- Slogan Turned Idiom
Slogans are propaganda, pushed out by political machines. Idioms are condensed wisdom. They have their own life and spread by themselves.
The boundary between slogans and idioms was blurred in China this February, when villages and street committees — the lowest level of governance in the country — improvised slogans to convey the complicated reasoning behind lockdown to everyday folks. Some of the slogans were so good, that they had a life of their own on the internet. Here are a couple of them.
“Save small money to spare a mask = Spend big money to be hospitalized”
“Better to wear a mask than a ventilator; Better to lay at home than at ICU”
If these slogans appear aggressive and hilarious to you, then you get how they look like to Chinese. More examples can be found here. In my opinion, one of the slogans have become worthy of an idiom. It is hung on a shabby wall, as shown below:
“Mask or ventilator? Your call”
The slogan poses a question and no answer, because the answer appears obvious. Why would anyone choose ventilator over mask? Putting on a mask can be uncomfortable, but putting on a ventilator as a coronavirus patient can be so uncomfortable that sedatives are necessary. Plus, when a coronavirus patient requires a ventilator, the chance of dying is up to 81%.
In just a few words, the slogan incapsulates how the coronavirus outbreak is perceived in China. The options on the table are limited: either all-out containment measures, or something much less desirable. Uncomfortable as wearing a mask may be, the alternative is so much more dangerous.
The slogan-turned-idiom is inaccurate in one aspect though. It assumes wearing a mask is an individual choice. It is not. In response to the outbreak, public health authorities in the East and West issued diverged guidelines on mask wearing. Authorities in East Asia advise mask wearing in a wide range of situations. Authorities in the West advise no necessity for healthy people, unless taking care of a coronavirus patient. As a result, “mask or ventilator” is much less a choice of the individual, than the choice of the societies where individuals live— the East, or the West.
2. Dissenting Experts
When we decide our response to the pandemic, we turn to experts. In a pandemic, public health experts gather data, build models, make predictions, and issue guidelines. As commoners lack expertise, experts are trusted for the good of us all.
Except that experts around the world have made every different recommendations. As shown below, Hong Kong CDC advises masks for healthy people. American CDC advises against it.
When I ask friends from East Asia for their opinions of different mask guidelines, they say the Western experts must be onto something. Maybe facemasks are associated with sickness and thus ominous in the western culture. Or, maybe there are so many guns in America, it will be unsafe if everyone wears a mask. After all, Western experts dominate the global field of public health, and people have the tendency to justify what authorities say, even if what they say appear counter-intuitive.
The real reason behind the diverging guidelines is a lack of data. We do not know enough about three questions. First, how often do the infected show no symptoms? Second, how effectively can asymtompatic people infect others? Third, if many people wear masks in a public setting, how does that affect the dynamics of an airborne infectious disease?
For the first two questions, we know from early on that some people are asymptomatic, and they can infect others (JAMA, 2020/2/21). However, we do not have great estimates on the numbers as the virus is relatively new. For the third question, the existing studies only concerns past influenzas (which have fewer asymptomatic transmission) and have been conducted in the household setting, not grocery stores and workpalces.
Without good data, experts have to deduce from their past experieces. Experts in the East err on the side of safety, deducing that masks should be effective to prevent asymptomatic people from transmitting the virus to others. Experts in the West deduce the opposite.
The anti-mass-masking guideline is the international norm, endorsed by intergovernmental organizations such as WHO. The pro-mass-masking guidance has been a rebellion of regional clusters of public health experts. Swimming against the international norm and the global authorities, experts in East Asia have advocated for their dissenting opinion(Lancet, Lancet Respiratory Medicine, Nature Medicine). They argue that “absence of evidence is not evidence of absence” and has recently run experiments to show the utility of masks in preventing asymptomatic transmission. As hard as they have tried, mass masking has so far remained a dissenting opinion only. (Note: this has changed after writing this draft, as US CDC now recommends wearing mask in public, as of 4/3/2020).
3. Nonwoven polypropylene
Recently, US CDC is considering to revise mask guidelines (and just did, as of 4/3/2020). But there is one more question: can America produce enough masks? In addition to efficacy of masks, public health experts in the West bring an important assumption to their decision-making: If masks are recommended for everyone, medical professionals will be further deprived of masks.
If this assumption were true, then doctors and nurses in East Asia must have suffered from such a deprivation. However, they have not. The reason? Because when everyone is expected to wear masks, entrepreneurs see a massive new market and produce many more masks. Facemask has grown from a niche medical product to an everyday consumer good, so doctors and nurses in East Asia can easily have enough. One sign of sufficient medical supply is masks are now being imported from China.
One current narrative is that US is suffering from mask shortage due to a history of outsourcing. This view does not square with the reality that however many masks a country produced before the outbreak, their pre-existing capacity will not be nearly enough in an outbreak. For example, China produced 20 times more masks a day in mid-March than in early January. In other words, 95% of mask productivity in China were added in six weeks.
Therefore, the real question is not how many masks America can currently make, but how much more mask productivity America can potentially add. To make masks, we need mask making machines (which makes masks) and nonwoven polypropylene (which masks are made from). Mask making machines aren’t difficult to produce at all. Large and small workshops are capable of producing them and selling them online.
The only potential bottleneck is non-woven polypropylene. People have contradicting opinons on how hard it is to produce it. One report quotes a business person arguing that it takes 6 months to assemble a new production line for nonwoven cloth. In another report, an American manufacturer is already adding a second production line and testing the third, expecting to triple productivity in weeks.
To me, the second version of timeline is more convincing. A production line may take 6 months in normal times, but they can be much shorter if properly incentivized and helped. In South Korea, Samsung has been assigned to help with mask production, lending its expertise in manufacturing things much more precise (such as semiconductors). If America could become serious about making masks, coordinated expertise sharing could similarly help produce nonwoven polypropylene.
Public health experts are heroes and heroines, but they do not have expertise in nonwoven polypropylene production. Therefore, public health experts should not be burdened with anticipating future mask supply. If masks are likely to be useful, public health experts should advertise it rather than hide it. Then, politicians and entrepreurs must shoulder their responsibility to produce masks for everyone.
4. Containment versus Freedom
When writing this blogpost, I called a friend to ask how she would respond to “mask or ventilator”. She laughed and said: “No, I want neither. I want normalcy.”
My friend taught me a lesson. I wrongly assumed that we all desire avoiding the awful death by coronavirus. We desire the normal, the freedom to go out and enjoy life. We don’t desire either masks or ventilators, as they are abnormal and appear to limit our freedom. To live a life, we don’t and can’t worry about death all the time.
A dilemma thus emerges: Containment measures and freedom appear incompatible. When we stay at home to fight the virus, we are already giving up freedom, giving up things we normally enjoy.
And the dilemma doesn’t stop here. A person infected by coronavirus can unknowingly spread it. Given this knowledge, should we forcefully quanrantine the people who tested positive, even if they don’t have symptoms?
This is no hypothetical question. Currently in America, we let people who test positive and with mild or no syptoms go home. In East Asia, people who tested positive aren’t sent home, even if they only show mild symptoms or no symptoms. In Singapore, they are kept in hospital. In China, mild symptoms people are sent to a particular type of shelter hospital, built specifically for them (Lancet, 2020/4/2). This measure can prevent these people from spreading the virus to other members of their household.
Similar dilemmas arise with other containment measures. Should people put on masks in grocery stores, given almost anyone might unknowingly infect others? Should people who have come in touch with an infected person be informed, so that they can self-quarantine or get tested? If they should, can the government track the locations of everyone, so that they have the capcity to inform them?
America has picked the low-hanging fruits of containment measures: wash hands and stay at home. More containment measures, including mass masking wearing, quanrantine, and location tracking, will create more feelings that normalcy and freedom are being sacrificed.
Public intellectuals in the English world have rightly pointed out the dangers to freedom in responding to coronavirus (e.g. here). However, these questions are misplaced from a pragmatist point of view. The real question should be: How to make containment measures and freedom compatible? This is a real question, because it must be solved. It needs to be solved soon in this pandemic, and it needs to be solved time and again in the future, in our increasingly interconnected human race.
In the end, letting people die by not containing the virus is not advocating for freedom.
5. Values to be Clarified
As I compulsively checked coronavirus-related news, I noticed that many American car manufacturers have started to make ventilators: GM, Ford, Tesla. This is interesting, because car manufacturers in China also mobilized in response to coronavirus, but to make masks: BYD, SAIC-GM-Wuling. Here, the idiom “mask or ventilator” works on a societal level: The East chose the mask, and the West chose the ventilator.
Two images emerge before my eyes. One image is a patient on a ventilator, bravely fighting it out. The other image is a person wearing a mask, looking almost like a coward. As I try hard to understand the American cultural tastes, there seems a positive moral valence attached to ventilators, and a negative one attached to masks.
How does a society value the prevention of millions of deaths, which is predictable outcome if we do not suppress the virus? In the Confucian tradition, an ancient idiom says “a human life is of supreme importance”. There is good reason to prevent mass deaths. When bodies are piling up in the corner, people are not going to restaurants, the economy is not going to make rounds, and social order will be threatened.
Some argue that economics is the real problem in this pandemic. It is not. We can’t save the economy without saving lives. For pragmatic reasons, we have to clarify our value priorities.
Response to coronavirus is inherently global in scale. If the virus is still rampant in any country, then the world is not safe. Conversely, if the pandemic can be contained in any country, then the world will be a bit safer, as there will be less possibility of the virus being spread from this country to other countries.
In this context, what does wearing a mask mean morally? I argue that it is not cowardly behavior. It is doing the right thing to protect yourself and protect others, even though the protection isn’t perfect. It is not a sign of weakness, but as a sign of strength. A symbol of having faith in life. An act of altruism. A commitment of individuals on the same side against the virus. A bond that connects us.
If we attach positive values to it, the facemask may even become an object that American car manufacturers will proudly make.
6. Trust Experts, but Don’t Count on Them for Everything
Public health experts have done so much for all of us (e.g. Fauci). However, unlike in an American superhero movie, we can’t count on heroes only. After all, the key to suppress the curve is ordinary people lowering their risk of contraction or unknowing transmission to others. This includes washing hands, staying at home, and maybe wearing a mask in public. We can’t count on public health experts to wash hands for us. We have to count on everyone.
There are even more that we can’t count on public health experts. We can’t count on them to prdouce non-woven polypropylene. We can’t count on experts to solve the political and ethical dilemma of prevention versus freedom. We can’t count on experts to decide our own values of what matters most.
Some say “The best thing you can do to fight COVID-19 is nothing.” I beg to disagree. If we break down the things we need to do to respond to the pandemic, it becomes clear that many more talents can be used. International relations, particularly US-China relations, need to be worked on at this fragile time. Injustices caused by coronavirus need to be investigated, understood and redressed. Schoolchildren need to be effectively educated despite closure. And the list goes on.
Therefore, it is important for everyone to make their own diagnosis of the situation. Mask or ventilator? Or, is there something better I can do? Our response could include whether or not to wear a mask, how to use our own expertise to help solve part of the problem, and our own values and positions in public discussions of the outbreak.
When the virus broke out in China, I watched in awe how Chinese students in America raised funds and sourced masks to the centers of outbreak in China. When the virus hit the rest of the world, many of the same people did it again, only in reverse order — fundraising and sourcing masks from China to USA.
What they did were little things compared to what powerful organizations can do, but to me, they were inspiring stories that show you and I can do more. For a start, these are some initiatives on coronavirus that you may participate in or add to.
Experts and governments matter a lot, but I’m afraid they do not hold the key to respond to coronavirus. The key is how each of us, as our lives now literally depend on each other, make our human choice.
*All opinions are my own. If there are factual mistakes, please comment to let me know. Thank you!
