To those familiar with the city’s history there is poignant poetry in the fact the pandemic which has rocked the world for the last year emerged from Wuhan. More than 50 years ago in the midst of the cultural revolution, the city bore witness to another health crisis an analysis of which in addition to more recent data from Wuhan offers numerous lessons for a globe assessing and attempting to learn from SARs- COV2.
The first key lesson of Wuhan’s experience during the cultural revolution is the deleterious impact of leaders trading public health for power. At the heart of the cultural revolution as a whole was an attempt by an aging Mao to create new enemies as a mechanism to preserve power. One victim of this effort were physicians with one physician of the era noting for example China’s leading hematologist, being sent to do manual labor on a pig farm. The consequence of this among others in Wuhan was so many doctors being denounced that the healthcare infrastructure could no longer function. While thankfully we have yet to see such profound impacts in the United States it is undeniable that this narrative of portraying healthcare workers striving for the public good as an enemy of a government in crisis has been a constant of the present pandemic. Unfortunate realities such as the fact that top health experts such as Dr. Fauci need security for the first time in their careers while conspiracies regarding increased pay for false COVID diagnoses proliferate offer strong evidence of otherization.
The other key lesson from Wuhan stems from more recent history. Even before the pandemic hit the city offered a window into many of the issues which impact both American and Chinese medicine. One such issue is the increased market pressures that shape hospitals. In 2019, Chinese public hospitals received about 10% of their funding from subsidies compared to near-total government support a few decades ago. A solution mirroring America’s longer-standing market-based medical system is that more Chinese medical graduates are opting for higher-paid specialties worsening the lack of primary care in rural areas. Spats of violence against healthcare workers as prices and expectations rise are also shared between the USA and China. A final commonality is the impending doctor shortage as both the professional population and those they serve age. While the Pandemic turned the world’s attention to Wuhan the issues it was facing were already endemic the world over. Hopefully, the closer attention to Wuhan and its parallels abroad as magnified by our recent shared tragedy will engender substantive change rather than a return to pre-crisis normalcy both in the US and China.