The EconomistFebruary 8th 2020 China 352 doctor.InChinait isonlyone.
China’sinvestmentinhealthcarehas
mostlygonetobighospitalsincities.Wu-
hanhasabouthalfofHubei’sbestmedical
facilities,butonlyaboutone-fifthofthe
province’spopulation.Far lessattention
has been paid to primary-care clinics,
whichinmoredevelopedsystemshandle
minor ailmentsand escalatetherest to
specialists.Onlyabout5%ofChina’sregis-
tereddoctorsserveasgeneralpractition-
ers.Theaverageintheoecd, a clubmostly
ofrichcountries,is23%.AfterWuhanim-
poseda lockdowninlateJanuary,panicky
residents converged on large hospitals
seeking reassurance. The queues would
have promoted cross-infection, says Xi
ChenofYaleUniversity.
Publicangerabouthealthcare,includ-
ingthegougingofpatientsbyhospitals,
hastriggeredoccasionalviolenceagainst
doctors.In lateJanuary aman attacked
medicalstaffinWuhanafterhisfather-in-
lawdiedfromthevirus.Butthesystem’s
publicimagemayhaveimprovedduring
thecurrentcrisis.Manypeoplepraisedoc-
tors’willingnesstojointhefightinHubei,
despitehighratesofinfectionamongmed-
ical workersthere.They willneed such
supportinthestruggleahead. 7“T
here is noreason for measures that
unnecessarily interfere with interna-
tional travel and trade.” So declared the
World Health Organisation’s chief, Tedros
Adhanom Ghebreyesus, on February 3rd
after several countries, to prevent the
spread of the coronavirus, had closed their
borders with China or (like America and
Australia) announced that foreign citizens
who had recently visited China would be
barred from entering. Yet many people in
Hong Kong want the territory to seal itself
off from the Chinese mainland. Their de-
mands are putting new political pressure
on the territory’s leader, Carrie Lam, after
months of pro-democracy unrest.
As The Economistwent to press, 21 peo-
ple in Hong Kong had been detected with
the virus, of whom seven were from the
mainland. Six of the others were Hong
Kong residents who caught it while travel-
ling in China. They included a man whose
death, attributed to the virus, was an-
nounced on February 4th. It was the first
such fatality in the territory and only the
second outside the Chinese mainland (the
other was in the Philippines). The remain-
ing eight cases involved infections that oc-
curred in Hong Kong itself.
Mrs Lam has responded with ever-
tighter controls. On January 27th visitors
from Hubei, the province where the virus
was discovered, were banned from enter-
ing Hong Kong. On January 30th six of 14
border checkpoints were closed. Hong
Kongers who had travelled to Hubei were
ordered into quarantine centres. The
mainland’s government also imposed re-
strictions, stopping the issuing of permits
for tourist trips to Hong Kong. The number
of mainlanders arriving at border postsother than the airport fell by 90% com-
pared with two weeks earlier. Mrs Lam said
that closing the border entirely would be
“discriminatory”, but four days later she
announced that remaining entry points,
apart from the airport, two road bridges
and a cruise terminal, would be closed
from February 4th. On February 5th she an-
nounced that anyone arriving from the
mainland would be quarantined for 14 days
and the cruise terminal would be shut.
For some Hong Kongers, these mea-
sures have not been enough. On February
3rd around 3,000 non-essential medical
staff working in public hospitals went on
indefinite strike—the biggest such actionin the health system’s history. Their de-
mands include the full closure of the bor-
der. The following day their ranks swelled
to 7,000. They have vowed to continue
their strike, despite Mrs Lam’s measures.
She is in murky political water. The
strikers belong to a recently formed union
with links to activists who have been at the
forefront of the anti-government unrest
that has roiled the territory since June. Oth-
er pro-democracy unions have threatened
to join them, including one for bus drivers.
The central government, however,
would not be happy with a total ban. It ac-
cused America of sowing fear when it be-
came the first country to bar foreign travel-
lers coming from China. China’s acting
ambassador to Israel compared such con-
trols to the turning away of Jewish refugees
during the Holocaust. The embassy later
apologised, saying there was “no intention
whatsoever to compare the dark days of the
Holocaust with the current situation”.
But many Hong Kongers are fearful.
Memories are still fresh of sarsin 2003, a
disease caused by another coronavirus dis-
covered in China. That outbreak infected
about 1,750 people in Hong Kong and killed
almost 300. Mrs Lam, not least, will be
mindful of events that year. Public anger
over the government’s perceived hesitancy
in handling sarsfuelled unrest caused by a
proposed national-security bill. The crisis
eventually prompted the central govern-
ment to replace Tung Chee-hwa, Hong
Kong’s first post-colonial leader.
Mrs Lam appears to have retained the
central government’s backing during the
past few months of turmoil on Hong Kong’s
streets. But in a territory where distrust of
the government runs deep, it is unlikely
that her response to the new coronavirus
will boost her abysmal ratings at home. 7HONG KONG
The coronavirus is fuelling tensions in a protest-racked cityHong Kong and the mainlandKeep out
Doctors against border crossings