Why has the response to COVID-19 been so much more thorough and successful in China than in the capitalist West? How is it possible that China […] is able to limit the spread of the disease to less than 0.01 percent of its population, while rich countries like Britain are talking about ‘herd immunity’?
Published on Invent the Future, Mar 25, 2020
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. 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.”
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.
Under socialism, people come before profit
“Our greatest strength lies in our socialist system, which enables us to pool resources in a major mission. This is the key to our success.” (Xi Jinping)
Why has the response to COVID-19 been so much more thorough and successful in China than in the capitalist West? How is it possible that China – a developing country with a per capita GDP of just over $10,000 (less than 20 percent of the US figure) – is able to limit the spread of the disease to less than 0.01 percent of its population, while rich countries like Britain are talking about ‘herd immunity’?
As Indian communist Siteram Yechury memorably put it, “in the final analysis, it boils down to the question of who controls the state or whose class rule it is. Under bourgeois class rule, it is profit indicators that are the driving force. Under working class rule, it is society’s responsibilities that are the priorities.” The legendary South African freedom fighter Chris Hani made a similar point: “Socialism is not about big concepts and heavy theory. Socialism is about decent shelter for those who are homeless. It is about water for those who have no safe drinking water. It is about healthcare, it is about a life of dignity for the old. It is about overcoming the huge divide between urban and rural areas. It is about a decent education for all our people.”
In short, China is responding in such a responsible and effective manner to the COVID-19 pandemic because it’s a socialist country and its government is primarily accountable not to capital but to the people. The non-negotiable top priority of the government is “meeting people’s needs, ranging from those in education, employment, social security, medical services, housing, environment, to intellectual and cultural life.” Once it became clear that fighting COVID-19 meant choosing between saving millions of lives or protecting economic growth, China came down unambiguously on the side of saving lives.
Further, China’s relatively centralised system of economic control means that it can mobilise vast resources very quickly. As an analyst for the Council on Foreign Relations grudgingly observes, the Chinese state “can overcome bureaucratic nature and financial constraints and is able to mobilise all of the resources.” Similarly, CNN couldn’t but admit that China’s ability “to pull something like this off is thanks to the ability of a centralised, powerful leadership to react in a crisis.”
China certainly doesn’t have any shortage of private capital these days, but its economic strategy is nonetheless directed by the state. The government maintains tight control over the most important parts of the economy – the ‘commanding heights’: heavy industry, energy, finance, transport, communications, and foreign trade. Finance – which has a key influence over the entire economy – is dominated by the ‘big four’ state-owned banks, accountable to the Chinese government and people. Private production is encouraged to the extent (and only to the extent) that it contributes to modernisation, technological innovation, employment and improvement in living standards.
In capitalist countries, governments are essentially under the control of capital; in socialist countries, capital is essentially under the control of the government. As Eric Li put it, “There’s no way a group of billionaires could control China’s politburo as billionaires control American policy making.” Communist Party rule means that the government can take the decision to privilege the interests of human life over those of capital, and the owners of capital have no option but to go along with that, even where it means having their property seized.
Indeed, many big Chinese companies have put their services at the disposal of the fight against the virus. An article on the World Economic Forum blog notes that “corporations including Alibaba, Baidu, Bank of China, ByteDance, China Construction Bank, China COSCO Shipping Corporation, China Merchants Group, Envision Energy, Fosun Group, Guangzhou Pharmaceutical, JD.com, Mengniu, Ping An, SinoChem, Sinopec, Tai Kang Insurance, Tencent, Xiaomi, Yili and others have donated large volumes of healthcare, food and other supplies to the affected areas. Manufacturers including BYD, Foxconn, Guangzhou Automobile Group Co. and SAIC-GM-Wuling are setting up makeshift assembly lines to produce additional masks and disinfectants.” Other companies have provided autonomous robots for delivery of supplies to patients under quarantine.
China’s response to the pandemic has seen the extensive use of cutting edge technology, incorporating the latest developments in artificial intelligence, robotics and medical imaging. It’s also well ahead of the curve when it comes to things like online shopping, cashless payment and remote education. This video gives a fascinating insight into how these technologies are being leveraged to enforce containment measures in Nanjing.
Veteran science writer Philip Ball noted recently that, in several fields of science and technology, “China is starting to set the pace for others to follow. On my tour of Chinese labs in 1992, only those I saw at the flagship Peking University looked comparable to what you might find at a good university in the west. Today the resources available to China’s top scientists are enviable to many of their western counterparts.”
Given the level of scientific backwardness, generalised poverty and ignorance prevailing at the time of the founding of the People’s Republic of China in 1949, it is nothing short of incredible that China has emerged as a world leader in science and technology. That it has done so is testament to the systematic efforts and strategic vision of its socialist leadership.
Another aspect of Chinese socialism that’s proving invaluable in the present crisis is the existence of an enormous, highly competent and well-organised communist party, which has activists in all neighbourhoods and workplaces. CPC branches have taken the lead in terms of ensuring that people’s basic needs are met while they’re stuck at home, coordinating deliveries of food and medicine. Millions of CPC members across the country have volunteered for this work, the need for which was emphasisedby Xi Jinping back in January: “Party committees and governments at all levels must take novel coronavirus outbreak prevention and control as the top priority of their work.”
A further key difference between China and the major western capitalist countries is that the working classes of Europe and the US have been facing neoliberal austerity for the last decade. Health services and social services have taken a battering. The COVID-19 death rate in Italy and Spain is far higher than in China, in spite of Italy and Spain being much wealthier in per capita income terms. The testing rate, treatment rate, provision of information, distribution of food, care for the elderly and vulnerable, transfer of compensatory payments and mental health support is all far better in China than in Europe and North America.
There’s been no austerity in China; quite the opposite. Real wages have more than doubled in the last decade, and the welfare state has been ramped up massively. The rollout of universal health coverage over the last 15 years has been described by the World Bank as “unparalleled”, and represents “the largest expansion of insurance coverage in human history”. The number of hospital beds per 1,000 people (4.34) is significantly higher than the OECD average (2.9), the US (2.7) or the UK (2.5). This is clearly an important part of China’s ability to minimise the harm caused by the epidemic.
The basic dichotomy of global politics in the current era is, on the one hand, US efforts to re-assert its global hegemony through coercion and bullying, and on the other, China’s commitment to “peace, development and win-win cooperation” and the construction of a multipolar world.
China saw its first internationalist duty in relation to COVID-19 as being containment of the outbreak in Hubei, thereby buying the rest of the world time to take pre-emptive measures. Martin Jacques, author of the best-selling When China Rules the World, explains: “We must remember that this was a new virus that no-one knew anything about. China was, if you like, the guinea pig. China’s problem and everyone else’s problems were fundamentally different. China was faced with a new virus. Everyone else can learn from China. Because of China they know what the coronavirus is. They don’t have to start all over again.”
By early March, the outbreak in China was basically under control but the situation was deteriorating quickly in Iran, Italy, Spain and elsewhere. China made it clear that it was ready to offer support at every level to other countries suffering outbreaks, as well as collaborating with companies and research institutes worldwide in the development of vaccines and treatments. It has sent medical teams and vast quantities of supplies – millions of surgical masks, hundreds of thousands of testing kits, tens of thousands of ventilators – to countries around the world, including Italy, Spain, Iran, Cambodia, Venezuela, Cuba, the Philippines, France, Iraq, Serbia and Poland.
Chinese health experts have been coordinating closely with the Africa Centres for Disease Control and Prevention in order to help prepare the continent for quick and decisive action against the pandemic. The Jack Ma Foundation, coordinating with the Ethiopian government, has agreed to send 100,000 face masks, 20,000 test kits and 1,000 medical use protective suits to every country in Africa.
While China sends aid and solidarity to all corners of the globe, the US continues to impose punishing sanctions on countries that refuse to bend to its will. China has joined the calls for sanctions against Iran and Venezuela to be lifted. Pointing to the inhumanity of imposing sanctions at such a time, Foreign Ministry Spokesperson Geng Shuang stated: “At this critical juncture where all governments and people across the world are fighting the pandemic, the US is still stubborn in sanctioning Venezuela, showing not the least respect for humanitarianism.”
Learn from China
In the first three weeks of March, the number of confirmed COVID-19 cases in China increased from 80,026 to 81,054 (1.3 percent). The cases in the rest of the world during the same time period increased from 8,559 to 223,982 (2,516 percent) and continue to rise fast. China’s case graph looks like the top-left quadrant of a circle; Europe and North America’s case graph looks the bottom-right quadrant.
Clearly, now is the time to learn from China rather than engage in China-bashing. Any government currently facing an outbreak and not actively learning from China’s success is committing a very serious crime against its population. Unfortunately the combination of racism and anti-communism prevailing in the West – a toxic mix of yellow peril and red scare – makes it difficult for governments and media outlets to acknowledge China’s efforts.
Numerous articles have fretted about the violation of rights involved in locking down Chinese cities. Human Rights Watch chief Kenneth Roth stated in early February that “quarantines of this sort typically don’t work. This is not a rights-oriented approach to public health. This is treating public health with a sledgehammer.” A few weeks later, with Wuhan having defeated its outbreak and with cities throughout Europe imposing lockdowns, these comments only serve as yet more proof of Roth’s ignorance and pro-imperialist bias.
Donald Trump has stoked up anti-China sentiment and anti-Asian racist hysteria by insistently referring to COVID-19 as “the China Virus”. Like any virus, COVID-19 is essentially a blob of nucleic acid and as such can’t be considered as having a nationality, but this is not the point. Trump’s reactionary statements are deliberately designed to push the blame for the pandemic onto China, to deflect from China’s successful containment measures and to therefore explain away the US’s failures.
John Ross writes that “instead of learning the positive lessons of China’s ability to control the virus, the Western media and the US government engaged in anti-China propaganda. The bitter truth is that the anti-China propaganda campaign has to some extent contributed to the West being negligent to the looming crisis and they are now facing a medical, human and economic disaster.”
It’s hard to imagine the people of Europe and North America will quietly accept the deaths of millions of people from COVID-19 when they can see for themselves that other countries are managing the situation so much more effectively. The ruthless and moribund nature of western capitalism is being thoroughly exposed. Ultimately, what this global health crisis is demonstrating is that socialism is far superior to capitalism when it comes to meeting people’s basic needs and protecting the most fundamental human right: the right to life.