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In China, every cough and sniffle is a crisis

USE the words ‘China’, ‘respiratory’, ‘virus’ and ‘unknown’ in the same sentence and you will soon get people’s attention. That is just what has happened and, of course, our old friend Global Health Now was on hand to convey the news in its usual alarmist tones.

Its lead article on Monday was headed: China’s Respiratory Illnesses Raise Concerns. This rekindled ‘pandemic fears’ amongst ‘worrisome reports about respiratory illnesses’ emerging from China. It was enough to alarm the WHO, so we should consider ourselves lucky that we are not masked up, locked down and queueing for vaccines again.

Chinese media, always a reliable source of information, were reporting that hospitals in the north of the country were ‘overwhelmed’ with patients. The Chinese health authorities, however, deny that they are overwhelmed. Of course ‘overwhelmed’ is another word designed to instil fear into the hearts of the innumerate and those who live in a fact-free zone. The possibility of hospitals being overwhelmed in the UK (they never were) was a driving force behind all our Covid-related decisions if the ongoing Covid-19 Inquiry is anything to go by.

I spend a great deal of time in China and, as I am a health professional, I visit a great many hospitals. Chinese hospitals are  unimaginably big to anyone who has even visited our large London hospitals. For example, St Thomas’ Hospital London, one of our biggest, has just over 800 beds and our largest hospital, Manchester General Infirmary, has 1,700. The hospital affiliated to the university where I work has 2,200 beds, and this is small by Chinese standards. Many have more than 5,000 beds. The largest in Zhengzhou has 7,000 beds and is aiming for 10,000.

Frankly, Chinese hospitals are always overwhelmed. I have never visited a hospital either in a rural area or in a major city that did not seem to be working at full capacity. Emergency rooms are packed full to standing room only and I have never seen an empty bed on a ward. Quite how you would know the difference when a respiratory illness struck is beyond me.

The reasons are partly structural and partly cultural. The Chinese government are pouring resources into primary care, especially in view of their ever-increasing population of older people. However, capacity is way below demand on the one hand and, on the other hand, most Chinese people will simply go direct to hospital. The Chinese are also obsessed by illness.

I do not flinch from saying that Chinese people seem to enjoy ill-health. Either that or they are the unhealthiest people in the world. In any case, they always seem to be ill. Most days with colleagues begin with a list of signs and symptoms and a stab at guessing which dread disease they have that day. Every itch, every sniffle and, God forbid, every sneeze indicates that something is wrong.

Thus, every cough is a ‘cold’ and every sneeze becomes ‘the flu’, leading Westerners like me who really have had the flu to wonder if they have the slightest idea what flu is like. I am regularly informed by colleagues who seem to have a slight cold or hay fever (also referred to as ‘the flu’) that they have flu. I invariably tell them that I can diagnose with absolute certainty that they do not have the flu. ‘How?’ they ask. ‘Simple,’ I reply, ‘you would not be standing there if you did.’ This causes great merriment and not a little pity for this poor ignorant Westerner who knows so little about respiratory infections.

Moreover, every ailment must have a remedy. They would no sooner scratch an itch than pull down their pants in public. This is amply demonstrated if you scratch your head, stretch with tiredness or give a muffled cough. Some ointment will be proffered or the suggestion made that you may need to lie down or see a doctor. One of my colleagues, a senior nurse who had just made the long-haul flight with me from UK to China, went to hospital in the middle of the night to ask if they had a cure for her jetlag. The doctor, sensibly, sent her packing.

I may seem to be digressing, but I am not. I don’t doubt that, with the cold weather coming in (and it is very cold in the north of China),  people are outdoors less, living in very close proximity in tiny apartments and that seasonal colds have set in. In fact, Chinese health officials, at pains to quash any rumours about Covid, eventually confirmed that the common cold may be one of the culprits behind the reports. That and a few other viruses, but nothing novel or ‘unknown’. The journal Nature confirmed this, saying that such a surge in respiratory infections at this time was not unexpected, and Global Health Now referred to the ‘immunity gap’ being experienced by Chinese people as a result of prolonged lockdown.

Undoubtedly, lots of folk are visiting Chinese hospitals complaining of coughs and colds. They always do. Having been whipped into an epidemiological frenzy over the Covid years, it is hardly surprising that the man on the Beijing bicycle is worried that he is going to die every time he sneezes. Thankfully, despite the best efforts of outlets such as Global Health Now, common sense seems to have prevailed. The last thing the world needs is another ‘pandemic’.

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