The international media have trumpeted China’s impressive and unprecedented response to the novel coronavirus outbreak that began in late 2019. In addition to taking unprecedented action by locking down over 53 million people (more that the population of South Korea), China has been lauded for its rapid hospital construction. Numerous breathless descriptions can be found in the news of China’s “resolute” and “decisive” actions, with regular assertions that no other country could possibly match China’s actions. Even the World Health Organization (WHO) has been publicly fulsome in its praise of Chinese transparency and willingness to act in response to this new global threat.
The state’s ability to take quick and dramatic decisions and then implement them reflects what may be referred to as China’s “authoritarian advantage.” An authoritarian regime may take even controversial, untested policies and quickly implement them in the field. As is regularly noted in the press, no democratic government would dare to take many of the steps China is taking – not just quarantines, dramatic social distancing requirements, and rapid hospital construction, but also control over domestic media, massive mobilization of health workers from across the country, and more.
According to many public health experts and media outlets, China has clearly learned the lessons of SARS in 2002-03, when officials attempted to hide the outbreak, hoping that it could be managed domestically. The result of that approach was an epidemic that became far more serious than might otherwise have been the case.
But has a lesson been learned and does the “authoritarian advantage” actually confer an advantage?
When considering how best to prepare for and respond to an epidemic outbreak, the public health literature recognizes the central role played by public health and other government officials at the central and local levels. These officials must treat and inform the public while sharing health-related information, but without engendering panic. When an outbreak occurs and hospitals are flooded by worried citizens, officials must effectively manage them, ensuring that those who require treatment receive it, and those who can stay home do so while receiving the support they require.
Support for those in social isolation or quarantine at home means providing services they might otherwise obtain on their own – food, medicine, water, and other supplies often delivered to their doors. The population must be confident that its needs will be met, and that the sacrifices being asked of them are necessary. Above all, the population must have confidence and trust in the information and in the officials providing it.
The public health literature also recognizes the important role that civil society organizations (CSOs) may play in public health service provision. These organizations often spring from within local communities (e.g. religious and social groups) and draw their membership from the local population. Members of these CSOs are therefore often familiar with the concerns that drive local communities and have built long-term ties of understanding and trust. As a result, these CSOs are well placed to work hand in hand with over-stretched public health officials to provide the many services the local population requires during an epidemic. This cooperation fosters a bottom-up approach to epidemic response that is based on service provision within the local communities and a relationship built on trust.
When he came to power in 2012, Xi Jinping began recentralizing power in his own, and the Chinese Communist Party’s hands. As part of this process, the once slowly expanding political space available to domestic and international CSOs active in China has been steadily eroded. These CSOs are increasingly constrained by stringent new regulations and laws that often make it impossible for them to provide services – including public health services – that they once offered. This represents a significant shift from a past where CSO-local government collaboration supported public health services to the population that local governments could not or would not alone provide.
One can argue that, in the case of the current outbreak, CSOs are not required. As we have seen, China is able to mobilize public health workers from across the country, sending them to Wuhan to “battle” the outbreak. The same can be said regarding other resources – equipment, medicines, testing kits, masks, and more. However, as the coronavirus spreads across the country, these resources will be needed in place and local governments will be increasingly reluctant to share them.
One can also point to China’s neighborhood committees as an alternative to CSOs. The committees – often retirees who keep an eye on their neighbors on behalf of the Party – have indeed played a role in providing basic services. However, as the public health literature clearly notes, trust is key to ensuring public cooperation. Neighborhood committees have a difficult history and are often distrusted by the population, both due to their legacy and because they are often viewed as agents of the Party.
If the coronavirus continues to spread, already scarce resources will become more so. And while the Party has demonstrated its “authoritarian advantage” by implementing large-scale and impressive initiatives, these initiatives ultimately depend on the capacity for long-term implementation based on community trust and cooperation. Trust is difficult to maintain in a secretive, authoritarian system. Having undermined China’s once growing civil society, a trusted potential ally in the coronavirus containment, the Party has undermined a key tool for effective epidemic response. It seems the Party has not yet learned the lessons of SARS as well as we initially thought.
Jonathan Schwartz, Ph.D., is a professor at the Department of Political Science, State University of New York, New Paltz.