While China stepped up investments in its health infrastructure after SARS, the US downgraded it and India had always neglected it
As on May 6, the internationally accepted pandemic figures were as follows: the US, 32.6 million infections and 579,000 deaths; India, 20.7 million infections and 226,000 deaths; and China, 90,721 cases and 4636 deaths. The contrast is clear. The main reason: China had greatly improved its public health infrastructure, the US downgraded it and India neglected it.
In an article in The Conversation dated November 3, 2020, Elanah Uretsky, a Brandeis University Professor and an expert on public health in China, had said that the control of the COVID-19 virus in China “was not the result of authoritarian policy, but of a national prioritization of the health sector after the SARS pandemic.”
SARS, which struck the world in 2002-03, had infected over 8,000 people worldwide and killed about 800, 65% of which were in China and Hong Kong.
“SARS exposed serious weaknesses in China’s public health system and prompted its government to reinvent its public health system,” Uretsky wrote. Specifically, the government “improved training of public health professionals and developed one of the most sophisticated disease surveillance systems in the world.”
In contrast, the Trump administration in the US had made major cuts to the budgets of the National Institutes of Health and Centers for Disease Control and Prevention. The budget submitted by the Trump administration in February 2020, as the pandemic was beginning, had called for an additional reduction of US$ 693 million to the CDC budget.
In the case of the government of India, the health budget has always been low. By the last count it was 0.34% of the GDP, while it should be 2.5% as per the 2017 National Health Plan.
Knowing that there were no safe or proven treatments or an effective vaccine, China relied on time-honored non-pharmaceutical interventions to conquer the epidemic. “First and foremost was containing the virus through controlling the sources of infection and blocking transmission. This was accomplished through early detection (testing), isolation, treatment and tracing the close contacts of any infected individual,” she points out.
Though it was caught off guard when COVID-19 broke out in December 2019, the government quickly mobilized its resources to bring the epidemic almost to a halt inside its borders within three months, the US expert said. The methods China adopted to fight COVID-19 had their origin in the way it tackled the SARS epidemic, including mask wearing, widespread testing, contact tracing and isolation. The only difference was in the intensity of the control measures, many of which came under flak in Western democracies for their severity.
But they worked. Within a year of the outbreak of COVID-19 in Wuhan, people in China were able to “travel, eat in restaurants and go into theaters, and kids go to school without much concern for their health,” Uretsky notes.
There is a general opinion in the West that Chinese official statistics are suspect and there could be under reporting of inconvenient facts. But Ananth Krishnan, Beijing correspondent of the Indian daily The Hindu and author of India’s China Challenge: A Journey through China’s Rise refutes this contention as regards COVID. “There is no evidence to suggest there are currently thousands of cases or hidden outbreaks. This is backed up by, among other things, the return to normalcy, opening of schools, the boom in domestic travel, the current situation in hospitals, and not to mention, independent accounts from foreign reporters based in China,” he wrote a year after the outbreak.
Initially, Beijing suppressed news of the emergence of an unknown killer in Wuhan in the Hubei province in December 2019. 80,000 were infected and 30,000 had died there. But the government came out of hiding in January 2020 to declare a lockdown in that province between January 23 and April 16. 50 million people in Hubei province were quarantined. Some other provinces were also locked down for various periods. The lockdowns were exceptionally stringent.
Plethora of Measures
The government made good use of the lockdown to plan and execute a plethora of control measures. New York Times reported that the government had ordered the erection of entire towns of prefabricated buildings to serve as quarantine centers. Hospitals came up in a matter of days. Farm lands were commandeered, and within hours, owners of construction companies and factories were given orders and funds came quickly. Sinopharm, a state-owned pharmaceutical company, got government funding in three and a half days according to New York Times. Contact tracing and testing was aggressive. The Hindu reported that in Qingdao, the entire city of 10.92 million was tested in five days.
The State quickly mobilized its huge bureaucracy. More than 4,000 medical workers were sent to ground zero in Hubei. And the vast Communist Party network right down to the hamlet level was harnessed to good effect.
The indigenously-developed Chinese vaccine might have been produced and used without following the set international procedure, but the government gambled by using it on millions in China and making it available to subsequently to 80 countries and international organizations. There were reports that the Chinese vaccines were less effective than Western makes. But overall, the vaccines have worked with little or no issues.
Other Key Factors
Besides efficiency there were other contributory factors. A major advantage that China had (and still has) is that the average Chinese citizen is habitually acquiescent, following orders instinctively. This enabled large-scale mobilization with a mere bark of an order or the crack of a whip. In contrast to democracies, the Chinese State is unabashedly intrusive. As the New York Times put it: “The top leaders have levers to reach down from the corridors of central power, to every street, and even apartment building!”
Breaches of virus containment rules were deemed anti-national and punished. A New York Times report mentioned a villager near Shijiazhuang who was tied to a tree because he tried to flout quarantine restrictions to go out to buy cigarettes. More than 5,000 local party and government officials were sacked in 2020 for failure to deliver, the paper reported.
The security or surveillance system put in place initially to identify, track, intercept and punish political dissenters, came in handy in COVID-19 infection contact tracing. India’s former National Security Advisor Shivshankar Menon says in his latest book: India and Asian Geopolitics that China has consistently spent more on domestic surveillance and security than on external defense. Indeed, there was suppression of speech and dissent, so much so that the doctor who first reported the virus in Wuhan was arrested. Subsequently he succumbed to COVID triggering world-wide outrage. However most Chinese would argue that unimpaired circulation of information could have hampered virus containment.
Though China recovered almost fully in 2020, it continues to be extremely vigilant about the resurgence of the pandemic. There are still about 15,050 cases to be cured. Recently, there had been “imported” cases due to which, a Chinese state-owned airline, Sichuan, suddenly stopped vital cargo flights to India, putting Indian vaccine manufacturers in a spot. However, later, due to the dire situation in India, the airlines and the Chinese government expedited relief supplies.
Simultaneous Economic Recovery
During the height of the pandemic, the Chinese economy did plummet like other economies in the world, but China got on to the road to recovery faster. Even Western media reports acknowledged that during the 76-day lockdown in Wuhan, major industries were allowed to function. Innovative measures were taken to keep economic activity going, albeit with the most stringent safeguards. Few contracts were canceled. Few workers were laid off. Government gave loans and waived taxes to stimulate continued activity. Those in quarantine and under lockdowns were very well served by commandeered but highly trained personnel. New ways of functioning under lockdown were discovered and implemented.
With the wheels of the economy kept moving, China grew by 4% while the other economies fell by 43%, according to UNCTAD.