The Big Question: Katherine Mason on the challenges presented by the coronavirus outbreak

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Katherine A. Mason is a medical anthropologist who has conducted ethnographic fieldwork in China and the U.S. Her research addresses issues in medical anthropology, population health, bioethics, China studies, reproductive health, mental health, and global health.

Her first book, Infectious Change: Reinventing Chinese Public Health after an Epidemic, based on fieldwork she conducted in southeastern China on the professionalization and ethics of public health in China following the 2003 SARS epidemic, was published by Stanford University Press in 2016 and won the Foundation for the Sociology of Health and Illness Book Prize in 2019.

Mason is currently working on a multi-sited ethnographic field project that examines family experiences and models of care for perinatal mood and anxiety disorders in the U.S. and China.

What is the biggest question regarding the new coronavirus?

I’m going to take a bit of an anthropological copout here and say that this question very much depends on where you sit. For the global health community writ large, the biggest question is, Will this become a true global pandemic? And if it does, will it be a catastrophic pandemic along the lines of the 1918-19 influenza pandemic that killed an estimated 50 million people, or will it be a relatively more minor event like the H1N1 influenza pandemic that broke out in 2009 and killed around 200,000? That is what the WHO, CDC, and other large global health agencies are really focused on at the moment.

For the average person sitting where I sit in Rhode Island, the biggest question is somewhat different. It is, how much is this going to affect me, now and in the future? Is this virus going to take hold in the US? If it does, what will happen? Will I get sick? Will I be isolated? Am I going to die? Will there be societal and economic disarray? Should I be very afraid, sort of afraid, or not afraid at all?

For the average person in China – especially in Hubei – who has been under lockdown for weeks and is living this epidemic right now in a very dramatic fashion, the biggest question is entirely different. It is, when, and how, is this ever going to end? People are certainly afraid of getting the disease, of being isolated, and of dying, but increasingly they are more afraid of the response. When will they be able to get back to work or back to school? When will they be able to leave their homes again? Or, if they are like the millions of people who left their residences for the Lunar New Year holiday and were never allowed to return, when can I go home and resume my normal life? There is only so long that you can keep tens of millions of people under lockdown. Things are going to get really ugly if this question is not resolved very soon.

Why is it significant?

Certainly it’s significant because we are talking about life and death and, if this were a pandemic along the lines of the 1918-19 pandemic, that could mean tens of millions of deaths around the world (there is no indication, however, that this virus is anywhere near that bad).

But it’s also significant because right now there are already hundreds of millions of people in China whose lives have been completely turned upside down by the response to the virus. I think it’s really important for people outside China to understand just how devastating the response to this virus – that is, the massive efforts on the part of the Chinese government to contain the virus and prevent a full-on pandemic – has been for Chinese people already.

As a thought exercise, I invite you to imagine what would happen if the US government decided to entirely seal off and confine to their homes the entire Northeastern portion of the United States from Washington to Maine – which is roughly the population currently under quarantine in Hubei province. Then imagine that they further put checkpoints on all interstate highways, shut down public transportation across the entire country, made laws about when people are allowed to leave their homes, and went door to door rounding up and taking away anyone who seemed like they might have a respiratory illness.

Imagine that this continued for an indefinite period of time with no clear end in sight. I invite you to further imagine what our reaction would be if the entire world started shutting down its borders with the US, airlifting their citizens of the country, shutting down trade routes and barring US citizens from traveling. This is what is happening in China. It is an extremely serious situation.

Where is the answer likely to come from?

Time will tell. All eyes are on what happens in the next few weeks. If the virus expands beyond China and begins spreading widely in the rest of the world, then ironically this is likely to be a good thing for the Chinese, because it would mean that pressure to contain it inside the country will eventually diminish and people will be able to go back to their lives.

The problem is that a lot of damage has already been done. Small and medium sized businesses in China have been devastated, and the many millions of migrant workers who depend on the ability to move around in order to earn a livelihood are really suffering already.

If the virus turns out not to be as deadly as some fear, then its global importance might quickly diminish and this may just become yet another ordinary virus that circulates every winter. But China is likely to live with the consequences of what has already happened for a long time to come.

For more information about Katherine Mason, visit her lab page. More information also on Twitter @BrownAnthro and @PSTC_Bro

IMAGE SOURCE: Creative Commons; Kathe

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