Spring 2020 | Publication

COVID-19 and China’s Insecurities

Beijing’s counterfactual campaign to disprove that COVID-19 originated in China reflects the leadership’s deep-seated insecurities about the intersection of public health and Great Power status.  This anxiety offers important insight into the government’s current and future behavior.1

Throughout the 1800s, missionaries traveled to China to build critical public health infrastructure.  The hospital today known as Wuhan Central Hospital, for example, was founded by Italian missionary Bishop Eustachius Zanoli.2

Such efforts to provide healthcare to China were a central part of the Middle Kingdom’s relationship with the West.  Dr. Peter Parker, the first missionary doctor to China, founded the Canton Hospital in the 1830s, when the city was the hub of emerging trade between China and European powers.3  The hospital operates to this day under the name Canton Pok Tsai Hospital.4

Amid civil war in the 1890s, Westerners built temporary hospitals as “epidemics raged amongst the overcrowded population,” giving “rise to horrid diseases,” and locals were unable to provide medical supplies.5  The dire situation continued for decades.  In the early 1900s, China was estimated to have the highest death rate in the world, with “75 percent of the deaths [being] preventable.”6

Constant risk of epidemics stemming from China’s unsanitary food markets and eating practices loomed.  As missionary Mary Ninde Gamewell described in her 1919 account, “Food and meat shops, fruit-stalls and markets are centers of infection … Fruit, to make it more tempting, is often cut open, where it soon turns brown from decay and the dust that rises from the much-traveled street.  Flies constitute one of China’s gravest perils. In warm weather, meat shops are black with them.”7

China’s dependence on the West for public health infrastructure appears to have seeded enduring insecurities about the capacity of the country to provide indigenous healthcare.  Even as recently as the 1990s, Chinese experts did not believe a Western-style hospital could operate in China.8

China’s current disinformation efforts regarding COVID-19 has an important dimension based on this history of insecurity specific to the healthcare sector.  For Beijing, the Chinese origins of COVID-19 evoke uncomfortable parallels to the claims during the “Century of Humiliation” that China’s atrocious public health conditions required Western intervention.  Evidence that COVID-19 erupted as a public health menace due to consumption of exotic wildlife and/or mismanagement stirs deep, historically-based insecurities within China’s regime.

Tellingly, Chairman Xi Jinping deliberately has characterized China as contributing to the public health needs of “developing countries” to differentiate itself from the China of centuries past.  At the G20 Leaders’ Summit he expressed, “G20 members need to jointly help developing countries with weak public health systems enhance preparedness and response. … China will be more than ready to share our good practices, conduct joint research and development of drugs and vaccines, and provide assistance where we can to countries hit by the growing outbreak.”9

Perhaps fearing a repeat of history whereby Western powers would use China’s public health problems as a pretext for intervention, Beijing has been frantically working to position itself as a Great Power exporter of public health solutions.  According to state-run press, China has exported $1.43 billion worth of medical supplies amid the pandemic.10

Beijing’s approach reveals fundamental differences between its worldview and that of the Western powers a century ago.  In contrast to the Western missionaries of yesteryear who sought to change day-to-day attitudes and behaviors, such as with respect to personal hygiene, China today seeks to export not a public-health mindset, but a surveillance mindset.  For example, Singapore, South Korea, and Taiwan have adopted patient tracking technology similar to the system used by the Chinese government.11  This threat will require monumental efforts of the United States to overcome.

Accessing accurate insights into China’s aspirations and anxieties requires methods that defy Beijing’s formidable information operations and other mechanisms of deception.  COVID-19 offers a powerful case study in the importance of historical analysis to overcoming contemporary obstacles to understanding China.  The ability of the United States to counter China’s Great Power ambitions depends in large measure on a willingness to embrace analytical alternatives to the relationship-based framework that has dominated since the 1970s.

The tension that has erupted between the United States and China regarding COVID-19 has far greater significance than the narrow question of responsibility for the pandemic.  Rather, the dispute has forced Beijing to confront persistent fears of inadequacy and humiliation. This sensitivity makes the stakes of COVID-19 much higher than might be readily apparent.


© 2020 Baron Public Affairs, LLC. All Rights Reserved. No part of these materials may be reproduced or transmitted in any form or by any means, electronic or mechanical, including but not limited to photocopy, recording or any other information storage or retrieval system known now or in the future, without the express written permission of Baron Public Affairs, LLC. The unauthorized reproduction or distribution of this copyrighted work is illegal and may result in civil or criminal penalties under the U.S. Copyright Act and applicable copyright law.


*Photo: Peking Union Medical College was founded by The Rockefeller Foundation and was closely affiliated with missionary efforts for decades.  John Z. Bowers, “The Founding of Peking Union Medical College: Policies and Personalities,” Bulletin of the History of Medicine, Vol. 45, No. 4 (1971): 305-321, www.jstor.org/stable/44450079.

1  Chinese state officials have gone as far as to blame the United States for the virus’s spread.  Chinese Foreign Ministry spokesperson Zhao Lijian tweeted, “It might be the U.S. army who brought the epidemic to Wuhan.  Be transparent!  Make public your data!  US [sic] owe us an explanation!”
“Outspoken Chinese diplomat says tweet on COVID-19 origin was response to U.S. stigmatization of China,” Global Times, April 7, 2020, https://www.globaltimes.cn/con-tent/1184903.shtml.

2  William Huang, “Give credit where credit’s due: the Christian background to China’s best hospitals,” Mercatornet, March 24, 2020, https://mercatornet.com/give-credit-where-credits-due-the-christian-background-to-chinas-best-hospitals/47079.

3  Mary Ninde Gamewell, New Life Currents in China, New York, New York: Missionary Education Movement of the United States and Canada, 1919.

4  “Canton hospital: the first Western hospital in China,” Guangdong News, September 22, 2014, http://www.newsgd.com/gdnews/content/2014-09/22/content_108953935.htm.

5  Sven Hedin, Through Asia, New York, New York: Harper Publishers, 1899.

6  Mary Ninde Gamewell, ibid.

7  Ibid.

8  Michael Wenderoth, “Beijing United Family Hospital Turns Twenty: a conversation with Roberta Lipson, CEO,” China Center, June 19, 2017, https://www.chinacenter.net/2017/china_currents/16-2/beijing-united-family-hospital-turns-twenty-conversation-rober ta-lipson-ceo.

9  “Full text of Xi’s remarks at Extraordinary G20 Leaders’ Summit,” Xinhua, March 27, 2020, http://www.xinhuanet.com/english/2020-03/27/c_138920767.htm.

10 “China’s medical supplies exports top 10 bln yuan,” Xinhua, April 5, 2020, http://www.xinhuanet.com/english/2020-04/05/c_138949803.htm.

11  Joshua Kurlantzick, “Can the U.S. Emulate Asia’s Coronavirus Response?” Council on Foreign Relations, March 18, 2020, https://www.cfr.org/in-brief/can-us-emu-late-asias-coronavirus-response; and Yasheng Huang, Meicen Sun, and Yuze Sui, “How Digital Contact Tracing Slowed Covid-19 in East Asia,” Harvard Business Review, April 15, 2020, https://hbr.org/2020/04/how-digital-contact-tracing-slowed-covid-19-in-east-asia.