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Coronavirus Outbreak Risks Reviving Stigma for China Coronavirus Outbreak Risks Reviving Stigma for China
(1 day later)
SARS. Bird flu. And now a new coronavirus.SARS. Bird flu. And now a new coronavirus.
A lot of epidemics seem to come out of China, leading some to point accusing fingers. President Trump’s trade czar, Peter Navarro, for one, once went so far as to describe the country as a “disease incubator,” and that was before the latest outbreak.A lot of epidemics seem to come out of China, leading some to point accusing fingers. President Trump’s trade czar, Peter Navarro, for one, once went so far as to describe the country as a “disease incubator,” and that was before the latest outbreak.
But those perceptions are outdated.But those perceptions are outdated.
While some of the most serious outbreaks have been traced to Chinese origins, others associated with China may have started elsewhere.While some of the most serious outbreaks have been traced to Chinese origins, others associated with China may have started elsewhere.
Old stereotypes have also contributed to unfounded portrayals of China as a source of contagion, when in fact it has progressed further than many countries in eradicating scourges that can flourish in developing regions.Old stereotypes have also contributed to unfounded portrayals of China as a source of contagion, when in fact it has progressed further than many countries in eradicating scourges that can flourish in developing regions.
Still, China’s recent history of what are known as zoonotic infections — viruses, bacteria and parasites that spread between animals and humans — has raised questions about public-health practices in the world’s most populous country.Still, China’s recent history of what are known as zoonotic infections — viruses, bacteria and parasites that spread between animals and humans — has raised questions about public-health practices in the world’s most populous country.
And while the Chinese government has strengthened disease detection and monitoring capabilities, its tendency to play down or even cover up mass outbreaks may play a role in their severity and scope.And while the Chinese government has strengthened disease detection and monitoring capabilities, its tendency to play down or even cover up mass outbreaks may play a role in their severity and scope.
Dr. Jennifer Huang Bouey, an epidemiologist and senior policy researcher at the RAND Corporation, a research organization, said China had become a leader in the study of contagious disease. The flu vaccines provided in the United States, for example, are often traced to research done in China.Dr. Jennifer Huang Bouey, an epidemiologist and senior policy researcher at the RAND Corporation, a research organization, said China had become a leader in the study of contagious disease. The flu vaccines provided in the United States, for example, are often traced to research done in China.
At the same time, Dr. Bouey said, China remains somewhat of a laboratory itself.At the same time, Dr. Bouey said, China remains somewhat of a laboratory itself.
“There is quite a fair amount of epidemics originating in China or passing through China,” she said.“There is quite a fair amount of epidemics originating in China or passing through China,” she said.
Here are five basic questions and answers on China and infectious diseases.Here are five basic questions and answers on China and infectious diseases.
Two of the devastating flu pandemics of the 20th century — the Asian flu of 1957 and the Hong Kong flu of 1968 — both originated in China and left a trail of about three million deaths worldwide.Two of the devastating flu pandemics of the 20th century — the Asian flu of 1957 and the Hong Kong flu of 1968 — both originated in China and left a trail of about three million deaths worldwide.
The 2003 epidemic of Severe Acute Respiratory Syndrome, or SARS, which killed 774 people, nearly all of them in mainland China, was traced to palm civets sold as exotic meat in southern Chinese food markets.The 2003 epidemic of Severe Acute Respiratory Syndrome, or SARS, which killed 774 people, nearly all of them in mainland China, was traced to palm civets sold as exotic meat in southern Chinese food markets.
The virus behind a deadly 1997 bird flu outbreak that fatally infected at least 18 people in Hong Kong is believed to have originated among fowl raised in southern mainland China — the source of virtually all poultry in the Chinese territory.The virus behind a deadly 1997 bird flu outbreak that fatally infected at least 18 people in Hong Kong is believed to have originated among fowl raised in southern mainland China — the source of virtually all poultry in the Chinese territory.
Last year, nearly half of China’s pigs were wiped out by a virus that causes African swine fever, an incurable disease. While the virus does not sicken humans and did not originate in China, critics say Chinese government policies and mismanagement may have inadvertently helped the epidemic accelerate through the country’s pig population — the world’s largest — and spread elsewhere in Asia.Last year, nearly half of China’s pigs were wiped out by a virus that causes African swine fever, an incurable disease. While the virus does not sicken humans and did not originate in China, critics say Chinese government policies and mismanagement may have inadvertently helped the epidemic accelerate through the country’s pig population — the world’s largest — and spread elsewhere in Asia.
And as of Monday, the new coronavirus traced to a live-animal market in the central Chinese city of Wuhan had killed 908 people and infected more than 40,000 in China and two dozen other countries and territories. The coronavirus, so named because of its spiky halo look under a microscope, may have originated in bats.And as of Monday, the new coronavirus traced to a live-animal market in the central Chinese city of Wuhan had killed 908 people and infected more than 40,000 in China and two dozen other countries and territories. The coronavirus, so named because of its spiky halo look under a microscope, may have originated in bats.
Many epidemiologists point to some fundamental facts about China: its population of 1.4 billion people, the proximity of urban and rural dwellers, as well as the slaughterhouses and urban markets where animals are freshly butchered. Fourteen of the world’s 50 most populous metropolitan areas are in China.Many epidemiologists point to some fundamental facts about China: its population of 1.4 billion people, the proximity of urban and rural dwellers, as well as the slaughterhouses and urban markets where animals are freshly butchered. Fourteen of the world’s 50 most populous metropolitan areas are in China.
“The Chinese economy, combined with the Chinese population, have experienced so much growth that you are looking at putting large numbers of people in close contact with large numbers of animals in a confined space,” said Sean Beckmann, a disease ecologist and biology professor at Stetson University in DeLand, Fla.“The Chinese economy, combined with the Chinese population, have experienced so much growth that you are looking at putting large numbers of people in close contact with large numbers of animals in a confined space,” said Sean Beckmann, a disease ecologist and biology professor at Stetson University in DeLand, Fla.
Dr. Beckmann called China “the perfect storm” for zoonotic diseases to flourish. “It gives lots of opportunity for these viruses to cross a species boundary,” he said.Dr. Beckmann called China “the perfect storm” for zoonotic diseases to flourish. “It gives lots of opportunity for these viruses to cross a species boundary,” he said.
No.No.
The Ebola virus, for example, which has ravaged parts of central and Western Africa, is named after the Ebola River in what is now the Democratic Republic of Congo, where the virus was discovered. It may have been transmitted by fruit bats.The Ebola virus, for example, which has ravaged parts of central and Western Africa, is named after the Ebola River in what is now the Democratic Republic of Congo, where the virus was discovered. It may have been transmitted by fruit bats.
The Marburg virus, which causes a hemorrhagic fever similar to Ebola’s, was also traced to a virus that resides in African fruit bats. It was named after a town in Germany where it was first detected in laboratory workers in 1967.The Marburg virus, which causes a hemorrhagic fever similar to Ebola’s, was also traced to a virus that resides in African fruit bats. It was named after a town in Germany where it was first detected in laboratory workers in 1967.
A flu pandemic in 2009, which killed 17,000 people, was traced to a pig farm in central Mexico.A flu pandemic in 2009, which killed 17,000 people, was traced to a pig farm in central Mexico.
And Middle East Respiratory Syndrome, or MERS, has been traced to camels and bats in Saudi Arabia. It is similar to SARS and has killed at least 858 people and sickened nearly 25,000 in 27 countries since it was first reported in 2012.And Middle East Respiratory Syndrome, or MERS, has been traced to camels and bats in Saudi Arabia. It is similar to SARS and has killed at least 858 people and sickened nearly 25,000 in 27 countries since it was first reported in 2012.
Chinese officials say yes, and point to what they call an overreaction by the United States and other countries to the coronavirus epidemic. Those countries have imposed virtual travel bans to China and evacuated citizens.Chinese officials say yes, and point to what they call an overreaction by the United States and other countries to the coronavirus epidemic. Those countries have imposed virtual travel bans to China and evacuated citizens.
The Chinese government also has denounced incidents of anti-Chinese hostility linked to the epidemic.The Chinese government also has denounced incidents of anti-Chinese hostility linked to the epidemic.
“I do not want to see this,” Huang Ping, China’s consul general in New York, said at a news conference last week. “The virus is the enemy, not the Chinese people.”“I do not want to see this,” Huang Ping, China’s consul general in New York, said at a news conference last week. “The virus is the enemy, not the Chinese people.”
There is, in fact, a long history of China being stigmatized over disease.There is, in fact, a long history of China being stigmatized over disease.
In the 19th century, a wave of immigration from Asia prompted warnings of a “yellow peril” and a supposed threat to public health.In the 19th century, a wave of immigration from Asia prompted warnings of a “yellow peril” and a supposed threat to public health.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Echoes of that are still sometimes heard. In late January, a French newspaper ran a Page 1 story headlined “yellow alert” about the “Chinese coronavirus.” It later apologized.Echoes of that are still sometimes heard. In late January, a French newspaper ran a Page 1 story headlined “yellow alert” about the “Chinese coronavirus.” It later apologized.
There are those who have tried to blame China for some of the biggest public health calamities of all time.There are those who have tried to blame China for some of the biggest public health calamities of all time.
Some historians claimed that China was the likely source of the deadliest flu pandemic in history, the 1918 Spanish Flu — a misnomer itself. The effects of that flu were global. It was associated mainly with Spain because Spanish news reports about the disease, unlike those in countries fighting in World War I, were not censored.Some historians claimed that China was the likely source of the deadliest flu pandemic in history, the 1918 Spanish Flu — a misnomer itself. The effects of that flu were global. It was associated mainly with Spain because Spanish news reports about the disease, unlike those in countries fighting in World War I, were not censored.
In fact, the origin of the pandemic remains a mystery. Some research suggests that it may have been a United States military training base in Kansas, Camp Funston.In fact, the origin of the pandemic remains a mystery. Some research suggests that it may have been a United States military training base in Kansas, Camp Funston.
The Chinese Communist Party is most fearful of the sort of chaos that has historically destabilized China. Party officials tend to prioritize stability, even if it means suppressing important information that, critics say, the public needs to know.The Chinese Communist Party is most fearful of the sort of chaos that has historically destabilized China. Party officials tend to prioritize stability, even if it means suppressing important information that, critics say, the public needs to know.
The latest example of this may be Dr. Li Wenliang, a Wuhan physician who was punished for having warned early in the outbreak about what he saw as SARS-like cases — and who died last week from the infection. And until very recently, the government also declined repeated offers by international disease experts to send teams to China to help battle the outbreak.The latest example of this may be Dr. Li Wenliang, a Wuhan physician who was punished for having warned early in the outbreak about what he saw as SARS-like cases — and who died last week from the infection. And until very recently, the government also declined repeated offers by international disease experts to send teams to China to help battle the outbreak.
Many infectious disease experts say they hope the leaders in Beijing learn from Dr. Li’s death.Many infectious disease experts say they hope the leaders in Beijing learn from Dr. Li’s death.
“You want to have doctors who are empowered and encouraged,” said Dr. Amesh Adalja, a senior scholar at Johns Hopkins University. “You want to reward these types of people. In their effort to manage chaos and silence astute doctors, I would argue the government took a shortsighted action and it had a cascading impact.”“You want to have doctors who are empowered and encouraged,” said Dr. Amesh Adalja, a senior scholar at Johns Hopkins University. “You want to reward these types of people. In their effort to manage chaos and silence astute doctors, I would argue the government took a shortsighted action and it had a cascading impact.”
Some remain skeptical that the central authorities in Beijing will change their behavior.Some remain skeptical that the central authorities in Beijing will change their behavior.
Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, said the official tendency to control and suppress remained strong.Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, said the official tendency to control and suppress remained strong.
“This is a pattern,” he said, “essentially, fundamentally the same: cover-up, inaction, then the central government steps in and takes draconian measures. This is like a Greek tragedy.”“This is a pattern,” he said, “essentially, fundamentally the same: cover-up, inaction, then the central government steps in and takes draconian measures. This is like a Greek tragedy.”
Donald G. McNeil Jr. contributed reporting.Donald G. McNeil Jr. contributed reporting.