the existence of a cluster of cases but provided very little additional insight. That same day, however, local Wuhan officials closed the Huanan Seafood Wholesale Market, which had been identified as a suspected center for the outbreak. Meanwhile, Chinese researchers successfully mapped the coronavirus’ complete genetic information on January 2 – a feat that would help researchers all over the world understand where and how the virus spread – although they didn’t make it publicly available to the rest of the world until more than a week later on January 11. That day, China also reported its first death, that of a 61-year-old man.
As cases mounted and Chinese officials moved to lock down Wuhan, Beijing mobilized its resources on the global stage, much as it had at home. The CCP’s United Front Work Department (UFWD), which is responsible for maintaining ties with overseas Chinese, reached out to local Chinese civic groups abroad and encouraged them to assist China in the country’s moment of need. The response was immediate and overwhelming. Bloomberg News reported that Chinese volunteers in Nagoya, Japan bought 520,000 masks in three days.33 Churches, philanthropic organizations, multinationals, and governments across the world also mobilized to send PPE to China. One of those who answered the call was Li Lu. A former student leader of the 1989 democracy protests in Tiananmen Square, Li had fled China for the United States in the wake of the government crackdown. In short order, he graduated with a BA, JD, and MBA from Columbia University, became an American citizen, and started his own investment fund, Himalaya Capital Management. Li and I were at a conference in San Diego in late January when I overheard him on the phone during a break desperately attempting to secure PPE to send to China. As he later explained to me, he had lived through the 1976 Tangshan earthquake and remembered the chaos of the Chinese government’s efforts at the time. He saw some of the same confusion during the early months of the pandemic as Chinese leaders tried to manage the PPE supply through only two government-designated organizations: the International Red Cross and the All-China Federation of Philanthropy. Both were ill equipped to manage the situation. Li found his own way to get more than $1,500,000 in PPE and financial assistance where it needed to go by using “layers of friends” and networks both in and outside China. In addition, the day after the death of Dr. Li, Li established a foundation to help take care of the families of nurses and doctors who had died or were permanently incapacitated. Overall, organizations in the United States provided 18 tons of masks, gowns, respirators, gauze, and other needed materials.34 By the end of February, the international community had provided China with items worth $1.2 billion.35
Beijing also directed its ambassadors to fan out to try to control the narrative. At the conclusion of the San Diego conference, I sat in a half-empty auditorium listening to China’s ambassador to the United States Cui Tiankai deliver a keynote address. His message was straightforward: China was behaving in a transparent manner and sharing information with the international community. Moreover, China’s sacrifice was not only for the Chinese people but also for the rest of the world. Cui, like his fellow ambassadors, avoided any hint of culpability for the virus’ initial spread. And behind the scenes, Chinese officials requested that other countries not publicize their assistance to China or stoke fear by banning travel or closing their borders to Chinese nationals.36 These requests betrayed the fragility of the CCP’s legitimacy at home; in a system of performative rather than electoral accountability, a perceived failure in pandemic management could result in a governance crisis.
By mid-March, the Chinese government had largely arrested the spread of the virus. Chinese officials and the media pivoted quickly to sell a new message: China was the world leader in pandemic response.37 The country had amassed the world’s largest cache of PPE. (China itself was already the world’s largest manufacturer of PPE, producing 60 percent of protective garments,38 and a critical source of the precursor materials necessary to develop COVID-19 vaccines and drug therapies.) And with PPE to spare and a demonstrable record of success in beating back the virus, the government brought the same actors back on duty, but with a different mission.
Chinese ambassadors now promoted Beijing’s “Knowledge Center for China’s Experiences in response to COVID-19” on their embassy websites, featuring QR codes that provided access to scientific papers, short policy briefs, and videos with Chinese doctors that touted Xi Jinping’s leadership and the country’s impressive COVID-19 response.39 The government also encouraged Chinese companies such as Alibaba and Huawei to become informal brand ambassadors for Beijing by providing PPE and other assistance to countries struggling with shortages. Overseas Chinese followed suit. Li Lu organized a webinar featuring three Chinese doctors from Wuhan and Shanghai who had been at the forefront of fighting the pandemic. Hundreds of US scientists, doctors, and other health professionals attended. In addition, he used his personal funds to buy millions of dollars of PPE to supply to US hospitals. And in a stroke of good luck, the head of one of China’s premier electric car makers, BYD (also one of Himalaya Capital’s portfolio companies), happened to be in the United States, and Li persuaded him to start producing face masks. With 3,000 engineers behind the effort, BYD became the largest face mask producer in the world – and one of only two Chinese companies that received official US National Institute for Occupational Safety and Health certification and Emergency Use Authorization from the Food and Drug Administration for medical equipment. “Viruses don’t recognize borders or ideology,” Li reminded me when we talked again in fall 2020. “They affect people equally. Things that can protect Chinese can help Americans, and drugs will work both ways.”
A Period of Strategic Opportunity
For Chinese leaders, the second stage of the pandemic represented what they like to refer to as a “period of strategic opportunity.” Xi managed to use the pandemic to make progress on several health-related priorities, most notably bolstering his still nascent Health Silk Road (HSR), an offshoot of his 2013 grand-scale global infrastructure plan “One Belt, One Road” (later translated as the Belt and Road Initiative or BRI).40 Thirty countries, as well as the WHO and UN Programme on HIV/AIDS, had previously signed memoranda of understanding as HSR partners;41 now China was sending them doctors, medical devices, and technology, such as contact-tracing capabilities and e-medicine.42 In a March phone call with then Italian prime minister Giuseppe Conte, Xi Jinping stated, “Italy and China are the cornerstones of the new Silk Road of Health,”43 and he sent 300 doctors to Italy to cement the partnership. Foreign Minister Luigi Di Maio criticized Europe for providing less assistance than China,44 although not all Italians agreed with his assessment. As one Italian observer noted, China’s aid was provided primarily as part of a commercial deal, whereas European assistance was “more substantial” and arrived in the form of donations.45
In addition, Xi seized the opportunity presented by the pandemic to promote traditional Chinese medicine (TCM). Xi had long supported TCM, describing it as “the treasure of ancient Chinese science and the key to the archive of Chinese civilization.”46 TCM is both lucrative – with a global market value of more than $400 billion – and an important source of potential Chinese cultural or soft power influence. Early in his tenure, Xi set targets for the production and use of TCM within China, established TCM centers, programs, and workshops in several African and other countries,47 and worked with Margaret Chan, a former Hong Kong health official and WHO head, to develop and release a 10-year strategy to integrate TCM into the world’s healthcare systems. (The plan called for countries to educate their citizens on TCM’s benefits and ensure that insurance companies provided reimbursement for TCM.)48 In 2019 – over the objection of much of the international scientific community – the WHO agreed to include TCM in its International Classification of Diseases (a document that validates certain treatments and medicines for doctors to diagnose patients) without subjecting TCM practices to the same rigorous testing demanded of Western treatments.49 This provided TCM with an invaluable official seal of approval.
Despite limited medical evidence as to the benefits of TCM for treating COVID-19, Xi instructed Chinese hospitals to prescribe it as part of their COVID-19 treatment protocol.50 He also pushed the distribution of TCM and TCM medical specialists
