“No
evidence of a real crisis yet”
Brown
University
In 2001, fresh from college, Katherine Mason seized upon an
opportunity to teach English in China. Then, mere miles away from her home and
workplace, a deadly virus struck: severe acute respiratory syndrome, better
known today as SARS.
“I got evacuated by the program that was
sponsoring me,” she said. “When I returned to the United States, my parents
tried to quarantine me in my sister’s apartment.”
Between 2002 and 2004, SARS killed at
least 774 people worldwide and instilled fear in the hearts of Americans early
in its spread. But that fear, Mason observed, didn’t strike China as
quickly.
“So many flu-like viruses come through
that part of China that they didn’t start panicking until it began to spread
all over the world,” she said.
Mason, who had majored in molecular
biology, became interested in this cultural gulf between two nations grappling
with the same virus. Today, she is an assistant professor of anthropology at
Brown and a leading expert on the historical, social and political context
of public health in China.
Her 2016 book, “Infectious Change: Reinventing Chinese Public Health After an Epidemic,” examines how the outbreak of SARS “reimagined public health as a professionalized, biomedicalized and technological machine — one that has frequently failed to serve the Chinese people.”
Her 2016 book, “Infectious Change: Reinventing Chinese Public Health After an Epidemic,” examines how the outbreak of SARS “reimagined public health as a professionalized, biomedicalized and technological machine — one that has frequently failed to serve the Chinese people.”
Now, Mason has joined millions of
medical professionals, scholars and members of the public in closely following
the trajectory of another illness — a type of coronavirus that broke out
in Wuhan in December 2019 and has since spread to at least six countries,
according to the World Health Organization (WHO).
As in the early aughts, she believes medical anthropologists can add crucial perspective to global conversations on epidemics, from SARS to H1N1 to coronavirus.
As in the early aughts, she believes medical anthropologists can add crucial perspective to global conversations on epidemics, from SARS to H1N1 to coronavirus.
“I think that it’s just as important to
understand the social and political context behind an epidemic as it is to
understand the symptoms and causes of the virus,” Mason said. “When it comes to
the spread of a virus, government transparency is just as important as good
medical care, and public panic is just as detrimental as poor medical care.”
Following news of the first two reported
cases of coronavirus in the U.S., Mason answered questions about the virus, the
history of China’s public health system and the inverse relationship between
government transparency and public panic.
Q: First, what is coronavirus? What are its symptoms?
Coronaviruses are a family of viruses
that range in seriousness from the common cold to things like SARS (severe
acute respiratory syndrome) and MERS (Middle East respiratory syndrome). The
symptoms are similar to a lot of other respiratory viruses: coughing, fever,
sore throat.
It’s difficult to distinguish among respiratory viruses. One question right now is, is it possible that some people may have been infected with a milder version of this coronavirus that is no more dangerous than the common cold? Another issue is, many people are showing up to hospitals with a fever and are worried that they have this particular virus, but their fever could be due to any number of things.
Q: On Jan. 24, Brown sent out an advisory to its
campus about signs and symptoms to look for — to what extent should people
worry about coronavirus spreading to the Northeast?
I don’t think we need to worry very much about that right now. Only two cases of this coronavirus have been reported in the United States; one is on the other side of the country, and the other is in Chicago.
I think the fact that the WHO has declined at this point in time to declare this a "public health emergency of international concern" — which they did declare for SARS in 2003 — is important. That is a sign that this particular coronavirus should not worry people in Rhode Island right now, unless they plan to travel to Wuhan soon.
Q: Does this virus have the potential to affect us as deeply as SARS did?
I think that the world is more ready to
handle an epidemic on the level of SARS today. SARS did not end up killing as
many people as many imagined it would, but it scared people, and it pushed
governments to do a huge amount of behind-the-scenes work to prepare for
similar situations in the future.
Everyone is always worried about the
possibility of the sort of global flu pandemic we saw in 1918 and 1919. I think
that’s why there’s a certain amount of overreacting happening now — because
people don’t want to be accused of underreacting.
On the one hand, you could argue that it’s better to overreact, that it protects our health and safety more. On the other hand, you can only cry wolf so many times. If this virus turns out not to be as serious an epidemic as people are worried it is, the overreaction might diminish the extent to which people take future epidemics seriously.
On the one hand, you could argue that it’s better to overreact, that it protects our health and safety more. On the other hand, you can only cry wolf so many times. If this virus turns out not to be as serious an epidemic as people are worried it is, the overreaction might diminish the extent to which people take future epidemics seriously.
Q: What made the SARS epidemic so serious?
A number of things. First, it had close
to a 10% fatality rate, which is quite high. Second, it was new and unfamiliar.
And third, the Chinese government was slow to react at both the local and
national levels — partly because they were not being forthcoming about how
many cases they had, and partly because they didn’t think it was as important
as the international community thought it was.
They didn’t treat it with real seriousness until a whistleblower at a Beijing hospital revealed that the government had covered up hundreds of fatalities there. Once the cat was out of the bag, they were quarantining whole universities and apartment complexes.
They didn’t treat it with real seriousness until a whistleblower at a Beijing hospital revealed that the government had covered up hundreds of fatalities there. Once the cat was out of the bag, they were quarantining whole universities and apartment complexes.
Q: What’s different about China’s response to the
coronavirus outbreak today?
The response today has been much swifter and more serious. They are now quarantining entire cities. They are suspending public transit and other travel. The Chinese government is taking some dramatic steps to say to everyone, including its own citizens, “Look, we’re doing something.”
When SARS broke out, China got a lot of bad press for their response and lack of transparency, so they want to show the world in as visible a way as possible that they’re taking action.
The response today has been much swifter and more serious. They are now quarantining entire cities. They are suspending public transit and other travel. The Chinese government is taking some dramatic steps to say to everyone, including its own citizens, “Look, we’re doing something.”
When SARS broke out, China got a lot of bad press for their response and lack of transparency, so they want to show the world in as visible a way as possible that they’re taking action.
Q: How has China changed since SARS?
First, the public health system has been
completely overhauled. A huge amount of resources were dedicated to building a
health surveillance system with a strict chain of command.
As in the past, if a doctor in China were to speak to a news reporter about the number of coronavirus cases they’ve seen, they would be in huge trouble. But now there are much stricter rules and better systems for information sharing, and those cases are supposed to be shared with a direct supervisor, then it gets moved up the chain all the way to a central authority. But note that it doesn't always work that way — local authorities often cover up the truth.
As in the past, if a doctor in China were to speak to a news reporter about the number of coronavirus cases they’ve seen, they would be in huge trouble. But now there are much stricter rules and better systems for information sharing, and those cases are supposed to be shared with a direct supervisor, then it gets moved up the chain all the way to a central authority. But note that it doesn't always work that way — local authorities often cover up the truth.
Second, the leadership in China is very
different today. [President] Xi Jinping is one of the more conservative and
purely authoritarian leaders they’ve had in a while. He is more focused on
cracking down on internet regulations and the spread of information.
I think those public health reforms,
combined with the lack of transparency in this administration, have led to a
response to this virus that is starting to backfire. Chinese people know that
what the government is telling them is a sanitized version of what’s really
happening.
When people don’t have reliable, transparent information about what is going on, they might assume the worst case scenario is happening and panic. When people panic, it’s hard to handle. No government has the capacity to handle a city of 11 million people panicking, visiting the hospital and sharing videos from the hospital on social media, which is what’s happening right now in Wuhan.
When people don’t have reliable, transparent information about what is going on, they might assume the worst case scenario is happening and panic. When people panic, it’s hard to handle. No government has the capacity to handle a city of 11 million people panicking, visiting the hospital and sharing videos from the hospital on social media, which is what’s happening right now in Wuhan.
Q: Here in the U.S., what should members of the public
keep in mind as they follow news and social media coverage about coronavirus?
They should not panic. This is not the
end of the world. They should know that the videos, photos and commentary
they’re seeing say more about the public’s reaction to the virus than about the
seriousness of the virus itself.
It is tragic that this virus has claimed 26 lives so far, but people should know that most of those who have died had additional health complications, and on a global scale, 26 is not a large number. Right now, this is not as much of a crisis as it is made out to be. That could change, but there is no evidence of a real crisis yet.
It is tragic that this virus has claimed 26 lives so far, but people should know that most of those who have died had additional health complications, and on a global scale, 26 is not a large number. Right now, this is not as much of a crisis as it is made out to be. That could change, but there is no evidence of a real crisis yet.