Lyu Shupeng, Qian Chen, McIntyre Aaron, Lee Ching-Hung
School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China.
Healthcare (Basel). 2023 Jun 26;11(13):1848. doi: 10.3390/healthcare11131848.
After three years of global rampage, the COVID-19 epidemic, the most serious infectious disease to occur worldwide since the 1918 influenza pandemic, is nearing its end. From the global experience, medical control and social control are the two main dimensions in the prevention and control of COVID-19. From the perspective of "two types of control", namely medical control and social control, this paper finds that the political system, economic structure, and cultural values of the United States greatly limit the government's ability to impose social control, forcing it to adopt medical control to fight the virus in a single dimension. In contrast, China's political system, economic structure, and cultural values allow its government to adopt stringent, extensive, and frequent social control, as well as medical control to fight the virus. This approach departs from the traditional pathway of fighting the epidemic, i.e., "infection-treatment-immunization", thereby outpacing the evolution of the virus and controlling its spread more rapidly. This finding helps explain why the Chinese government adopted a strict "zeroing" and "dynamic zeroing" policy during the first three years, at the cost of enormous economic, social, and even political legitimacy. It was not until late 2022, when the Omicron variant with the waning virulence became prevalent, that China chose to "coexist" with the virus, thus avoiding a massive epidemic-related death. While the United States adopted a pulsed-style strategy at the beginning of the epidemic, i.e., "relaxation-suppression-relaxation-suppression", and began to "coexist" with the virus in just one year, resulting in a large number of excess deaths associated with the epidemic. The study contributes to explaining the difference in the interplay between public health priorities and COVID-19 response strategies in China and the United States, based on the specific public health context and the perspective of "medical control" and "social control".
在全球肆虐三年之后,新冠疫情这一自1918年流感大流行以来全球发生的最严重传染病正接近尾声。从全球经验来看,医疗管控和社会管控是新冠疫情防控的两个主要维度。从医疗管控和社会管控这“两类管控”的视角出发,本文发现,美国的政治制度、经济结构和文化价值观极大地限制了政府实施社会管控的能力,迫使其采取单一维度的医疗管控来对抗病毒。相比之下,中国的政治制度、经济结构和文化价值观使其政府能够采取严格、广泛且频繁的社会管控以及医疗管控来抗击病毒。这种方式背离了传统的抗疫路径,即“感染—治疗—免疫”,从而超越了病毒的进化速度,更迅速地控制了其传播。这一发现有助于解释为何中国政府在最初三年采取了严格的“清零”和“动态清零”政策,为此付出了巨大的经济、社会乃至政治合法性代价。直到2022年末,当毒力减弱的奥密克戎变异株流行开来时,中国才选择与病毒“共存”,从而避免了大规模的疫情相关死亡。而美国在疫情初期采取了脉冲式策略,即“放松—抑制—放松—抑制”,并在仅仅一年后就开始与病毒“共存”,导致大量与疫情相关的超额死亡。这项研究有助于从特定的公共卫生背景以及“医疗管控”和“社会管控”的视角出发,解释中美两国在公共卫生优先事项与新冠疫情应对策略相互作用方面的差异。