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Over the past week, COVID-19 cases have spiked around the world.

As of the time of writing, 400 cases have been confirmed in Italy, while Denmark and Norway both saw their first cases. In Iran, the death toll has climbed to at least 19, with its deputy health minister tested positive for the virus. South Korea announced an additional 334 cases on February 25, bringing the total number of the infected up to 1,595, making it the largest outbreak outside of China. Nearly 900 cases have been reported in Japan. The United States is seeing its first instance of potential community transmission. And on February 26, the World Health Organization (WHO) said "the number of new cases reported outside China exceeded the number of new cases in China for the first time."

WHO Director-General Dr. Tedros Adhanom Ghebreyesus had made warnings to the world that each country needs to prepare for a domestic outbreak. However, as the number soars, national governments appear to be scrambling for responses.

"The problem is that the source of the disease is still unknown," Prof. John Cai, director of CEIBS Centre for Health Care Management and Policy, commented on the worldwide spread, "with no sources identified and no viable vaccine, quarantine appears to be the most effective way to combat the virus."

But governance has a decisive effect on a quarantine's effectiveness. "Once an outbreak occurs, a centralized response is needed, and few countries can match China's ability to mobilize the government and the society," observed the professor, who pointed out that throughout China's cultural history, collectivism is emphasized. This gives people a sense of collective responsibility in face of crisis, enabling the government to call on the society as a whole to respond to the crisis. Citizen's self-quarantining at home is an example of the responsibility taken up by the society. The WHO's press conference on February 24 praised China's "all-of-society" and "all-of-government" response to the virus.

In other countries, like European nations and the U.S., individualism often take precedence. This makes it harder for government to enlist the entire society in a centralized way to prevent the spread of the disease.

"Also, the relationship between the 'CDCs' and their respective governments is crucial in a public health crisis," Cai said. The departments responsible for disease control and prevention can focus exclusively on the medical and health side of the issue. The ruling administrations, however, have to do a balancing act. They need to find a balance between the necessity for taking drastic public health actions and the economy, politics, and diplomacy. 

This could partially explain the contradictory rhetoric coming out of the Trump administration on this disease. From different standpoints, the agency and the administration could reach different conclusions on the COVID-19. While the CDC is alerted, the officials inside the White House might not have reached the similar awareness level as the health experts, thus making the U.S. CDC's suggestions at odds with the administration's statements.

CDC's authority, Cai believes, is essential in governments' responses to COVID-19. The agency's power in time of public health crisis must be clarified in more details given their expertise on the subject. Similar deficiency exists in China too. Dr. Zhong Nanshan, a well-known Chinese respiratory expert, also asserted that the Chinese CDC doesn't have enough authority to make decision. Continuous research and accumulation are critical in deterring and combating infectious diseases, and CDC's role has to be elevated.

"China's system gives it an advantage in managing the outbreak," Prof. Cai said. And the world should take notice of it. However, given the difference in governance, learning from China might not be a small feat.

Script writer: Huang Jiyuan

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