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Karl Marx in Wuhan, by Carlos Martinez

May 6, 2020

China and Covid-19, a Three-Part Series, Part 2

Reposted from Invent the Future, where it forms the first part of “Karl Marx in Wuhan: How Chinese Socialism Is Defeating COVID-19“ by Carlos Martinez. See second part of Martinez’s article. For my reservations regarding Martinez’s discussion of “Chinese socialism,” see China Sets the Pace in Covid-19 Battle, by John Riddell. 

By Carlos Martinez: The initial outbreak of coronavirus disease 2019 (Covid-19) took place in the Chinese city of Wuhan, the capital of Hubei province, in early January 2020. The epidemic was limited almost entirely to China until a month later, when it flared up in Iran, South Korea, Japan and Italy.

Hospital team in China

By 11 March, it was clear that sustained community-level transmission of the virus was occurring in multiple regions of the world, and the World Health Organisation (WHO) declared it a pandemic. With the virus spreading throughout Europe and North America, there is now a serious possibility that COVID-19 will infect a large proportion of the global population and cause the early death of millions of people. It is a global health emergency of almost unprecedented proportions.

China’s Successes Containing the Virus

In the absence of a vaccine or cure, the only way to defeat a viral epidemic is to drastically reduce contagion, and this is achieved through rigorous testing, contact tracing, isolation of patients, and social distancing for the wider population.

Once it understood the nature and scope of the crisis, the Chinese government took swift, uncompromising action. A total lockdown was imposed in Hubei, the epicentre of the outbreak, on 23 January, at which point there were around 800 confirmed cases. Tens of millions of people were required to stay indoors. Schools and workplaces were closed, and sporting and cultural events were cancelled. In the words of Bruce Aylward, epidemiologist and senior advisor to the Director General of WHO, “old-fashioned public health tools” were deployed “with a rigour and innovation of approach on a scale that we’ve never seen in history.”

China and Covid-19: A Three-Part Series

1. “China Sets the Pace in Global Covid-19 Battle,” by John Riddell
2. “Karl Marx in Wuhan,” by Carlos Martinez
3. “How Chinese Socialism Is Defeating Covid-19,” by Carlos Martinez

The report of the WHO-China Joint Mission, conducted in late February, concluded that “in the face of a previously unknown virus, China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history.” The report noted that up-to-date public health information was regularly and widely distributed through multiple channels; there was a coordinated nationwide effort to get sufficient medical supplies to Hubei; and local authorities worked to ensure a stable supply of basic goods and to prevent speculation and hoarding.

The government announced immediately that testing and treatment – including expensive and sophisticated techniques such as extracorporeal membrane oxygenation – would be free to all, and it immediately introduced various measures to mitigate the effect on people’s daily lives (for example pausing mortgage and credit card payments, and providing subsidies to ensure continued payment of wages).

Food shopping moved completely online, and provincial authorities and Communist Party of China (CPC) local branches coordinated to ensure every home received food packages and that people on medication received their prescriptions.

More than 30,000 doctors and nurses were sent to Wuhan from across China. Forty-five hospitals were designated as Covid-19 treatment centres, 12 temporary hospitals were converted from exhibition centres and similar buildings, and two brand new hospitals (with a capacity of 1,000 and 1,300 beds) were constructed from the ground up in a matter of days.

The health system prioritised keeping people alive, scaling up the production of ventilators and adding capacity across the range of treatment and detection options. Dr Aylward remarked: “the Chinese are really good at keeping people alive with this disease.”

Public health officials attempted to trace every single confirmed case, and then tested everyone that had come into contact with the infected person, in line with the WHO’s clear message to “test, test, test”.

China’s containment effort has been facilitated by the extensive use of advanced technology. Temperature checking stations have been set up throughout the country, and people have been asked to install a smartphone app that provides information, allows users to check and report symptoms, and enables the health authorities to monitor the spread of the disease.

Artificial intelligence is being widely deployed; for example a prediction model “is helping health care authorities in Chongqing and Shenzhen predict outbreaks ahead of time with accuracy rates of more than 90 per cent.” Meanwhile Chinese tech giants have made crucial services available for the fight against Covid-19. “Alibaba Cloud has offered AI computing capabilities to public research institutions for free to support virus gene sequencing, new drug R&D and protein screenings. Baidu has opened up LinearFold, its RNA prediction algorithm, to genetic testing agencies, epidemic prevention centres and research institutes around the world. Neusoft Medical donated high-end CT scanners, AI medical imaging, cloud platform and remote advanced post-processing software to hospitals in Wuhan.”

Robots have been put to use delivering meals to people under quarantine. Huawei and China Telecom worked together to set up a 5G-enabled remote video diagnostic centre, enabling medical staff to conduct remote online consultations.

In a clear sign of its commitment to international cooperation to contain the virus, the Chinese Centre for Disease Control sequenced the entire Covid-19 genome and published it within a few days of the virus being identified. By comparison, it took two months for the genome to be sequenced during the 2014 Ebola outbreak.

China’s “incredibly difficult measures” were recognised by the WHO as having probably prevented hundreds of thousands of cases. The crisis reached its peak in early February, when new confirmed cases were increasing at a rate of around 3,000 per day. The curve started to flatten in mid-February, and was almost completely flat by the beginning of March: in the first three weeks of March, case numbers increased from 80,026 to 81,008, and at the time of writing (in late March), almost all new cases in China are imported rather than domestically transmitted.

Containment measures successfully prevented any really serious outbreak in China outside Hubei. The worst affected province after Hubei has been Guangdong, a vast province of 113 million people in Southern China, where by late March there had been around 1,400 confirmed cases and just eight deaths. At the time of writing, two of the provinces neighbouring Hubei, Hunan and Anhui, have zero active confirmed cases.

With the outbreak clearly under control in China, lockdown measures are being eased and people are starting to return to normal life, while remaining vigilant to the possibility of a resurgence of the virus. China’s extraordinary response to Covid-19, although it came at significant economic and human cost, has provided an indispensable lesson to the rest of the world in how to tackle this pandemic. An epidemiological analysis in The Lancet stated: “What has happened in China shows that quarantine, social distancing, and isolation of infected populations can contain the epidemic. This impact of the Covid-19 response in China is encouraging for the many countries where Covid-19 is beginning to spread.”

The response in the capitalist west has been far less impressive

One important effect of China’s drastic containment measures was to slow down the global spread of the virus, giving other countries time to prepare. In Vietnam, and also in China outside Hubei, cases numbers have been very low, since fairly severe containment measures were introduced early on.

However, given Covid-19’s high contagion rate and China’s level of connectedness with the rest of the world, it was inevitable that Covid-19 would spread globally unless other countries took suitable precautionary measures. By the middle of February, there were outbreaks in Japan and South Korea, both of which fairly quickly implemented wide-scale testing, isolation and containment, and both of which are seeing a significant downturn in cases.

The epicentre of the pandemic is now Europe, with Italy, Spain, Germany, France, Switzerland, Netherlands, Belgium, Norway and Denmark experiencing serious outbreaks that haven’t as yet managed to break the exponential growth in case numbers. All these countries have now imposed lockdowns and are responding in a reasonably aggressive way, but the trajectory of the statistics indicates that the response has been “too little, too late”.

The number of Covid-19 cases per capita is far higher in Western Europe than in China (as of 24 March, there are 1,057 cases per million people in Italy and 1,016 per million in Switzerland, compared with 56 per million in China).

Given that the rest of the world had several weeks’ advance notice of the impending crisis, countries (particularly wealthy countries with the necessary resources) should have started taking precautionary measures by late January. They should have ensured they had a sufficient supply of test kits, ventilators, masks and protective clothing; they should have added human and physical capacity to their healthcare systems; and they should have put systems in place to mitigate the harmful impact of any lockdown. As John Ross points out, “while China benefited greatly from determined action against the virus, the facts show the West entirely wasted this precious time.”

The most shamefully irresponsible and inept responses thus far are to be found in Britain and the United States. With case numbers creeping up, by mid-to-late February it was obvious that an outbreak was developing, yet it took another month for those countries to start introducing containment measures, and these have thus far been woefully insufficient.

Donald Trump went from denying there was any problem – “we have it totally under control; it’s one person coming in from China and we have it under control. It’s going to be just fine” – to claiming that nobody could have seen the crisis coming. On 6 March he said “this is something that you can never really think is going to happen. What a problem. Came out of nowhere.” This is patently absurd. While non-specialists might not have understood the seriousness of the threat, there was no shortage of well-respected scientists raising the alarm, and indeed Trump was briefed by US intelligence agencies on the issue from late January onwards.

After the first handful of cases, the governments in Britain and the US should have set up free and easily-accessible testing facilities for those with symptoms; they should have set up quarantine facilities for those that tested positive; they should have given advice and provided support for self-isolation of older and immunocompromised people, as well as those with underlying conditions that make them more vulnerable to the disease. They should have started building healthcare capacity; they should have put contingency plans in place for closing schools and public spaces and for ensuring the steady supply of basic goods in case of a lockdown.

In the event, the British government barely commented on Covid-19 until the second week of March, by which time there had already been several hundred confirmed cases (and almost certainly tens of thousands of unconfirmed cases). In open defiance of WHO recommendations, Britain’s chief medical adviser Chris Whitty stated that it wasn’t necessary to do widespread testing: “we will move from having testing mainly done in homes and outpatients and walk-in centres, to a situation where people who are remaining at home do not need testing”. Prime Minister Boris Johnson suggested that perhaps the country needed to “just take it on the chin”, let everyone get ill and accept that large numbers of people will die.

A couple of days later, this policy of criminal negligence was dressed up in scientific clothing by calling it ‘herd immunity’, a hypothesis that was quickly, comprehensively and unceremoniously debunked. Herd immunity “would require a significant proportion of the population to be infected and recover from Covid-19. Achieving herd immunity would require well over 47 million people to be infected in the UK.”

This could well result in over a million deaths and several more million hospitalisations. As Jeremy Rossman, senior lecturer in virology at the University of Kent, points out, “we can and we must do better than that. China is rapidly controlling the spread of Covid-19 without requiring herd immunity (only 0.0056% of its population has been infected).”

Under intense popular pressure, the British government finally closed schools, public spaces, restaurants, cafes, clubs and pubs on 20 March. A rescue package has been announced to compensate businesses and workers for loss of income (although at the time of writing this doesn’t extend to millions of casual, temporary and self-employed workers). However, the measures fall far short of what was introduced and proven to work in China at a much earlier stage in the virus’s progression. The government’s top advisers have said that 20,000 deaths from Covid-19 would be a best-case scenario, and analysis by researchers at UCL and Cambridge indicates that the current strategy is likely to cause between 35,000 and 70,000 excess deaths. This is especially shocking in light of the fact that China’s death toll will probably not exceed 4,000. Given China’s population is 21 times the size of Britain’s, that means Britain’s likely death rate for Covid-19 is in the order of 300 times higher than China’s. And rather than adding the vast capacity needed by the National Health Service to provide adequate testing and treatment (not to mention the personal protective equipment needed by health workers), the government is apparently more focussed on constructing temporary morgues.

It’s all too obvious that the reluctance to adequately deal with the crisis at hand is based on economic concerns. Indeed the prime minister’s chief adviser, Dominic Cummings, was reported as saying “protect the economy and if that means some pensioners die, too bad.” This is an idea that seems to have resonated on the other side of the Atlantic. GDP growth in Britain is practically zero, and crashing out of the EU at the end of the year is poised to push the economy into recession. A period of Covid-19 lockdown will of course significantly reduce economic activity and therefore affect profits, and it’s precisely this factor that explains the shamefully lackadaisical response of the British government in the face of a pandemic.

This text is continued at: How Chinese Socialism is Defeating Covid-19.

Source: Invent the Future

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