Libération - 07.04.2020

THE NEW YORK TIMES INTERNATIONAL WEEKLY AND INTERNATIONAL REPORT APPEAR IN THE FOLLOWING PUBLICATIONS: CLARÍN, ARGENTINA n DER STANDARD, AUSTRIA n LA RAZÓN,
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WORLD TRENDS

II THE NEW YORK TIMES INTERNATIONAL WEEKLY TUESDAY, APRIL 7, 2020

INTERNATIONAL WEEKLY NANCY LEE Executive editor TOM BR ADY Editor ALAN MATTINGLY Managing editor

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course they should have seized on it, found it, gone to understand it.” Aggressive action just a week earlier in mid-January could have cut the number of infections by two-thirds, according to a recent study. Another study found that if China had moved three weeks earlier, it might have prevented 95 percent of the country’s cases. “I regret that back then I didn’t keep screaming out at the top of my voice,” Ai Fen, one of the doctors at Wuhan Central Hospital who spotted cases in December, said in a Chinese magazine. China’s leader, Xi Jinping, has sought to move past the early fail- ings and shift attention to the drive to end the outbreak. The central leadership has focused blame on local bureaucrats, dismissing two health officials and the party sec- retaries for Hubei Province and its capital, Wuhan. Now, interviews, leaked documents and investi- gations by the Chinese media re- veal how a system built to protect medical expertise and infection reports from political tampering succumbed to tampering. The failures in the first weeks “greatly reduced the vigilance and self-protection of the public and even medical workers, making it harder to contain the epidemic,” a study of the epidemic by 12 medical experts from Shanghai

Jiao Tong University said.

Preparing for the Worst Last year, health officials exud- ed confidence that China would never again suffer a crisis like SARS. In July, the Chinese Center for Disease Control and Preven- tion held its biggest infectious outbreak training exercise since the SARS epidemic in 2002 and 2003, showcasing strides made since SARS traumatized the nation. More than 8,200 officials took part in the drill, focused on a trav- eler arriving from abroad with a fever, triggering a hunt for other passengers. They raced to show they could quickly and effective- ly track, identify and contain the virus, including notifying Beijing. At the heart of China’s defenses was the Contagious Disease Na- tional Direct Reporting System, started in 2004. With it, health officers in Beijing could pore over reports from hospitals or local centers, spotting outbreak warning signs hours after a doctor diag- nosed a troublesome infection. “Viruses like SARS could emerge anytime, but there’ll never be another SARS incident,” Gao Fu, director of China’s disease control center, said in a speech last year. The system helped when China suffered outbreaks of avi- an influenza. And last November, China alerted the public to an outbreak of pneumonic plague in sparsely populated Inner Mongo- lia after only two cases. Since the outbreak in Wuhan, some doctors have said they were

unsure how to report early cases, which did not fit into the standard list of infections. But little-un- derstood infections could still be logged as “pneumonia of unknown etiology” — or unknown cause. Chinese health authorities warned hospitals to look out for such outliers. Dr. Yang said, “This was a way of capturing an outbreak while it was embryonic.”

‘A Baffling High Fever’ Dr. Ai was among the first to note a pattern among patients staggering into Wuhan’s hospitals with dry coughs, high fevers and lethargy. Computerized tomogra- phy scans often revealed exten- sive damage to their lungs. “It was a baffling high fever,” Dr. Ai said of a patient he saw on December 16, according to a Chinese magazine called People. “The medicines used throughout didn’t work.” By the end of the month, local disease control centers in Wuhan were receiving calls from doctors about strange pneumonia cases. In theory, doctors could have

reported such cases directly, but Chinese hospitals also answer to Communist Party bureaucra- cies. Hospitals often defer to local health authorities about reporting troublesome infections, apparent- ly to avoid surprising local leaders. That deference gave officials in Wuhan an opening to control information about the virus. Local disease control offices had counted 25 cases by December 30, according to a report leaked online in Febru- ary. That document was one of the first attempts by Wuhan to understand the extent of cases, and listed patients who had fallen ill starting December 12. “The local health administration clearly made a choice not to use the reporting system,” said Dali Yang, a University of Chicago professor studying policymaking in China. Word of the outbreak started to reach officials in Beijing after rumors and leaked documents spread online. Mr. Gao, the director of the Center for Disease Control, spotted the information online and raised alarms. The cen-

ter rushed experts to Wuhan. The first arrived the next morning. Officials from the National Health Commission have said that they ordered Wuhan to issue its first official announcement on the outbreak on December 31. That day the government also informed the World Health Organization. Cases were finally entered into the system on January 3.

Narrow Criteria Local officials outwardly wel- comed expert investigators sent by Beijing. Behind the scenes, they mounted an effort to limit the number of infections counted as part of the outbreak, creating bar- riers against doctors filing cases. A leaked report describes how in the first half of January, local officials told doctors that cases had to be confirmed by bureaucratic overseers. Starting on January 3, Wuhan’s Health Commission set narrow criteria for confirming that a case was part of the outbreak: Patients could be counted if they had been to the market or had close contact with a patient who had. That excluded a growing number of likely cases. For most of the first half of January, local officials maintained that there had been no new confirmed infections. Experts finished their assessment of Wuhan on January 19. “All the members of the expert team reported that the situation was grim,” Yuen Kwok-yung, a professor of infectious diseases at the University of Hong Kong who was among the team, told Caixin magazine. “Preventive measures had to fall in place immediately.” Days later, Wuhan was shut down. At the time, the coronavirus had killed 26 people and sick- ened more than 800. By the end of March, there were more than 820,000 cases worldwide; more than 40,000 had died.

pressuring Colombia, Algeria, Mozambique, Iraq and Nigeria. Mexico was already in a reces- sion, and many of its jobs are cen- tered on producing goods for the United States, now in a veritable lockdown. In wealthy nations, govern- ments have unleashed trillions of dollars in spending and credit to limit the economic damage.

But in poor countries, people who support themselves by collecting scrap metal from dumps risk hun- ger if they stay home. “Some of these countries are going to conduct real-life, un- pleasant experiments in the let- it-rip kind of approach, because I just don’t see how they can control it,” said Gabriel Sterne of Ox- ford Economics. India, a country of 1.3 billion people, is profoundly exposed.

Shagun, 45, a mother of five in New Delhi, sat on the sidewalk slicing fruit she sells to rickshaw drivers. She has rationed food for her children. “God forbid we are asked to move out of the footpath, we will be surviving on only one meal per day,” she said. Argentina was in peril before the pandemic. Its currency, the peso, lost over two-thirds of its value in 2018 and 2019, as inflation exceeded 50 percent. Its economy contracted by 2 percent last year. Government debt approached 90 percent of annual economic out- put, a signal of distress. For Alejandro Aníbal Alon- so, 53, a taxi driver and father of two, the dangers are mounting. His creditor sent him a menacing email. “Payments do not stop due to the coronavirus,” it said. Mr. Alonso swallowed his fears and picked up a visitor arriving at the airport from the Netherlands. “I

can’t say no to a trip now,” he said. In Turkey, companies are satu- rated in debt, much of it in foreign currencies. The debts are the result of President Recep Tayyip Erdo- gan’s pursuit of growth at any cost. Gürsel Yenilmez, 42, closed his cafe in Istanbul. He has canceled purchases of olives and olive oil from producers in rural Turkey. “We can’t buy anything from them or pay them right now,” he said. Kenya is heavily reliant on Chinese imports. That trade has diminished by over one-third in

recent months. “We are just sitting around in the shop all day worried about when our customers will come,” said Faisal Ali Mohamed, who sells dresses. In Manila, Reynaldo Tating, 57, is grounded at home. Like millions of Filipinos, he works abroad, spending eight months a year sail- ing the world on cruise ships, mix- ing cocktails for tourists. Now, he worries that his em- ployer, a cruise operator, could go bankrupt. “I don’t know if we can return to our jobs,” he said. “Or whether we still have jobs.”

Outbreak Ravages Developing Nations

Amber Wang, Claire Fu, Lin Qiqing and Paul Mozur contributed reporting.

Con tin ued from Page I

A System to Track

Contagions Failed

ULET IFANSASTI FOR THE NEW YORK TIMES

ROMAN PILIPEY/EPA, VIA SHUTTERSTOCK Wuhan has begun lifting restrictions placed during the outbreak.

Tourism in Asia has been hit particularly hard by the outbreak. A temple complex in Yogyakarta, Indonesia, closed to the public.

WORLD TRENDS

TUESDAY, APRIL 7, 2020 THE NEW YORK TIMES INTERNATIONAL WEEKLY III

Aurélien Breeden, Elian Peltier, Daniel Politi, Tiffany May and Vivian Wang contributed reporting.

ALESSANDRO GRASSANI FOR THE NEW YORK TIMES Lighting a candle for the sick during quarantine in Milan, Italy.

By DAN BILEFSKY and CEYLAN YEGINSU MONTREAL — After the pair had sanitized the tops of their beer cans, Morgane Clément-Gagnon, 33, and the man she had met online sat spaced apart on a park bench in Montreal. The two had greeted each other by touching the tips of their sneakers. But as laughter gave way to talk about their fears, she leaned in for a kiss. Racked with fever and confined to her cramped two-bedroom apartment in Istanbul, Zeynap Boztas, 42, was feeling trapped, not only physically but psycholog- ically: The husband she planned to kick out of the house and divorce after finding dating apps on his iPad was now lying next to her in bed. In his apartment in Berlin, Mi- chael Scaturro, 38, was attending a virtual “happy hour” with 15 single friends from Berlin, Madrid, London and New York. The group sipped merlot and discussed the wisdom of finding a “corona boy- friend” or girlfriend to help get through the crisis. These are glimpses of the rad- ically altered lives of millions of

people around the world who are navigating love, hate and the ex- tensive terrain in between under the tyrannical rule of the coronavirus. In a matter of weeks, the global epidemic has transformed relationships, dating and sex. Wed- dings have been postponed, while divorce rates have reportedly soared in China as the crisis has eased. Lovers and family members are suffering aching separa- tions as borders have closed. The crisis has spawned a new lexicon. Where once there were “blackout babies,” we can now expect a wave of “coronababies” and a new generation of “quar- anteens” in 2033. Couples whose marriages are fraying under the pressures of self-isolation could be heading for a “covidivorce.” Getting away with affairs has also become tougher. When a man from a small town in Santiago del Estero Province in Argentina bragged to friends that he had a

tryst with a former lover return- ing from Spain, they reported him to the authorities. The entire town was put on lockdown on March 14. The man later became the first confirmed coronavirus case in the province. Dr. Lucy Atcheson, a Lon- don-based psychologist, said that lockdowns were engendering a new togetherness for some while amplifying friction and conflict for others. “It’s like putting all our issues into a frying pan and really heat- ing them up,” Dr. Atcheson said. “Something like this also makes you realize how short life is. So if you’re in a bad relationship, you’re going to leave when you can, because you’re going to realize life’s too short to suffer like this.” Ms. Boztas, the Istanbul woman, said the coronavirus had sent her to the brink of a mental breakdown. She had decided to separate from her husband of 12 years two weeks before the city went into lockdown. After she confronted him, he agreed to move out. “I finally thought that I would be free,” she said. But he insisted on staying in the family home until the threat of the coronavirus outbreak subsid- ed. Now, both she and her husband are fighting off cold and flulike symptoms that she fears could be the coronavirus. “Should I worry about my fever?” she said. “Should I worry about putting food on the table? Cleaning? Entertaining the kids? Picking up my husband’s dirty clothes off the floor? There is no- where to escape this in- sa n it y.” For single people, the corona crisis is bringing a different kind of challenge. After matching with a New Zea- land musician on Hinge, a dating app, Ms. Clément-Gagnon said, the two began a video call. Eager to meet, they opted for a “socially distanced silent disco” date in a park. Ms. Clément-Gagnon said she wanted to see him again. But there were obstacles: Her sister had just returned from Australia and was living with her in quarantine. The man wanted to return to New Zea- land to be with his family. The two texted constantly and weighed the risks of seeing each other again. In the end, Ms. Clé- ment-Gagnon decided to breach her quarantine and meet him in a friend’s empty apartment, talking, watching movies and finding com- fort in each other’s arms. “Is corona making something magic with all of this?” she asked. “I feel fear everywhere, and in this unexpected meeting I felt no fear. Maybe this is the corona story that will die with the disease. Whatev- er happens, it was a beautiful mo- ment.”

Relationships Worldwide

Are Tested by a Virus

By JULIE TURKEWITZ MARACAIBO, Venezuela — In their final minutes together, Jean Carlos, 8, held his mother’s hand and promised to “take deep breaths” so he wouldn’t cry. His sister, Crisol, 10, hid. His brother, Cristian, 12, hauled a blue suit- case into the yard. Aura Fernández, 38, a single mother of 10, beat back a surge of tears. Her bus came rolling down the road. Then she kissed her children, climbed aboard and disappeared. “I love you,” she said just before setting out. “Study hard.” Seven years into an economic collapse, Venezuela’s migrant crisis has grown into one of the largest in the world. By the end of 2020, an estimated 6.5 million people will have fled, according to the United Nations refugee agency. But hidden inside that data is a startling phenomenon. Vene- zuela’s mothers and fathers, de- termined to find work, food and medicine, are leaving hundreds of thousands of children in the care of grandparents, aunts, uncles and even siblings who have barely passed puberty themselves. Many parents do not want to put their children through the grueling and sometimes very dangerous upheaval of displace- ment. Others simply cannot af- ford to take them along. The exodus is so large that it is reshaping the very concept of childhood in Venezuela, sending grade-schoolers into the streets to work — and leaving many exposed to the abusive players who have filled the vacuum left by the collapsing Venezuelan state, including sex traffickers and armed groups. By one assessment, migrating parents have left behind nearly a million children. “You grow up fast,” said Ms. Fernández’s niece, Silvany, a

9-year-old. Her mother went to work in Colombia in October. Silvany and her cousins have remained with their ailing grandparents. And the fourth grader has assumed many of the responsibilities for her little brother, Samuel, age 1, feeding him and cradling him at night. In rare situations, children have been passed from grand- parent to cousin to neighbor, with each caretaker migrating or dis- appearing, until young people are on their own. “This is a phenomenon that is going to change the face of our society,” said Abel Saraiba, a psychologist at Cecodap, which provides counseling. These sep- arations, he added, have the po- tential to weaken the very generation that is supposed to one day rebuild Venezuela. The arrival of the coronavirus in Venezuela has isolated these children further. President Nicolás Maduro has announced a countrywide lockdown, sending the military to enforce the measures. The effort has cut many young people off from the teachers and neighbors who may be their only means of support. At the same time, borders are now closed.

Here in the state of Zulia, where Ms. Fernández left her children in January, the economic collapse is particularly stark. It was once rich in oil and cattle, and home to a flourishing class of petroleum workers who bought nice cars and took expensive vacations. Today, it is home to rolling blackouts, and jobs with monthly wages that barely buy two days’ worth of rice. The day she left, Ms. Fernán- dez hauled the empty blue suit- case that she planned to pack with goods to bring home to her children. At a taxi station, she boarded a battered Ford Bronco and said a final goodbye to her son Eras- mo, 19. Then she sped out of town, past a welcome sign that read “Zulia, a shining destination.” Already the distance from her children was ripping at her in- sides. In Venezuela, Ms. Fernández had managed cleaning supplies at a food company but found that she couldn’t survive on the mea- ger salary. She left for Colombia for the first time in late 2016, plac- ing her children in the care of her mother, Mariana Uriana, now 55, and father, Luis Fernández, 77. At the time, the country’s re- cession had already become a crisis, and the Fernández children were eating only once a day. Their fathers had long disappeared. In Colombia, Ms. Fernández found a job as a housekeeper in Barranquilla, and she began to send money home every two weeks, about $35 a month. But when Ms. Fernández came back in December, for Christ- mas, it was clear that not much else had changed. Her sister, In- grid, the mother of Silvany, had joined her in Barranquilla, leaving the grandparents in charge of 13 young people, with the help of a sometimes present group of aunts and uncles. And Ms. Fernández’s children were still eating only once a day. So she set off again.

Leaving Children to Find Work

PHOTOGRAPHS BY MERIDITH KOHUT FOR THE NEW YORK TIMES

Sheyla Urdaneta, Meridith Kohut and Isayen Herrera contributed reporting.

Aura Fernández with her son before leaving Venezuela. Top, Silvany Vargas, a niece, caring for a brother.

Libération - 07.04.2020

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