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.