Facing both the disease and criticism of its response, the dynasty invited an international group of experts to the first international medical meeting in the country’s history. The meeting was a whos-who of scientific celebrities, including European and Japanese researchers who just a few years earlier had been on the front lines of a similar outbreak in Hong Kong.
Among the participants was a Malayan Chinese doctor named Wu Liande 伍连德. Cambridge-educated, Wu had been instrumental deputy director of the Imperial Army Medical College in Tianjin. Wu was connected by family to high ranking officials in Beijing, who insisted that he be named director of the group. Given the charge that China was incompetent to run its own affairs, it was vital the effort be led by a Chinese.
He would turn out to be an inspired choice. A tireless worker, Wu confirmed that the disease was pneumonic plague, which had spread from local animal populations to novice hunters, who caught the disease from fleas in infected pelts.
Wu had to fight entrenched attitudes and practices. In immigrant Manchuria, coffins of the dead were routinely stored in the open awaiting transport back in ancestral villages, or until the spring thaw permitted burial. Accompanied by armed soldiers, Wu personally oversaw the immediate cremation of all human remains.
Even as the dynasty entered its final days, Wu secured funding for new public hospitals and political backing for a permanent epidemic monitoring body. His Manchurian Plague Prevention Service would become a key foundation of China’s emerging public health infrastructure.
What can imperial China’s final plague teach us about the current global response to coronavirus?
Although criticized for not addressing the crisis in Wuhan, China’s government has since mobilized immense resources to halt its spread. Singapore, Korea, and now Italy have learned from this example and followed suit with innovative measures not only to control the movement of people but also to lessen the impact of the outbreak on daily life. These measures are already producing results in stemming the flow of the disease. History teaches us that they will also pay a dividend in terms of new institutions, and international esteem.
It also suggests that the United States is at a crisis point in more ways than one. Beyond the human cost of the outbreak, mixed messaging about the number of cases, public weakening of the CDC, and the apparent desire of the Trump administration to simply spin the crisis away erode international faith in the basic competence of American institutions. The poor response of the markets to stimulus measures suggests that the damage has already begun, but like the outbreak itself, there may be far more bad news lurking just beneath the surface.