In late 1910, a deadly plague started spreading in the northeast reaches of China, reaching the large city of Harbin. Tens of thousands of people coughed up blood; their skin pruned and turned purple. They all died.
This outbreak sent the Qing government into a tailspin: They didn’t know what illness was causing these deaths, let alone how to control it. So they brought in one of the best trained doctors in Asia at the time, Dr. Wu Lien-Teh. After performing autopsies, Dr. Wu found Yersinia pestis, a bacterium similar to the one that had caused bubonic plague in the West. He recognized Manchuria’s plague as a respiratory disease and urged everyone, especially health care professionals and law enforcement, to wear masks.
Chinese authorities, heeding his call, coupled masking with stringent lockdowns enforced by the police. Four months after the doctor was summoned, the plague ended. Although often overlooked in Western countries, Dr. Wu is recognized in world history as a pioneer of public health, helping to change the course of a respiratory disease spread by droplets that could have devastated China in the early 20th century, and perhaps spread far beyond its borders.
While the Chinese of that era complied with these strategies, public health professionals in the United States and other Western countries have struggled to get people to listen to them during the Covid-19 pandemic. China, too, ran into challenges early on, but the country’s institutional memory from previous viral outbreaks helped turn the tide. And as many Americans abandon masking, push to restore normality in places where risks of infection remain high and hesitate to get vaccinated, some public health experts have looked to Dr. Wu’s success, seeking lessons on handling not only Covid, but also future epidemics.
masks became a political flash point in the United States and elsewhere during the Spanish flu pandemic, the idea of using them persisted in China, and gauze masks became an important tool in the political agenda of the Nationalist Party when it took over in 1928. Public health officials recommended all citizens wear gauze masks in public spaces during outbreaks of meningitis or cholera.
Kyle Legleiter, the senior director of policy advocacy at The Colorado Health Foundation.
Another factor that might have contributed to Dr. Wu’s success in China would be the reverence residents and officials had for him as a figure of authority, Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, said.
In some ways, Dr. Anthony Fauci, the chief medical adviser on Covid to President Biden and a prominent public health figure since the 1980s, served in a role similar to the one Dr. Wu played in China, Dr. Huang said. But, his message perhaps didn’t always get through because Americans are more polarized in their political identities and beliefs.
Dr. Legleiter added that public health messaging only penetrates if the public identifies with or trusts that figure of authority.
“An individual person is a stand-in for a broader set of institutions or systems that they’re speaking on the behalf of,” Dr. Legleiter said. Those who lean conservative, for instance, may put Dr. Fauci and other scientists in the category of “the elites.” As such, they’re more likely to flout public health policies that such authority figures promote, and comply with proclamations from individuals they identify with the most.
Others say that public health is intrinsically tied to the legitimacy of the state promoting it. At the turn of the 20th century, China was in distress, Dr. Hanson said. Dr. Wu helped bring China out of a tumultuous period, and the enforcement of public health measures gave the country more legitimacy.
Similarly, because the current pandemic has laid bare shortcomings in the public health systems in the United States, Britain and other Western countries, some experts believe it can be a catalyst for change.
“Since the mid-19th century, the West has generally seen its ability to control infectious disease as a marker of their civilizational superiority over much of the rest of the world,” Dr. White said. While China was seen as the sick man of the world then, some commentators in China now attempt to brand the United States with that label.
Ruth Rogaski, a medical historian at Vanderbilt University who specializes in studying the Qing dynasty and modern China, believes that the coronavirus crisis similarly offers an opportunity for reflection, which can be very motivating.
“Epidemics can serve as inflection points,” Dr. Rogaski said. “Opportunities to rethink, retool and even revolutionize approaches to health.”
A few months ago, there was widespread talk about the possibility of a “fourth wave” of Covid-19 in the U.S. this spring. Many states were relaxing restrictions, and many Americans, tired of sitting at home, were beginning to expose themselves to greater Covid risk even though they weren’t yet vaccinated.
Fortunately, however, the fourth wave has not arrived.
Cases and hospitalizations rose only modestly in late March and early April, and they have since begun falling again. Deaths have not risen in months.
natural immunity by already having had Covid. The vaccination program expanded rapidly. And even as some Americans behaved recklessly, others continued to wear masks indoors. (Outdoor masks, as regular Morning readers know by now, seem to make little difference in most circumstances).
by the Kaiser Family Foundation, 13 percent of adults said they would definitely not get a shot; 6 percent said they would do so only if required by their employer, their school or another group; and 15 percent said they were waiting to see how the vaccines affected others.
(Related: A new Times story focuses on the millions of Americans who say they are open to getting the vaccine but have not yet managed to do so.)
politically conservative communities, for the most part — are also hesitant about the vaccine. So long as a large number of Americans over 40 remain unvaccinated, Covid deaths are unlikely to fall near zero anytime soon.
… especially worldwide
The second major Covid problem is outside the U.S.: Vaccination rates remain extremely low in most of the world, especially in poorer countries.
Worldwide, there are still some encouraging signs. Global cases have been falling over the past two weeks. Africa and much of Asia continue to report low levels of Covid, for reasons that are not entirely clear. Even in India, the site of a dire outbreak, caseloads have declined slightly in the past few days.
has been horrific. Cases have also been rising in Cambodia, Malaysia and Thailand. Brazil and much of South America are struggling, too. All of these countries serve as reminders that the world remains vulnerable to new waves.
The biggest Covid issue for the rest of 2021 is probably the speed of vaccinations in lower-income countries. It will determine both the future death toll and the likelihood that dangerous new variants take hold, in all countries. Roughly 90 percent of the world’s population has not yet received a shot.
Peggy Noonan argues. It will also hurt Republican electoral prospects, says Commentary’s Noah Rothman.
Cheney’s focus on Trump’s flaws, rather than on Democrats, puts her out of step with the rest of her party’s leadership, Eliana Johnson counters in Politico.
“It is because she is such a partisan, conservative Republican that her dissent is so significant,” New York magazine’s Jonathan Chait has written. But Maureen Dowd argues that Cheney deserves some blame for Republicans’ comfort with lies.
where you can find “bulk bins of fish balls, live lobsters brooding in blue tanks, a library of tofu.”
Dunbar’s number: Can you have more than 150 friends?
A Times classic: Why songs of the summer sound the same (and you may want to turn up the volume).
Lives Lived: Pat Bond was a foundational figure in the B.D.S.M. community. Two people showed up for the first meeting of the Eulenspiegel Society, which Bond started in the early 1970s; membership eventually grew to more than a thousand. He died at 94.
letter-of-recommendation feature. And he explains why you might like them, too. “The check mark is more important than whatever comes of the daily work whose completion you’re marking,” he argues. “The first represents actual living; the second, merely a life.”
Related: Atul Gawande’s 2007 piece in The New Yorker on the power of checklists. — Claire Moses, a Morning writer
PLAY, WATCH, EAT
What to Cook
Here are recipes, including namoura, a syrup-soaked Lebanese cake.
Here’s today’s Mini Crossword, and a clue: Pack of cards (four letters).
If you’re in the mood to play more, find all our games here.
Thanks for spending part of your morning with The Times. See you tomorrow. — David
P.S. Nineteen years ago today, Jimmy Carter became the first U.S. president, in or out of office, to visit Cuba since the 1959 revolution. He delivered part of his address in Spanish, The Times reported.
You can see today’s print front page here.
Today’s episode of “The Daily” is about Liz Cheney. On “The Argument,” a debate over D.C. statehood.
Below deck on their submarine, Indonesian sailors crowded around a crewman with a guitar and crooned a pop song called “Till We Meet Again.”
Weeks later, the same sailors vanished deep beneath the Pacific Ocean while descending for a torpedo drill, setting off a frantic international search. Indonesian military officials said on Sunday, four days after the vessel disappeared, that it had broken into three pieces hundreds of meters below the surface, leaving no survivors among the 53 crew members.
Now, the video of the submariners singing is resonating across Indonesian social media, in a nation where many people are jaded by a steady stream of bad news: devastating earthquakes, erupting volcanoes and sinking ferries.
composed the song, wrote on Instagram below a clip of the sailors’ performance.
paid their respects to the spirit world, consulting with seers or collecting what they believed were magic tokens, for example.
told The New York Times in 2018 that he made a point of incorporating local wisdom and traditional beliefs while communicating the science of disasters.
“The cultural approach works better than just science and technology,” Mr. Sutopo said. “If people think that it is punishment from God, it makes it easier for them to recover.”
The latest diaster struck last week, when a 44-year-old submarine, the Nanggala, disappeared before dawn during training exercises north of the Indonesian island of Bali. Search crews from the United States, India, Malaysia, Australia and Singapore later helped the Indonesian Navy hunt for the vessel in the Bali Sea.
For a few days, naval experts worried that the sub might run out of oxygen. Then the navy confirmed over the weekend that it had fractured and sank to a deep seabed.
Among the items a remote-controlled submersible found at the crash site was a tattered orange escape suit.
a melancholic version by the Indonesian singer Tami Aulia has more than nine million page views on YouTube.
But Mr. Soekamti said his band now avoids playing it and recently declined to include it on an upcoming live album.
“I am sad,” he said, “and, in a way, afraid.”
The army general who has ruled Myanmar since leading the overthrow of its civilian government arrived on Saturday in Indonesia for a meeting with leaders of other Southeast Asian nations, after some of them expressed concern about the army’s killing of hundreds of pro-democracy protesters.
It was the first time since the Feb. 1 coup that the army’s commander in chief, Senior Gen. Min Aung Hlaing, had ventured outside Myanmar. Critics feared that his presence with heads of state at the Association of Southeast Asian Nations meeting would give him the appearance of legitimacy.
Myanmar politicians who have formed what they call a National Unity Government called on Interpol and the Indonesian police this week to arrest the general upon arrival in Jakarta, the Indonesian capital, for crimes against humanity, including the ethnic cleansing campaign that drove more than 730,000 Rohingya Muslims out of the country in 2017.
The National Unity Government, which asserts that it is the legitimate government of Myanmar, also urged the 10-nation regional association, known as Asean, to give it a seat at the summit meeting and refuse to meet with General Min Aung Hlaing until he halts the killing of civilians.
targeted sanctions on regime leaders and military-owned businesses, but diplomatic efforts to stop the killing have been unsuccessful. The United Nations Security Council, where China and Russia can be counted on to support the Myanmar regime, has taken no action.
Asean, which has a policy of noninterference in the affairs of member nations, issued a statement in March calling on “all parties to refrain from instigating further violence,” seemingly ignoring the one-sided nature of the killings.
Among those expected to attend Saturday’s summit were the leaders of Indonesia, Singapore, Malaysia, Vietnam, Cambodia and Brunei. The Philippines, Thailand and Laos were expected to send representatives.
The governments of Indonesia and Malaysia have separately expressed concern about the coup, and Indonesia played a leading role in convening the meeting.
Some members of Asean, including Singapore and Thailand, have close business ties with Myanmar and its military, known as the Tatmadaw, which owns two of the country’s largest conglomerates.
Three Asean members, Thailand, Vietnam and Laos, sent representatives to the Tatmadaw’s Armed Forces Day celebration on March 27. On that day, soldiers and the police killed at least 160 protesters in its largest single-day killing spree since the coup.
slaughter of thousands in its war on drugs and Vietnam’s practice of giving long prison sentences to dissidents.
Asean stood by in 2017 as the Tatmadaw waged a ruthless campaign of murder, rape and ethnic cleansing against Rohingya Muslims, who fled in large numbers across the border into Bangladesh, which is not an Asean member. Nearly all the Rohingya refugees are still there, living in squalid, overcrowded camps.
As the Tatmadaw’s commander in chief, General Min Aung Hlaing oversaw the military operations against the Rohingya.
International human rights groups urged Asean not to meet with the general. Rather, they said, the group should impose sanctions on the junta’s leaders, press for the release of detainees and seek an end to the killings.
“Min Aung Hlaing, who faces international sanctions for his role in military atrocities and the brutal crackdown on pro-democracy protesters, should not be welcomed at an intergovernmental gathering to address a crisis he created,” said Brad Adams, the Asia director at Human Rights Watch.