We are pleased to reproduce this detailed comparison by Rosa Astra and Benjamin Zinevich in Liberation News of the Covid-19 containment measures taken by China and the US. The article describes the decisive steps taken by the Chinese government to suppress the pandemic; debunks the various ‘cover-up’ conspiracy theories; and contrasts the US’s disastrous failure to manage the pandemic with what has been achieved in China – “a system that values human lives over corporate profits”.
As the Omicron variant causes record levels of infection in the United States, the end of the pandemic seems as far away as ever. But far from preparing a robust response to defeat the virus, the Biden administration is preparing to surrender and encourage the public to “learn to live with” COVID indefinitely.
When the Party for Socialism and Liberation pointed out the fact that China has in fact succeeded at virtually eliminating deaths from the virus, we were attacked by far-right pundits like Ben Shapiro – who took the position that such a feat is essentially impossible and asserted that China’s achievement was just a massive falsification.
In the United States, which has seen more deaths from the disease than any other country on Earth, there were 476,863 new deaths in 2021, up from 370,777 in 2020.[1] However, it is in fact widely accepted that only two people died of the disease in China in 2021 on the mainland, plus 64 deaths in the Hong Kong Special Administrative Region and 843 in Taiwan (where the central government of China does not exercise control) – according to the Johns Hopkins University Center for Systems Science and Engineering COVID-19 Data Repository.[2] This brings China up to a total of 4,636 deaths in the mainland and 5,699 deaths overall since the beginning of the COVID-19 epidemic, most of which occurred in the first few months of 2020.
While 100% accuracy is an unattainable standard in epidemiological statistics and the true numbers of cases and deaths may be somewhat higher than reported in any country, sources as varied as the World Health Organization[3], a collection of peer reviewed medical articles on China’s COVID-19 response in the British Medical Association’s industry journal[4], the Worldometer Covid Tracker[5], and even the New York Times[6] report equivalent counts for the death toll of COVID-19 in China.[7]
While China’s response to COVID-19 may have been the strongest in the world, China is not unique in handling the pandemic far better than the United States or European capitalist countries. New Zealand has taken effective measures to contain the virus and had only 26 deaths from covid in 2021.[8] South Korea, a capitalist country with about 15% the population of the United States, has had 5,887 covid deaths so far, less than 0.6% of the total U.S. death toll.[9]
Still, to someone who lives under U.S. capitalism, a medical system that can successfully curb a pandemic like COVID-19 may seem like fantasy. What did the people, government, and Communist Party of China do to accomplish this incredible result?
China’s mass mobilization against COVID-19
Learning from the SARS outbreak in 2003 within Beijing and Guangdong province, the National Health Commission published the National Emergency Plan for Public Health emergencies in 2006.[10] Since then a comprehensive plan to prepare for contagious disease outbreaks has been enacted throughout China, organizing public health agencies at local, provincial, and national levels in preparation for any future public health emergencies.[11] During the Wuhan COVID outbreak, this plan had its first serious test.
As soon as the outbreak of a novel viral pneumonia was identified in Wuhan, authorities required all suspected or confirmed COVID-19 patients to be admitted to infectious disease hospitals. When these hospitals reached capacity, several temporary hospitals were built within a matter of days.[12] Public health authorities were able to request external assistance and 42,322 healthcare workers were deployed in Wuhan and the surrounding Hubei Province. National and local healthcare authorities established an epidemic response command center which directed the efforts of healthcare workers across the province. The center was able to quickly process and disseminate information on evolving best practices for diagnosing and treating the disease using social media posts, a regular newsletter, and daily online webinars attended by hundreds of thousands of healthcare professionals across China.[10]
Once the initial outbreak in Wuhan was contained, healthcare officials across the country updated their implementation of the Emergency Plan to take into account the lessons learned. Hospitals in every city were retrofitted to prevent droplet and airborne viral transmission. Lines of communication were established so that front-line healthcare workers could easily report and access accurate and up-to-date information as any outbreaks developed. Offices, stores, transit stations and other public spaces implemented temperature checks and testing centers to identify new cases, often before they become symptomatic. The country has implemented a “big data contact tracing” approach with a contact tracing app to notify anyone who came in contact with someone who tested positive, and inform them on exactly how they should quarantine and/or get tested.[13] Public health officials also publish information about every known outbreak so that people who may have been exposed but were missed by the contact tracing process can also find out and get tested.[14]
Once even a single case is identified in a city, officials will institute a local “precision lockdown,” sanitize spaces, and begin mass testing. China has developed portable mass testing centers that can process millions of PCR tests per day, which have been used to rapidly test the entire populations of Wuhan, Xi’an, and other cities where outbreaks were identified.[14] Local governments work with mass organizations to deliver free food and basic necessities to those instructed to stay at home.[15] Businesses are also required to continue paying workers during lockdowns, and with an 89% home ownership rate and extremely low rents there is no eviction crisis like in the United States.[16]
While China’s response to both the initial Wuhan outbreak and subsequent outbreaks in other cities were groundbreaking and lauded by medical experts worldwide, Chinese medical authorities have learned from mistakes and continued to improve responses in later outbreaks, never shying away from open reports of difficulties.
In the outbreak within Xi’an in late December 2021, Communist Party of China-aligned media has repeatedly reported about issues regarding slow food delivery programs[17], price gouging during food shortages[18], as well as computerized health system crashes[19]. While the U.S. government treats each outbreak and variant as if they have learned nothing since March 2020, each outbreak within China is a moment of learning for government officials, the medical community and everyday Chinese citizens.
At every step of China’s pandemic response, a key element has been the organization and mass mobilization of society to combat the pandemic. The inclusion of volunteers and workers from every sector of the economy in stopping transmission of the virus, meeting people’s needs during lockdowns, and recovering after an outbreak is contained has allowed the people of China to achieve a near zero-COVID reality.
The missing tell-tale signs of a cover-up
Despite the international scientific consensus that the reported COVID case and death counts in China are essentially correct, some corporate media in the United States continue to peddle conspiracy theories about a “cover-up” orchestrated by China and/or the WHO. Forbes published an article on January 2 with a headline bombastically asserting “Beijing Is Intentionally Underreporting China’s Covid Death Rate” which suggests that China’s true death count from COVID-19 is not 4,636 but 1.7 million.[20]
The figure of 1.7 million deaths from COVID-19 in China is derived from a machine learning model developed by The Economist.[21] Liberation News spoke with Dr. Stuart Gilmour, a professor of biostatistics at St. Luke’s International University in Japan on the accuracy of this model. Gilmour explained that “The Economist applies a machine learning method to estimate excess deaths using data on COVID cases, deaths, test numbers, test positivity rates and other indicators of pandemic severity from a large number of countries.” However, The Economist’s model is missing this data for many countries including China, so “they infer the data from other sources and then apply the same machine learning model to these countries.”
While it is clear that there are obvious problems with inferring data on countries where no data exists, Gilmour added, “”t attempts to apply a model developed in countries with a pandemic to countries (like China) without a pandemic, even though the same values (like test numbers and test positivity rates) have completely different epidemiological meanings” in these differing contexts. The result? “This leads to the huge over-estimates.”
While this machine learning model may work for countries that are experiencing actual pandemic-levels of exposure, countries that follow a zero-COVID policy successfully render this model completely useless.
In reviewing various anti-China sources that assert it is inconceivable that there were two COVID-19 deaths in mainland China last year, none present evidence that amounts to more than an assumed mistrust of the people of China. However, if we were to do the job of these imperial stenographers, how would one tell if China actually was covering up mass death from an uncontrolled pandemic? A disease outbreak in the most populous country on Earth causing over a million deaths would leave hard physical evidence that no cover-up could completely erase.
Some 1.7 million dead people would leave 1.7 million bodies. During Summer 2021, India was suffering a terrible upsurge in cases and deaths, however the Indian Health Minister Harsh Vardhan insisted that the Indian fatality was “one of the lowest in the world” at the time. Crematorium workers in India quickly spoke out, and grim footage of fields full of funeral pyres spread across the internet.[22] Further, 1.7 million deaths would require China to have experienced well over 100 million cases. Gilmour notes, “Every country with such a pandemic has seen its health system collapse – as we saw in India, Italy, the USA and the UK. When this happened briefly in Wuhan in February 2020 the videos and reports of chaos in hospitals and the community were all over Western media. It’s simply impossible that the same thing could have been happening for 18 months and no reports surfaced in any media.” There have been no such videos or testimonies coming from China.
To treat patients suffering from an ostensible mass outbreak, Chinese hospitals would need respirators, medical oxygen, monoclonal antibodies, antiviral drugs and other material in vast quantities. During the outbreak in India last spring, the scale of hospitalizations led to the complete exhaustion of the country’s oxygen supplies, and doctors across the country started reporting deaths due to the oxygen shortage.[23] China has not experienced such shortages — in fact, China has massively expanded exports of oxygen concentrators and other medical equipment during the pandemic to supply countries that are experiencing large-scale outbreaks.[24]
There are around 600,000 foriegn nationals living in China, including about 72,000 U.S. citizens. The cases of sickness and death among these would generally match the population at large; if there had truly been 1.7 million deaths in China (around 0.1% of the overall population), then we would expect about 72 of the U.S. citizens living in China to have died as well. The U.S. state department tabulates all deaths of U.S. citizens in other countries; from December 2019 until June 2021 (the latest month for which statistics are available), the State Dept has recorded a total of seven deaths of U.S. citizens in China from all causes combined.[25] None are listed explicitly as having died of COVID.
For China to cover up a massive COVID outbreak would require a conspiracy of hundreds of millions of people, from front-line medical workers, to friends and family of people whose hospitalizations or deaths were being covered up (many of whom live outside of China), to the U.S. State Department’s own accounting of American deaths in China.
The evidence simply does not support the capitalist media’s claims that China is covering up a massive COVID outbreak. But worse than simply being wrong, the cover-up narrative plays into the same racist “yellow peril” tropes that inflame anti-Asian hate crimes we see day after day here in the United States.
According to Gilmour, these claims of vast numbers of unreported deaths also directly undermine effective public health policy, as it “misrepresents the effectiveness of the policies [China] follows and creates a false narrative that eliminating COVID is impossible,” and “serve only to undermine support for the only policies that work, and which ultimately every country will need to adopt.”
One virus, two systems
Approaching the third year of the global pandemic, life in China is truly “back to normal” for most of the 1.4 billion people who live there. There are occasionally short-term, localized lockdowns in response to local outbreaks, and basic common sense precautions like temperature checks and testing remain in place, but there is no active pandemic within China. On Jan. 4, there were 175 new cases and zero deaths.[5] This is a monumental success of a system that values human lives over corporate profits.
Meanwhile on Jan. 5, the United States reported over 704,000 new cases of COVID-19[1], the highest ever daily case increase and nearly seven times as many cases in a single day as mainland China has had over the course of the entire pandemic.[5]
N95 masks and rapid antigen tests are sold out or bought up by scalpers who sell them at obscene markups. PCR testing sites across the country have lines hours long. Teachers across the country are involved in labor struggles with school districts that are unable or unwilling to provide safe working conditions.[26] [27]
President Joe Biden, far from providing any sort of plan or leadership during this acute crisis, took to Twitter to tell Americans to “Google “COVID test near me”” [28]
What the dramatic difference in public health outcomes between China and the United States demonstrate is that the massive death toll of the disease here in the United States is not an inevitable natural disaster, but the result of a system and a set of policy choices made to keep the capitalists’ profits flowing no matter how many lives it costs.
The U.S. could have taken swift action in the first months of 2020 to educate the public on the dangers of the disease, distribute masks, implement mass testing and contact tracing, and prepare for localized lockdowns where outbreaks were identified. Instead, then-president Trump and the U.S. media across the capitalist political spectrum took the opportunity to demonize China and decry their effective pandemic containment measures as “authoritarian,” sowing the seeds of the anti-mask and anti-vaccine movement that undermines U.S. public health efforts today.
As Liberation News reported in April of 2021, the global vaccine apartheid created by vaccine patents and hoarding by the U.S. and Western European governments hoarding worsened the rise of new, more dangerous variants of the virus. Now the Omicron variant is driving the most infectious wave of the pandemic yet in the United States and the reality of global vaccine apartheid remains in place.
The federal government has allowed pandemic unemployment and eviction protections to expire while refusing to issue further stimulus checks. Many workers are forced to choose between having no income at all or risking being infected with the virus in unsafe work environments for wages that are still not enough to live on. President Biden is threatening to resume student loan payments on May 1. Medical professionals are exhausted and collapsing under the system of underfunded, privatized healthcare, with no support and resources for their own physical or mental wellbeing.
By sowing doubt about China’s remarkable success in defeating the pandemic, the capitalist media seeks to quell mass outrage at our own government’s criminal mismanagement of the pandemic and manufacture consent for a policy of “living with” the virus and accepting hundreds of thousands of people killed or permanently disabled by COVID every year indefinitely. But this is not the only way! The last year has proven that a socialist system that puts human lives over capitalist profits can mobilize all aspects of society and put an end to the pandemic. What is needed here in the U.S. is a mass movement to fight for a socialist plan to defeat COVID-19.
References
1 – United States Coronavirus Statistics. (n.d.). Worldometer. Retrieved January 5, 2022, from https://www.worldometers.info/coronavirus/country/US
2 – Dong, E., Du, H., & Gardner, L. (2020, May 01). An interactive web-based dashboard to track COVID-19 in real time. The Lancet, 20(5), 533-534. https://doi.org/10.1016/S1473-3099(20)30120-1
3 – China: WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data. (n.d.). WHO Coronavirus (COVID-19) Dashboard. Retrieved January 5, 2022, from https://covid19.who.int/region/wpro/country/cn
4 – China’s response to Covid-19. (n.d.). The BMJ. https://www.bmj.com/how-china-responded-to-covid-19
5 – China Coronavirus Statistics. (n.d.). Worldometer. Retrieved January 5, 2022, from https://www.worldometers.info/coronavirus/country/china/
6 – Covid-19 World Map: Cases, Deaths and Global Trends. (n.d.). The New York Times. Retrieved January 5, 2022, from https://www.nytimes.com/interactive/2021/world/covid-cases.html
7 – These sources each tabulate the numbers differently, but their numbers agree when compared like with like. The John Hopkins CSSE COVID-19 data tracker reports separately for each province within China. The WHO report combined all of mainland China, the Hong Kong SAR, the Macau SAR (which has had zero deaths), and Taiwan into one number. Worldometers and the New York Times dashboard both have separate reports for each of those four areas.
8 – New Zealand Coronavirus Statistics. (n.d.). Worldometer. Retrieved January 5, 2022, from https://www.worldometers.info/coronavirus/country/new-zealand/
9 – South Korea COVID – Coronavirus Statistics. (n.d.). Worldometer. Retrieved January 6, 2022, from https://www.worldometers.info/coronavirus/country/south-korea/
10 – Du, B., Wang, C., & Singer, M. (2021, December 02). Learning for the next pandemic: the Wuhan experience of managing critically ill people. BMJ, 2021(375), e066090. https://www.bmj.com/content/375/BMJ-2021-066090
11 – Sun, M., Xu, N., Li, C., Wu, D., Zou, J., Luo, L., Yu, M., Zhang, Y., & Wang, H. (2018, April 11). The public health emergency management system in China: trends from 2002 to 2012. BMC Public Health, 18, 474. https://doi.org/10.1186/s12889-018-5284-1
12 – Ankel, S. (2020, February 5). How China Managed to Build an Entirely New Hospital in 10 Days. Business Insider. https://www.businessinsider.com/how-china-managed-build-entirely-new-hospital-in-10-days-2020-2
13 – In China, This Coronavirus App Pretty Much Controls Your Life. (n.d.). Futurism. https://futurism.com/contact-tracing-apps-china-coronavirus
14 – Chen, Q., Rodewald, L., Lai, S., & Gao, G. F. (2021, December 02). Rapid and sustained containment of covid-19 is achievable and worthwhile: implications for pandemic response. BMJ, 2021(375), e066169. https://doi.org/10.1136/BMJ-2021-066169
15 – Dou, E. (2021, December 30). Locked down in China’s Xi’an amid coronavirus outbreak, residents subsist on deliveries of vegetables. The Washington Post. https://www.washingtonpost.com/world/2021/12/30/china-covid-lockdown-xian/
16 – China Home Ownership Rate | 2022 Data | 2023 Forecast | 2013-2021 Historical | Chart. (n.d.). Trading Economics. Retrieved January 5, 2022, from https://tradingeconomics.com/china/home-ownership-rate
17 – Xi’an enhances food supplies amid reports of slow delivery. (2021, December 30). Global Times. Retrieved January 5, 2022, from https://www.globaltimes.cn/page/202112/1243818.shtml
18 – Xi’an to strictly regulate illegal activities like price gouging to ensure a stable market. (2021, December 26). Global Times. Retrieved January 5, 2022, from https://www.globaltimes.cn/page/202112/1243429.shtml
19 – Xi’an health code system crashes briefly amid city-wide COVID-19 screening. (2022, January 4). Global Times. Retrieved January 5, 2022, from https://www.globaltimes.cn/page/202201/1244024.shtml
20 – Danise, A., & Calhoun, G. (2022, January 3). Part 1: Beijing Is Intentionally Underreporting China’s Covid Death Rate. Forbes. https://www.forbes.com/sites/georgecalhoun/2022/01/02/beijing-is-intentionally-underreporting-chinas-covid-death-rate-part-1/
21 – How we estimated the true death toll of the pandemic. (2021, May 13). The Economist. https://www.economist.com/graphic-detail/2021/05/13/how-we-estimated-the-true-death-toll-of-the-pandemic
22 – Ellis, H. (2021, May 1). ‘We’re burning pyres all day’: India accused of undercounting deaths. The Guardian. https://www.theguardian.com/world/2021/may/01/were-burning-pyres-all-day-india-accused-of-undercounting-deaths
23 – Covid-19: India outrage over ‘no oxygen shortage death data’ claim. (2021, July 21). BBC. https://www.bbc.com/news/world-asia-india-57911638
24 – Li, J. (2021, May 18). Covid-19 prompts surge in China’s exports of oxygen concentrators — Quartz. Quartz. https://qz.com/2009596/covid-19-prompts-surge-in-chinas-exports-of-oxygen-concentrators/
25 – US Citizen Deaths Overseas. (2021, September 1). travel.gov. Retrieved January 5, 2022, from https://travel.state.gov/content/travel/en/international-travel/while-abroad/death-abroad1/death-statistics.html
26 – https://twitter.com/UESF/status/1478830303913279488
27 – https://twitter.com/CTULocal1/status/1478590050107543552
With all due respect, Comrades, i find the title/headline “One Virus, Two Systems” rather unfortunate: think of the universally accepted and used description of the interrelation of meanland China and Hong Kong – One Country, Two Systems.