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.
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. 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. 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.
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.
We do lead by example, that is why HH nurses provide education, that is why we have gov mandated regulations re: food etc. The problem with China and other countries is that they are lacking in regulation and/or inforcement, hence the current problem. We do not wag the finger in vain, we point out the issues for a reason, same principle why HH nurses wag the finger, in order to attempt to provide education and thus wellness.
We do lead by example, that is why HH nurses provide education, that is why we have gov mandated regulations re: food etc. The problem with China and other countries is that they are lacking in regulation and/or inforcement, hence the current problem. We do not wag the finger in vain, we point out the issues for a reason, same principle why HH nurses wag the finger, in order to attempt to provide education and thus wellness.
Can you provide the evidence for the bolded part? or you are just regurgitating fad du jour platitudes? There is currently an opioid epidemic in the U.S, is it because of a lack of regulation and/or enforcement? Or is it possible that there are other inextricable compounding variables? Let us not be myopic.
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?
In some cultures, living and sleeping in the same confines with dogs and cats is considered unhygienic and uncouth, let alone kissing them. The problem is that our ethnocentrism and delusions of infallibility have made most of us think that we are the barometer of measuring civility, as evidenced by the sanctimonious attitude herein. Unfortunate.
Actually, many of these HH patients live with perfectly able-bodied family members. Living in squalor is a choice they have made.
Indeed. Thank You. None of the HH patients that we saw was disabled. Most of the filth (in the environment and from a pathophysiological view) was induced by self-negligence, first and foremost.
Yawn. Puff piece from someone who thinks they know it all after spending a week in China. You are judging a whole culture and million of people based on a couple of toilets and 1 market? all you are doing are spreading racism/hate after “the fear” of coronavirus.
Who is this helping? Why even write this? You are just making yourself look like an idiot.
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.
I’m sorry you think calling out blatant racism and xenophobia is “offensive culture” but racism just isn’t acceptable anymore.
What does meat preparation in open air markets have to do with Coronavirus? There is no substantiated link and open air markets are common throughout the world, not just China...and that’s a fact.
Do you think the Chinese eat live rats? Do you think that is their culture? Do you think Chinese food is made of pet dogs and cats too?
I have seen videos of American women drinking urine and eating feces, is that normal behavior? Is that the American culture?
Nothing you or what the OP mentioned has anything whatsoever to do with Coronavirus and are excuses to differentiate and discriminate against the Chinese due to xenophobia.
Umm, I think you just did the very thing that you accuse the OP of doing.
I did that to illustrate the fallacy of his logic in using facts. Being factual and racist/xenophobic are not mutually exclusive. "There are three kinds of lies: lies, damned lies, and statistics." -Mark Twain. The poignancy of the latter lie is especially observable when a person takes anecdotal evidence (such as travelling stories to a particular region of China) then making generalized conclusions based on subjective observations about a diverse country of over 2 billion people. In rudimentary statistics, it is well known that the significance of obtained data does not necessarily translate to practical meaningfulness. It is easy to wallow in the miasma of the effects of a phenomenon, than it is to understand the causes. It is a phenomenon that cuts beyond the coronavirus.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
I understand how some readers found this article offensive. Some statements do reek of Western-centrism with a bit of sensationalism thrown in. I will say that I don't think the author's intentions were to malign a whole country.
If anything, I think the article could have been tweaked better. I was born in a third world country in Southeast Asia and have also travelled in the region including parts of mainland China and Hong Kong. The observations stated are true and in the eyes of a "Westerner" are no doubt, shocking. I would probably view this article more as an opinion piece and leave it at that. For one, the author is not a professional writer nor a healthcare professional. This is clearly stated in the article and should be taken as a disclaimer.
If the objective was to educate, I think there should have been a clearer discussion on the concept of "wet markets" and how they operate on the larger cultural milieu in a country like China or any other Asian country in the region. The difference with the wet market in Wuhan (and presumably with other similar wet markets in some parts of China) was that the animals butchered and sold were a combination of wildlife and those typically considered farmed. Such markets must also exist in other countries presumably even in Europe.
Having a picture taken off the internet of the "bat soup" was in poor taste. I don't recall ever reading that bat soups in China (if that was even a thing) for sure was the source of COVID19. It is, however, being theorized that bats do carry many zoonotic viruses and was officially incriminated as the source of the SARS epidemic in the early 2000's. Bats could have infected other wildlife in the region, then were caught, butchered, and sold in the Wuhan wet market, that is highly plausible.
I don't see a reason for discussion of unsanitary conditions in Chinese toilets have to do with COVID19. This is not a virus that is considered to be transmitted via enteral route. It is a flu or measles like virus that is transmitted via the respiratory droplet route. Having said that, yes, unsanitary handling of human waste is an important public health concern that must be addressed anywhere in the world. In the context of this article, it added to the tone of Western superiority that wasn't likely intended.
For a more interesting and well-written piece on wet markets, read this:
In some cultures, living and sleeping in the same confines with dogs and cats is considered unhygienic and uncouth, let alone kissing them. The problem is that our ethnocentrism and delusions of infallibility have made most of us think that we are the barometer of measuring civility, as evidenced by the sanctimonious attitude herein. Unfortunate.
So you can whine that it is hypocrisy and cultural bias because some view western dog/cat snuggles as gross... Viruses don't care about cultural sensitivities. Pandemic related zooinosis from dogs and cats is rare. Influenza Zooinosis from fowl and swine are not rare. Simple math governs chance. Coronavirus and Filovirus Zooinosis from Bush meat and wet markets is well demonstrated and Foodborne illness from poor butchery and food handling/storage is epidemiological knowledge going back well over a century.
The viruses don't give a crap about moral relativism or outrage. Viruses are simply replication machines that will reproduce, spread, and mutate between the species in which they are compatible. Viruses have no opinion about the resulting death and misery, only about genetic propagation before killing the host.
The OP wrote that he wasn't surprised that a (animal to human) disease started in a place where there are food/sanitation practices that would facilitate this occurrence. Maybe it's a generalization, but the underlying idea bears considering.
I swear that a fair number of people on AN have gift certificates for self-righteousness and outrage that they need to use before they expire.
I would to see video travelogues from these people traveling to wet markets and enjoying the cuisine for a week or two.
I don't see a reason for discussion of unsanitary conditions in Chinese toilets have to do with COVID19. This is not a virus that is considered to be transmitted via enteral route. It is a flu or measles like virus that is transmitted via the respiratory droplet route. Having said that, yes, unsanitary handling of human waste is an important public health concern that must be addressed anywhere in the world. In the context of this article, it added to the tone of Western superiority that wasn't likely intended.
You are mistaken about transmission modes. Fecal oral is highly suspected for COVID19 and it was a known significant mode for SARS which is the most closely related pathogenic betacoronavirus.
It is also worth it to note the difference between droplet and airborne which your statement conflates. These are different and require different precautions.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
4 minutes ago, SummitRN said:
You are mistaken about transmission modes. Fecal oral is highly suspected for COVID19 and it was a known significant mode for SARS which is the most closely related pathogenic betacoronavirus.
It is also worth it to note the difference between droplet and airborne which your statement conflates. These are different and require different precautions.
I just didn't see that in the CDC recommendations. The truth with this virus is there is no clear transmission route yet. Our hospital has admitted patients diagnosed with it. I have not taken care of them but we have maximum precautions: negative air pressure rooms, N95, gown, and gloves. Limited personnel allowed in room.
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.
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.
Daisy4RN
2,238 Posts
We do lead by example, that is why HH nurses provide education, that is why we have gov mandated regulations re: food etc. The problem with China and other countries is that they are lacking in regulation and/or inforcement, hence the current problem. We do not wag the finger in vain, we point out the issues for a reason, same principle why HH nurses wag the finger, in order to attempt to provide education and thus wellness.