The epidemic control measures in China from a historical perspective

About the Author

Christos Lynteris

Dr. Christos Lynteris is a Senior Lecturer in Social Anthropology at the University of St Andrews. He is the Principal Investigator of the Wellcome-funded project The Global War Against the Rat and the Epistemic Emergence of Zoonosis. His research focuses on the anthropology and history of epidemics and epidemiology, with a particular focus on zoonotic diseases.

Audio transcript

The outbreak of the new coronavirus in Wuhan and the spread of the epidemic across China have led to the adoption of community containment measures, such as quarantine and the lock-down of cities numbering millions of people. To understand what is happening in China, we need to place epidemic control measures in their proper historical context.

Epidemics and their control form an important but often neglected part of the modern history of China. Following the defeat of the Chinese Empire in the first and second Opium War, colonially controlled treaty-ports came under sanitary regimes imposed by foreign imperial powers. It was only in 1910 that the Qing Empire, only a few months before its collapse, rose to the task of epidemic control. This was in response to a devastating epidemic of pneumonic plague; an airborne form of the disease that decimated the North-Eastern Provinces of the Empire, known at the time as Manchuria.

What led to the adoption of isolation and quarantine for the first time by the Chinese state was the antagonism faced by Russia and Japan in the region. Controlling interlocking areas of Manchuria, these empires were quick to impose quarantine and isolation as a means of halting the epidemic, but also as a way of claiming control over the region.

Posing a threat to Chinese sovereignty over Manchuria, this led the Qing throne to authorise the adoption of the same measures by the Chinese authorities in the region. The success in halting the epidemic was recognised by the Republican heirs to the Chinese state, who as a result instituted the first epidemiological apparatus in China: The North Manchurian Plague Prevention Service. A service that was in reality concerned with the study and control of all infectious diseases.

The emergence of modern epidemic control in China was thus a highly political and indeed geopolitical event. Sovereignty and quarantine, as historians of the region have shown, have since been interlinked, with the ability of the Chinese state to hold a monopoly over the decision to apply quarantine measures when, where and in the way it deems necessary being a measure of state power.

Under the control of the Communist Party, China has undergone several transformations in public health policy. The SARS pandemic of 2003 in particular has traditionally been approached as a watershed, as it highlighted the need for international cooperation, and the limitations of national sovereignty in situations of epidemic emergency.

Those who however over-rely on the so-called lessons of SARS do so at their own peril. For China in 2020 is not China in 2003. In charge of the current crisis, President Xi has managed to maintain an acceptable level of international cooperation whilst at the same time reinforcing practices of quarantine as a tool and indeed a proof of national sovereignty.

The subtleties of announcements by Chinese officials are often lost to untrained ears. So when in his latest speech about the coronavirus, Xi described it as a demon, this was quickly dismissed as a mere metaphor. However, a historical perspective of epidemic control in China warns us against this quick dismissal of Xi’s turn of phrase.

Everyone in China would recognise in his choice of words the shadow of the founder of the People’s Republic, Mao Zedong, who in 1958 wrote one of his most famous poems, “Farewell to the God of Plague”. Written to celebrate and further boost mass-line styled efforts of eradicating schistosomiasis, the poem has been taught at schools for decades.

Describing the waste brought about by the pestilence, the poem ends with a promise of bidding the god or demon of plague farewell. Coming from Mao, and echoed in Xi, this is not simply some metaphysical well-wishing, but a promise of the state, and of the head of state, to its people; a promise for better days if only they follow faithfully the party line.

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