The West Is About to Fail the Coronavirus Test

China made huge mistakes managing the outbreak. The rest of the world may not do any better.

By Melissa Chan and Ethan Guillén, an independent consultant working in global health.
A rescue worker wearing a protective suit checks on a driver at a roadblock near Milan, Italy, on Feb. 24.
A rescue worker wearing a protective suit checks on a driver at a roadblock near Milan, Italy, on Feb. 24. Emanuele Cremaschi/Getty Images

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When an authoritarian accumulates power by eliminating political opponents and building a cult of personality around his leadership, the downside is that when things go wrong, often everybody blames him. Chinese President Xi Jinping has kept a low profile in this epidemic, which has killed more than 2,500 people in China as of Monday.

The crisis has become as great a strain on the country’s political leadership as it has on its medical workers. Stunningly, the system itself has acknowledged this, with the official account of one meeting led by Xi saying the coronavirus is “a major test of China’s system and capacity for governance.” Meanwhile, at ground zero in Wuhan, doctors don diapers because they have no time for breaks, while cancer patients complain of neglect.

How China manages COVID-19 is being closely scrutinized and widely criticized. But with global health specialists cautioning the current outbreak may not wane like the regular flu with the arrival of spring, and one epidemiologist at Harvard University even estimating a pandemic infecting 40 to 70 percent of the world—countries everywhere, including democracies, will be tested and judged on how they respond and how they treat people. And the signs are that many—including members of the G-7—will disappoint, in some cases calamitously.

Japan’s mishandling of the cruise ship quarantine of the Diamond Princess and the inadequate care it provided captive passengers show how even rich and open societies can bungle responses. The United States has been keeping Americans, including some who tested negative for the virus, on military bases. Meanwhile, the body that should be leading the global fight, the World Health Organization (WHO), lacks both the financial and political heft to manage a pandemic.

The response to the outbreak has been discouraging. The main tool has been brute isolation and quarantine. In China, that has meant restrictions on the movement of 760 million people, or more than half its population. South Korea announced it will lock down cities as necessary. Its fourth-largest city, Daegu, already looks like a ghost town. Countries from Australia to Russia have announced travel bans against Chinese citizens or those who have spent time in China.

The world is about to witness the fracturing of the global health policy space and what happens when countries do not work together.

While the epidemiology of the virus is not fully understood and very different from Ebola, the Ebola outbreak of 2014 should have brought critical lessons—but these have not been heeded. After that devastating outbreak, the WHO strengthened its emergency response capacity, but it depends on member states to support its mandate. Unfortunately, the organization continues to operate on a budget equivalent to that of a large hospital in the United States, because member states won’t pay up—crippling its ability to truly lead any global fight against the new and emerging disease.

A review of quarantine and isolation policies from the Ebola outbreak had also concluded that any measures taken should be based on science, rather than fear.

But fear has not only infected medical responses to the current outbreak—it has come at a time when fear has already defined politics in many places. The rise of far-right populist movements, led by stand-alone demagogues who question the international rules-based system, hampers country cooperation. Those same politicians and their supporters spread misinformation. Still others are capitalizing on the current climate—a new disinformation campaign linked to Russia promotes the conspiracy theory that the United States unleashed the virus.

The world is about to witness the fracturing of the global health policy space and what happens when countries do not work together. Look at the MS Westerdam cruise ship that was turned away at multiple ports, from Japan to Thailand, before finally being allowed to dock in Cambodia. Countries with a poor track record of human rights will absolutely suffer, but countries with civil liberties might not acquit themselves as well as might be hoped.

In theory, the United States should not have a problem handling the coronavirus. The Centers for Disease Control and Prevention is one of the most trusted federal agencies among citizens, and that is key: Trust in government influences behaviors and allows for the effective implementation of policy.

In 2014, Ebola came to the United States. One of us, Melissa Chan, was there, reporting outside Texas Health Presbyterian Hospital Dallas, where medical staff treated Thomas Eric Duncan, a Liberian visiting the United States. He died. Subsequently, two nurses who cared for him also contracted the disease. People panicked, and demanded a travel ban against Ebola-plagued countries in West Africa.

Despite tremendous pressure from Republicans but also from some members of his own party, then President Barack Obama did not give in to hysteria. “We have to remember the basic facts,” he said. “Trying to seal off an entire region of the world—if that were even possible—could actually make the situation worse.”

It is impossible to imagine Muslim-banning, wall-building, fact-defying President Donald Trump making a similar call should another panic ensue today. A leader more comfortable causing panic than assuaging it, a pandemic would test this administrations judgment and ability to govern, if not to the degree seen in China, at least enough to shake some of our beliefs about what we expect from our government.

Trump has already expressed displeasure over the transfer of sick Americans back to U.S. soil. On Sunday, Alabama Sen. Richard Shelby declared victory after he convinced the president to scuttle plans to move coronavirus patients to a facility in his state. If large numbers of Americans start falling ill, will “America First” mean one that serves healthy Americans while detaining the sick?

In Europe, Italy has locked down several cities and far-right politician Matteo Salvini has said the country should close its borders and suspend the Schengen treaty, which keeps the European Union’s borders open across the continent. Race-based attacks and discrimination against Chinese have escalated there. Many African countries have ignored appeals for help from their citizens living in China, afraid of bringing the virus to the continent.

Even in countries where health authorities have maintained level heads, attention and resources on the coronavirus may be disproportionate to its threat. Doctors are asking patients whether they have recently visited China or been in contact with anyone who has—all while the regular flu, which has a vaccine many opt not to take, is estimated to kill anywhere from 16,000 to 41,000 people this season in the United States alone and infect tens of millions more.

Some epidemiologists have pointed out that once the full extent of the coronavirus is known, it may have a similar mortality rate to a bad flu season. It could also, of course, be much worse. But as countries start tallying deaths, leaders may succumb to pressure from the public to take more action, regardless of whether decisions infringe on the free movement of people and human rights.

The tragedy in all this is that on a technical level, the world is more capable than ever of handling emerging diseases. Outbreak planning has advanced since the Ebola epidemic. Organizations can now quickly deploy researchers to study new viruses, and we have mechanisms in place to speed up research and create new vaccines and treatments. But the politics of fear have gripped the world, counter to public-health best practices. Fear hid the initial outbreak in China and allowed it to spread. Fear has guided decisions in Asia, Europe, and elsewhere. Unless governments choose to strengthen global health coordination and enact evidence-based policies, the result, in both authoritarian and democratic states alike, will be a man-made disaster as much as a natural one.

Melissa Chan is a national and foreign affairs reporter who previously worked as a broadcast correspondent for Al Jazeera. She is a collaborator with the Global Reporting Centre and a term member of the Council on Foreign Relations.

Ethan Guillén is an independent consultant working in global health. As Executive Director of Universities Allied for Essential Medicines, he worked on global health medicines innovation and pricing policy. Ethan was a part of the team that helped launch the Medicines Patent Pool, an organization that licenses medicine patents to have them produced generically for use in developing countries. Most recently he worked for Doctors Without Borders on policy matters related to the West African Ebola outbreak and diagnostic innovation.