Chris Anderson: Welcome to TED Connects. This is a new series of live conversations, trying to make sense of this weird moment that we’re in: coronavirus. Everyone’s suddenly changing how they live their lives, it’s so jolting, it’s so startling. We’re all trying to make sense of it, and it ain’t easy. That much we know. We’re trying to make sense of this together in the only way that we know how, which is by having wise humans coming on, talking to each other, listening to each other trying to learn from each other. We are apart, but we can use this moment to build community together, and that’s what we’re trying to do. So this is being produced by a virtual TED team scattered around New York, currently one of the epicenters of this pandemic. So it’s definitely a scary time for people here. I’d like to welcome to join me my cohost here, Whitney Pennington Rodgers. She’s our current affairs curator. Whitney Pennington Rodgers: We’re going to be looking a little bit at China’s response today.
When news surfaced about a strange viral outbreak in Wuhan, China at the very last days of 2019, I think a lot of people were confused about what was going on there, and in the months that followed, we learned more about the disease that’s now known as COVID-19, we watched the situation in China quickly worsen and in the most recent weeks dramatically improve. And I think as all of us around the world grapple with how we can contain and control the spread of COVID-19, there are a lot of lessons we can learn from what China experienced and how they responded. So we’re really thrilled to be joined today by the CEO of the “South China Morning Post,” Gary Liu, who’s here to share his perspective and insights. So, welcome Gary. Gary Liu: Thanks for having me. WPR: Hey there, Gary, thanks for being with us. And I think before we dive into things, I’d love to hear about just how things have been for you personally, your loved ones, those close to you, how have you been experiencing this? GL: It’s complicated.
So we’re here in Hong Kong, I’m working from home, like much of Hong Kong. I’m actually self-quarantined in our apartment here in Hong Kong, because there was a confirmed case in our workplace. So over the course of the last week plus, and likely for at least another week plus, the entire organization has been distributed and working from home. You know, when Hong Kong got its first confirmed case, I was actually back in the United States with my wife, we were taking a small break in the Rockies, and we came back to Hong Kong pretty soon after that to make sure we got back into Hong Kong before the airports shut. And at that point, it was all of our family in the United States and friends texting us and worrying about how things were in Hong Kong as the situation in China started escalating, and people were sending us, or trying to send us, supplies. Masks and sanitizer and stuff like that. And now it’s the opposite.
New York City is our home, so we certainly empathize with what you guys are dealing with right now and going through in the city. And we are seeing our friends and our family back home in New York and in California and checking in on them, trying to send equipment and materials back to them, so the script has flipped actually pretty fast over just the last couple of weeks. WPR: And you know, I think that’s actually a really interesting place to start and probably a question that a lot of people who aren’t in China have, you know, I think from the outside looking in, it seems as if what’s happened in China is kind of miraculous. That to go from, you know, you have a country with more than a billion people there, to go from as many as 80,000 cases to nearly zero new cases now, you know, what can you tell us about how this happened, to help us understand the current situation and just really how China ended up there? GL: Yeah, a lot has happened.
China has been dealing with this for several months now. Several-month head start, that’s not a good thing, but they have gone through several different phases. I think, Whitney, before I jump into it, there are a couple of caveats that are really important to make. The first one is that we’re still parsing what happened in China. The information system, as everyone knows, is still relatively closed. And so a lot of the information that we’re using to piece together what happened in China is still not fully complete. And so with every passing day, every passing week, there’s more information that allows us to retroactively make sure that we get the picture of what happened early on in those early days at the end of 2019, get that picture right. And there’s still a lot that’s happening today, even though I think the information sharing is much more open than it was early on, there’s still a lot of stuff that we need to parse. And the second important caveat here is that I think learning sometimes suggests that everything China did was right and good, and hopefully, other countries can take it and apply it, but that’s not 100 percent the case.
China, of course, did a lot that was right, and if we walked through the time line, I think it would be pretty apparent the decisions that they made kept the coronavirus from really exploding across the entire country and really limited it to one province and mostly one city. But there were also many, many missteps, and those are things that I think the world can also learn from, most importantly, China should learn from, because most of these — I think those of us who are professional observers would call missteps, are because they are systemic issues with the country, because of governance, lack of free information flow, stuff like that. Those are the initial caveats, but I think the timing of how China progressed from first case to now has been fascinating. WPR: Yeah, and I mean, so we know now that in Hubei province they’ve officially lifted the two-month lockdown. And are you getting the sense, do you feel like this is the right decision to make at this moment? GL: I don’t think I’m the right person to say whether or not it’s the right decision.
But certainly, this has been a progression of decisions, and I think they’ve been sitting on this decision for quite some time. Wuhan itself, which was where the pandemic started, it was the first epicenter and the major epicenter. Wuhan is opening up on April 8, that’s right now the schedule. And this is really, what we’re in now is the third of three phases from the first discovery of the virus in Wuhan. Now, April 8 will be about 11 weeks after Wuhan the city got completely shut down, and the Hubei province got shut down. And so for those who are in a shelter, at home kind of situations right now in the United States and wondering how long this is going to take, in Wuhan, they’ve been locked down for 11 weeks and only now has the Chinese government decided they’re ready to start letting people move freely around. WPR: And to your point earlier about some of the possible missteps in terms of reporting, I mean, there are still reports now that we might not be getting an accurate number of cases that we’re seeing in Wuhan or beyond, we’re hearing some people say there are no new cases, other people saying that there actually are cases.
So do you feel like there is accurate spread of information about the current state of the virus in China right now? GL: Generally, yes, with the caveat that it is based on the Chinese government’s definition. And this is one of the problems right now that even the World Health Organization is struggling with, is that the definition of what is a confirmed case, what is an infection, is different from country to country. As an example, in China, the folks that have tested positive but are asymptomatic, we understand now that they are not included, since February 7, they have not been included in the official numbers. Or at the very least, on February 7, they changed that definition, and they’re not included in those official numbers. And that could be another 50 percent on top of the numbers that we’re seeing today. So what we’ve found, our reporters have gotten their hands on some classified government documents and government data that suggests that a third of total actual positive tests are asymptomatic, and therefore not included in official numbers.
Now, I don’t think that this is an example of the Chinese government trying to hide information. This is a definitions issue, which countries have been debating and people are doing it in different ways. But like I said, there really have been three very distinct phases. We are in the third phase that I would call recovery and rehabilitation, rehabilitation being the rehabilitation of China’s image. But the first part was discovery and a lot of denial. And then there was this two-and-a-half-month period of response and containment. And that I think, the response and containment part is the most interesting to the rest of the world. WPR: And so maybe we can break some of that down, you know, thinking about China’s response. What were some of the specific things that you think China did right, both as a nation, individuals in the country, what were some of the things that you saw that worked really well? GL: OK, so let me walk through the time line, I want to try and get these dates right, because the dates do matter, I think again, for context, how many weeks it took from one step to another.
Let me actually back up into that initial first phase, that discovery and denial phase. The first time we heard about the coronavirus, this mysterious respiratory disease that looks somewhat like SARS, was on December 30. That was the day that there was a doctor, whose name is known all over the world for the unfortunate reason he ended up eventually dying, named Li Wenliang. And Li Wenliang, Dr. Li, posted to a private WeChat group on December
The very next day, December 31, was the first time that any Chinese officials — and on that day, it happened to be the actual provincial and the city officials — acknowledged that there were 27 people, at that moment in time, who had been diagnosed with this mysterious pneumonia, and they reported the cases to the World Health Organization. That was also the day that Dr. Li was reprimanded, officially reprimanded. So that was really the discovery, the end of the discovery and denial phase, because what we know now is that back to mid-December, several weeks before Dr. Li wrote his blog post, the authorities had already been notified that a SARS-like pneumonia was showing up in Wuhan hospitals. And action had already started down the chain of authority. They have now backdated, at least publicly backdated, the first case to December 1. But actually, in their confidential and classified government documents that again, our journalists have seen, and we’ve published a story — Officially, in classified documents, they’ve backdated the first COVID-19 case all the way back to November 17, as the earliest example that they can find based on symptoms and based on retroactive diagnosis for a COVID-19 case.
So in effect, there were several weeks before the acknowledgment to the World Health Organization that that was going on, and the first case with symptoms was actually identified about a month and a half before that notice to the World Health Organization. Then the second phase, which really started, let’s say, December 31, when the acknowledgment happened, was response and then massive containment. Now this phase, to be clear, still had some denial and a good amount of censorship happening within the country. So on January 1, the World Health Organization started working with China on trying to identify the virus and trying to figure out course of action. It wasn’t until several weeks later that Beijing, the central government, for the first time broke its silence, and that was on January 18. And actually, they broke the silence to deny that this was SARS, and in fact to “defy rumors” that were spreading around the Chinese internet. But there was a major date that happened two days afterwards, which was January 20.
Because for the first time, a member of the party, a senior government official who is now one of the central gentlemen that is actually leading the task force against COVID-19, his name is Zhong Nanshan, he’s an epidemiologist, he was one of the central figures during SARS 17 years ago. On January 20, he visited Wuhan. And he admitted, for the first time, that human-to-human transmission was possible. Now this was important, because prior to that, officials who had spoken up had said that human-to-human transmission was not likely, was not possible. And previous to that, all of the cases, the majority of the cases were tied to this seafood and wildlife marketplace that was in the city of Wuhan. But now, on January 20, human-to-human transmission, it’s possible, it’s happening, and so of course, the course of action, not only in China, but the course of action all over the world, started to change. And three days after that, Wuhan was locked down.
It was completely, I mean, it shocked the world that they could lock down that many people so quickly. Of course, now India yesterday announced that 1.3 billion people are being locked down. So we have another frame of reference now. And then the end of this middle second phase I think really came in March, around March 10. Actually, on March 10 I should say, because Chinese president, Xi Jinping, visited Wuhan. And these things, in Chinese politics, because everything is so well-choreographed, matters a whole lot. The fact that Xi Jinping visited Wuhan signaled that the Chinese government believed the worst was over. The reality was that probably about 20 days before that, the curve had already been flattened. So 20 days before that, probably around February 20, the infection rate was around 75,000, 76,000, and it’s effectively stayed within a couple of thousand since then. So on March 10, Xi Jinping’s visit to Wuhan kind of signaled the worst is over, and then they moved into the recovery and rehabilitation phase. WPR: OK.
I mean, if I’m hearing correctly — thank you for sharing all of that, it sounds like, although there was a slow period of getting the information out initially, eventually there was quick reaction from the Chinese government to respond to this, lock folks down. And it seems like that had a real impact on flattening the curve in China, in Wuhan. GL: A real impact. WPR: Yeah and I —GL: Absolutely. WPR: Yes, please go ahead, Gary. GL: The date of January 23 was not by coincidence. Because the Chinese New Year holiday started on January 24, the very next day. And the thing is, with the Chinese New Year holiday, is that it is, every single year, it’s the largest human migration that happens on Earth. About 400 million people travel during about a forty-day period that would have started on January 24. And that’s three billion trips, it’s just people traveling all over the country, 400 million people traveling.
Now, Wuhan is one of the most important cities in China, although before this, I don’t think a lot of people around the world knew the city of Wuhan, but it’s extremely important. It is considered the most important city in the center of China for many different reasons, but one of the key reasons is that it is one of the key transportation hubs of the country. So all of the major train lines, the high-speed train lines, the normal train lines, the trade lines, they all kind of converge on Wuhan. So you can imagine if 400 million people start moving around for Chinese New Year on January 24, a huge number of them were going to go through Wuhan. And of course, Wuhan itself is an 11-million-person city. The surrounding cities all added together, Hubei province has about 60 million people, and they were also largely going to travel. And so if January 23 they had not shut it down, and people had started traveling, the likelihood would have been that this would have been really, really hard, possibly, likely impossible to contain.
And even though they shut down before the Chinese New Year holiday started, we now also know that at least five million people actually left the surrounding areas and traveled. Which is one of the reasons why it did spread a little bit across the country, and then eventually spread to other parts of the world. WPR: And I’d like to come back to that as well, just thinking about the five million people who left and sort of where they landed today and how that affected things, but before we do that, I’m interested to talk with you a little bit more about — you mentioned this November date as one of the earliest cases you discovered that was reported was in November, and that’s something actually that I hadn’t heard before, and I imagine that might be news to a lot of people hearing this, and so I’m curious, when you think about the missteps from China’s perspective, in terms of what China did, you know, there is, as you mentioned, suppression of information is one thing, one major criticism of how China handled this.
And hearing that maybe there was knowledge of something as early as November, if that might have played a role in how we were able to control and contain this a lot sooner. GL: I do want to clarify, from what we understand, officials were not notified about this until mid-December. It wasn’t — So it was really a couple of weeks between officials realizing that there was a SARS-like pneumonia going around to when the first case was reported to the World Health Organization. It wasn’t all the way back to November 17. That was retroactively backdated, but that has not been made public by the government. We published it because we’ve seen the data that actually backdates the first case. From a misstep point of view, again, it’s a couple of weeks compared to what happened in SARS, which was a long time of locking down on information. This was much shorter, the period of time that the government wasn’t in complete shutdown mode.
But then, after that, of course, there was still continued censorship on the internet, especially within the Great Firewall of China, for communications between Chinese citizens. And you know, surprisingly to some, I think for a lot of China watchers not so surprisingly, is that the government has — the central government — over the course of the last several weeks, actually, I should say probably the last two months, has started to change their tone and to some degree admit that there needed to be better free flow of information. They’ve changed the official narrative of a couple of different things, including this initial whistleblower, Dr. Li, who unfortunately ended up passing away from the virus, they actually now refer to him as a national hero, they have officially removed the reprimand, the Wuhan police have apologized to Dr. Li’s family, and they have actually been — a couple of policemen — have been punished in Wuhan for the way that they handled the situation.
So there has definitely been an internal shift and there is a lot more sharing of data and information. I can tell you, from Hong Kong’s point of view, without the open sharing of information between the authorities, between Hong Kong and mainland China, I think Hong Kong’s response would have been much more different and I think Hong Kong would have suffered because of that. So that much more open sharing of information has benefited this city for sure. WPR: And we have Chris here who has a question, I think, from the audience. CA: Hey, Gary. The online audience, loving what you’re saying. It’s so interesting, you’re giving us amazing new insights here. Just in the current situation where much of — you know, there have been these very few reports of new cases. How much does it feel like life is getting back to normal? Do people really believe that this problem has been successfully tackled elsewhere? GL: I think the sentiment in mainland China is that yes, in China, the problem has been tackled.
And people are looking forward to going back to normal life. A lot of the other major cities, Shanghai, Beijing, are starting to get back to work. Many of the factories have now been reopened. The last stat that I saw was that 90 percent of the businesses that had been shut down are now reopened in China. So generally speaking, life is getting back to normal. Wuhan and Hubei are really the last places that are still shut down, with Wuhan being the city that is shut down until April 8. Hong Kong is a little bit different. Hong Kong has actually gone back into a second wave of social isolation and distancing. A bunch of different companies, us included, as well as the Hong Kong government and the civil service has now gone back to work from home. And it’s because we are starting to see a second wave, but for us, honestly, is the first time that we’ve had a spike of infections, and it’s because of imported cases.
It’s because a lot of Hong Kong residents who left Hong Kong prior to, well, actually when the virus first came into the city, are now returning, because oddly enough, the places they escaped to are now more dangerous than Hong Kong. And as they’re coming back, a lot of them are actually bringing the virus back with them. And so we’re starting to see a spike. Before this week, the highest infection day that Hong Kong had during the first two months of this was 10 infections in one day. Now the highest that we’ve seen in the last week was 48. So this is really the first spike that we’re seeing, and so Hong Kong is returning back to a state of alertness, to a state of caution, and more and more people are holed up at home. CA: Is it possible, in mainland China, that because of this redefinition that you spoke about, where if someone tests positive, but they’re not showing symptoms, that is not reported as a case. That seems significant to me.
Is that part of the explanation for why new reports have gone nearly to zero? GL: I don’t know if that’s the answer to it, but I do actually think that even with — and remember, these are folks that are tested, so the data that we have is that these folks have been tested, the tests have come back positive, but have not been added to the official number of infections, because they’re asymptomatic. But they have still gone through the process that is part of China’s containment strategy, which has worked extraordinarily well. Which is, first of all, lots and lots of people have been tested. And then once — if there is a positive test return, regardless of whether or not they’re symptomatic or asymptomatic, regardless of whether or not they’re added to official numbers, what happens next is that they are quarantined, they’re isolated, and contact tracing happens. Contact tracing is a key, key, key action.
And so they go and figure out where this person has been moving, where they’ve been, who they’ve been in contact with, and all those folks that they’ve been in close contact with, they get tested. And if they come back with a positive test, then they’re also isolated and they go through the process again. So China has not been testing people, finding that they’re asymptomatic and then just releasing them and letting them go home. That’s not the case. WPR: I think to that point too, Gary, what you mentioned about this trace-testing and being able to figure out who people have been in contact with to figure out who may also have been infected, you know, when you look at what’s happening in other parts of the world, you hear in the United States, where Chris and I are based right now, you’re hearing that people who are experiencing symptoms, have symptoms cannot get tested. You know, how does China’s ability to test so many people affect the way that they can respond to this and control this virus? GL: It really matters.
Without the significant testing and without the contact tracing that comes afterwards, I don’t think there’s a way that China could have contained it the way that they did. The same thing here in Hong Kong. If we didn’t have both of those, as minimum requirements in a health system, Hong Kong could not have contained it. And this is actually the reason why South Korea is the only other country besides China that has managed to flatten the curve, is because they aggressively tested. I think by far the highest per capita testing anywhere in the world, as far as we know right now. And they aggressively did contact tracing. And because of that, even though South Korea had this huge spike, and we thought that it was going to get out of hand, they were able to suppress it, control it, and now they’re in a much, much better place. WPR: One thing you mentioned earlier that I’d love to talk about, too, is SARS and the impact of going through that in 2002 and 2003 for China, other countries in Asia, Hong Kong.
You know, what effect did that have on everyone’s preparedness in that part of the world for the COVID-19 outbreak? GL: It was significant. I think the institutional and social memory of SARS matters a heck of a lot, when you look at China, Hong Kong, South Korea, Singapore, Taiwan, Japan, a lot of these countries in Asia have dealt with COVID-19. Let me use Hong Kong as an example, because it’s the one that I know the most intimately. But a lot of what I’m about to say actually does apply to those other areas of Asia. So for context, SARS, November 2002 to July 2003, very, very similar coronavirus to COVID-19, I think there’s about an 80 percent similarity to those two viruses. The global infected number was a little over 8,000, 774 deaths. So by percentage, deadlier than COVID-19 is but far less infectious than COVID-19 is. Now here’s why it impacted Hong Kong so much, and why the memory is so deep, and actually it tells you a lot about Hong Kong’s reaction to COVID-19.
Of the 8,000 infected, 22 percent were here in the city of 7.5 million, and 40 percent, actually 39 percent of the deaths, 299 people died in Hong Kong. Thirty-nine percent of the global deaths happened in Hong Kong. And SARS did not start in Hong Kong, it was imported into Hong Kong from southern China. And so SARS, again, deep, deep memory, but it was a massive turning point in the Hong Kong health care system and also the social practices of the city. And let me walk through some of that impact, because you can actually still see it, even before COVID-19, you see it every day. The health care system was able to really, very quickly, ramp up in capacity, because of preparation post-SARS.So after SARS, the Hong Kong health care authorities started preparing for greater capacity, especially for infectious diseases. There were new health alert systems, warnings and treatment protocols put in place.
I can tell you that a lot of folks that were here before SARS will tell you that in Hong Kong hospitals, before SARS, it was actually rare to see even medical professionals wear face masks. And now surgical masks are ubiquitous, not only in hospitals, but across the entire city. Anytime, anywhere, it seems, especially right now. New channels of communication and data and information exchange were opened up with mainland Chinese authorities, and technology was implemented, including now a supercomputer that actually does contact tracing in Hong Kong. You could trace the existence of the supercomputer and this contact-tracing ability back to changes that happened post-SARS.On the social side, there was also a huge change. The first thing I have to talk about is, of course, masks. Now, I know that there is still not consensus everywhere in the world about whether or not masks actually help in this situation.
I know that the World Health Organization as well as governments like the US, as well as Singapore, say that only medical personnel as well as people who are actually sick and showing symptoms need to be wearing masks. In Hong Kong, everyone wears masks. And the government, even though they flip-flopped a little bit during this epidemic, the general, the guidance is that everyone should be wearing masks. That started in SARS. Ninety percent of Hong Kongers during SARS wore masks, and that habit actually stayed with Hong Kongers, and so generally speaking, even outside of the pandemic, when people are sick and coughing, you’ll see them wear masks out in public. On top of that, there was — it became systemic, or I should say systematic controls for hygiene in social and public spaces. So if you visit Hong Kong, again, before all of this happened, you would have noticed that public spaces are constantly being disinfected.
One good example that everyone notices is that when you go into an elevator in public spaces, in buildings, they will either have one of two things, potentially both. They’ll either have a sign that tells you how often the elevator buttons are disinfected, or there will be a plastic, piece of sticky plastic, like a plastic sheet over the buttons so it effectively becomes a flat surface. When you eat out, Hong Kong is obviously famous for its dim sum, and one of the most famous things about Hong Kong dim sum are the dim sum carts, which are also very popular in New York’s Chinatown, as an example. Those dim sum carts, they pretty much went away after SARS. And so most dim sum restaurants that you’ll go to in Hong Kong now, the vast majority of them, you have to order off of a menu, you don’t have public carts going around because of hygiene issues. In most nice Chinese restaurants in Hong Kong now you will get, when you sit down, two pairs of chopsticks per person.
And those two pairs of chopsticks are different colored, because one is used to grab food from the center of the table to your plate, and the other one is for you to take the food and put it in your mouth. And honestly, there are hand sanitizers and hand-washing notices literally everywhere, and this is just part of the social behavior after SARS. Safety protocols in offices, everyone knows how to shut down an office and control traffic really well. Most major offices have temperature-check machines at the very least available, and then, of course, social distancing. People understand social distancing is important, and so the moment there was fear of what was happening across the border, naturally, people started social-distancing activities and self-quarantine became pretty normal. So those are all the social things as well as the health system things that kind of changed, and because of that, Hong Kong was able to react really, really fast, not just the government, not just the health authorities but the people of Hong Kong, and I think that’s the most important part, is that the entire city, that the community reacted and went into this mode where you wore masks, you washed your hands, you carried hand sanitizer, you stopped going to public places. WPR: I’m curious then, I think a lot of people who are listening at home and figuring out how can we apply some of those things here, and from where you sit, and when you see what’s going on in other parts of the world, where maybe people are struggling to make some of these changes.
You know, what are some of the specific things you think folks can adapt in their own cultures, in their own countries? GL: I think communication is a huge deal. If you talk to local Hong Kongers, they will likely opine that the communication from the Hong Kong government has not been top notch. But thankfully, there have been other authorities and certainly even just person-to-person communication has been pretty strong. A lot of corporates have done an incredible job in Hong Kong in communicating very transparently with their employees and insurance companies have also been making available all sorts of webinars and materials and made it actually quite easy for people to understand how to get tested, where to get tested, who to get tested. And so that communication, I think, has centralized, to some degree, the messaging. In a city like Hong Kong, everyone generally believes the same thing, and what they believe is generally true.
Of course, there’s still misinformation issues, as there are everywhere. But I think, possibly also because of SARS, because over the course of the 17 years, a lot