I’ve studied the history of viral outbreaks. Coronavirus panic shows how little China learned from SARS

We will never prevent or respond effectively to epidemic challenges if we fail to grasp the big picture that both China and Hong Kong are in danger of missing

The coronavirus outbreak in China is a reminder that infectious disease prevention and control aren’t matters of public health alone. They are also, crucially, social and political concerns. As the Wuhan crisis deepens and extends, political stress points are revealed. This could be 2003 all over again, when SARS hit the world. Then, as now, the issue is transparency and China’s role in global health.

During the SARS outbreak, Chinese authorities were widely condemned for covering up the scale of the initial outbreak, and for their reluctance to collaborate with the international community. It was in part as a response to these failures that over the last 16 years, China has sought to build up a more robust preparedness capacity. In a recent talk I attended by George Gao, the director-general of China’s Center for Disease Control and Prevention (CDC), much was made of the country’s state-of-the-art surveillance infrastructure, as well as its commitment to grappling with global epidemic challenges. China assisted in the international response to the 2014-2016 Ebola outbreak in West Africa.

How much of this has been window-dressing? Quite a bit, it would seem. For all the talk of increased transparency, the response to the ongoing coronavirus outbreak has been characterised by poor communication, little collaboration, and a heavy-handed approach that has fueled, rather than stemmed, public panic. Most of what the world knows about the epidemic is based on partial official accounts, or news stories leaked from the frontline.

Bloggers on Chinese social media have vented their frustration at what they view as an inadequate response. A senior journalist writing for the local Communist Party-run newspaper, the Hubei Daily, has censured the local leadership in a post on Weibo. The central government in Beijing has not been immune to criticism, either. In an interview on CCTV, Zhou Xianwang, the mayor of Wuhan, suggested that the blame for any lack of transparency should lie with Beijing. The central government’s stringent rules around the release of sensitive information had effectively tied his hands.

In Hong Kong, my home city and the global springboard for SARS in 2003, the novel coronavirus has merged into the ongoing anti-government protests to the degree that the Wuhan virus is now inseparable from the larger political narrative.

In early October 2019, the Hong Kong government brought in a “Prohibition on Face Covering Regulation” under a 1922, colonial-era ordinance. This banned citizens “from covering up their faces in unlawful and unauthorized assemblies as well as riots.” Although exceptions were made for those with pre-existing medical conditions, the ban was viewed by many as excessively heavy-handed.

Now Carrie Lam Cheng Yuet-ngor’s government has found itself in a quandary. It has been reluctant to backtrack on its banning of masks, even in the face of an epidemic. As the number of confirmed cases rises in Hong Kong and the epidemic spreads across the cities of the mainland, the government has been unwilling to shut the border, despite mounting calls from medical experts and politicians. Protesters, deeply suspicious of what they perceive as Lam’s soft approach to the viral threat (in contrast to her hardline approach to the protestors), have called for strikes against the official handling of the outbreak. Rail services between Hong Kong and mainland China have been targeted with demands for “anti-epidemic” action.

Politics shouldn’t be brought into public health: this has been one of the resounding messages promoted during the current crisis. Unfolding events in Hong Kong and mainland China, however, have brought home the truth that epidemic control inevitably involves more than managing a disease. It entails managing expectations and ensuring transparency. Effective governance isn’t synonymous with strongman authority. Disclosing weaknesses or shortcomings doesn’t necessarily lead to a lack of public confidence. And assertive action doesn’t always avert panic. In the end, trust is assuredly the basis of sound public health, just as it is a prerequisite for sound governance. We will never prevent or respond effectively to outbreaks if we fail to grasp this big picture and recognise that the politics of an epidemic matter.

Robert Peckham is MB Lee Professor in the Humanities and Medicine at the University of Hong Kong and author of ‘Epidemics in Modern Asia’