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Analysis
  |  
Health
  |  
Coronavirus

The Coronavirus Is Already Politically Fraught

What to know about the virus that’s spun China and WHO into a frenzy.

Crawford Kilian 24 Jan 2020 | TheTyee.ca

Tyee contributing editor Crawford Kilian blogs about the politics of global health at H5N1.

Sometime in mid-December, a dealer in Wuhan’s Huanan Seafood Market contracted something from one of the animals in the market. Huanan doesn’t sell only seafood; it’s a “wet market,” where live animals are slaughtered when purchased to ensure freshness.

Within a week or two the dealer was ill, and so were a number of other dealers and customers. Lab tests couldn’t at first identify the cause of their illness, but it soon became clear that it was a coronavirus — the seventh such virus known to infect humans. All disease outbreaks are political, but this outbreak has become political before it even has a name.

Alarms were likely going off in Beijing as well as Wuhan: coronavirus in China means SARS — the deadly respiratory disease that emerged in 2003 and spread across the country. The government of the day tried to cover it up, giving the SARS virus an advantage: it got to Hong Kong, and then, among other places, to unsuspecting Toronto.

If Beijing lost face by its inept coverup, the World Health Organization blew it by issuing a SARS travel advisory about Toronto. Tourism dried up. People avoided Toronto’s Chinese restaurants, associating SARS with anything Chinese. Jean Chrétien, then prime minister, was obliged to take his whole cabinet into a Chinese restaurant for a well-photographed feast. And once SARS was over, Toronto had to pay for a free rock concert starring the Rolling Stones, just to tell the world it was open for business again.

Serious disease outbreaks are always political. They reflect badly on local and national governments, which are never properly prepared for them. At best, an outbreak is an economic and political disaster. Tourism drops, business falls off, and the government of the day looks inept for allowing it to happen. A WHO travel advisory is salt in the wound.

Something similar happened in 2012 when Middle East Respiratory Syndrome (another coronavirus) emerged in Saudi Arabia. The House of Saud has said as little as possible about it; cases and outcomes are reported, but little more. When the South Koreans experienced an imported case that spread rapidly through an overcrowded health care system, we learned more about MERS than we ever had from the Saudis.

China redeemed its reputation with the emergence of a new bird flu, H7N9, in Shanghai in 2013. Cases were reported rapidly and fully, and Chinese research studies flooded online. Meanwhile, epidemiologists could also trace the spread of the virus in chickens from the spread of human victims — at that stage H7N9 didn’t make chickens visibly sick, so humans were the “sentinel species” signalling the virus’s appearance in far-flung parts of China.

In one sense, the emergence of today’s “novel CoV2019” has echoed the openness of the response to H7N9. Once the disease was recognized late in December, information began pouring out from Chinese and foreign health agencies. But most of it has been official statements, not the result of digging by local media. Wuhan newspapers like Yangtze River Daily were notably silent about the growing case numbers until President Xi Jinping himself took notice of the outbreak. Now it’s a front-page story.

So much of the best coronavirus coverage has come from Hong Kong, which has a relatively free press and access to local experts who are among the best in the world. Yi Guan, a virologist and veteran of H5N1, SARS, H1N1 and H7N9, is among them, and he’s already been to Wuhan. But he was quoted in the Globe and Mail as saying “the epidemic situation was out of control… I’ve experienced so much, and I’ve never felt scared before. But this time I’m scared.”

Beijing evidently feels just as scared, because it’s taking unprecedented steps to regain control. Even though stray cases have turned up in other Asian countries and as far away as Washington State, Beijing has effectively quarantined not only Wuhan, but several adjacent cities — a total of some 20 million people ordered to stay put. Travel has been shut down, whether by bus, plane or high-speed train. Countless Wuhan residents, already en route to family gatherings for Lunar New Year, may not be able to get back to Wuhan for days or weeks. The city is a major rail hub, critical to the millions of travellers over the New Year holiday, so their plans have been literally derailed. Business transportation must be equally snarled.

The quarantine has stunned the global health community as well as the Chinese. While most of the cases are still in Wuhan, the virus is out of the bag, with cases from Guangdong province and Hong Kong in the south to Heilongjiang and Inner Mongolia in the north. It’s already rumoured in social media that Xi will lift the quarantine after 10 days, but who knows where the outbreak will be by then?

Meanwhile, WHO’s Emergency Committee agonized for two days over whether to declare the outbreak a PHEIC — a public health emergency of international concern — and then decided to hold off for now. The key reason: no human-to-human spread in cases outside China. An unstated reason: a PHEIC would amount to a devastating travel advisory and might be read in Beijing as undesirable criticism. So it’s an emergency in China, but not for the rest of us.

The rest of us, however, seem to have decided otherwise. Even the Finns have declared their health care system braced for coronavirus. Mexico and Colombia have had health scares about possible cases. Here in B.C., masks are in short supply as anxious people buy them by the boxload.

Let’s put this in perspective. One Wuhan resident beat 11-million-to-1 odds by contracting the first case of novel coronavirus. A month later, China reports just 649 cases and 18 deaths. Those are still minuscule numbers in a nation of 1.4 billion, let alone the whole planet. By comparison, on Jan. 23 alone, Worldometers tells us, malaria killed close to 1,800 of us, over 3,000 of us died of HIV/AIDS and over 15,000 died of cancer.

But one virus, making a lucky jump from some animal in Huanan market to a luckless human, has rocked the biggest country in the world back on its heels in a matter of weeks. The economic and political repercussions will also become an emergency of international concern.

Xi Jinping, after years of entrenching himself as a leader for life, has shown either Mao-style determination to assert control, or completely lost his nerve. He’s presiding over a health care system far better than that which faced SARS and H1N1, but even the top experts see something in the coronavirus (or the response to it) that scares them too.

A rattled government makes mistakes, and then makes mistakes in trying to recover. Its people notice, and so do other governments. Hong Kong has seen over six months of upheaval by anti-Beijing protests; they will look like a kindergarten tantrum compared to what the mainland Chinese could unleash.

Whatever the actual outcome of this still-unnamed coronavirus, it has already changed the global health system as well as global politics and economics. The next virus will likely change them again.  [Tyee]

Read more: Health, Coronavirus

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