The Economist - USA (2020-02-08)

34 TheEconomistFebruary 8th 2020

1

T

he doctors who examined Rana

Zhou’s parents decided that the couple

had probably caught the coronavirus

which has been sweeping their home city,

Wuhan, and spreading globally. But they

said they did not have enough test kits to be

sure. Instead of finding them beds in a hos-

pital, officials in their neighbourhood told

them to go to one of many hotels which the

government has requisitioned in order to

monitor and isolate people with minor vi-

rus-related symptoms. But when her fa-

ther’s fever worsened, staff said they could

not take care of him. They told the pair they

would have to return home.

It is a scary time to be ill in Wuhan. The

city has one-third of all confirmed infec-

tions by the virus and three-quarters of the

deaths caused by it. People there are barred

from travelling elsewhere (similar rules

apply across Hubei, a Syria-sized province

of which Wuhan is the capital). Since late

January military medics have been piling

into the city. Soldiers are helping enforce

its cordons. The army’s growing presence

reassures many people, says a resident. But

some find it unnerving.

With hospitals brimming, the local gov-

ernment has announced new rules. Rather

than visiting hospitals, people who think

they might have the virus should tell dis-

trict officials about their symptoms and

seek examinations at local clinics—facili-

ties which, in normal times, many people

eschew in favour of what they regard as the

hospitals’ more professional care. Wuhan

has opened makeshift hospitals in an exhi-

bition centre and a sports arena to house

patients who are only mildly ill from the vi-

rus. Elsewhere in China health services are

also under strain, even if the pressure is

less than in Hubei. Officials in many places

have banned non-essential hospital visits

to avoid contagion. But many people,

afraid of catching the virus, now avoid hos-

pitals anyway, except in emergencies.

China’s health system can cope better

with shocks than in 2003 during the sars

outbreak. At that time, officials feared that

the spread of the virus might be hidden be-

cause rural residents, lacking health insur-

ance, would avoid hospitals. The govern-

ment tried to allay such concerns by

offering free treatment for sars. Since then

it has considerably expanded access to

state-funded insurance schemes. More

than 95% of Chinese are now covered. Out-

of-pocket payments have fallen from about

60% of medical expenses to 30%.

But for poorer people, the costs can still

be crippling. The government recently

promised that it would pay for all treat-

ment related to the new virus. That was too

late for a pregnant woman infected in Wu-

han. She died after her husband decided he

could no longer afford the bill, according to

a doctor there interviewed by Caixin, a

magazine. The policy changed the next day.

Barely better than barefoot

The government has spent lavishly on in-

frastructure, but its investment in health

care has failed to keep up. China says it has

about 2.6 doctors for every 1,000 people,

higher than the average for middle-income

countries. But the World Health Organisa-

tion says half of China’s doctors do not

have a bachelor’s degree. Among those in

villages and small towns, only 10-15% do.

Some practise traditional Chinese medi-

cine, a form of treatment that has govern-

ment approval but little scientific basis

(stocks of an oral liquid based on such

medicine have been flying off shelves since

a recent report by Xinhua, an official news

agency, that it can “suppress” the virus).

There is also an acute shortage of nurses.

The average in rich countries is three per

The Wuhan virus

Under observation

BEIJING

A weak health-care system complicates China’s battle with the coronavirus

China

35 PressureonCarrieLam

36 Chaguan: A people’s war

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