A recent editorial in The Economist claimed, in late February, that it was still too early to tell whether the gains from the containment policy adopted in China in response to the new coronavirus epidemic were worth the price paid in economic and individual terms. In the immediately preceding paragraph, however, the same editorial said that, without these containment measures, China would have “registered many millions of cases and tens of thousands of deaths”.
Curiously, the Economist editorial did not seem to notice that it had answered its own rhetorical query before it was raised: The gains from China’s remarkable use of containment measures have clearly, to date, outweighed the price.
The assessments of infections avoided and lives saved set out in the editorial are supported by a medical-modeling estimate from the University of Hong Kong published in The Lancet, in the United Kingdom, in January. According to that computer-based modeling, the numbers infected in China could have risen to over 2 million without effective containment by early March.
To get a feel for how a new influenza virus can spread widely and swiftly, we can usefully look at the outbreak of swine flu in the United States in 2009. Before we do so, we should be very clear about “virus identity”. The 2009 swine flu virus, which swept around the globe, was not a “North American virus” — it was a grim, universal micro-organism without any racial identity. The virus behind the COVID-19 epidemic is, equally, a global pathogen without any ethnic personality.
There is now widespread agreement that China’s decision to employ an “old style” quarantine (and trace) approach on an unprecedented scale has slowed the spread of novel coronavirus infections greatly, not just within China but across the world. This has since been verified by the World Health Organization
The first human-to-human outbreak of swine flu appears to have occurred in Mexico in late 2008. Early cases were identified in the US by April 2009. In the same month, the US Centers for Disease Control (CDC), arguably the premier disease control institution in the world, had categorized the new virus and understood how infectious it was.
The virus was intensely studied and serious work toward creating a vaccine began. No drastic containment measures were implemented in the US at that time, however. According to the CDC, by April 2010, around 60 million — about 18 percent of the US population — were infected by swine flu and over 12,000 died. There were no significant border closures with the US over that period, and few restrictions were placed on travel into and out of America. The lower estimate said that some 700 million people were eventually infected with swine flu worldwide and the death estimates ranged upward from 150,000. Fortunately, the mortality rate was comparatively low.
As China, this year, put in place the most extensive contact-tracing and quarantines the world has seen, various critics advised that the measures were draconian, a violation of human rights and ineffective. Moreover, they would have adverse economic and medical consequences. Too many critics imagined, usually from far away, that there was a clear choice between bad and good. In fact, the choice presented was far more difficult. It was, on a vast and novel scale, akin to the sort of medical emergency choices faced by hospital casualty departments on a daily basis. Very difficult priorities had to be worked out and applied urgently, under immense pressure and at great risk to the medical staff involved.
There is now widespread agreement that China’s decision to employ an “old style” quarantine (and trace) approach on an unprecedented scale has slowed the spread of novel coronavirus infections greatly, not just within China but across the world. This has since been verified by the World Health Organization. At the least, very valuable time has been bought for countries everywhere to make better response preparations. Today, without these quarantine measures, we would likely be witnessing a far greater uplift in the caseload on health systems globally, straining some to the breaking point. It’s also generally acknowledged that most countries, including the US and other wealthy economies, are comparatively unprepared to deal with an epidemic outbreak.
The vital window of opportunity may not, however, have been entirely well-used. A leading US epidemiologist, Marc Lipsitch, from Harvard University, very recently observed, in an interview with The New Yorker magazine, that the Chinese methods were more thorough than those being deployed in the US. Lamenting the lack of testing capacity in the US to find out what was really occurring, he said that “Our government’s response was something like 1 percent — or less — than what China did.”
Suppose, though, that the Western critics had been heeded and the massive quarantine had not gone ahead. Based on those HKU modeling estimates, by this time China might have had over 2 million cases and up to 40,000 deaths — instead of around 80,000 cases and some 3,000 deaths. We can be confident that, had matters unfolded in this way, the dominant, mainstream media narrative would have been governed by observations about China not knowing what to do, Beijing incompetence and doing too little too late.
A second wave of infections in China remains possible, of course. But already, thousands of lives have been saved and millions of likely infections have been avoided. Moreover, China is now better placed to deal with any second wave, having learned much from the initial wave. It is also in a stronger position to assist other jurisdictions fighting the spread of COVID-19 infections.
Apart from the huge general economic cost, the human cost, within China, of coping with the COVID-19 epidemic has been colossal. There is the death toll itself plus disturbing numbers of doctors and nurses have died and more than 3,000 medical personnel have been infected fighting the virus. Then there is the immense sacrifice the people of Wuhan (and Hubei province) have been called upon to make as a result of the drastic lockdown aspect of the quarantine.
Without the exceptional fortitude of the general population and the remarkable bravery and skills of those manning the medical front lines, this conspicuous level of containment could not have been achieved. A Canadian WHO expert, Dr Bruce Aylward, says that China’s bold approach “has changed the course of a rapidly escalating and deadly epidemic.”
China and the world owe a great debt to Wuhan — and Hubei. It should not be forgotten.
The author is a visiting professor in the Faculty of Law, the University of Hong Kong.
The views do not necessarily reflect those of China Daily.
