Coronavirus: Capitalism versus Communism, and Global Health versus National Health
United States and China are the two most powerful rivals on the global scene that are working almost independently but tirelessly on getting the Covid-19 under control. The question in the mind of many is “which of the two superpower’s health systems is more efficient and suitable for suppressing the current corona pandemic?”
The American Exceptionalism: Our country is the pillar of individualism and utilizes a health system that is by far the most suitable one in the world for addressing medical needs of individual patients. Any person with proper medical insurance or optimal financial status can potentially secure high quality medical and health services in the US. Meanwhile, we are wired to look at the world with our own individualistic biases that favor freedom of action for individuals over the collective or state-controlled worldly outlooks. We consider it as our own inalienable right to opt in or out of receiving any health-related interventions. Let’s be truthful to our core once and say it out loud: “I am an American, I have the right to refuse any health-related intervention or preventative measure for myself or my family!”
An American Story: Having said this I want to refresh your memories a little now. Do you recall the controversy over vaccination for measles? To quickly update you, this disease used to be one of the top killers of the babies until 1963 when we developed a vaccine against it. To give you more background information, currently measles is readily preventable with application of the trivalent MMR (Measles, Mumps, and Rubella) vaccine that safeguards against all three diseases. The CDC (Center for Disease Control) recommends that children should receive two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. You may also recall the 1997 -2001 controversy over unsubstantiated association between autism and MMR vaccine. As a result, many parents, contrary to CDC’s advice, decided to exercise their parental autonomy and denied MMR vaccination for their children. A recent report of the CDC has shown that in 2019 our country has experienced the highest surge in the number of new cases of measles since 1992*. It is also shown that areas or states with higher number of vaccine hesitancies (i.e. opposition to vaccination) has had the highest number of measles cases. Meanwhile, the World Health Organization (WHO) undertook a detailed biostatistical study and compared the efficacy of the US and China’s interventions in managing their 2019 cases of measles. WHO concluded that China, with a per-person measles infection rate of 0.006 per million, has by far outperformed our country, with a rate of 0.02 per million. This outperformance is largely attributable to the fact that in China vaccination for measles is obligatory and compulsory, whereas in the US patients have the option to exercise their autonomy over receiving vaccinations. Using measles as an example, it is apparent that China, a communist country with a totalitarian regime, is much better poised to control infectious pandemics compared to the US that advocates minimal governmental intrusions and maximal patient autonomies. This also seems to renew our appreciation for global health that became very popular after the avian flu, SARS and Zika pandemics, but were downplayed by the recent worldwide nationalistic trends.
Let us now relate the previous concepts to the current corona-related frenzy. There is so much talk in the media about quarantination, and it seems obvious that many people in the US have tendencies to resist mandatory quarantination. In response to the Covid-19 the Chinese government fully isolated the entire city of Wuhan for quarantination, and totally blocked travel into and out of the city. Imagine how difficult it would be or it would have been to isolate the entire city of Seattle that is claimed to be the original epicenter of the covid-19 in our country.
Voluntary and Involuntary Quarantine: A concept that makes more sense in the US than anywhere else is the concept of voluntary, as opposed to involuntary, quarantine. Throughout recent epidemics, the US public health professionals have had the tendency to advocate voluntary isolation (quarantine) of people in their homes as it does not require many societal interventions. Major impediments to compliance with involuntary quarantination have been loss of income and loss of employment for the affected individuals. It is conceivable that employees of states and state-affiliated organizations (e.g. colleges and universities), employees of cities, townships and big companies are more apt to voluntarily stay at their homes. Many of them, like children who love non-school days, welcome this opportunity to stay in their homes for as long as it takes! In contrast, those individuals who own small businesses or businesses with less than 6-8 employees do not have the luxury to afford home quarantine (no-show-for-work) for themselves or any of their employees without the assumption of financial losses. An exemption is the tech industry, as their employees can efficiently work from their homes. It is further conceivable that the US federal government or individual states would suffer utmost difficulties in managing the cost of the pandemics. In contrast, in prototypic communist countries states hold all resources and they have full power to impose involuntary quarantine of any duration or to financially support their involuntarily quarantined population for as long as the pandemics demand.
Conclusion: In short it appears that China’s health system is by far more suitable for managing pandemics. Don’t mistake me, I would love to see the city of Seattle, the epicenter of our imported covid-19, control its pandemic long before Wuhan! If so, it gives me the pleasurable feeling that our American way of dealing with this pandemic is indeed much superior and we can manage to overcome this made-in-China product without much difficulty!