My Visit to China: Could This Be A Reason Why Coronavirus Started There?

I've visited China and the wet markets where the coronavirus is believed to have started. With the conditions I saw it's not surprising that this is where the outbreak may have begun. Nurses COVID News

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With all the talk about the coronavirus, I wanted to share my experiences visiting China. A few years ago I traveled to Beijing and Shanghai as a tourist. While the country is amazing and has some unbelievable attractions, it is also obvious that they are still a developing nation.

Common Local Food Options

The first difference that I noticed was the choice of food options. Although they have McDonald’s and KFC they also have some local dishes that many in America would not put on the menu. I saw whole fish with the fins and scales served on a plate, mammals I won’t mention, and snakes. The latter is at the center of coronavirus issue as it’s suggested that a bat was eaten by a snake who then was eaten by a person.

Open-Air Wet Markets

While eating odd foods isn’t a bad thing, Andrew Zimmern has made a career of it, how the food is prepped in China is an issue. While in Shanghai I visited what they call a “wet market.” Several websites are claiming the coronavirus, and previously SARS started in wet markets. Think of a farmer’s market but the butchering of the animals happens behind the counter and the raw meat is hung in the open air. China Street Butcher Not only are they butchering pigs, ducks and chickens there are also stands with live frogs, eels, snakes and turtles. It’s not very sanitary and there are no regulations on how they discard the entrails. One moment a man could be butchering a snake, the next he could be handling a raw piece of pork before selling it to the consumer. The market was open-air even during the summer months. Raw meat sat out in 85-degree temperatures. The worst part was the unsanitary conditions. The animal waste, including feces, wasn’t discarded away from the food. I’m honestly surprised more people don’t get sick.

Human Waste Disposal

Another issue in China is how they deal with human waste. Many of the big cities are westernized when it comes to plumbing but even in cities like Beijing and Shanghai, it is not rare to come across squat toilets. Squat toilet - China The squat toilet is just what it sounds like. In nice areas, they can be made of porcelain, like the attached picture, but in many spots, they are made of metal or wood. They are essentially a hole in the floor that you squat over to do your business. Again, the sanitation of these toilets is not great, especially if the previous user was careless with their aim. Another issue with Chinese restrooms is that in most you are not allowed to flush the toilet paper. In many areas, the plumbing isn’t capable of handling the waste paper. So what do people do with the waste paper? They place it in a garbage can or open bin. And again, the sanitation varies on whether or not the previous user cared to hit the bin with their waste paper. Even in restaurants and bars in the cities, I saw overflowing bins of used waste paper. That was in major cities like Beijing and Shanghai. The situation was worse in more rural areas.

Disease Transmission

All of these poor practices can contribute to the spread of illness. The overall attitude though is not one of cleanliness and sanitation. Washing your hands after butchering an animal or going to the restroom is not seen as necessary in many parts of the country. For China to stem the tide of illness, and prevent future issues, they really need to change public attitudes around hygiene. The coronavirus can be spread via infected secretions, fecal matter or by a cough or sneeze. China’s hygiene standards increase the odds of all those possibilities.

Images provided by the author

Specializes in ICU + Infection Prevention.

People living in close quarters with fowl and swine is a source of zoonosis. This has been the source of several H5N1 outbreaks in Asia. It was the genesis of the 1918 H1N1 paninfluenza (probably in Kansas) and the 2009 H1N1 "swineflu" pandemic (source probably China). It was also the genesis of H3N2 Hong Kong paninfluenza and the H2N2 Asian paninfluenza.

Bush meat is a source of zoonosis, such as with SARS and Ebola.

COVID-19 is likely a bat virus that adapted to snakes (that eat bats) before jumping to humans, quite likely via a wildlife wet market in Wuhan. That is what the initial genomic analysis shows combined with epidemiological data that the PRC will share.

I've been to China and visited wet markets. I enjoyed my trip and the people. I think a bigger cultural problem for Chinese communal eating practices with shared dishes, lazy Susans, and using personal chopstiks to server from the communal dishes.

Specializes in ER.

I think that's what struck me wrong about the original article, the American triumphalism. I get tired of it.

No matter how this virus developed it's here now. It needs to be dealt with. But, the media hysteria is probably out of proportion as usual.

Specializes in Trauma, ER, HIV, Research, Neuro.
20 minutes ago, Neo Soldier said:

This offense culture may very well kill us.

If what this post states is accurate, then where is the racism? In parts of the world, food preparation is not regulated- this is just a fact. You could eat just about anything. I have seen actual videos on YouTube with people eating live rats. That may be their culture and while we should be sensitive, we know that rats carry disease. Lets not let our quest for sensitivity cloud our judgment as healthcare professionals.

The issue is not a matter of sensitivity. The OP is speaking from a biased, condescending perspective. Let’s call a spade a spade. It’s racist & xenophobic. No one is sensitive for calling the poster out. It’s necessary for growth as a culture & profession.

3 hours ago, Asystole RN said:

This article reeks of xenophobia and lightly veiled racism.

Coronavirus was first identified in China so the Chinese must have done something to cause it. Chinese culture is different from western culture so those differences must have caused it.

Not dissimilar to the hype that blamed HIV on homosexuals or the patently racist MSG hype around Chinese restaurants.

The fact is little is actually known about the origins of the virus, it is far too early to make any claims. OMG, you saw someone eat a whole fish with a head and scales and everything!?!?! Pretty damn common practice in Northern Michigan. "The overall attitude though is not one of cleanliness and sanitation." Based on what? This is different from who exactly? Ever been to a Broncos game?

Blaming this on Chinese culture with literally ZERO evidence is the height of xenophobia and racism.

Let's pump the breaks a little here on the racism train. It's quite the stretch comparing eye-witness accounts of food prep to blaming HIV on homosexuals. The only personal opinions given above were that China is an amazing country with unbelievable attractions. The rest were either straight forward observations or facts. For example:

- China is classified as a developing country by the World Trade Organization.

- "The fact is little is actually known about the origins of the virus..." That's incorrect, several major news organizations site scientists who link the coronavirus to Chinese wet markets. Here's one example, there are more if you search google: https://www.cbsnews.com/news/coronavirus-deadly-originated-wild-animal-wet-markets-urging-chinese-government-shut-down/

"The overall attitude though is not one of cleanliness and sanitation." Based on what? This is different from who exactly? Ever been to a Broncos game?"
It's based on my eyeballs seeing a lack of cleanliness and sanitation and speaking with Chinese citizens who described the situation to me.
I haven't been to a Broncos game but I have been to many other stadiums around the country. I haven't seen wild animals being butchered (like I saw in China) at any of the NFL games I've been to but I wouldn't put it past those darn Minnesota Vikings!

- "Blaming this on Chinese culture with literally ZERO evidence is the height of xenophobia and racism."
Chinese culture wasn't blamed. Documented food prep standards were blamed. And I wouldn't say "zero evidence" considering the following publications all quote doctors and scientists linking the coronavirus to China: NBC, CBS, Business Insider, Fortune, Huffington Post, Reuters, Wall St. Journal, NPR and many more. I guess they are all racist too??
The other evidence is the fact that I have been to a Chinese wet market and recorded my observations without bias in the article. And again, the only opinions from above were complimentary of China.

If you're looking to be outraged you'll find an excuse I guess.

Did you say you visited the wet market in Beijing or Wuhan? Cuz they are not the same city. Corona virus outbreak started in Wuhan, not Beijing. Plz don’t generalize cities in China. You went to Beijing MONTHS BEFORE THE OUTBREAK.

You also don’t have the local living expertise to generalize foreign cities as a foreigner. Are the regulations from state to state the same? Obviously not.
Lastly, that bat soup picture can be searched online and can be from any unknown sources in the World Wide Web. Easy for you to cast a negative spotlight on China.

Specializes in Travel, Home Health, Med-Surg.

Wow, are we medical professionals here. How are stating facts that wet markets have poor hygiene racist and xenophobic. I think most of us know that different cultures have different practices and I dont see any problem pointing out the negative aspects of those in order to remain healthy. I have also traveled to parts of the world where I would not eat from these types of markets, that is not racist.

Most officials believe that the Coronavirus started in Wuhan since that is where the virus was identified, again not racist when that is what officials stated.

Geez, cant a guy just write an article about his personal experience and ask a question about hygiene. We healthcare professionals (as well as the general public) should care about this.

1 hour ago, Gregg said:

Let's pump the breaks a little here on the racism train. It's quite the stretch comparing eye-witness accounts of food prep to blaming HIV on homosexuals. The only personal opinions given above were that China is an amazing country with unbelievable attractions. The rest were either straight forward observations or facts. For example:

- China is classified as a developing country by the World Trade Organization.

- "The fact is little is actually known about the origins of the virus..." That's incorrect, several major news organizations site scientists who link the coronavirus to Chinese wet markets. Here's one example, there are more if you search google: https://www.cbsnews.com/news/coronavirus-deadly-originated-wild-animal-wet-markets-urging-chinese-government-shut-down/

"The overall attitude though is not one of cleanliness and sanitation." Based on what? This is different from who exactly? Ever been to a Broncos game?"
It's based on my eyeballs seeing a lack of cleanliness and sanitation and speaking with Chinese citizens who described the situation to me.
I haven't been to a Broncos game but I have been to many other stadiums around the country. I haven't seen wild animals being butchered (like I saw in China) at any of the NFL games I've been to but I wouldn't put it past those darn Minnesota Vikings!

- "Blaming this on Chinese culture with literally ZERO evidence is the height of xenophobia and racism."
Chinese culture wasn't blamed. Documented food prep standards were blamed. And I wouldn't say "zero evidence" considering the following publications all quote doctors and scientists linking the coronavirus to China: NBC, CBS, Business Insider, Fortune, Huffington Post, Reuters, Wall St. Journal, NPR and many more. I guess they are all racist too??
The other evidence is the fact that I have been to a Chinese wet market and recorded my observations without bias in the article. And again, the only opinions from above were complimentary of China.

If you're looking to be outraged you'll find an excuse I guess.

It is my hope that you do know that certain facts can be used to gain bias. For instance, there is a prevalence of incest in certain demographics in parts of America, one can take such statistics and make broad generalization about an entire country. How unfair would it be if a person came here and went to say Apalachia and then generalized his observations there to an entire country? Your premise of concern regarding the virus is valid; however, the unmitigated bias of your analysis compounded with sanctimonious innuendos leave much to be desired, especially from an Admin.

When I did my home health rotations, I was surprised at the lack of hygiene inside American households. Out of 12 houses, only 1 was decent enough for us to sit down. The smell of cat/dog urine reeked in several houses. Wise men once said that charity begins at home, and we ought to look at the log in our eyes before we point the splinter in the eyes of others. On the hygiene front, we should lead by example, not wagging fingers.

Specializes in ICU + Infection Prevention.
14 minutes ago, cynical-RN said:

When I did my home health rotations, I was surprised at the lack of hygiene inside American households. Out of 12 houses, only 1 was decent enough for us to sit down.

Not to be... cynical... but ever think that the reason they need home health visits also makes it hard for those disadvantaged people to do their own home cleaning and maintenance? ?

Now why don't you compare that to the households of 12 of your friends who are not health disadvantaged and needing HH visits?

It's also common practice among Chinese to spit everywhere. In New Zealand (which gets a lot of Chinese tourists) there are signs (in Chinese and English) in the airport imploring people not to spit on the flooring/carpets.

And don't get me started on the skinning-alive of dogs.. (thanks facebook for that image that I'll never un-see.

23 minutes ago, SummitRN said:

Not to be... cynical... but ever think that the reason they need home health visits also makes it hard for those disadvantaged people to do their own home cleaning and maintenance? ?

Now why don't you compare that to the households of 12 of your friends who are not health disadvantaged and needing HH visits?

Actually, many of these HH patients live with perfectly able-bodied family members. Living in squalor is a choice they have made.

Specializes in Travel, Home Health, Med-Surg.
47 minutes ago, cynical-RN said:

It is my hope that you do know that certain facts can be used to gain bias. For instance, there is a prevalence of incest in certain demographics in parts of America, one can take such statistics and make broad generalization about an entire country. How unfair would it be if a person came here and went to say Apalachia and then generalized his observations there to an entire country? Your premise of concern regarding the virus is valid; however, the unmitigated bias of your analysis compounded with sanctimonious innuendos leave much to be desired, especially from an Admin.

Umm, I think you just did the very thing that you accuse the OP of doing.

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