Foreign Affairs

The Politics of Disease

When “Contagion hit theaters in 2011, millions shelled out money to watch a panic ensue after the outbreak of a global pandemic. Viewers were given more than a pleasurable movie experience; they were also given a front row seat to a very realistic model of what a disease outbreak would like in the United States. After all, the procedures followed by the CDC in the movie are based on the organization’s real-life protocols, as well as accounts from epidemiologists, or public health officials who investigate patterns and causes of disease, such as Dr. Anna Schuchat. However, “Contagionfails to demonstrate the crippling effects of the absence of government transparency on epidemic control. 

The fictitious disease in “Contagion, loosely modeled after the Nipah virus, begins in southeast Asia before quickly reaching other countries through human transmission. Countries and global health organizations begin working together immediately as a united front against the spread of disease, and the United States leads the research and development of the vaccine. While the idea of seamless international cooperation is comforting, the reality of disease control is much more complex. 

The outbreak of the coronavirus, officially known as COVID-19, has been making headlines for nearly a month. The disease was first seen in Wuhan, China, where it presented as several unusual cases of pneumonia. On Jan. 7, 2020, the World Health Organization announced that it is a new disease that is transmitted through “being in proximity to an infected person… or touching a surface where (droplets generated by a sick person coughing or sneezing) land.” Four days later, China announced its first death from the disease. From there, the rate of transmission and number of deaths grew exponentially. 

On Jan. 31, The World Health Organization declared a “global health emergency” and “issued a level four warning.” International travel was strongly discouraged out of fear of the disease spreading to other countries via human-to-human transmission. Some major companies, including Starbucks, McDonald’s, and Apple, closed their locations in China. In spite of these efforts to contain the disease, within two months, it spread to Europe, North America, Asia, and Australia. By the beginning of March, nearly every country was scrambling to prepare for more outbreaks of the disease. 

As of April 1st, there were over a million cases of COVID-19 worldwide. Over 50,000 people have died from medical complications as a result of the disease. Around the world, healthcare professionals and world leaders are desperate to generate more ventilators, hospital beds, and personal protective equipment (PPE), such as masks and gloves. Even in Italy, whose healthcare system is ranked second in the world, mass casualty protocols have been implemented. This means that some hospitals have been forced to “send away patients and only admit those with COVID-19.” Similarly, hospitals in the United Kingdom have become so overwhelmed that they have started “turning away coronavirus patients.” 

Panic and misinformation surrounding the virus have affected other areas than healthcare. In the U.S. especially, the wholesale food industry has become overwhelmed with millions of desperate shoppers. Suppliers and store employees have been working around the clock to keep shelves stocked. People have already begun to hoard supplies, such as toilet paper, canned and dried foods, and cleaning products. Moreover, people have been buying masks and gloves at such a rate that the already-dwindling stockpile of such equipment for medical professionals is growing even smaller. 

All of this panic- the scrambling of governments, the pressure on healthcare systems, and the stockpiling of goods by the public- is fueled by a critical lack of information. There was nearly a month between when COVID-19 first started appearing in China and when the virus began to spread to other countries, during which Chinese government and health officials had time to collect data and begin to formulate a plan to deal with the spread. 

The time between outbreaks begs a very important question: Could China have minimized the severity of the ongoing global outbreak? Recent reports seem to indicate yes. 

On Dec. 30th, doctor Li Wenliang sent out a warning to fellow medical professionals after contracting what we now know as the coronavirus at the Wuhan Central Hospital, urging them to take the necessary clothing precautions to avoid being infected. He was immediately charged by public authorities with “spreading rumors” and “severely disturbing the social order.” He was also forced to sign a document recanting his previous statements about the outbreak. Tragically, Wenliang died from the virus on Jan. 30, which sparked a wave of emotional online responses from Chinese citizens that harshly criticized the Chinese government. Most of these comments were quickly removed by the government. 

The backlash from the Chinese public in response to the mishandling of information regarding the outbreak has led to major changes in the lower level of Chinese government. Zhou Xianwang, the mayor of Wuhan, went on live television on Jan. 27 to address citizens’ concerns about the epidemic. He admitted that “the city government had failed to provide timely information or act on what it knew,” and offered to resign. Similarly, the health chief of Huanggang city was removed from her position after failing to answer basic questions about the spread of the disease on national television. 

The majority of the blame for the mishandling of the outbreak might appear to lie with local government, but this lack of transparency is a symptom of a systemic issue within Chinese bureaucracy. Professor Sam Crane, the chair of Asian Studies at Williams College in Massachusetts, noted that there appears to be “a pattern of denial and cover-up and evasion” within Chinese bureaucracy. This is evinced by Xianwang’s recent television address, in which he alluded to being unable to declare an epidemic due to “laws that barred him (from doing so) without permission (from the President).” Evidently, the level of transparency practiced by every Chinese official is not an individual decision, but rather a decision made by the national government and ultimately, the President.

In fact, Chinese President Xi Jinping has been far from forthcoming. In response to criticism that the Chinese government has not been adaptive enough in response to the coronavirus outbreak, Xi recently published a comprehensive timeline of the actions the Chinese government has taken to combat the virus. However, the timeline also reveals that Xi “was aware of the outbreak’s severity two weeks before revealing the information publicly,” which has incited intense scrutiny by the international community and from Chinese citizens. Furthermore, the Chinese government reportedly had to be asked repeatedly to provide information “that could (have) shed light on hospital transmission and help(ed) assess the level of risk.”

This is not the first time that a lack of clear risk communication surrounding an epidemic in China has led to serious geopolitical consequences. In 2003, there was an outbreak of a SARS coronavirus that originated in China. Similar to its response to COVID-19, the Chinese government failed to clearly communicate with its citizens and the global community, which resulted in “many avoidable cases of SARS.” The outbreak ultimately affected 26 countries and resulted in over 8000 cases

This behavior, in conjunction with the response to COVID-19, reveals a dangerous pattern of “the restriction of information to the public” by the Chinese government. The absence of a free and independent media forces the Chinese public to rely on information from the government, which has proven to be an inconsistent source at best. The deliberate secrecy and borderline conspiracy hinted at by Xianwang in his television address underscores both this inconsistency and also the implications for the rest of the world.

The importance of transparent, adaptive government in times of crisis cannot be overstated. A clear flow of information between a government and its constituency is essential to the well-being of both parties, and a disruption or obstacle that cripples that channel of communication only causes confusion, panic, and in the case of COVID-19, the potentially preventable deaths of thousands of people worldwide. 
Vaccines, hospitals, and genome sequencing can only take us so far. Having the means to treat or identify a disease means nothing if there is no faith in the government’s ability to implement it. After all, the only thing that keeps outbreaks or any other national crisis from becoming an all-out panic is the public’s faith in the government to keep order and make the best decisions it can for its constituency. Without that trust, we’re no better off than Matt Damon in “Contagion” frantically running up and down the streets of Minneapolis, desperately searching for answers as the rest of the world falls apart.

Categories: Foreign Affairs

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