument against civilian mask use reflects valid medical concerns over supply strains and incorrect mask usage. From what I've seen in China, it is clear that the majority of people do not always wear masks correctly, and often wear a single mask more than once, which can do more harm than good.
Scientists also cite a lack of "conclusive evidence" to show that wearing masks is effective for most people in these kinds of situations. However, that lack of evidence appears to be more the result of a lack in studies, than the presence of any countervailing evidence. And there are in fact several small studies which find that masks have had an impact during similar past events like SARS. But testing the efficacy of masks while simultaneously trying to tackle large-scale viral outbreaks is clearly no easy logistical task.
In any case, if you ask someone in China today whether they think wearing a mask is a good idea, they will almost certainly give you a resounding YES. And it is not just the Chinese, but Japanese, South Koreans, and increasingly people all over the world who are buying and wearing masks. Officials in Iran have started wearing masks at press conferences, as have troops on the streets of Italy. I have even been asked by a number of family and friends back in England which mask products I would recommend.
*Masks being worn by officials in Iran and troops in Italy (Reuters).
Does this mean that Westerners don't believe the advice of their governments or health professionals when it comes to mask usage? Have they been, er, masking the truth? 😷 Are people and authorities around the world now more convinced by the advice of the Chinese government? And is this therefore a sign of China's growing influence?
Perhaps. But this mask controversy may also have something to do with a broader clash of cultures and ideas. It reflects differences between evidence-based Western medicine and forms of traditional or homeopathic medicine prevalent in Asia. The simplistic conclusion of Western medical professionals that "masks don't work" fails to consider the precise situations in which they have been in used in non-Western contexts.
In countries such as China, there is not such a strong culture of washing hands, particularly in less developed regions of the country. Spitting and coughing without covering one's mouth are also more prevalent than in the West. And, as elsewhere in Asia, urban environments here are often very densely populated, raising the risk of contagion.
Rather than try to change a billion people's hygiene habits overnight (though hand washing has also been an element of official government advice), Beijing has instead advocated the use of face masks as a short-term measure. It has thus been effective probably not so much as a way of reducing airborne transmission, but as a way of limiting hand-to-face contact.
There is also a non-medical reason why masks have been effective in China. They have raised awareness and caution among the public, providing a constant visible reminder for people to stay vigilant and keep a distance from others in public. Masks have even taken on a symbolic importance, becoming a sign of solidarity and unity in the fight against a common coronaviral enemy.
As the coronavirus continues its spread globally, this question of whether or not to wear a mask continues to divide the international community. Unfortunately, the wearing of masks by overseas Chinese communities has led to them being targeted in racist attacks. It's just one sad example of how the coronavirus outbreak has prompted a wave of nasty stigmatisation of Asian diaspora groups (as this viral article made clear).
For their part, Chinese people have ridiculed the fact that many Westerners are not wearing masks. And they have found support on the issue from their international neighbours Japan and South Korea, following those countries' donations of masks at a critical time in the outbreak. (A gesture that has since been dubbed "mask diplomacy".)
A cartoon by a Chinese blogger depicts the ongoing debate over the efficacy of masks between China (left) and other countries (right).
Just the other day in Beijing, I stumbled across a new batch of South Korean-made masks at a convenience store. It seemed sadly ironic to me that these masks should be shipped in from Korea at a time when the situation was deteriorating there, but improving here in China. There were even reports that Seoul was suffering from a mask shortage. My humble mask thus seemed to crudely encapsulate how the coronavirus has brought into focus both the best and worst aspects of today's globalised, interdependent world.
For the time being, widespread mask wearing remains a mostly Chinese and Asian phenomenon. But should the practice gradually be adopted more widely around the world – perhaps even forcing a change in tune from Western governments and health professionals – then it would be yet another sign of how China's influence has grown during this coronavirus pandemic.
The Korean-made KF94 mask I purchased in Beijing (with mandatory selfie).
3. Free Medical Care for All
Masks offer a nice segue to another precedent set by China in this global pandemic – the provision of free medical treatment to any and all infected by the coronavirus. After initial shortages, surgical masks were made available to communities across China during the early stages of the outbreak. I myself was able to pick some up at a nearby pharmacy in Beijing free of charge.
But this just scratches the surface of what has been an enormous undertaking to provide free medical care to people across the country. The most significant operation has been in the epicentre Wuhan, where two temporary hospitals were rapidly built to cope with an overwhelming number of patients.
There have since been almost 50,000 confirmed cases in the city, with over 35,000 people discharged. That is a mind-boggling number of patients for one city to have processed in such a short space of time for a single illness! But what is even more amazing is that all of those treated patients will have received the care they needed for no charge whatsoever.
The same operation has been replicated across China, albeit on a much smaller scale, with designated hospitals ready to receive patients for testing and, if necessary, treatment. And all of these hospitals have come under the centralised coordination of the Chinese state heath system, including its Centre for Disease Control (CDC) and army medical units.
To those in the United Kingdom and other countries with free healthcare, this will not seem at all remarkable. We Brits take it for granted that treatment should be free to everybody at the point of care. But for many in the world, particularly in the United States, this is far from normal. And it is still very unclear how such highly-privatised health systems will respond to what is essentially a public rather than private emergency.
A makeshift hospital ward in Italy similar to those set up in China's Hubei province (NYT).
The initial signs have been far from encouraging. Italy's mixed public-private system is said to be struggling to handle a growing number of cases. The US, meanwhile, is experiencing a massive shortage of testing kits. At the time of writing, it is estimated that the country has only done around 8,000 tests, while South Korea has performed over 200,000. Even the UK, another relatively small country in population terms, has completed almost three times as many tests as the US to date.
All of this has prompted the head of the American CDC to admit that his system is failing. The question is: what will happen next? It may be that these highly privatised and fragmented health systems somehow manage to cope with the growing crisis. Or it may be that they simply buckle under huge pressure and a lack of any clear coordination.
Let's hope it is not the latter. But if that worst-case scenario is to be avoided, then it may be necessary to take a leaf out of China's book, by ensuring free, timely medical care to all who need it. That is precisely what has happened in South Korea and Japan, where the government has a legal responsibility to shoulder medical costs incurred by infectious diseases such as COVID-19.
4. A Warlike Strategy and Battle Cry
So far I have discussed at length several key components of China's approach to tackling the coronavirus – quarantines, masks, and free treatment. All of these measures appear to have been successful and are now being adopted by countries worldwide to varying degrees. There is one final aspect which I would like to touch on, which encompasses all of the above: the adoption of a coherent strategy and a compelling message.
From the beginning of efforts to combat the coronavirus in China, government propaganda has characterised it as all-out warfare, using highly militaristic language in slogans and speeches. In Chinese, the terms being used most are “people’s war”, 全民战争 (quanmin zhanzheng), and “defense”, 保卫战 (baowei zhan). State media mouthpieces also refer to an "epidemic battle", written as 战“疫” (zhanyi) – this is a bit of wordplay combining the terms for "battle", 战役 (zhanyi) and "epidemic", 疫情 (yiqing).
What has been the impact of this warlike rhetoric? Without conducting a survey it is impossible to know exactly. Some external observers may dismiss this official messaging as a kind of "brainwashing" or just mere "window dressing". But from what I've witnessed in China, I would have to disagree.
Rather, I believe that China's use of a belligerent strategy and language has had a significant impact on containment efforts, impressing upon people the gravity of this peacetime disaster. More than that, the idea that this is a "war" appears to have brought people together at a critical time.
Army medics from the Chinese People's Liberation Army (PLA) arriving in Wuhan (cpanet.org.cn).
On a practical level, China’s war mentality has meant military troops, medics and volunteers being deployed to the “front lines” in Wuhan and around the country. Conducting a military operation of this scale will have been an exercise of enormous value for China’s massive PLA force, most of which has never been tested by actual warfare. And that valuable experience will go some way to offsetting the huge social and economic costs incurred from the outbreak, preparing China better for future emergencies, whether natural disasters, like this one, or man-made conflicts.
After witnessing these warlike words and actions from China, the rest of the world has faced a choice: whether to adopt a similarly militaristic mentality, or not. Some have chosen to quickly follow suit, including South Korea. This is perhaps unsurprising as, like China, South Korean society is in many ways still highly militarised. (Military service remains compulsory for all South Korean men and the country is technically still at war with the North.)
Outside of East Asia, there have been some instances of militaristic strategies being used. In the UK, for example, health secretary Matt Hancock recently spoke of a “battle plan” for COVID-19, which the British press has labelled a “war on the coronavirus”. Meanwhile, some UK supermarkets are said to have introduced warlike rationing.
Perhaps the most visible use of military personnel so far in the West has been in Italy, where troops have been deployed to enforce a nationwide lockdown. Public health professionals there and respected epidemiologists in the UK have both described the current situation as one of warlike proportions.
In the US, by comparison, warlike rhetoric has been much more muted. Instead, President Trump has chosen to consistently play down the threat posed by the novel coronavirus. (One commentator has glibly suggested that he is choosing to declare a war on truth, rather than the coronavirus...)
This may be a recognition that the Trump administration is simply not prepared to fight such a ‘war’, and unable to unite a very divided American political scene, not least on the eve of a presidential election. But it may also reflect a reluctance to follow the lead of China, which the White House has increasingly portrayed as its strategic competitor.
As I write this blog, there are signs that the US situation could be changing, with National Guard troops now being deployed to the most hard-hit states, just as China did during the escalation of its outbreak. But that is surely not enough. There needs to be much more from Washington, both in terms of a coherent, unified strategy, and also in terms of a compelling message that rouses people into action and brings the country together.
US Air Force medics prepare for coronavirus operations. Could this be the first signs of a more "Chinese-style" response from the US? (Stripes)
Conclusion
As the coronavirus continues to spread, so does fear, confusion and uncertainty. For many around the world, it is still not clear exactly how threatening this illness is and what steps should be taken to prevent and control it. Such uncertainty is not surprising given that this is a "novel" virus, previously unknown to science.
But confusion has also been exacerbated by other factors. Partly by the plethora of mixed messages in news reports and on social media, the so-called “info-demic”. But partly also because this pandemic is a global event, happening across various countries, each with their own unique cultures and ways of managing public health crises.
As I have argued above, the steps China has taken – from mass quarantines and face masks, to free treatment and coherent strategy – appear to have been successful. Not only that, these precedents seem to be shaping global containment efforts.
In highlighting this, my aim is not to suggest that the Chinese approach is necessarily better or suited to all international settings. It is important to recognise that countries present very different contexts, whether in terms of politics, culture, demography or other factors, and there is no single 'correct' approach.
I do, however, feel there are some lessons that other countries can learn from the way China has succeeded in containing its outbreak. But doing so will require humility and flexibility to consider new, unorthodox approaches. And, in the increasingly hawkish corridors of Washington and Westminster, that will be no easy task.
Beyond the immediate importance of containing this pandemic, the result of all this could be that China emerges in a stronger position than where it began. That somehow, despite the incredible social and economic costs incurred by the government and people, the coronavirus could end up being a blessing in disguise for China, propelling it to a position of greater global influence, and one step closer to the superpower status it covets.
Source: FT
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