What should we learn from Beijing’s draconian response to Covid-19?
China was Ground Zero for the coronavirus disease now spreading across the planet. Beginning in December and probably before, the virus “spilled over” from its natural reservoir, likely among bats, and infected its first known human hosts — probably in the context of a “wet” market located at Wuhan in central China. Undetected by the authorities, the virus moved into the community, unleashing an epidemic that now spans the globe, but is ebbing in China itself.
A second epidemic, however, is following closely behind COVID-19 — a surge of belief in the capacity of dictatorships to deal decisively with medical emergencies, in contrast with the supposed weakness of democracies. In this view, democratic countries are hamstrung by the need to win consent and to move slowly with due regard to law and civil liberties.
This second epidemic proclaims the need to follow the “Chinese model” by taking a sledgehammer to the crisis, closing borders and locking down enormous populations and vast swaths of territory. The Chinese strongman Xi Jinping basks in the glow of this account; the World Health Organization lavishes praise on his “heroic” interventions; and political leaders around the world discuss the possible wisdom of following the Chinese playbook. Even in the New York Times, an opinion piece calls for the world to respond to coronavirus “by going medieval” and “attacking it with the iron fist instead of the latex glove.”
What is the Chinese model, and how do we measure its success? On Jan. 23, Beijing announced that the city of Wuhan and then the entire province of Hubei would be enclosed by a ring of troops and police who would cordon off some 60 million people in one of the largest public health experiments ever undertaken. All movement in and out of the area — by plane, boat, rail, and road — was halted, and severe penalties were mandated for attempts to elude the ring of containment known as a sanitary cordon, a measure originally devised to combat the Black Death, but now implemented on a gigantic scale.
At the same time, within the stricken and isolated area in China, the regime announced a lockdown that banned public and private transportation and confined residents to their homes, allowing one person only in each household to go outdoors to purchase supplies at supermarkets and pharmacies twice a week. Alternatively, the authorities have removed suspected contacts to hospitals for quarantines lasting the duration of the incubation period for coronavirus — 14 days.
The measures were enforced by the encouragement and payment of neighbors to spy on neighbors, by loudspeaker and television broadcasts, and by surprise visits from local party officials. Citizens who fell ill were sent to hospitals.
Most tellingly, the regime insisted on a monopoly of the dissemination of information. As a result, physicians who sought to protect patients and colleagues by informing them that they faced danger from a virulent and unknown disease were reprimanded and silenced, sometimes dying later from the virus. The most famous case was Dr. Li Wenliang, whose death set off waves of popular indignation. He was seen as the embodiment of an alternative policy that could have empowered both health-care workers and citizens to protect themselves.
It is difficult to be entirely certain in assessing the Chinese accomplishment. The regime’s statistics suggest that emergency measures slowed the progress of the contagion and caused a slow, steady decline in cases and deaths. The World Health Organization mission to China, led by the epidemiologist Bruce Aylward in February, glowingly lauded the regime’s achievement, declaring it a model.
Aylward even announced that the world owed China a “debt of gratitude.” More recently, Italy has ignited a debate among European governments by taking decisive measures that many regard as a comparatively pale but still resolute imitation of China’s approach.
Residents of Italian cities have even been quoted as saying that they are now living in Wuhan.
It is dangerous, however, to accept the Chinese model prematurely and without scrutiny. In hindsight, it may come to look very different. It is difficult now to assess public health in Hubei Province. The situation is vastly improved, but the meaning of the official statistics of the regime is unclear, especially since the methodology used to compute them changed repeatedly during the course of the outbreak.
It is also uncertain, even according to Chinese medical authorities, that the decline in the profile of the epidemic is definitive. Transmission continues at a lower level, and a rebound remains a much-feared possibility.