Why the Coronavirus crises is getting out of control in China?

Chinese journalist and HealthLEADS (formerly Health Analytics Asia) first-check member Qian Sun traces different shortcomings and deficiencies in China’s response to coronavirus crises. She writes that even though the local government might have found out the potential danger of the virus as early as in December, it seems they covered it up, and missed the first best window of opportunity to inform the public and contain the spread of the virus.

Since the first coronavirus (officially named COVID-19) case was reported in China, it has spread rapidly from an initial outbreak in Wuhan, a city in central China, to 25 other countries, and has resulted in the quarantine of at least 16 Chinese cities. Already according to the Chinese authorities the number of cases reported in China has reached to 20,487 and the death toll has climbed to 426 (as of February 3, 2020). The World Health Organisation has declared it as a “public health emergency”. This is only the fifth time that the WHO has declared a public health emergency of international concern.

Wuhan, the city where the virus originated, has been under an unprecedented quarantine since January 23. Hospitals are overcrowded and many lack essential medical supplies such as masks and protective suits. Doctors and nurses have been working non-stop and are under extreme pressure.

There have been cases of people dying with pneumonia-like symptoms at home but not being included in the death toll, suggesting that the coronavirus could be higher than the Chinese health authorities have acknowledged.

The coronavirus outbreak is not the first public health crisis that happened in China in recent years. The way SARS started and spread in China and around the globe in 2002 and 2003 is a lot like the current public health crises.

How China is responding to the outbreak is under close scrutiny, given that it is widely criticised for initially covering up the crisis. The Chinese government has admitted “shortcomings and deficiencies” in the country’s response. President Xi Jinping has declared “a people’s war of prevention” against the epidemic, threatening punishment for anyone deemed to be neglecting their duties as control efforts ramped up. Why is the coronavirus crises getting out of control in China?

Here are some key reasons:

The hierarchical bureaucracy and the importance of social stability over everything

In China, politics takes place in a framework of a socialist republic run by a single party. The local governor is supposed to obey the instructions from Beijing. The ruling government sets the goal, and the provincial officers follow. As a one-party state, the General Secretary of the Communist Party of China holds ultimate power and authority over state and government. The top political priorities in China have been economic development and social stability.

In the eyes of local officials, for years ensuring social stability means control of information flow and letting people know as little as possible. Furthermore, local officials need to wait for permission from above to disclose any information.

But keeping a contiguous virus under control and keeping social stability are goals that require the opposite measures. In order to battle against a fast-spreading virus, the most important is transparency, which has never been the strong suit of the Chinese government.

In the case of coronavirus, even though the local government might have found out the potential danger of the virus as early as end December, it seems they covered it up, and missed the first best window of opportunity to inform the public and contain the spread of the virus. Organisations or individuals are not even allowed to release treatment information to the public without authorization. For the first two weeks, the Wuhan Municipal Health Commission authorities put secrecy and order ahead of openly sharing information and alerting people to the threat. The authorities silenced doctors and others for raising red flags.

The lack of trustworthy media outlet

There is public unrest right now in China as coronavirus is spreading to new areas. There are panic and fear and people still don’t know how to deal with the situation. Hospitals and healthcare centres are packed with people desperate to know if they, too, were infected. Rumours like “coronavirus are much more powerful than SARS, the death rate is around 15%”, “strong alcoholic drinks and smoking can prevent from containing the virus” are circling around social media every day.  Rumours about cats and dogs being able to spread the coronavirus have even led to people disown and throw their pets from tower blocks.  If there had been a credible news source to undertake the responsibility and debunk rumours, the fear wouldn’t have been so big.

In China, most media outlets are state-run. The official media owned by the party have a track record of covering up for the government. When it comes to trust, very few Chinese would believe them. While the private media has more spaces to move around, there is always a red line that they cannot cross, so they withhold information as well. The desire to limit media and information critical of the government authorities can sweep up even general information shared between individuals—including outside China.

It’s about the time – Spring Festival

The outbreak of the virus happened around the time of China’s most important holiday – the spring festival, which follows the lunar calendar. This year, the transition from the pig year to the rat year is on the solar calendar from January 24th to January 25th, 2020. According to China’s National Development and Reform Commission, 2.43 billion travellers are estimated to use public transportation during the Spring Festival. This year, the travel rush started on the 10th of January and will end on the 18th of February. Between January 15th to 23rd, 1.065 million people travelled out of Wuhan to other cities and almost 5 million people left Wuhan before it was quarantined.

This holiday season led to another serious issue. China is one of the biggest producers of medical supply. China produces 50% of the world supply of face masks. Because of the spring festival, many factories are closed. Soon after the outbreak, many factories received orders and started working. Since it was hard to find workers, especially after the travel restrictions, it took them a while to restart the work.

According to the information from China’s Ministry of Industry and Information Technology,  the productivity of factories has recovered nation-wide since January 21st, 2020. Currently, 12 million masks can be produced daily in China. But Wuhan alone needs more than 8 million daily. The provincial governor of Zhejiang – the province with the second most confirmed cases said on January 27th that there will be a shortage of 4 million surgical masks in four days.

Low trust in charity organisations like Red Cross

Many people across China and overseas are mobilising resources to get the much needed medical supplies to the hospitals. With products pouring into Hubei every day, there still seems to be a severe shortage in almost every hospital. Crucial medical supplies from across China is failing to arrive at the hospitals on the front lines of a coronavirus outbreak.

The government is currently sending all the donated goods to the hospitals through five charity organisations backed by the government. One among them is the Red Cross Society of China which still hasn’t fully recovered from the scandal of 2011 where a 20-year-old woman claimed to be the general manager of the organisation but later turned out to be “professional mistress” and gambler.

In any crisis in China, the local Red Cross is a key part of relief efforts – acting to ensure donations made by the public reach the places they are needed. But people are angry about the mismanagement in the distribution of relief, particularly about masks and medical supplies. According to the Hubei vice-governor Li Qiang, the Red Cross in Wuhan alone had received more than 9,000 boxes of masks, more than 70,000 protective clothes and more than 80,000 goggles, but there were few people to receive and distribute the goods. The Caixin media reported that the Red Cross warehouse, which is approximately the size of two football fields, was almost entirely full of medical supplies but only a handful of people were sorting them for distribution.

Incidents like these have created a public distrust toward government-backed charity organisations. As the crises escalated, many donations are trying to bypass the designated organisations and trying to deliver the goods directly to doctors and nurses. A number of hospitals are now saying they will only accept direct donations, effectively bypassing the Red Cross. This includes Huoshenshan, the 1,000-bed field hospital built by the military in eight days, which is due to open this week.