James Fallows

James Fallows is a national correspondent for The Atlantic and has written for the magazine since the late 1970s. He has reported extensively from outside the United States and once worked as President Carter's chief speechwriter. His latest book is China Airborne. More

James Fallows is based in Washington as a national correspondent for The Atlantic. He has worked for the magazine for nearly 30 years and in that time has also lived in Seattle, Berkeley, Austin, Tokyo, Kuala Lumpur, Shanghai, and Beijing. He was raised in Redlands, California, received his undergraduate degree in American history and literature from Harvard, and received a graduate degree in economics from Oxford as a Rhodes scholar. In addition to working for The Atlantic, he has spent two years as chief White House speechwriter for Jimmy Carter, two years as the editor of US News & World Report, and six months as a program designer at Microsoft. He is an instrument-rated private pilot. He is also now the chair in U.S. media at the U.S. Studies Centre at the University of Sydney, in Australia.

Fallows has been a finalist for the National Magazine Award five times and has won once; he has also won the American Book Award for nonfiction and a N.Y. Emmy award for the documentary series Doing Business in China. He was the founding chairman of the New America Foundation. His recent books Blind Into Baghdad (2006) and Postcards From Tomorrow Square (2009) are based on his writings for The Atlantic. His latest book is China Airborne. He is married to Deborah Fallows, author of the recent book Dreaming in Chinese. They have two married sons.

Fallows welcomes and frequently quotes from reader mail sent via the "Email" button below. Unless you specify otherwise, we consider any incoming mail available for possible quotation -- but not with the sender's real name unless you explicitly state that it may be used. If you are wondering why Fallows does not use a "Comments" field below his posts, please see previous explanations here and here.

James Fallows: Flu

  • Two quick updates: flu in China, 64-bit code

    Flu: Over the months, I have frequently remarked on the difference between the Chinese government's approach to H1N1/swine flu and that of many other countries. Difference in brief: the Chinese government has applied sweeping quarantine measures to try to keep the disease out of the country and then to limit its spread; many other countries have viewed the spread as more or less unavoidable and have tried to cope with the consequences.

    Thumbnail image for Quarantine.jpg

    (Photo from this previous post, about visiting Americans quarantined in Shanghai.)  In all countries the emerging view seems to be: the flu has not been that dangerous so far, during this atypical, spring time emergence (in the Northern Hemisphere). But it might be a more serious problem when it comes back in new form during the regular flu season, as the weather gets cold.

    A reader who has recently been in Beijing writes to make a point I have heard from a number of health professionals too:

    "I'm not an immunologist or anything remotely close.  But I wonder if China is actually hurting themselves by so aggressively stopping the spread of H1N1.  The current incarnation of H1N1 seems to be less lethal than the variants that we normally deal with.  Wouldn't it be better to let this variety of H1N1 spread so that people build up immunity to this mild version of H1N1 and then if H1N1 becomes more lethal they will already have some immunity?

    "By the way, while I was at university this summer in Beijing, a student living on the sixth floor of a dorm became ill with H1N1 and the police came with buses and removed about 60 people from that floor."

    The argument from the Chinese authorities is that in a big, poor country with a shaky public health network, they have no choice but to fight a new disease with everything they've got. Memories of the under-reaction to SARS in 2003 also have a Hurricane Katrina-style "let's not make that mistake again" effect. Given the inconvenience many people, Chinese and foreign, have already suffered in the name of flu control, I hope the hyper-aggressive early response to the flu doesn't backfire.

    64-bit code: Last week, I declared a moratorium on discussion of "huge pages" in Apple's operating systems. (Hey, it was interesting at the time.) The reply below, for nerds only, qualifies in the spirit of fair-response. A reader writes:

    "I have nothing to add to the "huge pages" discussion. I promise.

    "But I would like address Mr. [Ken] Broomfield's closing statement which, I believe, is misleading:
    [Broomfield wrote} " 'For regular users out there, you may want to ask why Photoshop is 64- bit on Windows and not on the Mac. Apple's been touting 64-bit computing for a few years now, somewhat dishonestly, but has dropped the ball in a couple of areas. Some of this goes back to the origins of the Mac, 25 years ago.'

    "The short answer is that Photoshop CS4 for Mac is not 64-bit... because Adobe didn't have time to make it 64-bit before it shipped. Apple did not "drop the ball. Photoshop CS5 _will_ be 64-bit when it ships in 2010.

    "Aside from time, no reason Photoshop CS4 could not have been 64-bit.  Adobe Photoshop Lightroom 2 (or simply Lightroom, as most people call it) was 64-bit from the get-go. And it shipped over a year ago.

    "There's a longer answer why Photoshop CS4 is not 64-bit that involves things like Carbon and Cocoa and APIs and bickering between tech giants. But let's just leave it that Adobe had only so much time to work on CS4. And that they chose (wisely, I think) to devote their 64-bit efforts for Macintosh to Photoshop CS5."

    For those who might want more on the subject (!), here you go:

    - A 2008 blog entry from John Nack of Adobe, the senior product manager for Photoshop CS4, on why it's not 64-bit on the Mac;

    - Another entry by Nack last month, on some of the hype surrounding 64-bit computing;

    - And from another reader: "Simple answer: Photoshop came over to Mac OS X as a Carbon application, and at a fairly late date Apple decided/announced that this framework would not
    be completely converted to 64-bit. So in order to get 64-bit Photoshop, Adobe needs to re-work Photoshop so that it is a Cocoa application and only calls Carbon functionality through Cocoa's integration tools."

    Now we know.

    More »

  • Festival of updates #8: Chinese/US attitudes on race, flu

    These are both big, complicated topics, but to catch up on recent developments in each:

    - I mentioned many times last year that there seemed to be less excitement about Barack Obama's rise in China than in, say, Europe or Africa, and that this was due at least partly to racial attitudes.* Many Chinese people with experience in America appreciate the centrality of black-white relations in the story of America's development. For instance, in a profile of Gao Xiqing, who directs the Chinese government's vast investments in the U.S., I mentioned that he has a small portrait of Martin Luther King over his desk in Beijing. (Gao went to law school at Duke.) But in my experience, many ordinary people with little exposure outside China freely expressed anti-black racial attitudes. During the 2008 primary season, this turned up as a kind of puzzlement about whether a black candidate could plausibly have the skill, sophistication, knowledge, work habits, etc to stand up to veteran opponents like Hillary Clinton or John McCain.

    That's the context in which to read the stories about the hard times faced by a (beautiful) young Chinese model-aspirant whose mother is a Han Chinese from Shanghai and whose father was a black American. The girl, Lou Jing, is at right, and her mother at center in this picture:

    Stories from last week here, in the Straits Times in Singapore (thanks, C. Tan), and from the Shanghaiist site here. A summary (in English) of some of the harsh Chinese on-line chatter at this site, which was also the source of the picture. Discussion of parallel situations in Korea here. The ChinaSmack site, which translates a lot of blog material into English, is said to have a discussion here, but for whatever reason I can't get it to load.

    UPDATE: The China Smack link did finally come up, which has a lot of trenchant material, including what is claimed to be a statement by Lou Jing herself, plus this additional and additionally charming photo:

    To be clear about the context: this is not a "blame China" episode but rather one of many illustrations of the differences in day by day social realities and perceived versus ignored sources of tension in particular societies. That's all to say about it for now.

    - In the same "varying realities" vein, I mentioned repeatedly through this spring how H1N1/swine flu was being taken as a huge public-health emergency in China, leading to extraordinary gestures of what most foreigners considered heavy-handed security-theater. But inside China, the prevalent perception was that the government was taking all necessary and proper steps -- while the US was being self-indulgently and irresponsibly lax, letting infected people roam free to spread disease wherever they went. I'm judging this by what I saw in the Chinese press and by the voluminous complaint messages I received from Chinese readers.

    That is the context for this item by James Areddy of the WSJ last week, concerning an inflight-video on a Chinese airline flight explaining what a "shame" it is that flu virus has been spreading from America. As Areddy points out, the video refers to mei zhou -- 美洲, "the Americas" -- as the source of infection, rather than mei guo, 美国, "America." So maybe it's  Mexico-US-Canada NAFTA-solidarity in blame. On the other hand, the English subtitles say "America." In any case, interesting as a reminder of difference in attitudes. This will matter more, of course, if the flu comes back in a more lethal form this fall. (Photo by Areddy from his item:)


    * In part, it also reflected the long-standing Chinese assumption that Democrats will be tougher than Republicans on trade policy, and the preference for sticking with known figures in US politics. Hillary Clinton was much better known to the Chinese public and officialdom than Obama was, and thus she seemed the safer bet from their point of view.

  • If you've been wondering about BiggieSu

    His Beijing quarantine saga, previously mentioned here and here, has now come to its end. May have been a nuisance for him, but highly entertaining for the reading public -- especially with this taxonomy of "The Seven People You'll Meet in Hotel Quarantine." Full chronicles here.

    After two dispatches, I received no further updates from the Chinese-American person being quarantined in Shanghai (and whose mother apparently developed H1N1.) I am assuming that all is well there and the person decided that more attention would be a minus rather than a plus.

    On leaving Beijing airport a day and a half ago, my wife and I found that all the government officials we encountered -- security screeners, passport stampers, general standing-around staff -- wore medical-type masks over their faces and in many cases surgical-style gloves, testament to constant vigilance against the dreaded flu. On arrival 13 hours later in the US, we saw a little sign in front of the US immigration desk, saying that if we felt feverish or fluish, it would be a good idea to avoid close contact with other people -- but that was that. I have a theory about what the resolute Chinese government response to this so-far-not-very-powerful disease says about "security theater" in the Chinese context. But that's for later.

  • Updates: education, quarantine

    As mentioned two days ago, Mike Su was taken off to quarantine in Beijing after someone on his flight from America turned out to be sick. Today Su has posted a richly (and fancifully) illustrated account of "Life in the Big House" at his quarantine hotel. .

    And from another foreigner who has been teaching English in a rural area:

    Apropos of the thread about the Chinese testing system, several of our very best students earned very high marks in the English section of the recent 'further study' battery that determines whether or not a student may continue their higher education. In spite of their excellent performance in their major subject, they are crippled in their attempt to attend any Chinese college or university for post graduate work because they were a few points deficient in the politics portion of the examination.

    No matter how well one does in other parts of the test, failure to pass the politics (read 'indoctrination certification') portion disqualifies a student from any further education except under very diminished circumstances. Imagine the flowing tears and heartbreak surrounding graduation 2009. Even our Chinese colleagues are incensed.
    That grinding sound you hear is enamel coming off my teeth.

    I have examples of the content of these "political" courses, which are among the most visible holdovers of Marxism in today's China, but not available right now. More later.

  • Journal of the plague year, #2

    A second-day installment from the Chinese-American person now quarantined in Shanghai. First installment here. In this episode, a family member who has just been to the United States is diagnosed with... the H1N1 flu! Some additional thoughts from inside the quarantine site at the end of the dispatch.

     My mom was on all the major news outlets yesterday... "Woman has been diagnosed as a  confirmed case ..."  She had a slight cold which she caught at [a college graduation ceremony she just attended in the US] but was all better by the time she got on the plane. She had no fever, no cough, no physical symptoms of the flu. However, during one of the numerous times they measured her temperature while she was in quarantine, she was found to have a "fever" of 0.2C above normal.
    They took her to an infectious disease hospital where they gave her a blood test. The PCR results came back positive. Other than that one measurement, her temperature has been normal since. The doctor that is treating her told her privately that he was sorry for her because as a medical professional, he recognizes that H1N1 is the normal flu but that he has to follow government protocol, "you are asymptomic with a low viral load so you were very unlucky to have gotten caught." ...

    My mom has the virus and I have her cell phone so for the past day, I've been getting all kinds of phone calls and texts from her friends. The texts usually say something to the effect of, "We are so sorry. Please be comforted to know that you are under the care of the best doctors. Do not worry because you will recover from this horrible disease."  The phone calls are a bit more awkward because when I tell them that my mom has no physical side-effects, the reactions tends to be "Oh, of course not but don't worry yourself sick. You must take care of yourself.  Take care of your body and stay strong psychologically." Oh, Chinese media, you have done a wonderful job of brainwashing your audience.

    I shouldn't be making fun of family friends who mean only well when they send me their condolences, however misguided.  Yet, there are others who have behaved in a manner that is to say the least, extremely disappointing.  Before we knew we were going to be quarantined, my mom went to her office to check her email. She was there for less than an hour.  She rode the elevator to the 10th floor and ran into some of her students on the way. At the time, she had no idea that she was carrying the latent virus. In the past 24 hours, the floor below and above where her office is has been cordoned off. Everyone working on those floors must submit to regular temperature checks. The place is swarmed with health officials and notices are up everywhere asking people who know my mother to be under high alert. Some have voluntarily requested to be quarantined for fear of having being infected. Three people, working in the floor above my mother's, complained of feeling feverish and were rushed off to the hospital.  

    I am sorry if somehow, my mom did in fact infect those people with H1N1 although that likelihood is small and symptoms rarely develop that quickly. My mother is now racked with guilt for having inconvenienced so many people but she is also feeling somewhat betrayed.  A seemingly innocuous visit to her office has now been labeled as an "incident" by the government (murder would also be placed in the "incident" category).  Everyone who works for the institute has to attend a meeting to learn about H1N1 prevention and the heads of the institute have been summoned to report to officials in Beijing. We didn't know any of this was happening in the outside world but one of mom's co-workers called to tell her. In that same conversation, he not so subtly suggested that my dad, who is still in the US for a conference, should voluntarily quarantine himself for a week upon his return to China.

    A picture of my mother in her hospital bed was taken and released to the media without her permission. Although they have not gone as far as to reveal her name, they have released enough personal information (including where she lives and works) to have made it very easy to identify her. She can't claim "innocence" but this incident has intensified her distain for Chinese politics. My parents work for [an elite organization, which] is filled with Chinese who were educated abroad but chose to return to the place of their birth. They love China as a country but as I have told some of you in the past, one of their biggest worries (which I once considered irrational) is that a movement like the CR could easily happen again. It is why my father insisted that my mom become a US citizen even though it severely limits her career working for a government funded organization.  Looking at the mass hysteria that the government was able to create and manipulate using H1N1, did China not learn anything?   

    There are many little things that you become aware of when living in China... Every time I come home, I have to report to the police station to register my "foreign status".  This past Christmas, I failed to do so right away and two police officers showed up at my door. How did they know I was there? That is anybody's guess.  These incidents are strange in isolation but taken together, are far more disturbing. I was willing to overlook them in the past because I was so blindly fond of China but that is not the case anymore.  

    In an additional note, the quarantinee is careful to emphasize that "the quarantine workers at the hotel are treating us courteously andthe general attitude seems to be that they believe they are doing this for our own protection." But:

     My indignation is directed at what I see as an overreaction and needless fear-mongering by officials and the state media (though I suppose the media hype is not just limited to China)....  The implications of creating mass paranoia are disturbing especially in this country. Most of the Chinese people who have called to offer me their condolences have also told me that I should not be upset because I am getting taken care of at no expense to myself. It must a cultural difference because I'm not exactly feeling grateful for this surreal experience.

    More »

  • Journal of the plague year (Shanghai edition)

    An extraordinary statement from someone now being quarantined in Shanghai is below and after the jump. First, a bit of context:

    The World Health Organization has of course now declared H1N1 a "pandemic," while emphasizing that its effects so far are mild. You can look long and hard at the WHO's main site about the disease (nerds will note that the site's URL retains its original basename "swineflu" rather than the less porcophobic current term) without seeing any recommendations for widespread quarantine programs or closing of national borders etc.

    To put the disease's toll in perspective: of the 30,000 cases reported so far all around the world, about 150 people appear to have died from this variant of flu. And in many "though not all" of these cases, according to the WHO, the victims had "underlying chronic conditions." For comparison: since the time I woke up this morning, about 150 people have died of tuberculosis in China alone.* Estimates vary, but "normal" seasonal flu typically kills around 1,000 people per day worldwide.

    [*TB math: According to the UN, China's average annual death rate from tuberculosis is about 15 per 100,000 population. For a Chinese population of 1.3 billion, that would mean about 195,000 TB deaths per year, or about 535 per day.] 

    Of course any new disease strain raises new concerns about potential mutations. And of course a big, poor country like China has different public health considerations than, say, Switzerland might. But bear in mind the dimensions of this current disease threat relative to other real concerns while reading this account from earlier this week, by a person currently quarantined in Shanghai. The writer is originally Chinese but now with U.S. citizenship. It is quite long, but you will not regret reading to the very end. It begins:

    When I landed in Shanghai on Saturday afternoon, a team of medical officials wearing white bio-hazard suites boarded the plane with heat wands and measured everyone's temperature. All passengers were required to remain in their seats while they went around to each individual to check them for physical symptoms of H1N1. These measures had become standard protocol in China due to fears of a H1N1 outbreak. We all passed the inspection and were let off of the plane. I thought I was free to enjoy my two weeks in China.
    On Sunday, I took the subway into downtown Shanghai and spent most of the day visiting The Bund, Nanjing Lu and Yu Yuan (3 of the most crowded tourist attractions in Shanghai).  At four pm, I received a call on my cell phone from the health department informing me that someone sitting three rows behind me on the plane had developed symptoms of H1N1 and that I was to be quarantined. I was told to go home immediately and a medical team arrived at the house to ask me questions.

    After asking me to wear a surgical mask and gloves and disinfecting our house with some kind of spray, these men, dressed in masks and white suites like Martians, took me downstairs where another handful of men were waiting with an ambulance. Sirens blaring, I was driven through traffic to an isolated hotel on the outskirts of the City.

    I am now sitting by myself in a room, in a building full of other "suspected" H1N1 patient. I can use the internet, the phone and watch TV but there is a lock on the front door and I'm not allowed to leave my room or talk to the other "guests". Three women dressed in full gear deliver food to me three times a day (7:30, noon and 5:30 pm) and I get my temperature taken too. They confiscated my passport but there are plenty of posters and pamphlets everywhere describing precautions and horror that is H1N1.

    The funniest part about all of this? I don't have H1N1. Although the people here refuse to answer most of my questions, I was given an English document from the government describing proper procedure for the quarantine. I quote, from the section "When will you be free to leave"

    "The time to lift the medical observation depends on the diagnosis of the passenger with fever symptoms. If the diagnosis rules out the possibility of A H1N1 infection, you will be free to leave immediately...However, if the test report shows anything suspicious or needs another diagnosis, your time of staying here will have to be extended according to official notice..."

    That is what the official government notice says. "I will be free to leave immediately," yet when I asked the workers here about that statement, they claimed that I was misinterpreting the text. Clearly, my English skills have regressed rapidly. When I asked for a blood test, the official way to confirm whether or not I carry the virus, I was denied, "We only test people who look sick. You don't look sick. If you develop a fever, we will test you." 

    So I am still here in my hotel room, healthy but treated as if I have the plague. Counting down the days. One down, six more to go.

    The standard procedure, quarantine for all passengers sitting three rows in front or three rows behind someone with H1N1, seemed amusing when I first heard about it a few weeks ago. I defended it as an understandable reaction for a nation which had screwed up badly during the SARS epidemic. Now, frustrated, bored, and utterly disappointed at the demise of a trip that I had look forward to since December, the reality is no longer amusing.

    Those who know me know that I rarely lose my temper, but I lost it yesterday and many times since. I am angry because I see all of this as unfair. This hotel room feels like a prison and I'm being incarcerated for a "crime" that I did not commit with no way to prove my "innocence". 

    "Crime" is in quotation marks because, as those of us who lived through [a recent university commencement ceremony] can attest to, H1N1 is for all practical if not publicity purposes, no different from any other strain of flu. Yes people get sick from it and there is always the risk of mutation but is a 7 day isolation period the appropriate way to treat individuals who may or may not have the virus based on some artificial boundary of three rows? And if H1N1 was in fact deadly, how could have they even have allowed the suspected carrier to get off of the plane and travel through all kinds of crowded places before placing them in quarantine in the first place?

    I thought I was free to enjoy my time in Shanghai until I was tracked down at a coffee shop on Nanjing Street. Not only did they track me down, which was pretty competent in an Orwellian sort of way, they also informed many of my parents' colleagues and neighbors of our "illness". 

    A picture of my mom and her basic information was featured on the news without her knowledge of consent.  In this country, you are guilty until proven innocent and don't expect any privacy in the mean time. Ever since SARS, flu outbreaks have carried a heavy social stigma. I don't know what the implications will be for my parents whose entire circle of acquaintances and semi-acquaintances have somehow gotten news of this.  But from the withering glances (plus a lot of pointing and mothers shielding their children) that my neighbors gave me when I was being taken away in an ambulance yesterday, I can probably guess.

    Out of frustration, I complained that I was being treated unfairly. I spoke my mind and said that I felt as if my rights were being violated by the Communist government. When I said this, I sent my jailers into a frenzy, "Don't criticize China! Do not criticize China!"  Those of you who know me know that in the past, I've always tended to defend the Chinese government. Yes some of their measures were draconian but they were also efficient and effective, I said. And at the time, I truly believed that it was a fair tradeoff. Fewer rights for faster outcomes.

    I take all of that back. I rarely get angry but I am so angry now. I've never felt so keenly the disadvantages of living under a government that does not recognize the concept of personal rights. Some of that anger is personal, no one wants to spend most of their vacation alone and enclosed. But the deeper anger is directed at my sense of helplessness. I cannot do anything to extract myself from a nightmare that is out of my control and blown way out of proportion. I have no way of defending myself and have not come up with any logical justifications to soothe my anger. I am being treated courteously by the staff here but it still feels like being in prison.

    Since I have infinite time on my hands, I've been watching a lot of Chinese television. The official state media is filled with reports of the dangers of H1N1. Yesterday, an entire talk show was devoted to interviewing a healthy Chinese woman studying abroad who is refusing to visit her family in China this summer because she did not want to risk infecting them with the disease. Reporters and officials in her hometown praised her sense of "civic responsibility" and "patriotism". The piece concluded with words to the effect of, China welcomes and embraces all of her children from around the world. 

    While this type of blatant propaganda would have amused me even a week back, watching it yesterday made me sick. I've been asked multiple times to provide the names of anyone I came in contact with during my 24 hours of freedom (friends, taxi drivers, cashiers, and waitresses...). I've refused so good luck finding them and the thousands of other people "exposed" to my presence in the city.  Call me a horrible person but I refuse to help the "glorious cause". 

    Although the context is different, the political puppet show that is the H1N1 witch hunt has given me glimpses of the emotions and irrationalities which allowed the CR to happen only 40 years ago. If I had any illusions about what the government of this country will or will not do, I've been disabused of those notions. I feel sorry for the Chinese people who from watching the Chinese news, live in fear of being swamped by a deadly outbreak of H1N1 or other new forms of flu sure to arise in the future. I can no longer defend the actions of this government or look forward to living in a country where the precautionary response to H1N1 is the benign tip of the iceberg. There are many other things I want to say but I should probably censor myself from writing them in this email...

    Although the official flight details are not being released to the press, [Ray Nagin, the mayor of New Orleans] was on the same flight as me (though I had no idea that the mayor of NO would fly economy as the three row zone of quarantine would seem to suggest). 

    I have six day left here and I'll be spending them in "quiet" reflection. I will probably make peace with this at some point though it will take a while. Maybe I will look back one day and feel instead of anger and frustration, the humor in being caught in a situation so illogical that it must not be real.  Maybe everything was too good in my life and karma was bound to catch up with me at some point. On the bright side, this is the closest I will hopefully ever get to prison though I did commit to spending the next two years in this country. If there is a silver lining, it is that I realize now that I am much more American than Chinese in my temperament and beliefs. I didn't feel any sort of emotion when I became an US citizen three years ago. In fact, I saw it as a practical decision. But now, I appreciate that privilege so much more.

    More »

  • Well, here's one way to respond to the flu threat

    From an organization holding a conference I plan to attend in Beijing starting tomorrow,  whose sessions have been scheduled for a government-run meeting site:

    Change of Venue
    Due to the concerns of the H1N1 virus, the Chinese government has banned gatherings of groups larger than 50 people at all government facilities. Due to this new circumstance, we are no longer able to host the forum at the [xxxxx]. We have now changed the venue to the [xxxx] Hotel. The schedule of the forum will remain the same, and we apologize for any inconvenience this may have caused you.

    I have no independent information about whether, when, by whom, and with what geographic extent such an order might have been issued. And of course it's hardly the first time I've heard of a last-minute change of site (or cancellation) for a long-scheduled gathering in China, for reasons having nothing to do with flu.

    Whatever the back story here, to me the announcement is an interesting historical document concerning the management of public opinion in China during the current flu episode -- and the success of the government in making any measure, no matter how hazily connected to systematic public health reasoning, seem part of a resolute effort to protect the Chinese people against lax standards elsewhere, notably including the United States. No other countries are imposing quarantine rules as strict as China's? So much more to the credit of the government protecting us here!! Yes, Americans too are familiar with such "security theater" -- just not when it comes to flu. And I can't help remembering that in recent hours I passed through airports in Kunming and Beijing, "government facilities" in both cases, where tens of thousands of people were gathered. So far we all survived.

  • Compare and contrast: "quarantine" in the US and China

    Below on the left, the image from the recent diary of a (perfectly healthy) AP correspondent who, with his wife, ended up in Chinese quarantine for a week, simply because their plane had stopped at a Mexican airport. Starting on the right, an account from a reader in the US who has an actual swine flu patient in her house. The eccentricities of each country's approach are on display here -- along with, as discussed earlier, the reasons why China's reaction might understandably differ from America's or Europe's. The reader begins:

    Quarantine.jpg"In striking contrast to the story of quarantine in China, I am here in Illinois with a house guest with the swine flu, and only the vaguest instructions about avoiding spreading the infection.  The young woman came down with the flu Monday morning, after not feeling great on Sunday.  Since her health insurance is an HMO from another part of the country, it took several phone calls to insurance companies, doctors, etc., to get an appointment - not that the current round of health care reform is likely to address this ridiculous bureaucracy, but that's another topic.

    "We got her in to see a doctor.  In the waiting room were large signs saying, if you have flu symptoms, take a mask (at the reception desk) and use the hand sanitizer -- a huge bottle on the reception desk.  One other miserable looking young person was there also wearing a mask.  Most of the rest of the people in the waiting room were elderly.

    "Not a long wait, she was seen by the doctor, and yep, probably swine flu.  A prescription for five days of Tamiflu, a note of caution to cough into a tissue or sleeve, and use hand sanitizer. No need for the mask outside the waiting room.  A nose swab sample sent off to the state lab, wait 24 hours for a result.  If it is positive, she can't fly for seven days.  Should her boyfriend have preventative Tamiflu?  No, not necessary, no one in the household needs to be concerned unless there is someone with compromised health.

    "That's it.  Today we got the word that it is indeed swine flu, and she has changed her plane reservation.  I debated whether I should go to work or not -- my husband is already at work out of town, potentially spreading the virus.  In the end, I went to work, with a supply of hand sanitizer.  I canceled a meeting I had scheduled with someone with compromised health.

    "The patient is not feeling too bad - I would say it is like a normal seasonal respiratory flu.  Her temperature is down today, and she and her boyfriend (my son) went to the park briefly.  My husband, son and I are all still feeling fine.

    "The irony is that our older son is heading to Mexico for the summer.  We've been fussing at him, worried that it wasn't safe.  He's been saying, you could get the swine flu there in Chicago.  He's coming home Saturday, and leaving Sunday for Mexico, and we are quarantining him at a friend's house so there is no chance he catches the swine flu and takes it to Mexico.  At least here we have Tamiflu easily available.

    "So, no hazmat suits, no quarantine; leaving the doctor's office we waited for an elevator with no other passengers, lest we spread virus.  But no one told us to do so."

    [An hour later]"Addendum: So my house guest with the swine flu just re-booked her ticket, since the doctor told her not to fly until Sunday.  American Airlines was very insistent that there was a $150 re-booking charge, swine flu or not.  She offered a doctor's certificate.  No, they have no way of receiving faxes, and they are not interested.  She asked for the manager.  No, the manager agreed, that's the policy, you re-book, you pay.  Finally, persistence won out, and she persuaded them to rebook without the fee; but a special manager is calling her tomorrow during regular working hours because they really are not authorized to do this re-booking without the fee, "we're breaking the rules."  

    More »

  • Very interesting flu-quarantine diary

    Will Weissert, an AP correspondent based in Havana, traveled with his wife to China for a wedding -- and ended up spending a week in quarantine. His account of the quarantine, here and with pictures beginning here, is very interesting on the nuts and bolts of how the system works. It's not a complaint, though there are some complaining details. Mainly a chronicle, with details I hadn't seen elsewhere.

    Here is his wife in the quarantine-hotel room, as Chinese officials take notes on her condition.

    And here is the intro to his account of how they ended up in this situation:

    My wife and I are in perfect health, but after flying to China for my college friend's wedding we're being quarantined in a remote hotel for seven days. The reason: Our flight from our home in Havana included a layover in Cancun, and China is taking no chances with swine flu.

    Never mind that we were in Cancun for only two hours, that we didn't leave the airport and that Mexican doctors with electronic thermometers checked us for fever on arrival and departure. Never mind that when our Continental Airlines flight from Newark touched down in Shanghai, we and everyone else on board were not allowed to leave our seats until health workers clamored aboard and pointed a blue beam at our foreheads to take our temperatures.

    The Mexican stamps in our passports -- my wife is Chilean, I'm American -- are enough for authorities to pull us out of line at immigration and send us to a medical room where attendants in white lab coats take our temperature yet again and give us surgical masks...

    After 3 1/2 hours, a man in uniform -- speaking by phone with a communist official everyone calls "the leader" -- announces we will be confined to a hotel room for seven days.

    We say we'll simply fly back home. He tells us that isn't possible.

    Worth reading the rest. (Thanks to Daniel Lippman.)

  • Europe, America, China respond to the flu

    From Kevin Miller, of the University of Michigan, an observation on why the differing European, American, and Chinese approaches to the current spread of flu might be explained by the respective health threats the areas face:

    I have a colleague, a native German, who went to Germany last week and reported that the general attitude was that Americans were being crazily hysterical about this. It makes sense to me that a) the Chinese are really being hysterical, b) Germans are calm, and c) we're somewhere in between.

    If you look at the medical safety net in each country, this makes perfect sense (plus the big worry that this could combine with bird flu, which they have in China. H1N1 seems to be easy to catch but rarely serious; bird flu is hard to catch but often fatal; flu viruses seem good at swapping DNA within host nuclei. If the same person had both bird flu and H1N1, this could lead to something really bad).

    More »

  • Visas in the time of flu

    If you're thinking about coming to China from the US, you should know that visa rules have recently tightened up dramatically, as they did before the Olympics last year. Here's why.

    Inside China, the detected flu cases have doubled, from one person to two, and the quarantine-and-tracking efforts are stepping up. Newspaper charts have shown the infected people's progress through the country and reported the efforts to find and quarantine everyone who was, say, riding in the same railroad car. A report I saw this morning said that most of the people who had been on the same Beijing-Jinan train with Victim #2 were still "at large."


    [Reader R. Skinner points out the inventive West-to-East rendering of the Toronto->Vancouver-> Beijing flight.]
    Meanwhile, in mail from Chinese readers and in Chinese and English news sources I've seen more and more frequent mentions of the need to crack down on the "real" source of the problem: the United States. Both of the infected people had, after all, come on flights originating in the US (flights from Mexico having been cancelled for quite a while.)  Eg this lead editorial in yesterday's Global Times, the new state run voice to the outside world. 


    I don't see an online source for this item, parts of which you can read if you click on the image to see a larger version. The gist is that the US is again being lax, fat, and happy in not imposing as many internal restrictions to limit the spread of flu as China is doing. Eg:

    "The situation is now clear: the US must respond to the epidemic with more active, effective measures.... At the moment, life in the US is continuing much as before, with Americans traveling as widely as usual... But the impact of swine flu can be disastrous for countries without proper preventive systems....

    "China has taken exhaustive measures to track down all of the people who traveled with the two swine flu victims. A few are still missing, posing a risk to the rest of the population."

    In practice, here is what it means for Americans. In the olden days, ie until last week, if you got in line at a Chinese consulate early enough in the morning to reach the visa window before the noon lunch break, one of your choices would be "expedited" same-day service. For an extra fee of something like $150, you could get the visa after lunch. If you missed the morning rush and applied in the afternoon, you could still normally get your visa the next day. If you had all the right forms and there were no complications, you could more or less count on getting a visa in one or two days.

    Now, "because of flu," expedited handling is called off and visas for Americans are, according to various reports, subject to a mandatory six-working-day processing period. I have heard of one big-deal conference scheduled for next week that has just been scrubbed because attendees couldn't get visas, and various other ripple effects. One more thing to be aware of if you're thinking of a visit.

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  • Expats in China: NOT being called in for health checks (updated)

    Yesterday I posted a report from a teacher in Hangzhou who, along with other foreigners on the staff, was being called in for special health checks as part of anti-flu precautions. The teacher wondered whether this was a Hangzhou localism or a wider policy.

    Since then I have received no reports of special health checks for foreigners, and many comments to the effect that "all is routine here." So it appears to be a one-city or even one-school policy. Worth noting.

    Update: Have heard from one teacher in Suzhou about health checks there too (not far from Hangzhou, so maybe....) and an expat in Beijing about getting temperature checked on the way into his apartment building gym. Adding: "(lucky they didn't take it one the way out. Would have been quarantined for sure. Or perhaps shipped out to a morgue)."

  • For expats in China: being called for health checks?

    A foreign teacher in Hangzhou writes with a question:

    I was informed this past Friday by my school's Foreign Affairs Dept. that we should report our "health status" by 3 pm daily. Only the foreign teachers have been asked to report their health (whatever that means, we are still not really sure) according to my Chinese colleagues. I was wondering if you had A. heard any other reports of such behavior and B. Does this indicate that the virus is in Hangzhou? (It doesn't seem likely if Chinese teachers aren't also being "checked") Or is this just another example of over-response (since none of us have been out of the country in over a month)? 

    I have not heard of or experienced anything like this, and my default explanation for regional variations is that it's a great big country with lots of different things going on. But if anyone has experienced something similar, let me know and I'll collate results. Meanwhile, stay healthy!

  • First they came for the Mexicans. Then, the Canadians...

    I awake* to find numerous dispatches from Canadian and Canandian-friendly sources pointing out that a group of students from Canada has been placed in quarantine in China strictly because of their nationality -- not because they've come from flu-infected areas or fit any other rational criterion for quarantine. This is happening in the northeastern** city of Changchun, a regional industrial hub with a population about the size of New York's. According to the CBC account,

    Chinese officials in Changchun pulled the group aside after their plane landed in the northeastern city on Saturday, according to Martin Deslauriers, a Quebecer who is part of the language exchange group.

    An official came on board and asked all the Canadian passengers to present themselves, Deslauriers said. Health officials then took them to a room at the airport to have their temperatures taken, he said. No one in his group had a fever, but they were still informed they would be placed in quarantine, he said.

    And there they'll be for seven days. The story suggested that some students were disgruntled but others were considering it as much an adventure as an ordeal.

    Policy point: At one level, this is as arbitrary as the more widespread quarantining of Mexican passport holders, discussed in many posts here -- and more obviously nutty. Canadians? Is it because they come from someplace close to Mexico? If so, isn't there some other big country right in between those two? What about all its citizens? Therefore, by this train of reasoning, the case shows the unprincipled power of the Chinese state etc.

    But I am more struck by the additional element of illustrating how uneven, inexplicable, and anything-but-thorough the application of that power can be. For one thing, this appears to be policy free-lancing on the part of the local authorities. The story quoted its student interviewee thus: "Deslauriers said the students have been told by officials that the quarantine is a provincial measure and not part of a national plan by the Chinese government."

    And, it's a "quarantine" that appears to be in the tradition of "quarantine theater," like the "security theater" so familiar at airports around the world. The students have to stay inside the hotel -- but apparently the staff that serves them comes and goes normally! Now, if any of those staff members held a Canadian passport... I hope everyone keeps feeling fine.

    * Although there is a coals-to-Newcastle superfluity in linking to anything on Andrew Sullivan's site, the video he posted today exactly depicts how every day of my life begins. This is a lot of the reason I have avoided holding "normal" jobs.
    ** China's northeastern region -- known in Chinese as 东北, or "EastNorth" -- is the part of the country that first came under Japanese control in the 1930s when it was known to the outside world as Manchuria. Within China today, Manchuria is not an in-favor term; 东北 is the way to go.


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