Offline: 2019-nCoV-"A desperate plea".

One aspect of the 2019 novel coronavirus (2019-nCoV) outbreak has been surprisingly overlooked. What is life like for those quarantined in Chinese cities? Here is an extract from one correspondent, received on Feb 2, in an email entitled, “A desperate plea from an ordinary citizen in China”. I have edited the text only slightly for clarity.

“Currently, there are at least five cities, including Wuhan, that have suspended the public transport system; ten provinces and cities, including Hubei and Beijing, that have shut down road passenger transport; 16 provinces that have suspended inter-provincial passenger transport; and many cities in 28 provinces that have completely or partially suspended urban public transportation. Yesterday, Huanggang issued a notice ordering a house quarantine for all urban households, allowing only a designated family member to shop for essentials once in every 2 days. The news and constant updates include messages from my local government telling me that many cities have made it mandatory to wear a mask in public or for using public transport. But masks have sold out so quickly in many smaller cities (and online as well), while prices have gone up 20 times. In short, if you are poor, you’re more than likely to not get a mask at all—and it's usually the poor who cannot afford to stop working.”

“At 7:30 pm yesterday, Hangzhou became the first city in China to issue a free mask policy for its citizens in seven urban districts to alleviate the problem that has been the elephant in the room, with an online reservation system for five masks for each person every 10 days. Even Wuhan hasn’t implemented any government policy like this to help its citizens. So access to masks largely depends on donations and self-help by local communities. The bottom line is, a large population in China is suffering, not just from the virus but from the resulting isolation, high uncertainty, anxiety, and stress, reduced resources and freedom for daily living, and loss of income. And the point on income really should be considered. With weak social protection in China, in conjunction with the estimate of 60% of labour engaged in the informal economy in Asian and Pacific developing countries (according to the International Labour Organization), lack of employment benefits and protection renders people extremely vulnerable to crises, such as the current one. There would have been social outcries if this happened in any other Western country, but just because there isn’t an outcry in China doesn’t make its people lesser people who shouldn’t be treated any less. If anything, it shows how deeply the population has been culturally and politically suppressed, and how the voice of the really poor in China gets completely buried and forgotten. This just isn’t right.”

“In a crisis like this, it hurts me so much to see that it's (once again) the well-off who get priority and consideration. Those who actually do not have the ability or resources to take care of themselves inevitably get left behind. Government policies are understandably a combination of politics, economics, sociology, and international relations. But equality to health gets thrown out of the picture in the middle of all these, even in scholarship. This cannot be right. The top health journals should be redirected toward a more compassionate and sensitive discourse. The Lancet please do something, somebody please do something. In a practical sense, the government cares about its ‘face’ more than anything; if there was a prominent international voice calling for it to look into something it just might...and that's all that the suppressed and the poor have for hope. So please, help. I understand this might be an effort in vain, but I really hope it is not. So here it is, a desperate plea, and I really hope this message sees you in good time.”

Chinese health leaders have worked assiduously with international partners to extinguish the ongoing 2019-nCoV epidemic. While the macroscopic management of this outbreak is evolving, more microscopic elements should not be forgotten. Health providers at home and abroad must reassert the importance of the wellbeing of every Chinese citizen who is today living under the threat of this epidemic. And wellbeing means more than whether an individual has or doesn’t have 2019-nCoV infection.