The coronavirus outbreak in Wuhan exposes the dangers of central planning.
On January 21, 34 days after the Chinese government released the first official report on the Wuhan coronavirus outbreak, the number of infected patients had increased dramatically. At the same time, numerous Hubei government officials organized and attended an ornate Lunar New Year gala at the Hongshan Grand Auditorium. Amid a public health crisis, Hubei’s government press release praised an actress, Fengshuang, for having a cold yet “performing in the show with full perseverance.” (They deleted the post after media backlash—but you can see a screenshot below).
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Hubei government press release, now deleted.[/caption]
Across the Donghu lake, that very week, the Wuhan government told the public that they have enough medical supplies to contain and fight this virus. But while the Wuhan media continues to remain composed, all the hospitals in Wuhan are in a state of pandemonium, facing a shortage of medical resources.
Given that the allocation of medical resources is a bureaucratic matter in China, the crisis is only multiplying. It seems the Wuhan state government is not reporting the facts on the ground to the Chinese central government—which is likely why the Health Commission Ministry is refusing to do much more than quarantine residents.
The tension between what the Chinese people are being told and the coronavirus crisis in Wuhan is a case study in the horrific consequences of central planning and China’s authoritarian system of government.
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Hong Kong police ban Hubei residents from entering.[/caption]
PUBLIC HEALTH GOVERNANCE IN A CENTRALLY PLANNED BUREAUCRACY
In China’s centrally planned system, hospitals like Wuhan Fifth Hospital and Wuhan Union Hospital are public hospitals and are trusted to manage local outbreaks on their own. If additional medical resources are needed, protocol demands that those on the front line will contact those in charge to ensure requests for further supplies are made to the relevant national departments.
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Map of Wuhan with hospitals marked.[/caption]
In Wuhan, however, the lack of public acknowledgment from the local government has forced desperate doctors to turn to social media to ask for donations for medical supplies. It was a risky move; most of them have risked their jobs by going public.
“Many. Tens of Thousands. The more, the better. The average daily consumption of disposable medical masks in each hospital amounts to 100,000. The shortage gap of disposable masks across Wuhan is currently around 32 million.”
In response, the Ministry of Health Commission issued an order that blocked all hospitals from accepting any overseas donations and most other donations. Despite that fact, all hospitals in the region bravely chose saving lives over capitulating to the government’s demands.
My friend Medwin Zhu, a Chinese-American student at UCLA, cut his quarter short in order to become one of the chiefs of affairs for the largest student volunteer group in North America mobilizing against the medical crisis. When I asked him how I could help, he gave me a list of hospital contractors and asked if I could make some calls. “It is simple,” he instructed, “ask them if the contractor is alive. Because some hospitals have multiple contractors, when we’re checking information, they told us some of them are under quarantine or dead. Then ask them how many supplies they need. If they can’t say the number, ask them the order of magnitude. That’s it.”
During my phone campaign, I spoke with one of the contractors from Wuhan Union hospital, Yan Yi. Yan told me that all hospitals in Wuhan are under a critical medical supply shortage, saying, “We need medical supplies, anything.” When I asked how much, he told me, “Many. Tens of Thousands. The more, the better. The average daily consumption of disposable medical masks in each hospital amounts to 100,000. The shortage gap of disposable masks across Wuhan is currently around 32 million.”
Yan sent me a request donation list of Wuhan Union hospital, which has already spread all over Chinese social media.
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Wuhan Union Hospital donation list.[/caption]
Wuhan Union hospital is facing a slew of essential medical supply shortages: goggles, n95 masks, surgical masks, disposable medical masks, protective clothing, surgical gowns, impact-proof eye masks, and protective masks. Several other hospitals I called sent me similar lists. Medwin informed me that aid volunteers couldn’t even send donations to Wuhan No.5 hospital—the hospital is currently under lock-down. Carriers refuse to transmit supplies there because of the hazardous condition.
Yet, despite this urgent need, the Wuhan government and press remain silent.
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Chinese citizens on social media.[/caption]
IN DESPERATION, THE CHINESE PEOPLE TAKE TO SOCIAL MEDIA
The situation of Wuhan No.5 Hospital corroborates what I heard from some Chinese doctors; Wuhan CDC and the Chinese government have not accurately calculated the scale of the outbreak.
“There are infected people in Guangzhou. But so far, they said there are only fourteen confirmed. It’s more than that. It is a protocol. For local officials, they don’t want to deal with major chaos during the Lunar New Year.”
The situation is eerily reminiscent of the Severe Acute Respiratory Syndrome (SARS) crisis 17 years ago. During the SARS crisis in 2003, the Chinese government kept information from the public for months until a major breakout occurred from a hospital in Guangzhou, only a ten minutes drive from my friend Lenny Leung, lives. Many of Lenny’s friends (including Dr. Huang, a resident doctor at The Third Affiliated Hospital of Sun Yat-sen University) have expressed grave concerns. Based on the information from medical professionals who are working in Guangzhou, Wuhan, and Shanghai, the situation in Southeast Coastal Area and Wuhan is much more concerning than the news has reported.
“It feels like SARS,” Lenny said to me on the phone, “There are infected people in Guangzhou. But so far, they said there are only fourteen confirmed. It’s more than that. It is a protocol. For local officials, they don’t want to deal with major chaos during the Lunar New Year.” Lenny told me. In fact, the latest US news reports that coronavirus casualties will surpass SARS.
From the leaked group chat Lenny’s doctor friends shared with me, I’ve heard from a Shanghai doctor say that doctors from other departments like Orthopedics and Nephrology are already infected.
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Wuhan leaked chat.[/caption]
“Our hospital is already the first-rated (medical level) in the country,” he said in the chat. “If a nurse, or a doctor is infected, just like SARS, it is unavoidable that people in the whole section are potentially infected too. You guys need to be prepared. The whole Orthopedics department of my hospital has been infected. No one is safe,” Dr. Sun warned the others in the group.
“No one is going to add those numbers. Because many people died at home or ER, so their names won’t be added into the statistics,” he added in the group chat, referring to the announced official statistics. Still, information like this is only circulated in their inner circle, not to the public. At the time of this conversation, China had confirmed only 440 cases. The latest official statistics show that there are 5794 identified patients, 9239 suspected cases, and 132 deaths.
According to the information shared by Dr. Huang, however, many doctors from ‘first-and second-grade hospitals’ in major cities along the southeast coast have reached a consensus. They believe that the definite number of infections is five to six times the number officially announced by China, including those who have not been confirmed. The number of deaths, they estimate, is two to three times the official announcement.
"A Wuhan doctor told me that they have no choice. There are no more beds in hospitals. They can only refuse to accept patients. With or without confirmation, they can only send patients home. The doctor's order is self-quarantine. This is an advanced warning of the scarcity of Wuhan medical resources," Dr. Huang said. The number of deaths is still being counted. According to Dr. Huang, many of the unreported deaths were located in other small cities of Hubei, such as Huanggang and Enshi.
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Map of Wuhan with surrounding cities.[/caption]
To meet patient demands, at least four hospitals, the non-respiratory-related offices or departments in many hospitals have become quarantine wards. Yet the Hubei provincial government is still trying to cover up most information from the public.
On Weibo, posts from Wuhan people seeking help can be seen everywhere, most of which stem from their family members being sick but refusing to take medical treatments because they’ve been placated by the Chinese government’s lackadaisical attitude. We can only conclude from these desperate pleas that the medical system in Hubei is paralyzed.
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A member of the public pleads for help on Weibo.[/caption]
"In the early stages of the crisis, the Wuhan government kept the news from Beijing and did not report it,” according to Dr. Huang. As a result, “the entire country's medical system missed the prime time to deal with the crisis," Lenny told me.
It’s true, hearsay and rumor spreads as fast as a virus—which may be why Hubei’s local government strove harder than ever to stop public panic. But their efforts to tamp down on accurate information from amounts to a state-run misinformation campaign. Thankfully, many first-line doctors risked their professional reputations to share first-hand information.
“The bottom line is that for the time being, we need to maintain surveillance,” Dr. Henry I. Miller wrote for Human Events earlier this week. That may be impossible—as we move into February, obtaining information on the ground and overseas might be as hard as curing the disease itself.
