Having felt worried about COVID-19 in China since January, I’m now very worried if I get infected here in Finland. I guess many Chinese in Europe feel the same way I feel, especially when the policies are different in European countries from it in China. These differences, in my opinion, may have rooted in cultural difference.
Consequentialist thoughts
China has some consequentialist thoughts. Chinese government tried to avoid as many infections as they could. The central government and local governments tried to keep people at home no matter if they are exposed or not. The idea is that people showing no symptoms aren’t necessarily free from the virus. During the window period when exposed people haven’t developed symptoms, they may spread the virus to others if not keeping much social distance. If person A has exposed to the coronavirus without knowing the exposure, the person may spread the virus to others when going to a train station or a restaurant.
Many Chinese people or people from eastern cultures also have consequentialist thoughts. Some friends gave up their trip for Lunar New Year last minute before the trip. Some friends, who went back to China earlier than the outbreak, voluntarily stayed at home for 14 days after they came back to Finland. They have concerns about what if they brought the virus back to Finland? What if they spread the virus to others? Will they get blamed for spreading the virus? Etc, etc… Now you see why some Chinese media criticised some countries “irresponsible”…
When I was writing, the policies were changed in many countries…
Herd Immunity
Herd immunity is a theory in epidemiology. It assumes that when a large number of people in a population is immune to an infectious disease, chains of infection may be disrupted, thus providing protection to individuals who are not immune.
Many European countries suggest their citizens stay at home if they only have mild symptoms and hospitals only take seriously ill people due to health care capacities. These policies are mostly based on herd immunity.
What lacks in herd immunity is a vaccine. We don’t have a vaccine for COVID-19. We don’t know how long the immune we get from COVID-19 lasts. There is research showing the effectiveness of herd immunity can be insufficient to protect high-risk groups (Kim et al 2011; Kim 2014).
Herd immunity doesn’t concern social bonds. When talking about old people have much higher risks of death if infected with COVID-19, some people think old people are going to die anyway, while some people think about their grandparents. I would feel overwhelmed if my over 60-year-old friends or relatives unfortunately passed away due to COVID-19.
Don’t Rush to Hospitals!
Not rushing to hospitals is a way to protect ourselves, because symptoms we have may really result from normal flu. We are more likely to get infected by the coronavirus in hospitals, especially people having no habit wearing a mask in western countries. In China, people were also suggested to avoid going to the hospital. Instead, people can consult online or via hospital hotlines first before going.
Some people in European countries are angry or worried because hospitals only take serious cases, while the reasons why people with mild symptoms should not go to hospitals are not well established. The health care in a country indeed has its limited capacity. Don’t forget there are people hospitalised due to other diseases.
Work from distance if possible
Social distancing can slow down the spread of virus. Work at home if possible. If you suspect yourself being exposed, do voluntary quarantine, which has fewer long-term mental impacts than mandatory quarantine (Brook et al 2020).
Keep yourself updated with new information. People in quarantine feel stressed if they are not kept informed about the situation by health authorities (Cava et al 2005; Braunack-Mayer et al. 2013). Read news from reliable sources every day, but don’t get too addicted.
Earlier Situations in China
The COVID-19 outbreak started before Chinese New Year’s Eve. The Chinese central government and local governments spared no effort to stop the infections. Because Chinese New Year is the most important festival in China, most people “migrate” back to their hometown or home village to celebrate with close relatives.
Many people who worked in Wuhan migrated to different provinces where they are from, while many people who worked elsewhere migrated back to Wuhan. Before the Chinese government announced the lockdown of Wuhan City, the annual “migration” was almost completed. That is to say, there were a lot of travel flows, and infected people showing no symptoms may have infected others in public places and transports.
What China has done
People confirmed positive were interviewed where they had been and how they had travelled. The local governments published relevant information without personal identity. For example, patient A took “Train XXX in Car C from Location D to Location E during 19.00 – 23.00 on 20th Jan”. Patient F had dinner “at Restaurant G in City H at 18.00 – 19.00 on 21th Jan”. The information in quotation marks was published, and the governments tried to contact everyone possibly exposed, suggesting them and their family in quarantine.
The governments also suggested people not having any celebrations with their family, not even on New Year’s Eve. Restaurants and teahouses were asked to stop their business until the situation gets better. Small restaurants that are allowed to open can only serve people with take-way options.
Not everyone has a smartphone. The staff in local governments, including village leaders, went to towns and villages to inform people and “expel” people from the street back home.
China lowered the standard for confirming COVID-19. There was a peak of confirmed cases in China on 13th February 2020. Before changing the standard, a patient tested positive with the coronavirus counted as a case. After changing the standard, if a patient has symptoms and the CT scan shows lung lesions, a case is confirmed even without testing virus.
Online Sources
Online shopping supported quarantine. The number of online shoppers has grown stably in China. In 2018, there were 610.11 million online shoppers. People can purchase food and cloth easily. The delivery is normally to the door, not to the nearest post office.
Some blogs run by medical doctors and psychotherapists have written blogs about people’s concerns. For example, people were worried if the delivery staff carried the virus and contaminated the packages. Psychotherapists have written about why people feel stressed and addicted to the news and even rumours in this situation.
Funny things happened
At the very beginning, not all Chinese people behaved according to guidance from the governments. Some young people had to call the police to expel their parents from teahouses back home. (And many got blamed by parents afterwards…)
Some people purchased more food than what they actually needed, but perhaps not toilet papers. People complained to the local governments that soon regulated markets and kept prices stable to ensure food availabilities.
During the process, a lot of things happened in China. Good, and bad. If you’re not happy with the loose policies in the country you stay, try to stay at home and don’t get infected.
Source
Braunack-Mayer, A., Tooher, R., Collins, J. E., Street, J. M., & Marshall, H. (2013). Understanding the school community’s response to school closures during the H1N1 2009 influenza pandemic. BMC public health, 13(1), 344. https://doi.org/10.1186/1471-2458-13-344
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. https://doi.org/10.1016/S0140-6736(20)30460-8
Cava, M. A., Fay, K. E., Beanlands, H. J., McCay, E. A., & Wignall, R. (2005). The experience of quarantine for individuals affected by SARS in Toronto. Public Health Nursing, 22(5), 398-406. https://doi.org/10.1111/j.0737-1209.2005.220504.x
CNNIC (2019) Number of online shoppers in China from 2008 to 2018 link
Kim, T. H., Johnstone, J., & Loeb, M. (2011). Vaccine herd effect. Scandinavian journal of infectious diseases, 43(9), 683-689. https://doi.org/10.3109/00365548.2011.582247
Kim, T. H. (2014). Seasonal influenza and vaccine herd effect. Clinical and experimental vaccine research, 3(2), 128-132. https://doi.org/10.7774/cevr.2014.3.2.128
Reynolds, D. L., Garay, J. R., Deamond, S. L., Moran, M. K., Gold, W., & Styra, R. (2008). Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiology & Infection, 136(7), 997-1007. https://doi.org/10.1017/S0950268807009156
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