One year later, COVID is a low threat in China. How did they get here?

Written by Amy Ta, produced by Brian Hardzinski

KCRW is marking the one year anniversary of COVID-19 being declared a pandemic by the World Health Organization. March 11, 2020 was the day everything changed. 

It all began in China, where now the virus has nearly disappeared. The country’s National Health Commission reported just 11 new coronavirus cases on the mainland on Wednesday, and five new cases on Tuesday. China says it has a total of about 90,000 confirmed cases. Meanwhile, the  U.S. has more than 29 million cases, according to the CDC. 

Elanah Uretsky, medical anthropologist at Brandeis University, studies public health in China, and she says China’s numbers are probably accurate to a certain extent. “Getting an accurate assessment is contingent on very very comprehensive surveillance. But I think China has been able to do surveillance more comprehensively than a lot of other countries. And they still may be missing some cases. But they also have the ability to pick up small numbers of cases. So were there just five or were there just 11 cases, there could have been more cases than that.” 

Chinese authorities are reporting about 4600 as the total death toll. 

“The only reason to doubt that number is because the virus happened so early in China. … They didn't have it identified or named at the beginning, and there was no way of testing for it. … Were more than … something like 84,000 people infected before March of last year in China? Probably yes. Did more than 4600 people die in China from coronavirus? Probably yes. Will we ever know what that number is? Probably no, because it happened too early in the timeline to detect those cases,” says Uretsky.

Now life looks pretty good in China, she says, and her friends there have been moving around freely, going to restaurants and malls, celebrating holidays with friends and family. “They feel little threat from a virus at this point.”

Masks are optional and social distancing isn’t enforced, she describes. 

China’s effective measures to tame the virus 

Could the U.S. have done what China did, such as strict quarantines? Uretsky says yes, and at the start of the pandemic, we started going down that path but then stopped. 

“One of the first big outbreaks in the United States happened in New Rochelle, New York, and the government brought the National Guard in to cordon off New Rochelle, New York. That's the one and only time I ever remember that happening in this country.” 

She says the U.S. has had trouble tracking infected people, whereas China, Korea, Singapore, and Vietnam effectively did so.  

“One of the first cases happened in Boston where I live. It was a student from UMass Boston … a Chinese student who had returned from Wuhan after winter break. And his whereabouts were publicized. … He wanted people to know where he had been, so that they could be cautious. … So we can do this. … But I think we have this heightened sense of individualism in the United States that makes people suspicious of when their whereabouts are tracked or traced.” 

Another effective measure in China, Uretsky says, is putting infected people into field hospitals. “Here in the United States, when someone's infected, we send them home so that they can infect their families. That's one of the measures that helped China get the virus under control, the fact that they were taking people out of their homes and out of the community, and isolating them in a hospital that was meant just for people with coronavirus.”

China learned that public health was a collective effort following the 2003 SARS outbreak, which they realized could have brought down their economy. 

“That's what's really most important to them. Well, if we want to protect our economy, then we have to build up our public health efforts, we have to strengthen our public health capacity. And that was what they did. And they were able to mobilize it fairly quickly in this instance,” Uretsky says. 

China had a coordinated response from the national level too. Without that, they wouldn’t have made such achievements, Uretsky says. Compare that to the United States, where policies differed among states and even among counties within the same state. 

But no strong push for vaccinations, and trouble achieving herd immunity?

China tamed the virus before vaccines were even available. Uretsky says this is a catch-22 that may hurt them later, but their efforts to bring COVID under control are to be lauded. 

She says China has kept its infection level so low that the four vaccines they developed had to be tested in other countries such as Brazil and Turkey.  

“It also means that they're going to have a really, really hard time achieving herd immunity because there are few infections. … Chinese people don't feel threatened by this virus. So whereas we're all running out to see how we can get a vaccine … in China, they're much more relaxed about this … people don't see a need to go out and get vaccinated.” 

Uretsky says people don’t trust the Chinese vaccines either. 

So whereas the U.S. is working toward herd immunity, China’s going to have a tough time with that. “They have very few people who are infected, and very few people are willing to get vaccinated.”

The Chinese government doesn’t force its citizens to get vaccinated, she adds. 

“I do wonder what happens when they try to open up the country again. … There's only so long that they can sort of isolate themselves from the rest of the world. And I think when people start traveling around again, you're not going to have that immunity.”